It is a dangerous drug, but is it any more so than the other opioids? There are legal options that are much more powerful than heroin. In Canada and the UK, hospital patients sometimes are given heroin, under the name diamorphine. Assuming all the drugs are pure medical quality, is heroin any more dangerous than morphine, fentanyl, or oxycodone? Many of the dangers of heroin in the US are because it is illegal(violent crime, needle sharing, drug of unknown strength and quality).
The Controlled Substances Act says that Schedule I drugs are those that have “no currently accepted medical use in treatment in the United States.” while Schedule II drugs “have currently accepted medical use in treatment in the United States, or currently accepted medical use with severe restrictions.”
NM. DF got it better.
Of course, the drug schedules end up being something of a self-fulfilling prophecy: Heroin isn’t used medically because it’s Schedule I, and it’s Schedule I because it isn’t used medically.
Politics and ideology unrelated to actual medical facts are a significant factor at work here.
But then they put it in a slightly different form, a different name and viola.
“Ella toca el violín y él la viola.”
When my son broke his arm, we discovered he is allergic to morphine. He isn’t allergic to all narcotics, though, and took the codeine prescribed for him when he came home from getting his arm pinned.
I understand that some people in the UK and Canada who are allergic to morphine can tolerate heroin, and that’s what they get if they have end-stage cancer. G-d willing my son will never have anything like that unless he’s an old man, at which point maybe he can go to Canada. They gave him fentanyl, in the hospital with apparently no problems, so if he ever has surgery, he has that as an option.
Personally, morphine doesn’t help me with post-surgical pain as much as fentanyl does. Doesn’t get me high either. I’m one of those people with a natural resistance to getting high from narcotics. They make me sleepy if I’m already tired, but that’s about it. Benadryl makes me more warm and fuzzy than narcotics, and if I have a headache they make it worse.
Someone really needs to be working on non-narcotic pain killers stronger than NSAIDS.
Exactly
Wait, you cannot use heroin for medical use in the U.S? :eek:
When my grandmother had Terminal IV cancer, she got some, morphine was not doing anything. It was a big PITA to get the necessary clearances, but she got it, under medical supervision.
Anyone who gets heroin for pain relief is not going to be inane position to be a drug trafficker or dealer, so why the opposition to use under medical advice.
Look at the drug schedules. Seems to me the various drugs in the various categories are similar and do belong where they are. It would look odd to me if heroin was in the same category as Tylenol with codeine!
There are a number of opoids that are much stronger than heroin. The question is why is heroin in Sched 1 and the others are Sched. 2. What is it about heroin that is uniquely useless?
Absolutely. Heroin has a legitimate medical use, and is used medically in many countries (under the name diamorphine). It is not used medically in the United States, but there is nothing inherent in it that excludes its medical use in the United States other than its listing as a drug not to be thus used. The logic is therefore circular.
I read an essay a while ago (here’s a free excerpt from that article, but it’S in German - and it’s a pdf) that traces the parallel histories of heroin and aspirin (which were actually discovered by the same chemist within only ten days of his work) throughout the decades. The bottom line of the argument is that ideology played a great role in the image attached to various drugs than facts: Heroin has become the synonym for a truly diabolical drug (which was, in that case, a result of campaigning in the 1920s), but that this is not entirely justified. It has a great potential for dependence, but the adverse effects are more of a social than a medical nature.
As I said: politics and ideology.
Heroin causes extreme euphoria along with its pain-relieving actions. Other opioids don’t cause quite so much euphoria.
I’ve prescribed a wide variety of opioids in my career (and tried a lot of them during my active addiction to opioids, back before 1990). The ones which cause more euphoria are abused harder and heavier than the ones that cause less euphoria. And we’ve good opioids available to us without needing to resort to heroin.
So I have no problem with heroin being schedule I.
More euphoria than fentanyl?
I never did heroin, while I have had fentanyl. I’m told heroin is more euphoric than fentanyl, by those who have used both recreationally. I didn’t find fentanyl any more intense than IV dilaudid or morphine or demerol, myself.
If someone can make a case that heroin is significantly more effective as a whole than other opioids for certain situations where opioids are needed, I’d be on board with considering moving it to Schedule II. But I’ve not seen any compelling, scientifically-based info to that effect as of yet.
I read that in Nth stage cancer patients, those who were given heroin for pain relief at equivalent pain relief effect as morphene were found to be much more lucid.
Can you point me to that study? The studies I’ve seen (and I’ve seen a few, I oversee a hospice unit) indicate no particular consistent superiority of heroin over morphine or fentanyl or methadone for that type of situation. A drug that seems to leave one person clear-headed just leaves another one twice as muddled, quite often.
If that’s true, and if a person’s doctors can figure out which drug will work better for them, that might sometimes be an argument for prescription heroin, for some specific patients.