4 ms·

Opiates in and of themselves are relatively safe, only slightly worse for you than caffeine, although clearly (arguably?) more addictive. They have very few lon

by donatj 6y ago

Opiates in and of themselves are relatively safe, only slightly worse for you than caffeine, although clearly (arguably?) more addictive. They have very few long-term effects and the biggest negative health impact being constipation. There's a madness in society right now, akin to the reefer madness of the early 20th century. The negative of opiates themselves have been blown ludicrously out of proportion. I think we've cast far too negative light on opiates and too little light on the damage that's actually caused by their prohibition and thus people seeking street drugs. We've gone so far in the wrong direction that people with actual pain are being denied opiates. People are forced to suffer in order to avoid what, constipation? We should be both easing people off of opiates, and providing them to people in genuine pain.

obmelvin 6y ago
You make it sound like there's a problem with the people getting addicted, not the systemic overprescription of addictive drugs to unwitting patients who followed the authority of naive, at best, or even malicious medical professionals.
- DuskStar 6y ago
  I think he's saying that the drug war is the problem, not the addiction. That the steps that we're taking to fight addiction are worse than the addiction itself.
  - to11mtm 6y ago
    I would still argue the bigger problem is the way pharmaceutical companies push products on Doctors. Ever been to a doctor's office, get prescribed a certain medicine, and then look around the office and see 5 different knick-knacks from the Pharmaco (i.e. Calendars, Notepads, general adverts) in the room as they're writing the script? The issue is far far larger than Opioids. I think a bigger message should be sent on this issue. We are one of the only first world countries that even allows advertisement of Medications, and have repeatedly seen the impacts of these companies' marketing tactics.
- radley 6y ago
  I think they're pointing out that we may be overdoing it as a result of trying to resolve over-prescription.
- donatj 6y ago
  The doctors and drug companies make easy scapegoats, but if a person came to you in genuine pain, living an absolutely miserable life, and you knew without a doubt you could stop it, could you in good moral standing with yourself choose to keep this human being in pain? I certainly could not, I am not so heartless, and I certainly hope the same of my own doctors. I think we forgot that by and large near all these people were in genuine pain. It’s easy to disparage them from the sidelines, but walk a mile in their shoes.
  - rbranson 6y ago
    The whole point of having the prescription drug system is so that patients can be provided with safe, monitored access to potentially dangerous drugs. The entire purpose of a doctor being involved in the system is to prevent the outcome we are experiencing, otherwise they'd just sell these things over the counter.
  - res0nat0r 6y ago
    Pillmill docs and counties in the rust belt being prescribed so many pills that if split evenly would give each person in the county 10k pills a month is the issue. No one is denying that sensible opioid prescriptions are a good thing. The issue is Purdue Pharma lied about how addictive their pills were and encouraged over-prescription in pursuit of their #1 goal, not easing pain, but profits. https://www.pbs.org/wgbh/frontline/film/opioids-inc/ https://www.pbs.org/wgbh/frontline/film/opioids-inc/
  - nitrogen 6y ago
    The high school football players hooked on vicodin are definitely "in pain". Get your wisdom teeth out? Free opiates for you. Got injured during a game? Here you go, just one won't hurt.
  - obmelvin 6y ago
    I didn't call for banning anything. I said the issue is with overprescription and negligent doctors. You are describing a desire for proper healthcare - that is also something I am interested in. What I am not interested in is my friend getting 100 Vicodin for a bit of pain after some dental visit (maybe wisdom teeth removed? can't remember), that he later realized was way more than he needed and had him temporarily addicted.
- dodobirdlord 6y ago
  An addiction is only a problem if you stop having access to the drug. It used to be the case (I don't know about now amid the anti-opioid mania) that doctors didn't bother trying to avoid opiate addiction in patients who were in their last few months of years of life. The supply is assured, the benefits are obvious, the drugs are cheap (though some opiates are expensive because of massive research spending on making them less addictive!), and the patient is never going to experience withdrawal in the context of hospice care. Alcohol withdrawal is just as unpleasant and more likely to kill you than opiate withdrawal, but for no particularly good reason you can't buy oxycodone at the corner store. The failure is on all of us for creating a society in which being addicted to opiates will ruin your life. There's no reason this has to be the case.
husarcik 6y ago
I think it is more complex than this. Overdose is a real negative outcome.
- donatj 6y ago
  Overdoses themselves are relatively rare, particularly with prescribed drugs, and especially when you consider the absolutely enormous number of people on opiates. I believe the solution is to make opiates easily, cheaply and safely available in a controlled clinical setting, much like how Portugal got their opiate problem under control. Keeps people off street drugs, thus keeping their doses reasonable and opiates out of the hands of people who are not recovering.
- deelowe 6y ago
  Overdose is most common on illegal opiates due to inconsistencies in the product itself. It's gotten worse as fentanyl has made it's way into the supply chain which dramatically alters the potency of "normal" opiates.
- colechristensen 6y ago
  In the era of fentanyl, the overdose problem is largely caused by the black market nature of getting the drug, poorly mixed inactive ingredients with opiates which can have orders of magnitude difference in effective dose. Overdose on legally manufactured drugs being much overshadowed by the black market sourced drugs. It is difficult to come to conclusions about how much of the reactions are showboating and how much are legitimate, but it seems clear that the net negative outcomes can be minimized if you teach people about the drugs they want to take, allow them access to a reliable source, allow them access to treatment for misuse and addiction, and target the sources of suffering that lead people to try to escape with drugs. The situation though is considerably more complex than just these points.
  - husarcik 6y ago
    Please provide statistics for your claims. Most notably, largely caused by "black market nature of getting the drug". Thanks!
m463 6y ago
I heard it - with 12 doses or less you're addicted.
fiblye 6y ago
>Opiates in and of themselves are relatively safe, only slightly worse for you than caffeine, although clearly (arguably?) more addictive. I've heard this claim so much but I can't possibly comprehend the basis of it. Virtually nobody is out there overdosing and dying of caffeine (although it does happen). It's very addictive, yes, but if you deprived someone of their coffee for a month, they'll call you an asshole but they'll go about their normal life. With opiates, people are willing to live on the streets because they're more driven to put the drug over their personal well-being. I've known people who talked about having to empty their bowels with a spoon because they can't do it normally. Withdrawal is described as absolute hell and many people accept the possibility of overdose rather than the agony of going without it. People who built up a tolerance, quit using, then return often die because they took a little beyond their current tolerance. One major long term effect is that many people find it hard to find any joy in life as great as heroin. It's not reefer madness. Thousands are dying and people are oftentimes knowingly sacrificing their lives for opiates. The argument that it's not bad when used responsibly and in small amounts is true of virtually every drug ever. In practice, many people aren't using them responsibly, and the nature of some drugs makes them even more apt to be abused than others. People are desperate enough to see all the examples of people dying or otherwise destroying their lives for the drug but still deciding it's worth trying. The prohibition isn't the problem. The problem is people are struggling in life and opiates are providing an out. Making them more open and available will not help, and the oft-cited example of Portugal decriminalizing drugs doesn't mean every society should make opiates available. Drug overdoses recently increased in Portugal. [1] [1] https://www.emcdda.europa.eu/countries/drug-reports/2019/portugal/drug-induced-deaths_en https://www.emcdda.europa.eu/countries/drug-reports/2019/por...
- refurb 6y ago
  Most of the people dying of overdoses in the US died because of fentanyl.[1] From 1999-2018: Prescription opioid deaths went from 1 to 5 per 100,000. Heroin deaths went from 1 to 5 per 100,000. Deaths from fentanyl went from 0 to 10 per 100,000. So at peak, prescription opioid deaths were ~25% of all opioid overdoses. And most deaths had others drugs in their system. [1]https://www.cdc.gov/drugoverdose/epidemic/index.html https://www.cdc.gov/drugoverdose/epidemic/index.html
steveland 6y ago
Everything is wrong about your comment, including the words 'a,' 'and,' and 'the.' Are you trying to be Zoe Lund 2.0?
- saagarjha 6y ago
  You may think they are completely wrong, but it is your duty to explain why you think so rather than writing a comment that provides no additional information.
Lammy 6y ago
Opiates are a comfortable place to exist for people with little economic hope for the future. I'd rather focus on that.

by donatj 6y ago

obmelvin 6y ago

You make it sound like there's a problem with the people getting addicted, not the systemic overprescription of addictive drugs to unwitting patients who followed the authority of naive, at best, or even malicious medical professionals.

DuskStar 6y ago
I think he's saying that the drug war is the problem, not the addiction. That the steps that we're taking to fight addiction are worse than the addiction itself.
- to11mtm 6y ago
  I would still argue the bigger problem is the way pharmaceutical companies push products on Doctors. Ever been to a doctor's office, get prescribed a certain medicine, and then look around the office and see 5 different knick-knacks from the Pharmaco (i.e. Calendars, Notepads, general adverts) in the room as they're writing the script? The issue is far far larger than Opioids. I think a bigger message should be sent on this issue. We are one of the only first world countries that even allows advertisement of Medications, and have repeatedly seen the impacts of these companies' marketing tactics.
radley 6y ago
I think they're pointing out that we may be overdoing it as a result of trying to resolve over-prescription.
donatj 6y ago
The doctors and drug companies make easy scapegoats, but if a person came to you in genuine pain, living an absolutely miserable life, and you knew without a doubt you could stop it, could you in good moral standing with yourself choose to keep this human being in pain? I certainly could not, I am not so heartless, and I certainly hope the same of my own doctors. I think we forgot that by and large near all these people were in genuine pain. It’s easy to disparage them from the sidelines, but walk a mile in their shoes.
- rbranson 6y ago
  The whole point of having the prescription drug system is so that patients can be provided with safe, monitored access to potentially dangerous drugs. The entire purpose of a doctor being involved in the system is to prevent the outcome we are experiencing, otherwise they'd just sell these things over the counter.
- res0nat0r 6y ago
  Pillmill docs and counties in the rust belt being prescribed so many pills that if split evenly would give each person in the county 10k pills a month is the issue. No one is denying that sensible opioid prescriptions are a good thing. The issue is Purdue Pharma lied about how addictive their pills were and encouraged over-prescription in pursuit of their #1 goal, not easing pain, but profits. https://www.pbs.org/wgbh/frontline/film/opioids-inc/ https://www.pbs.org/wgbh/frontline/film/opioids-inc/
- nitrogen 6y ago
  The high school football players hooked on vicodin are definitely "in pain". Get your wisdom teeth out? Free opiates for you. Got injured during a game? Here you go, just one won't hurt.
- obmelvin 6y ago
  I didn't call for banning anything. I said the issue is with overprescription and negligent doctors. You are describing a desire for proper healthcare - that is also something I am interested in. What I am not interested in is my friend getting 100 Vicodin for a bit of pain after some dental visit (maybe wisdom teeth removed? can't remember), that he later realized was way more than he needed and had him temporarily addicted.
dodobirdlord 6y ago
An addiction is only a problem if you stop having access to the drug. It used to be the case (I don't know about now amid the anti-opioid mania) that doctors didn't bother trying to avoid opiate addiction in patients who were in their last few months of years of life. The supply is assured, the benefits are obvious, the drugs are cheap (though some opiates are expensive because of massive research spending on making them less addictive!), and the patient is never going to experience withdrawal in the context of hospice care. Alcohol withdrawal is just as unpleasant and more likely to kill you than opiate withdrawal, but for no particularly good reason you can't buy oxycodone at the corner store. The failure is on all of us for creating a society in which being addicted to opiates will ruin your life. There's no reason this has to be the case.

husarcik 6y ago

I think it is more complex than this. Overdose is a real negative outcome.

donatj 6y ago
Overdoses themselves are relatively rare, particularly with prescribed drugs, and especially when you consider the absolutely enormous number of people on opiates. I believe the solution is to make opiates easily, cheaply and safely available in a controlled clinical setting, much like how Portugal got their opiate problem under control. Keeps people off street drugs, thus keeping their doses reasonable and opiates out of the hands of people who are not recovering.
deelowe 6y ago
Overdose is most common on illegal opiates due to inconsistencies in the product itself. It's gotten worse as fentanyl has made it's way into the supply chain which dramatically alters the potency of "normal" opiates.
colechristensen 6y ago
In the era of fentanyl, the overdose problem is largely caused by the black market nature of getting the drug, poorly mixed inactive ingredients with opiates which can have orders of magnitude difference in effective dose. Overdose on legally manufactured drugs being much overshadowed by the black market sourced drugs. It is difficult to come to conclusions about how much of the reactions are showboating and how much are legitimate, but it seems clear that the net negative outcomes can be minimized if you teach people about the drugs they want to take, allow them access to a reliable source, allow them access to treatment for misuse and addiction, and target the sources of suffering that lead people to try to escape with drugs. The situation though is considerably more complex than just these points.
- husarcik 6y ago
  Please provide statistics for your claims. Most notably, largely caused by "black market nature of getting the drug". Thanks!

m463 6y ago

I heard it - with 12 doses or less you're addicted.

fiblye 6y ago

>Opiates in and of themselves are relatively safe, only slightly worse for you than caffeine, although clearly (arguably?) more addictive. I've heard this claim so much but I can't possibly comprehend the basis of it. Virtually nobody is out there overdosing and dying of caffeine (although it does happen). It's very addictive, yes, but if you deprived someone of their coffee for a month, they'll call you an asshole but they'll go about their normal life. With opiates, people are willing to live on the streets because they're more driven to put the drug over their personal well-being. I've known people who talked about having to empty their bowels with a spoon because they can't do it normally. Withdrawal is described as absolute hell and many people accept the possibility of overdose rather than the agony of going without it. People who built up a tolerance, quit using, then return often die because they took a little beyond their current tolerance. One major long term effect is that many people find it hard to find any joy in life as great as heroin. It's not reefer madness. Thousands are dying and people are oftentimes knowingly sacrificing their lives for opiates. The argument that it's not bad when used responsibly and in small amounts is true of virtually every drug ever. In practice, many people aren't using them responsibly, and the nature of some drugs makes them even more apt to be abused than others. People are desperate enough to see all the examples of people dying or otherwise destroying their lives for the drug but still deciding it's worth trying. The prohibition isn't the problem. The problem is people are struggling in life and opiates are providing an out. Making them more open and available will not help, and the oft-cited example of Portugal decriminalizing drugs doesn't mean every society should make opiates available. Drug overdoses recently increased in Portugal. [1] [1] https://www.emcdda.europa.eu/countries/drug-reports/2019/portugal/drug-induced-deaths_en https://www.emcdda.europa.eu/countries/drug-reports/2019/por...

refurb 6y ago
Most of the people dying of overdoses in the US died because of fentanyl.[1] From 1999-2018: Prescription opioid deaths went from 1 to 5 per 100,000. Heroin deaths went from 1 to 5 per 100,000. Deaths from fentanyl went from 0 to 10 per 100,000. So at peak, prescription opioid deaths were ~25% of all opioid overdoses. And most deaths had others drugs in their system. [1]https://www.cdc.gov/drugoverdose/epidemic/index.html https://www.cdc.gov/drugoverdose/epidemic/index.html

steveland 6y ago

Everything is wrong about your comment, including the words 'a,' 'and,' and 'the.' Are you trying to be Zoe Lund 2.0?

saagarjha 6y ago
You may think they are completely wrong, but it is your duty to explain why you think so rather than writing a comment that provides no additional information.

Lammy 6y ago

Opiates are a comfortable place to exist for people with little economic hope for the future. I'd rather focus on that.