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The death grip of heroin is mostly unrelated to the actual medical properties of heroin (or most opioids). The worst health effects come from the impurities in

The death grip of heroin is mostly unrelated to the actual medical properties of heroin (or most opioids). The worst health effects come from the impurities in the substance (Strychnine, a common additive, is generally speaking not a substance beneficial to your health), the conditions under which it's used (shared needles, lack of hygiene) and the treadmill of having to organize funds for the next shot. Medically speaking, heroin is less harmful than alcohol. It's very hard to actually overdose if the purity is constant. It's a preferred drug for pallative care in many countries since it's effective and relatively easy to use (similar tor morphine). Heroin addicts on a constant regime of pure heroin can be well-functioning members of society. See https://en.wikipedia.org/wiki/Heroin-assisted_treatment https://en.wikipedia.org/wiki/Heroin-assisted_treatment So if you truly care about the health of the afflicted persons, legalization with a strict control is the most effective option that is currently on the table.

meri_dian 9y ago
I understand what you are saying. I agree that heroin by itself is not very harmful to the body relative to some other drugs. But let me be more clear about what I mean by "death grip". When someone cares so much about a drug that it becomes the focal point of their lives, where they become so utterly ruled by the object of their addiction that friends and family and all else not the drug become secondary fixtures in their lives, then they have become the walking dead and are very much in the death grip. I have seen it with friends. Some are still breathing, some are not. Sure people on medical grade heroin regimens can continue to exist, but the drug will kill them inside nonetheless. Revitalization is possible of course, but it is exceedingly difficult.
- Xylakant 9y ago
  The point of medical heroine is that people on that regime can and do become well-functioning humans again. It’s not the drug that kills them, it’s the loss of all social support network and the ill effects that come with the situation.
- tmp-20150107 9y ago
  The point of medical heroin, or other harm reduction programs, is to allow people to get on with their actual life without the all consuming addiction being front and centre all the time. I'm currently on a methadone program in the UK (there aren't any heroin based programmes as far as I know here) and it lets me keep up my job as a software engineer without daily worries about having to make sure I can score and not be 'sick' (i.e. withdrawing) and unable to work or go to the office. A heroin prescription would accomplish the same thing for me, and for people in a worse situation - perhaps unemployed or homeless - it would mean even more, since they could devote their energy to rebuilding their life. Personally, I don't really need a safe injecting space - I own my own home and have a pretty stable lifestyle, but again, I can see how for other addicts it would be incredibly helpful. Again and again, as seen in other comments, it can be seen how despite objections these places provide an objective positive benefit to society.
  - meri_dian 9y ago
    I'm curious to hear about your program. Is the goal to get you clean? Slowly wean you off heroin?
    - skellera 9y ago
      Heroin addiction is 90% looking for or doing something to get more. It’s an incredible time sink. It’s impossible to have a meaningful life like that. What medically administered heroin does is allow people to get that time back so they can rebuild their lives. Once they see that things are better, they become more successful when finally coming off of it. Even if it takes forever, they are still productive members or society instead of a drain.
    - tmp-20150107 9y ago
      Like 'skellera says in the sibling comment, heroin is an incredible time-sink. The methadone programme I am on (provided free by the UK NHS) is something that will let me gradually reduce the amount of heroin I'm taking, and eventually yes, get clean. After a couple on months in, I'm down to ~25% of what I was taking daily before, and that should reduce further to zero over time. A methadone maintenance program will gradually increase the amount of methadone prescribed, while the user reduces the amount of heroin they take, until the user is 'stable' and no longer using heroin. After that I certainly would like to then stop taking methadone too, but in some cases the maintenance can continue indefinitely and it would still be considered a net positive outcome...
fiblye 9y ago
Heroin wasn't historically a problem because the users died. Heroin's been a problem because of just how far people will go to get it, and how a massive amount of people will drop everything else in life just to get a steady supply of it. Opiates are the most addictive substances in the world. Once someone gets a taste of it, their life is forever changed. People can smoke a cigarette a couple times and decide it's not for them. People can have beers once in a while and move on. There aren't many people who try heroin a couple times then realize they're busy and drop it forever.
- Retric 9y ago
  I knows several people that tried Heroin a few times and gave it up, but where addicted to cigarettes. Different people have different drug preferences ans I doubt we have good statistics on this stuff. I like many people where given opioids post surgery and ended up tossing the pills vs finishing the prescription, yet people get really addicted to the same medication.
  - tmp-20150107 9y ago
    Indeed, it's entirely possible for people to take heroin at the weekends or similar, and put it down without problems, and I know several friends who do it irregularly without getting addicted - although only smoking, I've never heard of anyone injecting IV heroin who wasn't an addict...
    - Xylakant 9y ago
      Injections are apparently much more potent than smoking, so it makes sense that people already addicted prefer that to keep the required amount lower. For recreational uses, smoking would just be much more practical.
      - tmp-20150107 9y ago
        Indeed. The bio-availability from 'chasing the dragon' on tin-foil is something like 50% or even less, although in the UK at least powdered heroin is adulterated with things like caffeine (which causes heroin to vaporize at a lower temperature) to make smoking more effective. Obviously IV injecting gives 100% bio-availability, though.

meri_dian 9y ago

I understand what you are saying. I agree that heroin by itself is not very harmful to the body relative to some other drugs. But let me be more clear about what I mean by "death grip". When someone cares so much about a drug that it becomes the focal point of their lives, where they become so utterly ruled by the object of their addiction that friends and family and all else not the drug become secondary fixtures in their lives, then they have become the walking dead and are very much in the death grip. I have seen it with friends. Some are still breathing, some are not. Sure people on medical grade heroin regimens can continue to exist, but the drug will kill them inside nonetheless. Revitalization is possible of course, but it is exceedingly difficult.

Xylakant 9y ago
The point of medical heroine is that people on that regime can and do become well-functioning humans again. It’s not the drug that kills them, it’s the loss of all social support network and the ill effects that come with the situation.
tmp-20150107 9y ago
The point of medical heroin, or other harm reduction programs, is to allow people to get on with their actual life without the all consuming addiction being front and centre all the time. I'm currently on a methadone program in the UK (there aren't any heroin based programmes as far as I know here) and it lets me keep up my job as a software engineer without daily worries about having to make sure I can score and not be 'sick' (i.e. withdrawing) and unable to work or go to the office. A heroin prescription would accomplish the same thing for me, and for people in a worse situation - perhaps unemployed or homeless - it would mean even more, since they could devote their energy to rebuilding their life. Personally, I don't really need a safe injecting space - I own my own home and have a pretty stable lifestyle, but again, I can see how for other addicts it would be incredibly helpful. Again and again, as seen in other comments, it can be seen how despite objections these places provide an objective positive benefit to society.
- meri_dian 9y ago
  I'm curious to hear about your program. Is the goal to get you clean? Slowly wean you off heroin?
  - skellera 9y ago
    Heroin addiction is 90% looking for or doing something to get more. It’s an incredible time sink. It’s impossible to have a meaningful life like that. What medically administered heroin does is allow people to get that time back so they can rebuild their lives. Once they see that things are better, they become more successful when finally coming off of it. Even if it takes forever, they are still productive members or society instead of a drain.
  - tmp-20150107 9y ago
    Like 'skellera says in the sibling comment, heroin is an incredible time-sink. The methadone programme I am on (provided free by the UK NHS) is something that will let me gradually reduce the amount of heroin I'm taking, and eventually yes, get clean. After a couple on months in, I'm down to ~25% of what I was taking daily before, and that should reduce further to zero over time. A methadone maintenance program will gradually increase the amount of methadone prescribed, while the user reduces the amount of heroin they take, until the user is 'stable' and no longer using heroin. After that I certainly would like to then stop taking methadone too, but in some cases the maintenance can continue indefinitely and it would still be considered a net positive outcome...

fiblye 9y ago

Heroin wasn't historically a problem because the users died. Heroin's been a problem because of just how far people will go to get it, and how a massive amount of people will drop everything else in life just to get a steady supply of it. Opiates are the most addictive substances in the world. Once someone gets a taste of it, their life is forever changed. People can smoke a cigarette a couple times and decide it's not for them. People can have beers once in a while and move on. There aren't many people who try heroin a couple times then realize they're busy and drop it forever.

Retric 9y ago
I knows several people that tried Heroin a few times and gave it up, but where addicted to cigarettes. Different people have different drug preferences ans I doubt we have good statistics on this stuff. I like many people where given opioids post surgery and ended up tossing the pills vs finishing the prescription, yet people get really addicted to the same medication.
- tmp-20150107 9y ago
  Indeed, it's entirely possible for people to take heroin at the weekends or similar, and put it down without problems, and I know several friends who do it irregularly without getting addicted - although only smoking, I've never heard of anyone injecting IV heroin who wasn't an addict...
  - Xylakant 9y ago
    Injections are apparently much more potent than smoking, so it makes sense that people already addicted prefer that to keep the required amount lower. For recreational uses, smoking would just be much more practical.
    - tmp-20150107 9y ago
      Indeed. The bio-availability from 'chasing the dragon' on tin-foil is something like 50% or even less, although in the UK at least powdered heroin is adulterated with things like caffeine (which causes heroin to vaporize at a lower temperature) to make smoking more effective. Obviously IV injecting gives 100% bio-availability, though.