# What should we be doing about the heroin crisis? **URL:** \ **Category:** Great Debates\ **Created:** [September 11, 2017, 7:55pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079 "2017-09-11T19:55:18Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![Evan\_Drake](https://avatars.discourse-cdn.com/v4/letter/e/b487fb/32.png) [@Evan\_Drake](https://boards.straightdope.com/u/Evan_Drake)\ **Post date:** [September 12, 2017, 12:13pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/41 "2017-09-12T12:13:06Z")
> [@pkbites](#): > > Cite? > > I’ve been told by numerous addicts that it’s false about being able to easily get it in prison. It’s not like what television and the movies show and then when drugs are available it’s very inconsistent at best and in tiny amounts. Griffin1977 may be referring to the British prison experience, where drugs are more plentiful, and the inmates more awful. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 12, 2017, 12:41pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/42 "2017-09-12T12:41:38Z")
> [@Evan\_Drake](#): > > Griffin1977 may be referring to the British prison experience, where drugs are more plentiful, and the inmates more awful. I dispute that there is an awfulness gap. The US may incarcerate a larger percentage of less than awful people than GB, but the awfulness of our most awful inmates should **not** be so disparaged. After all my particular prison system had a guy that ATE quite a few people. And he didn’t use heroin either. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [September 12, 2017, 1:04pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/43 "2017-09-12T13:04:34Z")
Yes, doctors should be exercising responsibility in what they’re prescribing, and not prescribing things that are harmful. But where are they getting the information to do that? If a new drug comes onto the market, how do you learn how harmful it is? And if the makers of the drug, the ones who know the most about it, are telling you that it’s safe, how can you contradict that? > [@](#): > > Quoth **pkbites** : > > When I was a teen in the mid-70’s everyone knew opiates weren’t to be fucked with. The pot heads, the acid trippers, even the coke users knew to never, ever try heroin. What happened to that attitude among youth? I think that part of it might be the attitude of “All drugs are bad”. If everyone (parents, teachers, Very Special Episodes of after-school TV) is telling you that all drugs are bad, and don’t use any of them, it doesn’t matter what it is, and then you discover that, say, marijuana isn’t all that big a deal after all, well, maybe what they’re saying about meth and heroin is just as exaggerated. I think that we should be making more clear to kids that some drugs really are worse than others. That might result in more kids using marijuana, but if it also results in less using the truly nasty stuff, that’s probably a good trade-off. ---
**Author:** ![Evan\_Drake](https://avatars.discourse-cdn.com/v4/letter/e/b487fb/32.png) [@Evan\_Drake](https://boards.straightdope.com/u/Evan_Drake)\ **Post date:** [September 12, 2017, 1:12pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/44 "2017-09-12T13:12:45Z")
> [@Qadgop\_the\_Mercotan](#): > > I dispute that there is an awfulness gap. The US may incarcerate a larger percentage of less than awful people than GB, but the awfulness of our most awful inmates should **not** be so disparaged. After all my particular prison system had a guy that ATE quite a few people. And he didn’t use heroin either. Withdrawn, then. ---
**Author:** ![HumbleThinker](https://avatars.discourse-cdn.com/v4/letter/h/5daacb/32.png) [@HumbleThinker](https://boards.straightdope.com/u/HumbleThinker)\ **Post date:** [September 12, 2017, 3:16pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/45 "2017-09-12T15:16:40Z")
> [@Reddy\_Mercury](#): > > Legalization encourages it. There is a difference between decriminalization and legalization. I would support the former; not the latter. Being caught with an illicit drug should go on the person’s “permanent record” but not result in any fine or jail time. But they’d still have to say to a potential employer that they were arrested for having an illicit drug; the employer would therefore know what they’re potentially dealing with. Why do you think “legalization encourages it?” ---
**Author:** ![griffin1977](https://avatars.discourse-cdn.com/v4/letter/g/977dab/32.png) [@griffin1977](https://boards.straightdope.com/u/griffin1977)\ **Post date:** [September 12, 2017, 4:40pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/46 "2017-09-12T16:40:48Z")
> [@LSLGuy](#): > > Your post seems to have a couple of typos or missing or extra "not"s in it. But your point is clear enough. > > Ref the last paragraph, the issue today is not that street drugs are cheaper. It’s that current efforts to close down the pill mills and clamp on the pharmacies have reduced (not eliminated) the ability of individual addicts to get the volume of drugs they want. When the doc will write 30 pills a month and you want to eat 5 a day, the exess has to come from somewhere. That somewhere is the street. > > And for the ever-growing number of addicts who the docs are now recognizing and shunning completely, 100% of their supply has to come from the street. While what you describe does happen, it is also common for legal (though now addicted) opioid users to turn to street drugs as they can’t afford the cost of prescriptions. Which says a lot as to how messed up the US healthcare system is that the insanely marked up illegal drugs are still cheaper. > [@LSLGuy](#): > > IMO \*\*asahi \*\*mostly nailed it. We have a dysfunctional defective society that is creating people prone to mental / emotional problems, drug addiction, crime, etc., at an unprecedented and apparently ever-increasing rate. > > Everything else we might do is simply treating a symptom, not a cause. The fix lies deep in the system. I have the good fortune to have none of those problems or desires. So do many of you. How do we make it so only 1 in a thousand have these problems rather than one in (WAG) 5 or 10? > For major social ills you need to treat both symptoms \*and \*causes, and you need to treat for a hundred years until the last children of the last defective person have died. Fat friggin’ chance of any thoughtful response even vaguely in that general direction by our current “leadership” and current culture. Overarching “defective society” argument don’t really hold water as the addiction rate has changed so much. Herion use was dropping for many years in the 90s, was the US becoming less defective then? Has US become 600% more defective in the last few years? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 12, 2017, 4:47pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/47 "2017-09-12T16:47:26Z")
> [@griffin1977](#): > > Overarching “defective society” argument don’t really hold water as the addiction rate has changed so much. Herion use was dropping for many years in the 90s, was the US becoming less defective then? Has US become 600% more defective in the last few years? The defect is that a lot of white middle class folks who previously were not candidates for opioid abuse were introduced to oxycodone in large numbers by their physicians. Many had their ‘activation’ switch flipped on by this very potent euphoria-inducing drug. Like a potential diabetic who never would have developed the disease if they’d stuck with their whole grain, low glycemic index diet but sadly got turned onto mashed potatoes and Pepsi by the liter, they now have the active disease. ---
**Author:** ![griffin1977](https://avatars.discourse-cdn.com/v4/letter/g/977dab/32.png) [@griffin1977](https://boards.straightdope.com/u/griffin1977)\ **Post date:** [September 12, 2017, 4:49pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/48 "2017-09-12T16:49:57Z")
> [@Chronos](#): > > Yes, doctors should be exercising responsibility in what they’re prescribing, and not prescribing things that are harmful. But where are they getting the information to do that? If a new drug comes onto the market, how do you learn how harmful it is? And if the makers of the drug, the ones who know the most about it, are telling you that it’s safe, how can you contradict that? The new drugs were still opioids. Whatever the drug rep says and the fancy brand name, if you tell to someone to take an opioid regularly and don’t expect they will end being an opioid addict you are not qualified to be a doctor. It is really basic medicine. ---
**Author:** ![griffin1977](https://avatars.discourse-cdn.com/v4/letter/g/977dab/32.png) [@griffin1977](https://boards.straightdope.com/u/griffin1977)\ **Post date:** [September 12, 2017, 4:53pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/49 "2017-09-12T16:53:02Z")
> [@Qadgop\_the\_Mercotan](#): > > The defect is that a lot of white middle class folks who previously were not candidates for opioid abuse were introduced to oxycodone in large numbers by their physicians. Many had their ‘activation’ switch flipped on by this very potent euphoria-inducing drug. > > Like a potential diabetic who never would have developed the disease if they’d stuck with their whole grain, low glycemic index diet but sadly got turned onto mashed potatoes and Pepsi by the liter, they now have the active disease. True but what evidence is there that switch only exists in “defective” societies? It is pretty much a fundamental physiological fact that if you give someone opioid drugs regularly they will end up addicted. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 12, 2017, 4:55pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/50 "2017-09-12T16:55:44Z")
> [@griffin1977](#): > > The new drugs were still opioids. Whatever the drug rep says and the fancy brand name, if you tell to someone to take an opioid regularly and don’t expect they will end being an opioid addict you are not qualified to be a doctor. It is really basic medicine. While all opioids are potentially addicting, some are far more likely to induce an active addiction much more rapidly than others. Those are the highly potent, short acting agents which have been shown to cause a LOT of euphoria. Heroin, Oxycodone, Dilaudid, and fentanyl are good examples of that type. Morphine, hydrocone are similar but not quite as potent for causing that spike of euphoria. Codeine causes less euphoria, and tramadol even less than that. Methadone causes much less euphoria, but lasts a LOT longer and has unique issues for that and other reasons. Not that any of the are safe, but some will cause more problems than others. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 12, 2017, 4:57pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/51 "2017-09-12T16:57:04Z")
> [@griffin1977](#): > > True but what evidence is there that switch only exists in “defective” societies? It is pretty much a fundamental physiological fact that if you give someone opioid drugs regularly they will end up addicted. I consider all human societies to be inherently defective. And in my view, it’s the rise in opioid addiction that’s caused more societal defects, not the reverse. And it’s biology and genetics that results in the potential for addiction, not defective societies. Life stressors certainly can contribute too, but even the best societies have people who are stressed out. ---
**Author:** ![Strassia](https://avatars.discourse-cdn.com/v4/letter/s/e8c25b/32.png) [@Strassia](https://boards.straightdope.com/u/Strassia)\ **Post date:** [September 12, 2017, 6:43pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/52 "2017-09-12T18:43:49Z")
> [@Qadgop\_the\_Mercotan](#): > > While all opioids are potentially addicting, some are far more likely to induce an active addiction much more rapidly than others. Those are the highly potent, short acting agents which have been shown to cause a LOT of euphoria. Heroin, Oxycodone, Dilaudid, and fentanyl are good examples of that type. Morphine, hydrocone are similar but not quite as potent for causing that spike of euphoria. Codeine causes less euphoria, and tramadol even less than that. > > Methadone causes much less euphoria, but lasts a LOT longer and has unique issues for that and other reasons. > > Not that any of the are safe, but some will cause more problems than others. I have also heard that Oxycontine, has made the problem worse due to the fact that patients are only supposed to take it twice a day, but it can wear off in less than 12 hours. That sets up ideal conditions for addiction. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 12, 2017, 7:21pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/53 "2017-09-12T19:21:17Z")
> [@Strassia](#): > > I have also heard that Oxycontine, has made the problem worse due to the fact that patients are only supposed to take it twice a day, but it can wear off in less than 12 hours. That sets up ideal conditions for addiction. It was often prescribed 3 times a day. But generally lasted 12 hours for most people. And believe me, the problem with it was not that it wasn’t prescribed frequently _enough_. The average chronic non-malignant pain patient didn’t need it twice a day, much less three times a day. But they sure wanted it more often. ---
**Author:** ![MichaelEmouse](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/michaelemouse/32/101_2.png) [@MichaelEmouse](https://boards.straightdope.com/u/MichaelEmouse)\ **Post date:** [September 12, 2017, 7:35pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/54 "2017-09-12T19:35:39Z")
Could marijuana have substituted for opioids in many cases of opioid overprescription? If so, was marijuana considered to represent too great a potential for abuse? It seems that opioid and meth are the big scourges of lower-middle/working class whites in the US. Are there any links between those two drugs besides being illegal, stupidly dangerous and used by lots of down and out white people? Are they commonly combined in some kind of super speedball? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 12, 2017, 10:03pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/55 "2017-09-12T22:03:49Z")
> [@MichaelEmouse](#): > > Could marijuana have substituted for opioids in many cases of opioid overprescription? If so, was marijuana considered to represent too great a potential for abuse? Regarding marijuana, they’ve already identified over 90 different molecules in it that are active in the brain, all with apparent different characteristics and effects, which have not been clearly defined to any real extent. Shotgunning someone with that many different pharmaceutical-type substances would not be my first choice for someone with malignant pain, or acute traumatic pain. Opioids have been shown to be effective for those types of pain, pot has not. As for using it for chronic pain, again the issue of what effect which molecule has makes it pretty unscientific, and there’s been little study about possible long-term effects. For all we know, it could, like opioids, actually increase pain over time when used for chronic pain. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [September 12, 2017, 10:24pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/56 "2017-09-12T22:24:26Z")
> [@kayaker](#): > > A friend’s daughter got involved with heroin, did rehab informally and formally several times and eventually died of heroin related problems. She was 20 when she died. > > When her heroin use was initially discovered she was a junior in high school. I was shocked, and asked her _why_. I told her I smoked weed, did some coke, messed with mushrooms and acid, but heroin scared the crap out of me. She explained that she wanted to party, and heroin was the easiest/cheapest to get. A person who would use a drug like heroin for this reason would use pretty much anything, as long as it was available. In the long run, her death was probably for the best, if you think about it. ☹ ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [September 12, 2017, 10:26pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/57 "2017-09-12T22:26:41Z")
> [@griffin1977](#): > > I’ve talked to doctors I know in the UK about this and they are completely amazed doctors were not prosecuted (or at the very least struck off wholesale) for this. Everyone who’s interested knows who the local or regional doctors are who will write for anything on patient request (this includes things like parents who insist their kids have ADHD even though multiple doctors have said they don’t), and the pharmacies where those prescriptions can be filled, no questions asked. And everyone involved gets in BIIIIIIG trouble when it catches up with them. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [September 12, 2017, 10:39pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/58 "2017-09-12T22:39:30Z")
> [@nearwildheaven](#): > > A person who would use a drug like heroin for this reason would use pretty much anything, as long as it was available. > > In the long run, her death was probably for the best, if you think about it. ☹ I cannot believe you would say that. Kids like to get high, I know I did (and do to this day). I hope you one day experience the pain her mom went through. ---
**Author:** ![MichaelEmouse](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/michaelemouse/32/101_2.png) [@MichaelEmouse](https://boards.straightdope.com/u/MichaelEmouse)\ **Post date:** [September 12, 2017, 10:40pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/59 "2017-09-12T22:40:46Z")
> [@Qadgop\_the\_Mercotan](#): > > Regarding marijuana, they’ve already identified over 90 different molecules in it that are active in the brain, all with apparent different characteristics and effects, which have not been clearly defined to any real extent. Shotgunning someone with that many different pharmaceutical-type substances would not be my first choice for someone with malignant pain, or acute traumatic pain. Opioids have been shown to be effective for those types of pain, pot has not. > > As for using it for chronic pain, again the issue of what effect which molecule has makes it pretty unscientific, and there’s been little study about possible long-term effects. For all we know, it could, like opioids, actually increase pain over time when used for chronic pain. What are the reasons for this dearth of studies? Pot has been used for quite a long time, what’s in the way of such studies? What would it take to get sufficient data on the long-term effects and in what timeframe? ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [September 12, 2017, 10:40pm UTC](https://boards.straightdope.com/t/what-should-we-be-doing-about-the-heroin-crisis/796079/60 "2017-09-12T22:40:48Z")
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