Fentanyl is 50 times stronger than Heroin. The mexican cartels are making the F because its much more efficient for obvious reasons. You can manufacture it and do not rely on a plant for one thing.
We have a fentanyl epidemic where I am and much of the heroin on the street has F in it no matter what you think it is. It’s just a more economically efficient powerful product. Very easy to die.
I’ve had some med and pain issues, and I don’t believe that there is a strong boundary between pain and dependency. It can change over time. If you have never been through it you can make those distinctions. Try living it.
The same way a job will expand to fill the time, a pain will expand to fill out a prescription. It’s just having a human body.
That doesn’t have anything to do with the current opiate epidemic. The war on Crack is a separate topic that I will probably agree with you but that is not what we are talking about. The separate drugs classes are very different in their implications and, no, you can’t just make them all legal even in a controlled way and expect a good outcome. Marijuana is a rare exception because it is a fairly benign drug that isn’t physically addictive, it is cheap and it does not hurt the user or others at least in the short-term. There are very few drugs like that (LSD may be another but ironically, antibiotics are not).
Opiates are a lot more dangerous pharmaceuticaly than either Crack or even regular cocaine. Do you know what happens if you try to stop the latter? Not a lot. Users may get ticked off for a while if they get cut off from their supply but it doesn’t generally require a medical intervention unlike opiates. You just have to wait it out and walk it off assuming there are no legal complications involved.
Admittedly, one of the most deadly drugs there is is already widely available and legal. Alcohol is one of the only drugs that can literally kill someone that is addicted to it if they try or have to stop suddenly without medical intervention (its close relatives, barbiturates and benzodiazepines like Valium are the others). You can’t have prohibition against alcohol itself but it also isn’t wise to make barbiturates and benzodiazepines easily available either anymore than it is for the prescription opiates. It is just welcoming addiction, despair and death for people that wouldn’t have had to go through it if the legal gateway wasn’t there in the first place.
Ya know?
I was out in 85 degree weather doing light physical work.
So far today, I have taken exactly 1 pill for pain - 4 mg hydromorphone.
Before developing osteoarthritis and getting continuous opioids, I would hoard as many of the Vicodin* (5/500) as I could.
Meaning: I did NOT take every pill available.
Today, of the morphine and hydromorphone available, I took exactly one pill - the smallest dose I had.
Am I still an “addict” who will self-destruct and make a huge mess?
All you experts tell me how to use the drugs I’ve been using for 15+ years.
as mentioned, I have high tolerance for CNS depressants - I found only two drugs worked:
Vicodin and Demerol. I liked Demerol too much to want to use it again (post-surgical pain)
You can do whatever you want to do. It wouldn’t be wise to depend on the possibility, though, that one was exactly like you if one was in your situation.
If I had to speculate on worst cases it would be the benzos that become the problem first down the road. You need more, and more, or start to have other pains, say IBS, and there is no reason. Maybe you’re getting intradose w/d from the benzodiazepine and Drs can’t or won’t recognize it, because they just don’t. Sounds like you would not consider the need. But if your system broke down, and you had dysphoria, pain and/or anxiety, you wouldn’t have a choice. If it happens you might need to take **a few years **to get off the benzos. You never face these things until you have to. Until then you’re indestructible.
I would be in pain as it happened a few times like for example, the pain clinic doc went on the Spring Break for a week and I was due for a refill. In that case I eat a bunch of IBUs.
Saying “Opioids aren’t that dangerous as long as you don’t combine them with other drugs” is like saying “Pointing a gun at your head and pulling the trigger isn’t that dangerous as long as the gun isn’t loaded”.
I disagree. It’s more like saying “Pointing a gun at your head and pulling the trigger isn’t that dangerous as long as the gun isn’t loaded with armor-piercing bullets with explosive tips”.
Opioids are plenty dangerous and cause lots of mortality on their own.
I personally know several people who originally started opioid usage via a doctor’s RX. This is so not true that it’s not dangerous unless combined with other drugs and/or alcohol. Simply not true. It is extremely addicting and it is killing many. Once these people can no longer access medically prescribed opioids, they turn to the streets for the cheaper, better version: heroin. Many doctors set up “pain management clinics” wherein people pay like $500 per month just to receive the RX. I’ve witnessed with my own eyes a line around a building. Not ALL opioid abuse is started by RX, but many times, yes. I hold the medical community responsible for those.
Nowhere did I say that everyone who takes opiates for pain will get high. Simply that it’s no guarantee that using them for pain will ensure a person’s sobriety.
This may already have been mentioned but there’s evidence that chronic use of opioids changes how someone feels pain. One study found that patients who used opioids daily for knee pain reported significantly higher levels of pain after knee replacement than did patients who had not resorted to pre-op opioids. There was not a statistical difference in amount of damage to the knees or work done.
Since one of pain’s components is perception (which comprises both hard wired physical/neurological response as well as emotional reaction IMO) it could be that the patients who were on pre-op opioids felt more pain and also felt more after surgery. But it could also be that people who had access to narcotic pain relief via sympathetic physician or openness to narcotic use may be setting up their bodies to longer term or even permanent reliance.
It’s a difficult issue because pain, regardless of what influences it, is real. Unfortunately, side effects don’t discriminate between those who are reliant and those who are addicted and they can be deadly alone or in combination with other agents.
Working with a pain specialist or clinic can be helpful. Sometimes it will take multiple attempts to find a combination of drug/behavior/treatment modalities that control the pain with minimum narcotic use (individual for each patient). And it can be very difficult to choose treatment which may only incrementally decrease pain when a very slight increase of opioids provides the same effect or better.
But in the long run I think people who take the minimum required narcotic are overall better off.
I have spells where the Vicodin wasn’t enough so I had to double it but still stayed 4x a day. So far it worked out.
On my last injection which was for my neck the doc used electricity to burn the nerves. He had a few needles in my neck when a nurse said (to the doc) here let me help you and grabbed my head and twisted it. That hurt like hell and I swore at the nurse. I was hurting bad and I told doc so and he said he has about 30 seconds left and then he’ll inject some medicine in to alleviate the pain.
When he did that it felt so good that I fell asleep. They had to roll me of the table to the gurney and take me to recovery. I woke up later raring to go and the nurse gave me a script for 16 of the 7.5/325 Vicodin. I asked the nurse am I gonna need them and she said I might.
I did need them. I had to take the 7.5 and the 5 together to stop the nasty pain when the medicine wore off. I wanted to go back and strangle that friggin nurse.
There’s a great book out last year that addresses OP’s question as well as the overall history of the current opiate epidemic. It’s called Dreamland. Highly recommended.
Among other things, it lays out the history of the theory that prescribed opioids don’t become addictive if the patient is suffering from pain (which is false), and how an entire revolution in opiate prescribing was basically a castle made of sand resting on a single letter to the editor in the New England Journal of Medicine. It also explains very convincingly how a combination of the spread of black tar heroin and the spread of pill mill pain clinics and new marketing techniques is what led to the current heroin epidemic.