# Are Opioid Drugs More Dangerous Than Crack or Heroin? **URL:** \ **Category:** Factual Questions\ **Created:** [June 11, 2015, 4:17pm UTC](https://boards.straightdope.com/t/are-opioid-drugs-more-dangerous-than-crack-or-heroin/722265 "2015-06-11T16:17:44Z")\ **Posts on this page:** 8\ **Page:** 2
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [June 12, 2015, 10:35pm UTC](https://boards.straightdope.com/t/are-opioid-drugs-more-dangerous-than-crack-or-heroin/722265/21 "2015-06-12T22:35:07Z")
> [@grude](#): > > Opiates/opioids are NOT NOT NOT instantly physically addictive, that is nonsense. It takes weeks to months of round the clock dosing to cause a physical addiction. > > To put this in perspective, it would be like saying a single beer would cause you to be physically addicted to alcohol, in reality it takes a long time of continuous dosing to get there. > > I posted before my skepticism about this so called RX drug epidemic, I knew someone with stage four cancer that was visible externally and had medical staff SHOCKED at seeing it, nurses and doctors. And the strongest opiate they ever got from their doctors was 15mg morphine tablets. So I think this idea doctors are just throwing gobs and gobs of opiates at patients is BS. It’s not BS. Some doctors will write for anything a patient requests, and some pharmacies will fill them, no questions asked. :mad: Legitimate practitioners know the difference; when I worked at the grocery store, and knew my patients, I didn’t question orders from the pain clinic (and the one in this area is legitimate) or oncologists, but the guy at the walk-in clinic down the road was another story. He stopped after getting a few too many phone calls from local pharmacies questioning his writing of prescriptions for people we knew were addicts, but some don’t do that until they are arrested and their licenses yanked. People who are addicted to opiates almost always have a history of other addictive behavior. It does not exist in a vacuum. ---
**Author:** ![Lucas\_Jackson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lucas_jackson/32/303_2.png) [@Lucas\_Jackson](https://boards.straightdope.com/u/Lucas_Jackson)\ **Post date:** [June 12, 2015, 11:47pm UTC](https://boards.straightdope.com/t/are-opioid-drugs-more-dangerous-than-crack-or-heroin/722265/22 "2015-06-12T23:47:57Z")
To address the OP, aren’t opioid drugs more dangerous than heroin (when misused) due to the high levels of Tylenol? ---
**Author:** ![JayRx1981](https://avatars.discourse-cdn.com/v4/letter/j/71e660/32.png) [@JayRx1981](https://boards.straightdope.com/u/JayRx1981)\ **Post date:** [June 13, 2015, 12:27am UTC](https://boards.straightdope.com/t/are-opioid-drugs-more-dangerous-than-crack-or-heroin/722265/23 "2015-06-13T00:27:12Z")
> [@White SIFL](#): > > To address the OP, aren’t opioid drugs more dangerous than heroin (when misused) due to the high levels of Tylenol? Not all opioids come paired with acetaminophen/paracetamol, and even then not necessarily. Vicodin/Norco/Lortab/Xodol are all variations on hydrocodone/acetaminophen, but Hysingla and Zohydro ER (now with tamper resistance!) are both Hydrocodone only. Likewise, Percocet/Roxicet/Endocet are all oxycodone/acetaminophen combinations, but Roxicodone and Oxycontin are both oxycodone only preparations (in immediate-release and extended-release form, respectively). Further, the acetaminophen only plays a major role in toxicity in acute doses over 4-6 grams in the absence of liver pathology or combination with hepatotoxic agents. Chronically, I’ve come across recommendations to avoid more than 2.5-3.25 grams, daily, but 3.25 grams would still allow 10 hydrocodone/apap 10/325mg (100mg MED) or 10 oxycodone/apap 10/325mg (~150-200mg MED depending on the source of your equianalgesic dosing chart) tablets to be taken “safely” daily. ---
**Author:** ![Final\_Legacy](https://avatars.discourse-cdn.com/v4/letter/f/f0a364/32.png) [@Final\_Legacy](https://boards.straightdope.com/u/Final_Legacy)\ **Post date:** [June 13, 2015, 3:30am UTC](https://boards.straightdope.com/t/are-opioid-drugs-more-dangerous-than-crack-or-heroin/722265/24 "2015-06-13T03:30:07Z")
> [@boffking](#): > > I think the biggest issue with these opioid drugs is their extremely high potential for addiction. The addiction is what drives people to place bomb threats at pharmacies or rob people. I think these drugs should be cheaply available to anyone who wants them, which IMO would significantly cut down violent crime. bingo ---
**Author:** ![obbn](https://avatars.discourse-cdn.com/v4/letter/o/d6d6ee/32.png) [@obbn](https://boards.straightdope.com/u/obbn)\ **Post date:** [June 13, 2015, 9:35am UTC](https://boards.straightdope.com/t/are-opioid-drugs-more-dangerous-than-crack-or-heroin/722265/25 "2015-06-13T09:35:24Z")
> [@White SIFL](#): > > To address the OP, aren’t opioid drugs more dangerous than heroin (when misused) due to the high levels of Tylenol? Even with legitimate use of opiods, Tylenol is a huge concern. Thankfully my doctor switched me over to straight oxycodone from Percocet. I was getting very nervous about the amount of Tylenol I was taking in everyday. I was way more scared of a Tylenol overdose than I ever was of an opioid overdose. ---
**Author:** ![aldiboronti](https://avatars.discourse-cdn.com/v4/letter/a/9fc348/32.png) [@aldiboronti](https://boards.straightdope.com/u/aldiboronti)\ **Post date:** [June 13, 2015, 12:09pm UTC](https://boards.straightdope.com/t/are-opioid-drugs-more-dangerous-than-crack-or-heroin/722265/26 "2015-06-13T12:09:41Z")
> [@Stink Fish Pot](#): > > Man-made opiates are (IMO, anyway) much more dangerous than their natural counterparts, all other things being equal. In a lab, the pharmaceutical companies can tweak something to make it actually more addictive than its natural counterpart. > > I don’t have a cite, but I remember reading about (and seeing a documentary) on addiction and the ability for people to get off of various drugs. The comparison drug was methadone vs. heroin. Addicts could get methadone from a clinic for free or for a nominal charge, but most of them couldn’t stop taking the methadone. Various opinions are out there, but people who have been addicted to heroin and methadone at one point in their lives seem to agree that getting away from methadone is much harder than heroine. > > This could be a product of a small sample size, or maybe addicts who know they can get free methadone don’t have the motivation they need to get off the drug, like they would if they were spending a fortune on heroine. I don’t know. > > However, not all prescription opiates are cheap. A drug like oxycontin, which is still being made under patent protection, is very expensive, depending on your insurance co-pay. Percocet, on the other hand, is now made generically and it is much more affordable. Supposedly, percocets are faster acting, but don’t last as long, whereas the oxycontins are extended release. > > It is unfortunate that doctors are hesitant to write scripts for opiods/opiates, but i am sure they don’t want the liability. Plus, the Pain Management industry is booming, so a regular doctor can just make you go see one of these specialty doctors instead. > > From what I’ve heard, though… People with chronic pain issues are now forced to add another doctor to their list. And once you are established as a patient, the doctor doesn’t even come in to see you to write a script. A PA comes in, sees the patient for 5 minutes, and writes the scripts, and the patient is on his/her way. Insurance companies are billed for a specialty office visit, and if there is no change in meds for the patient, it resembles little more than paying for a visit to a legalized pusher. > > (I have a relative suffering from chronic pain, and this info is from a conversation I had with them.). IANAD, IANAL, IANADU, IANAS. > > The biggest problem with street drugs (at least in my eyes) is I wouldn’t have any way to test the drug to see how weak or strong a dose is. This would make using street drugs as a long term solution to managing pain a risky proposition at best. I don’t know how people can risk their lives by taking something they buy off someone on the street, but I guess when someone gets to that point, they aren’t all that concerned with dying as much as they are concerned with dealing with their situation. From personal experience I can confirm that methadone is far harder to kick than heroin. This wasn’t just me, all my fellow-addicts agreed. ---
**Author:** ![Annie-Xmas](https://avatars.discourse-cdn.com/v4/letter/a/ecc23a/32.png) [@Annie-Xmas](https://boards.straightdope.com/u/Annie-Xmas)\ **Post date:** [June 13, 2015, 5:12pm UTC](https://boards.straightdope.com/t/are-opioid-drugs-more-dangerous-than-crack-or-heroin/722265/27 "2015-06-13T17:12:01Z")
Every time I try to complain about a prescription drug, I’m told “It’s not drugs. It’s medication.” Apparently the [del]drug[/del] pharmaceutical companies would have people believe that NO prescription medications have any bad effects whatsoever. ---
**Author:** ![Melbourne](https://avatars.discourse-cdn.com/v4/letter/m/b5e925/32.png) [@Melbourne](https://boards.straightdope.com/u/Melbourne)\ **Post date:** [June 15, 2015, 3:18am UTC](https://boards.straightdope.com/t/are-opioid-drugs-more-dangerous-than-crack-or-heroin/722265/28 "2015-06-15T03:18:46Z")
> [@boffking](#): > > I think the biggest issue with these opioid drugs is their extremely high potential for addiction. The addiction is what drives people to place bomb threats at pharmacies or rob people. I think these drugs should be cheaply available to anyone who wants them, which IMO would significantly cut down violent crime. You mean like nicotine? Cigarettes were cheaply available to any adult who wanted them, but caused quite a lot of armed robberies around here, as “give me everything you have in the cash register, and a carton of cigarettes”. Desperate smokers in nicotine withdrawal who didn’t have enough cash for packet of cigarettes. Still happens, but less often, partly due to lower smoking rates, caused in part by higher cigarette prices. [Previous page](https://boards.straightdope.com/t/are-opioid-drugs-more-dangerous-than-crack-or-heroin/722265.md?page=1)