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They aren't addictive to the vast majority of people. In this respect it's similar to alcohol: only harmful to a small group of people, but for them very harmf

They aren't addictive to the vast majority of people. In this respect it's similar to alcohol: only harmful to a small group of people, but for them very harmful. I think the key is looking for commonalities of the people at risk of addiction and finding alternative therapies for them.

saiya-jin 7y ago
Can you please show a single credible source that claims that things like heroin or opium "aren't addictive to vast majority of the people"? From everything I ever read or heard on that topic this is simply not true, I wonder what makes you say those things... And that statement about alcohol is an outright lie in the way you state it.
- edoceo 7y ago
  Alcohol, Heroin and Nicotine. All are super addictive and after some time the body becomes chemically dependant. It's why you get "dope-sick" when you kick.
  - bromuro 7y ago
    People can drink alcohol every day without being addicted to it.
    - zentiggr 7y ago
      Maybe some very few, or 'a glass a day' type consumption, sure. I've seen alcoholic withdrawal and it's not pretty. Drying out from a real addiction can need medical attention.
    - toomanybeersies 7y ago
      Some people smoke cigarettes every day without being addicted to them, and I'm sure some people can smoke opium every day without being addicted to it (probably can't say the same for injecting heroin). Doesn't mean it's good for you (neither is drinking every day).
      - loeg 7y ago
        You don't have to inject heroin to consume it, FWIW. You're right that intravenous use is probably more addiction prone (not to mention, dangerous for all kinds of reasons).
    - loeg 7y ago
      People can consume nicotine and heroin every day without being addicted to it, in whatever sense you are imagining that means for alcohol users.
- leetcrew 7y ago
  "Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them. Between 8 and 12 percent develop an opioid use disorder." [0] "According to the 2017 NSDUH, 14.1 million adults ages 18 and older (5.7 percent of this age group) had AUD (Alcohol Use Disorder)." [1] depending on your definition of "vast", these seem to support GP's claims (certainly not an "outright lie"). the rates compared here aren't quite apples-to-apples, but they do suggest the rate of addiction to alcohol is pretty similar to that of opioids. [0] https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdos... [1] https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics https://www.niaaa.nih.gov/publications/brochures-and-fact-sh...
  - ClumsyPilot 7y ago
    The percentage is twice higher, and opioids are regulated and hard to get to boot. It's plausible that we would be looking at 20%+ if you could get them at the store like you can a beer.
    - loeg 7y ago
      It's also plausible that the 8% figure is representative of unfettered access. Conceivably everyone who wants opioids has access to opioids in some form or another now, and those who want it especially badly will put in special effort to get it. Heroin and kratom are easier to obtain than prescription opioids (if you don't have a visually obvious physical trauma and health insurance). We know the number of patients prescribed opioids each year; it peaked in 2012 (it has been declining since then)[1]. We could look at abuse / addiction data over some period where prescriptions rose, and see if the disease rate rose significantly. It would be suggestive, if not conclusive, because we prescribe opioids to something like 20% of the population each year. (For comparison, about 66% of persons >12, or 55% of the total population, drinks any alcohol in a given year; figures from 2014.[2]) > After a steady increase in the overall national opioid prescribing rate starting in 2006, the total number of prescriptions dispensed peaked in 2012 at more than 255 million and a prescribing rate of 81.3 prescriptions per 100 persons. I don't have good figures for historical rates of opioid addiction at hand, but we can look at 2016 (roughly).[3] > In 2016, an estimated 1,753,000, or 0.7% of persons aged 12 and older, reported a substance use disorder in the past year involving misuse of prescription pain relievers Going back to [1], the prescribing rate was 66.5 per 100 in 2016 and (in 2017, but taking for representative) "an average of 3.4 opioid prescriptions dispensed per patient." So we get 66.5/3.4 => ~19.6 per 100 people prescribed opiates, or 19.6% of people. 0.7% / 19.6% is an addiction rate of about 3.5%. There are definitely holes in this, but it's definitely plausible that the real rate for unfettered acecss is single digit. We could also look at Portugal as an example. Decriminalization isn't the same thing as full legalization and unfettered access, but[4]: > It is estimated that there were 33 290 high-risk opioid users in Portugal in 2015, which is about 5.2 per 1 000 of the adult population. In the same year, the number of people who inject drugs was estimated at 13 160 (2 per 1 000 people aged 15-64). ("High risk" in EMCDDA terms is injecting drug use or any long-term or regular use; it's a reasonable proxy for addiction, although might overestimate.[5]) [1]: https://www.cdc.gov/drugoverdose/data/prescribing/prescribing-practices.html https://www.cdc.gov/drugoverdose/data/prescribing/prescribin... [2]: https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015.htm#tab2-71b https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTab... [3]: https://www.cdc.gov/drugoverdose/pdf/pubs/2018-cdc-drug-surveillance-report.pdf https://www.cdc.gov/drugoverdose/pdf/pubs/2018-cdc-drug-surv... [4]: http://www.emcdda.europa.eu/publications/country-drug-reports/2019/portugal http://www.emcdda.europa.eu/publications/country-drug-report... [5]: http://www.emcdda.europa.eu/data/2014/methods-hrdu http://www.emcdda.europa.eu/data/2014/methods-hrdu
- nitrogen 7y ago
  I have met people who claim to have tried various hard drugs without addiction, but they usually don't talk about it because of the taboo. As a non-using bystander I would find it interesting if both prescription and banned substances had something like LD50 but for addiction. A measure of what dosage pattern will lead to 50% of the population being addicted. An AD50.
  - toomanybeersies 7y ago
    For better or worse I know a lot of people who smoke methamphetamine. Never smoked it myself and never would. Most of them smoke it recreationally without it causing any problems in their life or addiction. They have no issues when they're not smoking it, they can stop when they want, and they don't let it negatively affect the rest of their life (work, relationships, etc.). Some of them are weekly smokers, some of them are only once or twice a year. But around 10-20% of the people I know who smoke it have issues with dependence and addiction, and it's caused massive problems for them (and those around them) and for some of them it's destroyed their life. I don't know anyone who uses heroin, but I'd imagine that it's the same. "Hard drugs" are surprisingly non-addictive, less addictive than nicotine and probably even less addictive than caffeine. The reason why these drugs are "hard" though is that if people do develop an addiction, it's so incredibly destructive. It becomes their life, everything they do becomes drug-seeking behaviour. They don't even like the drug any more, but they need to keep doing it just to feel normal.
    - loeg 7y ago
      > The reason why these drugs are "hard" though is that if people do develop an addiction, it's so incredibly destructive. Eh. Do you know many alcoholics? The "hard" qualifier is mostly just arbitrary societal taboos reinforced by the federal government.
mcguire 7y ago
https://www.latimes.com/projects/oxycontin-part1/ https://www.latimes.com/projects/oxycontin-part1/ "Purdue tells doctors to prescribe stronger doses, not more frequent ones, when patients complain that OxyContin doesn’t last 12 hours."
toomanybeersies 7y ago
The key is better education and destigmatisation around addiction and its causes, and encouraging open dialogue. Otherwise we'd end up in a weird, accidentally classist society where poor (and other "at-risk") people aren't allowed opioids but wealthy people are. People don't want to, or choose to become addicted, and it's not like people take a drug once and they're instantly hooked. People being prescribed potentially addictive medication (and those around them, friends and family) need to be educated on the warning signs of dependence, and encouraged to talk about it. There shouldn't be a stigma in admitting addiction, it's not a moral or personal failing, but it's treated as such by so many people.

saiya-jin 7y ago

Can you please show a single credible source that claims that things like heroin or opium "aren't addictive to vast majority of the people"? From everything I ever read or heard on that topic this is simply not true, I wonder what makes you say those things... And that statement about alcohol is an outright lie in the way you state it.

edoceo 7y ago
Alcohol, Heroin and Nicotine. All are super addictive and after some time the body becomes chemically dependant. It's why you get "dope-sick" when you kick.
- bromuro 7y ago
  People can drink alcohol every day without being addicted to it.
  - zentiggr 7y ago
    Maybe some very few, or 'a glass a day' type consumption, sure. I've seen alcoholic withdrawal and it's not pretty. Drying out from a real addiction can need medical attention.
  - toomanybeersies 7y ago
    Some people smoke cigarettes every day without being addicted to them, and I'm sure some people can smoke opium every day without being addicted to it (probably can't say the same for injecting heroin). Doesn't mean it's good for you (neither is drinking every day).
    - loeg 7y ago
      You don't have to inject heroin to consume it, FWIW. You're right that intravenous use is probably more addiction prone (not to mention, dangerous for all kinds of reasons).
  - loeg 7y ago
    People can consume nicotine and heroin every day without being addicted to it, in whatever sense you are imagining that means for alcohol users.
leetcrew 7y ago
"Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them. Between 8 and 12 percent develop an opioid use disorder." [0] "According to the 2017 NSDUH, 14.1 million adults ages 18 and older (5.7 percent of this age group) had AUD (Alcohol Use Disorder)." [1] depending on your definition of "vast", these seem to support GP's claims (certainly not an "outright lie"). the rates compared here aren't quite apples-to-apples, but they do suggest the rate of addiction to alcohol is pretty similar to that of opioids. [0] https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdos... [1] https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics https://www.niaaa.nih.gov/publications/brochures-and-fact-sh...
- ClumsyPilot 7y ago
  The percentage is twice higher, and opioids are regulated and hard to get to boot. It's plausible that we would be looking at 20%+ if you could get them at the store like you can a beer.
  - loeg 7y ago
    It's also plausible that the 8% figure is representative of unfettered access. Conceivably everyone who wants opioids has access to opioids in some form or another now, and those who want it especially badly will put in special effort to get it. Heroin and kratom are easier to obtain than prescription opioids (if you don't have a visually obvious physical trauma and health insurance). We know the number of patients prescribed opioids each year; it peaked in 2012 (it has been declining since then)[1]. We could look at abuse / addiction data over some period where prescriptions rose, and see if the disease rate rose significantly. It would be suggestive, if not conclusive, because we prescribe opioids to something like 20% of the population each year. (For comparison, about 66% of persons >12, or 55% of the total population, drinks any alcohol in a given year; figures from 2014.[2]) > After a steady increase in the overall national opioid prescribing rate starting in 2006, the total number of prescriptions dispensed peaked in 2012 at more than 255 million and a prescribing rate of 81.3 prescriptions per 100 persons. I don't have good figures for historical rates of opioid addiction at hand, but we can look at 2016 (roughly).[3] > In 2016, an estimated 1,753,000, or 0.7% of persons aged 12 and older, reported a substance use disorder in the past year involving misuse of prescription pain relievers Going back to [1], the prescribing rate was 66.5 per 100 in 2016 and (in 2017, but taking for representative) "an average of 3.4 opioid prescriptions dispensed per patient." So we get 66.5/3.4 => ~19.6 per 100 people prescribed opiates, or 19.6% of people. 0.7% / 19.6% is an addiction rate of about 3.5%. There are definitely holes in this, but it's definitely plausible that the real rate for unfettered acecss is single digit. We could also look at Portugal as an example. Decriminalization isn't the same thing as full legalization and unfettered access, but[4]: > It is estimated that there were 33 290 high-risk opioid users in Portugal in 2015, which is about 5.2 per 1 000 of the adult population. In the same year, the number of people who inject drugs was estimated at 13 160 (2 per 1 000 people aged 15-64). ("High risk" in EMCDDA terms is injecting drug use or any long-term or regular use; it's a reasonable proxy for addiction, although might overestimate.[5]) [1]: https://www.cdc.gov/drugoverdose/data/prescribing/prescribing-practices.html https://www.cdc.gov/drugoverdose/data/prescribing/prescribin... [2]: https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015.htm#tab2-71b https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTab... [3]: https://www.cdc.gov/drugoverdose/pdf/pubs/2018-cdc-drug-surveillance-report.pdf https://www.cdc.gov/drugoverdose/pdf/pubs/2018-cdc-drug-surv... [4]: http://www.emcdda.europa.eu/publications/country-drug-reports/2019/portugal http://www.emcdda.europa.eu/publications/country-drug-report... [5]: http://www.emcdda.europa.eu/data/2014/methods-hrdu http://www.emcdda.europa.eu/data/2014/methods-hrdu
nitrogen 7y ago
I have met people who claim to have tried various hard drugs without addiction, but they usually don't talk about it because of the taboo. As a non-using bystander I would find it interesting if both prescription and banned substances had something like LD50 but for addiction. A measure of what dosage pattern will lead to 50% of the population being addicted. An AD50.
- toomanybeersies 7y ago
  For better or worse I know a lot of people who smoke methamphetamine. Never smoked it myself and never would. Most of them smoke it recreationally without it causing any problems in their life or addiction. They have no issues when they're not smoking it, they can stop when they want, and they don't let it negatively affect the rest of their life (work, relationships, etc.). Some of them are weekly smokers, some of them are only once or twice a year. But around 10-20% of the people I know who smoke it have issues with dependence and addiction, and it's caused massive problems for them (and those around them) and for some of them it's destroyed their life. I don't know anyone who uses heroin, but I'd imagine that it's the same. "Hard drugs" are surprisingly non-addictive, less addictive than nicotine and probably even less addictive than caffeine. The reason why these drugs are "hard" though is that if people do develop an addiction, it's so incredibly destructive. It becomes their life, everything they do becomes drug-seeking behaviour. They don't even like the drug any more, but they need to keep doing it just to feel normal.
  - loeg 7y ago
    > The reason why these drugs are "hard" though is that if people do develop an addiction, it's so incredibly destructive. Eh. Do you know many alcoholics? The "hard" qualifier is mostly just arbitrary societal taboos reinforced by the federal government.

mcguire 7y ago

https://www.latimes.com/projects/oxycontin-part1/ https://www.latimes.com/projects/oxycontin-part1/ "Purdue tells doctors to prescribe stronger doses, not more frequent ones, when patients complain that OxyContin doesn’t last 12 hours."

toomanybeersies 7y ago

The key is better education and destigmatisation around addiction and its causes, and encouraging open dialogue. Otherwise we'd end up in a weird, accidentally classist society where poor (and other "at-risk") people aren't allowed opioids but wealthy people are. People don't want to, or choose to become addicted, and it's not like people take a drug once and they're instantly hooked. People being prescribed potentially addictive medication (and those around them, friends and family) need to be educated on the warning signs of dependence, and encouraged to talk about it. There shouldn't be a stigma in admitting addiction, it's not a moral or personal failing, but it's treated as such by so many people.