Herion question

[insider]

Is pure herion one of the safest illicit drugs to use? Also, is it true that herion appears to be the drug of choice for doctors who use illicit drugs?

[kinoons]

the safest of the illicit drugs? thats like asking whats the best bullet to be shot by to not die...

the big question about heroin is first how strong is it? Its impossible to know how much will make you feel relaxed and chilled out, compaired to how much will stop your breathing

or you can worry about what else that crazy dealer down the street has cut into the drug your shooting directly into your veins....

so I'd say ,in short, don't do any of them...

[kinoons]

the safest of the illicit drugs? thats like asking whats the best bullet to be shot by to not die...

the big question about heroin is first how strong is it? Its impossible to know how much will make you feel relaxed and chilled out, compaired to how much will stop your breathing

or you can worry about what else that crazy dealer down the street has cut into the drug your shooting directly into your veins....

so I'd say ,in short, don't do any of them...

[kinoons]

ahhhhh! the dreaded double post..... <hangs his head in shame>

[Qadgop the Mercotan]

Originally posted by insider
Is pure herion one of the safest illicit drugs to use? Also, is it true that herion appears to be the drug of choice for doctors who use illicit drugs?

No and no. I won't get into a discussion as to which drugs are "safe" to abuse, but opiate addicts who are physicians generally don't abuse heroin, at least not in the US, as they can generally get their hands on pure pharmaceutical grade hydrocodone, oxycodone, demerol, morphine, fentanyl, and others. All of these substances can cause respiratory arrest and death, just like heroin. Street heroin can also be cut with other substances which cause pulmonary edema and death (you drown in your own secretions).

I've known a few physicians who have been found in very embarrassing positions with a needle in their arm in a call room. The lucky ones were still alive when found. Many were not lucky.

Qadgop, MD

[elucidator]

They're wheeling you into the operating room. The anesthetic is taking hold, but as you slip under you see, in the corner by the sink, William Burroughs scrubbing up. He turns and smiles at you, 'cause he feels really good.

You want to scream, but you can't.....

[CrankyAsAnOldMan]

I thought herion was a specialized term for a decaying shorebird.

[elucidator]

No, you have confused that with "carry-on", a variety of smaller luggage for airline travel.

[Qadgop the Mercotan]

A Simpsons moment: Dr. Nick is holding a syringe, and says to Homer "This injection will make the operation a pleasant dream". He then punches Homer into unconsciousness, and injects himself.

[elucidator]

You know, many places you got to pee in a jar to get a job in the mailroom, make sure you don't smoke dope or anything like that.

Mercotan, my man, you be saying this doesn't apply to surgeons? What's your take on that?

Though, to be fair, I would prefer a doctor who had some passing familiarity with a bong, now and again.

But whacked on opiates? No, never, not ever, ....


Wait a tick. Isn't Cheney going under the knife soon? How thoroughly is his surgeon checked out?

"No, no. First you pee in the jar, then you scrub, then you put on the rubber gloves"

[Miller]

Actually, "herion" is an obsolete physics term. Early on, instead of differenting charges as "positive/negative" It was "male/female." What we call a "postivily charged" particle was an ion, and a "negativly charged" particle was, of course, a herion. All this got changed in the '70s.

[Skelji]

Oh, man, I'm OD'ing on puns here.

I'll just be herion on out of here.

[elucidator]

Originally posted by Miller
..."negativly charged" particle was, of course, a herion. All this got changed in the '70s...

The poster is obviously unaware of the impact of Feminist Physics. The utterly correct term would be a "Herion."

At one time, the programming error known as an "infintite loop" was defined as an "error ring". (This has not been confirmed.)

[Morrison's Lament]

Ignoring the DOUBLE spelling error in the OP (ok, so I'm not exactly ignoring it ), I'd just like to say:

Mmmmmmmm.... hheeerooiinn... mmmmm.....

Ehm, drugs are bad, mmkay?

--- G. Raven

[Pjen]

In controlled doses, heroin is extremely safe. Many addicts in Britain in the fifties, sixties and seventies received regular injections of pure diamorphine at controlled levels for many years. As long as there is no overdose and no individual reaction, diamorphine is about as safe as they come. It is still used as a medication for pain relief in the UK.

The program to maintain people with a dependency on heroin using diamorphine gradually collapsed over twenty years as:

1/ Political pressure limited the number of doctors who could prescribe (initially weeding out those who were abusing their position to make money as virtual suppliers, but eventually limiting prescription to hospital based government approved doctors who could act only within very strict guidelines.)

2/ Substituting Methadone (oral opiods in sugar syrup) for diamorphine. Heroin dependent peoiple disliked this as it removed the injection (part of the ritual psychological side of addiction) and it did not give the 'rush', only the soporific and withdrawal avoiding effects.

3/ Maintenance dosing was replaced with reduction and withdrawal. People dependent on heroin had to agree a reduction and withdrawal program.

The net effect of the above was the gradual drift back to street drugs for many people who had been safely maintained for years.

I would be interested to hear of any reliable cites for the harmfulness of diamorphine which show it as far more dangerous than any other regularly prescribed medication.

Consider:

Morphine salts:

Cautions: hypotension, hypothyroidism, asthma (avoid during attack) and decreased respiratory reserve, prostatic hypertrophy; pregnancy and breast-feeding; may precipitate coma in hepatic impairment (reduce dose or avoid but many such patients tolerate morphine well); reduce dose or avoid in renal impairment (see also Appendix 3), elderly and debilitated (reduce dose); convulsive disorders, dependence (severe withdrawal symptoms if withdrawn abruptly); use of cough suppressants containing opioid analgesics not generally recommended in children and should be avoided altogether in those under at least 1 year; interactions: Appendix 1 (opioid analgesics)


PALLIATIVE CARE. In the control of pain in terminal illness these cautions should not necessarily be a deterrent to the use of opioid analgesics


Contra-indications: avoid in acute respiratory depression, acute alcoholism and where risk of paralytic ileus; also avoid in raised intracranial pressure or head injury (in addition to interfering with respiration, affect pupillary responses vital for neurological assessment); avoid injection in phaeochromocytoma (risk of pressor response to histamine release)

Side-effects: nausea and vomiting (particularly in initial stages), constipation, and drowsiness; larger doses produce respiratory depression and hypotension; other side-effects include difficulty with micturition, ureteric or biliary spasm, dry mouth, sweating, headache, facial flushing, vertigo, bradycardia, tachycardia, palpitations, postural hypotension, hypothermia, hallucinations, dysphoria, mood changes, dependence, miosis, decreased libido or potency, rashes, urticaria and pruritus; overdosage: see Emergency Treatment of Poisoning ; for reversal of opioid-induced respiratory depression, see

Tricyclic antidpressants:

Cautions: cardiac disease (particularly with arrhythmias, see Contra-indications below), history of epilepsy, pregnancy and breast-feeding (Appendixes 4 and 5), elderly, hepatic impairment (avoid if severe), thyroid disease, phaeochromocytoma, history of mania, psychoses (may aggravate psychotic symptoms), angle-closure glaucoma, history of urinary retention, concurrent electroconvulsive therapy; if possible avoid abrupt withdrawal; anaesthesia (increased risk of arrhythmias and hypotension, see surgery section 15.1); porphyria (section 9.8.2); see section 7.4.2 for additional nocturnal enuresis warnings; interactions: Appendix 1 (antidepressants, tricyclic)


DRIVING. Drowsiness may affect performance of skilled tasks (e.g. driving); effects of alcohol enhanced


Contra-indications: recent myocardial infarction, arrhythmias (particularly heart block), not indicated in manic phase, severe liver disease

Side-effects: dry mouth, sedation, blurred vision (disturbance of accommodation, increased intra-ocular pressure), constipation, nausea, difficulty with micturition; cardiovascular side-effects (such as ECG changes, arrhythmias, postural hypotension, tachycardia, syncope, particularly with high doses); sweating, tremor, rashes and hypersensitivity reactions (including urticaria, photosensitivity), behavioural disturbances (particularly children), hypomania or mania, confusion (particularly elderly), interference with sexual function, blood sugar changes; increased appetite and weight gain (occasionally weight loss); endocrine side-effects such as testicular enlargement, gynaecomastia, galactorrhoea; also convulsions (see also Cautions), movement disorders and dyskinesias, fever, agranulocytosis, leucopenia, eosinophilia, purpura, thrombocytopenia, hyponatraemia (may be due to inappropriate antidiuretic hormone secretion) see CSM advice, section 4.3, abnormal liver function tests (jaundice); for a general outline of side-effects see also notes above; overdosage: see Emergency Treatment of Poisoning

Source British National Formulary 2001.

IMHO, if physician monitored, morphine salts are not considerably more harmful than anti-depressants, according to the above.

[Morrison's Lament]

In controlled doses, pretty much anything is safe


The thing about smack is that you can't control the doses

--- G. Raven

[casdave]

Completely agree with Pjen on the disastrous effects on the policy change in the UK on heroin.

Trouble is, we were warned about the results by US drug workers but as is usual, politicians made the decisions rather than those who actually knew what they were talking about.

The removal of heroin for maintenance meant that registered users turned to dealing more and more to feed their own habits and so created more users.

Australia tried to return to prescribed maintenence heroin ten or so years ago but came under immense pressure from the US which threatened sanctions on the one hand and large grants to produce medical grade opiates one the other provided that it compled with US demands.

[Qadgop the Mercotan]

Originally posted by elucidator
You know, many places you got to pee in a jar to get a job in the mailroom, make sure you don't smoke dope or anything like that.

Mercotan, my man, you be saying this doesn't apply to surgeons? What's your take on that?

Though, to be fair, I would prefer a doctor who had some passing familiarity with a bong, now and again.

But whacked on opiates? No, never, not ever, ....

So far, docs in the US don't gotta pee to get their licenses to practice, unless they've got a history of chemical dependency. Some employers of physicians do make a pre-job whiz quiz a requirement, but most do not. And frankly, I'd rather have my surgeon have opiates on board instead of THC. At least if he was habituated. Clean and sober would still be my first choice tho. By several miles.

I think that within 20 years, whiz quizzes will be as much a part of the job and licensing for physicians as it now is for commercial truckers and airline pilots. Is that a good thing? From the public's health standpoint, yes, I think so.

Pjen I can't disagree with anything you said. Public policy towards drug abuse in the US is pretty stupid, sorry UK is following suit. Heroin is a boogyman to the politicians, it's no more harmful or addictive than other commonly used opiates. Personally I still feel that medically unnecessary use of opiates is, at best, a terrible waste of time, and too often becomes a descent into a personal hell.

Qadgop,MD
working with drugs and addicts since 1984