Resolved: Opiates should be available for home use

Great Debates
1

I finally got the virus that was going around, and I felt like garbage with a nasty cough. What did I do? Took half a hydrocodone pill left over from a surgery, and now I feel OK! The cough disappears like magic, and the body aches are reduced much more effectively than by NSAIDs (though yes, it also contains acetaminophen, and yes NSAIDs are better for pain with inflammation, though they do a job on my stomach and I avoid them at all cost). The last time I did this, I took a whole pill, and it made me feel itchy and nauseous. I’m not going to become an opiate abuser, but it’s nice thing to have around when I need it.

Laudanum/tincture of opium was available OTC until the 1950s or so, as was codeine cough syrup until fairly recently. Tincture of opium is highly effective against three main symptoms: pain, cough, and diarrhea. Another useful remedy for cough that was available until fairly recently was paregoric, which combined a much weaker opium tincture with herbal extracts.

But ohhhh nooo, we can’t have nice things because people abuse opiates. Even though people are getting prescriptions for hillbilly heroin and abusing it anyway.

What about the danger of overdose? It’s there, but I just did a calculation, and it would take 6 teaspoons of laudanum to be fatal (google tells me 1 oz. minimum would be required for a fatality in an adult = 6 teaspoons). The maximum dose I see on 19th century laudanum bottles is 50 drops, which google tells me is 1/2 teaspoon. In short, you’d have to be trying on purpose to commit suicide in order to OD. Or just be pretty dumb.

But it doesn’t have to be laudanum. It would be useful to have pain and cough formulas containing opiates in pill or gelcap form.

The only major argument I can think of against this idea is that the availability of such opiates could ensnare potential addicts. I.e., they would otherwise not have gotten a taste of opiates, which then gets them started on their addiction. My counterargument is that these things are already available via prescription (which is why it was in the house), so that opportunity exists already. It’s merely a matter of degree.

I’m not minimizing the risk or terribleness of opiate addiction, but I don’t think it’s fair to keep useful drugs away from people because others can’t handle them. Thoughts?

2

It seems at the very least doctors should be able to prescribe opiates to treat cough.

3

Resolved : opiates are available for home use.

4

You forget that opiates are tolerance-building; unrestricted use will lead to the user needing a stronger and stronger dose to get the same level of pain relief. That’s the cycle that leads a lot of opiate addicts to heroin and fentanyl in the long run, and it’s in the public interest to make that process more difficult.

5

Welcome to the new, improved DEA.

Vicodin (the hydrocodone + acetaminophen) was available with a standard prescription.
It was DEA Narcotic Schedule III

It was re-classified as Sch II - the script was a triplicate on special engraved paper, It is now the same as morphine.

I have crippling pain from osteoarthritis. I had a chat with my PCP (who cut my morphine from 45 to 15). She assures me that the DEA is making her tell me to "get used to living in pain - we are not obliged to stop your pain, unless you can use OTC.
I have kidney failure NSAID are poison. And they have never worked for me.

I am not going to end up hooked to a dialyzer AND in pain.

She doesn’t care. No more morphine. You must keep exercising even if it causes pain you cannot control.

Never use Medicare if you want decent medical care.

6

How about listening to people who actually use them before announcing that “They are the road to certain ruin!”?

7

I’ve seen it happen to people I care about, and it’d happen to a lot more people if you could just buy opiates the same as you buy aspirin.

8

Right. I could have been more clear. I meant either OTC or not made inordinately inconvenient, depending on the compound.

9

Addiction is a side-effect, like any other. Drugs with a history of causing harmful side effects in people are generally controlled.

10

They are. There are prescription-only cough syrups containing codeine. However, you have to have a really bad coughing situation to get it. They don’t just hand it out on request.

11

A doctor can’t prescribe opiates to treat cough? Who stops them from doing so?

(I don’t know a lot about the whole system. The last time I had a prescription for something was maybe 20 years ago).

12

I think they can, but insurance won’t pay for it because it doesn’t fall within standard treatment parameters.

13

Conservatives believe that pain is uplifting. Until they suffer it.

14

This is my understanding as well. It’s not that there are a few people abusing as the OP suggests - there are more people dying from prescription drug abuse than from street drugs. It’s a public health problem - that’s why you cannot have unrestricted access to these drugs.

15

Opiates are too addictive, and they can easily ruin your life. Plenty of legitimate pain patients have wound up dead or trapped in a spiral of addiction because of opiates.

16

The phrase at the end of the post implying that it is generally just weak people who can’t handle very powerful drugs speaks to the total lack of understanding of biology on the part of the OP.

17

I’ve actually HAD tincture of opium ( I inherited a bottle from a terminally ill friend ) and I guarantee that if it were available OTC I’d be an addict. It’s been ten years and I’m getting a craving just writing this. And I’ve had a bottle of OxyContin sitting in my medicine cabinet untouched for 7-8 years at least, that stuff doesn’t tempt me at all - but laudanum is another story.

18

It really is a shame that opiates have such dangerous side effects, because they do work almost like magic on a whole host of symptoms that would seem unrelated to what most people think of them being for (pain). If they could be paired with something that blocks tolerance maybe the restrictions would lessen. I wonder what kind of progress is being made in terms of research into the mechanisms involved.

Sent from my LG-V410 using Tapatalk

19

No, I recognize that a certain percentage of people exposed to opiates will almost automatically become addicted, since they are biologically primed for it. I agree it has nothing to do with personal weakness (that propensity, at least).

20

Interesting. What was it like?