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That comment struck me too. Perhaps there is a difference between Opium overdose and Opioid overdose? When I think consuming opium, I conjure images of old chi

That comment struck me too. Perhaps there is a difference between Opium overdose and Opioid overdose? When I think consuming opium, I conjure images of old chinese artwork where they are smoking it in a hookah type instrument. The Opioid overdoses are mostly Fentanyl and other extracts from opium. I'm not an expert, but if I am understanding correctly, it seems easier access to Opium which may be, according to the GP, hard to OD on, would reduce the Opioid OD epidemic.

darawk 7y ago
That may be what the OP was thinking, but it's not the case. You can very much OD on regular Opium. It is even easier to OD on its extracts (specifically morphine), and even easier still to OD on its synthetic analogues (fentanyl). However, you can absolutely OD and die on pure opium.
- idDriven 7y ago
  The dude said 'unintentionally' overdose on opium. This article covering Laudanum (opium + alcohol tincture) deaths in the 1800s sounds like the overdoses were largely intentional or one where an adult dose was given to a child. https://www.apnews.com/910654effffe42f985ebe01f299407f5 https://www.apnews.com/910654effffe42f985ebe01f299407f5 As long as the strength is known most addicts will measure the dose or titrate up safely.
  - darawk 7y ago
    I'm aware, I repeated his 'unintentional'. Unintentional overdose deaths on Opium are certainly less common than fentanyl. But they are nowhere near as difficult to achieve as Marijuana, which is basically impossible.
- cc-d 7y ago
  >That may be what the OP was thinking, but it's not the case. You can very much OD on regular Opium Read above. Orally, it's a strong emetic. Unless a user takes vastly more than a normal dose for their body weight, they will vomit and be fine. Opium, when smoked, is even safer as users pass out well before overdose. It is easier to overdose on acetaminophen, and many other things you can pick up over the counter at your local pharmacy. > It is even easier to OD on its extracts (specifically morphine) Yes, but this is why I am using the word opium, and not morphine. > its synthetic analogues (fentanyl). Fentanyl is not an analog of anything found in opium, it's an entirely different molecule with no relationship whatsoever to the traditional opiates.
  - darawk 7y ago
    I'm aware of all that. People still overdose on opium frequently. Users that are more tolerant to the opioid nausea will not vomit as readily when ODing. The emetic effect is not as strong or as universal as you seem to think it is.
cc-d 7y ago
>Perhaps there is a difference between Opium overdose and Opioid overdose? Opium has three primary constituents, morphine, codeine, thebaine. An opioid, roughly, is anything which agonizes opioid receptors, which are mu, delta, and kappa. mu-receptor agonists specifically are usually what people are referring to when they use the term 'opioid'. Morphine, which is an opiate (an opioid, but one that is derived from opium), is what usually produces death during an opium overdose (it also happens to be alkaloid which produces most of the desirable effect). You can look up morphine ld50 numbers to get an idea of how much morphine it would take to kill somebody. While morphine is the principal opioid at work in opium, it is still only a tiny % of the opium's total volume. >When I think consuming opium, I conjure images of old chinese artwork where they are smoking it in a hookah type instrument. It being smoked also makes it considerably safer. Users pass out before overdose. >The Opioid overdoses are mostly Fentanyl and other extracts from opium. Correct. Morphine is a somewhat strong opioid in its own right, but it doesn't even hold a candle to the more powerful opioids science has discovered. Not even close. The strength of an opioid is often described in morphine equivalents, that is how much of x is comparable to the same amount of morphine. Fentanyl is roughly 50x as powerful as morphine, which makes it a rather dangerous compound for untrained people to handle, especially to inject. That being said, as long as the dosages are measured correctly, fentanyl is not significantly more dangerous than any other commonly used opioid. It's the black market dynamics which make it particularly prone to kill users. Fentanyl is also nowhere near the most powerful opioid being sold on the street either. The literature has opioids that are, roughly, several thousand times as powerful as morphine. Meaning if it takes on average 1g of pure morphine to kill a human, less than a single mg of some of the stronger fentanyl analogs can be sufficient enough to kill. Much lower if injected. This is what is killing everybody. Some fentanyl analogs are close to chemical weapons in terms of potency, and drug dealers with a 3rd grade equivalent education are handling it like they would cocaine or similar.
- darawk 7y ago
  Fentanyl is more like 100x the potency of morphine. And while it's true that morphine is the strongest opiate directly present in opium, codeine is converted into morphine by cytochrome P450 in the liver, increasing the effective morphine dose. Here's some citations: https://www.oregonpainguidance.org/wp-content/uploads/2018/02/Powers_et_al-2017-Journal_of_Forensic_Sciences.pdf?x91687 https://www.oregonpainguidance.org/wp-content/uploads/2018/0...

darawk 7y ago

That may be what the OP was thinking, but it's not the case. You can very much OD on regular Opium. It is even easier to OD on its extracts (specifically morphine), and even easier still to OD on its synthetic analogues (fentanyl). However, you can absolutely OD and die on pure opium.

idDriven 7y ago
The dude said 'unintentionally' overdose on opium. This article covering Laudanum (opium + alcohol tincture) deaths in the 1800s sounds like the overdoses were largely intentional or one where an adult dose was given to a child. https://www.apnews.com/910654effffe42f985ebe01f299407f5 https://www.apnews.com/910654effffe42f985ebe01f299407f5 As long as the strength is known most addicts will measure the dose or titrate up safely.
- darawk 7y ago
  I'm aware, I repeated his 'unintentional'. Unintentional overdose deaths on Opium are certainly less common than fentanyl. But they are nowhere near as difficult to achieve as Marijuana, which is basically impossible.
cc-d 7y ago
>That may be what the OP was thinking, but it's not the case. You can very much OD on regular Opium Read above. Orally, it's a strong emetic. Unless a user takes vastly more than a normal dose for their body weight, they will vomit and be fine. Opium, when smoked, is even safer as users pass out well before overdose. It is easier to overdose on acetaminophen, and many other things you can pick up over the counter at your local pharmacy. > It is even easier to OD on its extracts (specifically morphine) Yes, but this is why I am using the word opium, and not morphine. > its synthetic analogues (fentanyl). Fentanyl is not an analog of anything found in opium, it's an entirely different molecule with no relationship whatsoever to the traditional opiates.
- darawk 7y ago
  I'm aware of all that. People still overdose on opium frequently. Users that are more tolerant to the opioid nausea will not vomit as readily when ODing. The emetic effect is not as strong or as universal as you seem to think it is.

cc-d 7y ago

>Perhaps there is a difference between Opium overdose and Opioid overdose? Opium has three primary constituents, morphine, codeine, thebaine. An opioid, roughly, is anything which agonizes opioid receptors, which are mu, delta, and kappa. mu-receptor agonists specifically are usually what people are referring to when they use the term 'opioid'. Morphine, which is an opiate (an opioid, but one that is derived from opium), is what usually produces death during an opium overdose (it also happens to be alkaloid which produces most of the desirable effect). You can look up morphine ld50 numbers to get an idea of how much morphine it would take to kill somebody. While morphine is the principal opioid at work in opium, it is still only a tiny % of the opium's total volume. >When I think consuming opium, I conjure images of old chinese artwork where they are smoking it in a hookah type instrument. It being smoked also makes it considerably safer. Users pass out before overdose. >The Opioid overdoses are mostly Fentanyl and other extracts from opium. Correct. Morphine is a somewhat strong opioid in its own right, but it doesn't even hold a candle to the more powerful opioids science has discovered. Not even close. The strength of an opioid is often described in morphine equivalents, that is how much of x is comparable to the same amount of morphine. Fentanyl is roughly 50x as powerful as morphine, which makes it a rather dangerous compound for untrained people to handle, especially to inject. That being said, as long as the dosages are measured correctly, fentanyl is not significantly more dangerous than any other commonly used opioid. It's the black market dynamics which make it particularly prone to kill users. Fentanyl is also nowhere near the most powerful opioid being sold on the street either. The literature has opioids that are, roughly, several thousand times as powerful as morphine. Meaning if it takes on average 1g of pure morphine to kill a human, less than a single mg of some of the stronger fentanyl analogs can be sufficient enough to kill. Much lower if injected. This is what is killing everybody. Some fentanyl analogs are close to chemical weapons in terms of potency, and drug dealers with a 3rd grade equivalent education are handling it like they would cocaine or similar.

darawk 7y ago
Fentanyl is more like 100x the potency of morphine. And while it's true that morphine is the strongest opiate directly present in opium, codeine is converted into morphine by cytochrome P450 in the liver, increasing the effective morphine dose. Here's some citations: https://www.oregonpainguidance.org/wp-content/uploads/2018/02/Powers_et_al-2017-Journal_of_Forensic_Sciences.pdf?x91687 https://www.oregonpainguidance.org/wp-content/uploads/2018/0...