So basically there is a class of drugs which by themselves are pretty harmless in appropriate doses except for causing drowsiness and constipation. Overdoses can be fatal, but the same can be said of aspirin or Tylenol and other drugs in every bathroom. Some people do things like inject pills or use dirty needles to IV, but you don’t have to(like condemning all sex as dangerous because some people have unsafe sex with strangers.)
Opiates have no damaging effects on the body as far as toxicity long term, there are pain patients and methadone clinic patients who have been taking very large doses for years.
Opiates cause a physical dependency with long term use, which is not pleasant sure but with tapering and support meds most can step off with a few days of discomfort.
A small percent of any random group of people seem to be prone to addiction to opiates(I think estimates are around 1-2%) and they actually enjoy taking opiates and do not want to stop. Assuming they had easy access to a supply they would keep taking them and wouldn’t encounter much of a problem.
Is this accurate? To use an analogy there is a plant that if you eat it makes you feel weird, and if you take it continuously you will feel sick when you stop for some days. Some people enjoy the weird feeling and wish to take it always, but its taboo so this has enormous difficulties.
Now of course you never know whether you are prone to addiction or not, which is a good argument to think twice about taking opiates if you don’t need to. But if you do become addicted and there is a easy supply hey wouldn’t be much worse than the caffeine junkies lined up outside Starbucks would it?
So where did the enormous and overwhelming stigma and taboo come from?
Take it from one who knows. Opiate addiction changes people. It does not change them for the better. All else aside that’s reason enough to stay away from opiates.
I have no first-hand experience with opiates, and for all I know what I have beebn told may be exaggerated, but all I have been told would suggest that this line grossly, grossly minimizes the extreme difficulty of withdrawal, and therein lies the answer.
The OP is basically right, but since opioids are not avaliable everywhere for super cheap prices at pharmaceutical quality, it’s academic - it’s very difficult to be a succesful opioid addict because of these difficulties in supply. One is always on the edge of an abyss if the supply runs out. If governments just legalised the stuff then there would be no real problem. You can even avoid the constiptation by taking opioid agonists that act only in the gut.
Cold turkey of everything apart from methadone is not that bad, this is true (well, it’s awful, but it only lasts a few days). But that’s ignoring post-acute withdrawl symptom. Ever had restless legs, insane insomnia and no energy, and crushing depression… for three months? All the time knowing that one hit would fix it… and feel like the first time again?
I’ve taken long term, high doses of oxy and vicodin twice. I was aware that I would be addicted, as was my doc. My doc was confident that I would do what I had to to get off it when the time came. Both times I went cold turkey, and both times it was about 10 days of absolute hell.
My doc made a big deal of the fact that I was able to kick it both times. I know she was pretty stressed about prescribing it for me for so long. She has enough confidence in me now that she has made it available to me if I ever need it.
Its not the opoid that scared the shit out of her, it was all the acetominophen that comes with it that concerned her.
Former opiate addict checking in. The OP is basically right in theory however…
First, this is grossly understating the physical withdrawal effects. Second, if you could somehow become disembodied and only suffer the physical “discomfort” portion it would be more do-able but leaving out the mental state is ignoring the bigger problem.
And this is the problem.
Another problem is you are always chasing the dragon. Tolerance build up causes a need for upping the dosages to capture the same feelings of euphoria. Eventually you can’t get it at all (you will feel the effects, just not that same ‘wrapped in the warm hands of god’ feeling). I won’t say what dosage I was eventually up to but I’ll just say it was a staggering amount. This is very expensive. Prohibitively so.
IANA medical doper, but my experience with my brother-in-law’s addiction is that no, your post is not at all accurate. On one hand you’ve got the crazy demonization of opiates, with the old black and white scare anti-drug movies that we had to watch when I was little (if you even go near drugs your LIFE WILL BE RUINED FOREVER!!!) and on the other hand you’ve got things like your post which indicate that it’s no big deal and the major problem is just that society doesn’t accept it. In my experience, neither one of these extremes is accurate.
This, in my experience, is not at all accurate. Characterizing it as “few days of discomfort” is kinda like saying the Grand Canyon is a wee bit of a hole in the ground. A few days of unpleasant withdrawal can get someone off of opiates in the short term, but it doesn’t stop cravings and it is extremely difficult to keep dependent addicts off of opiates in the long term.
Ever hear of the opium dens of the 1800s? Read up on them some time. Caffeine addicts go to starbucks or hit up the coffee machine at work maybe several times a day, but they otherwise function just fine in society for the most part. So many people were getting hooked in opium dens and were no longer able to function in society that this alone was largely responsible for the ban on opiates outside of medical use.
If opiates were as harmless as the OP indicates, opium dens wouldn’t have been that big of an issue.
Opiates were widely used in the 1800s, partly because they were legal, partly because Chinese immigrants brought over the idea of opium dens, and partly because doctors had some silly notions that women needed to be medicated with things like opiates for menstrual cramps. You also had soldiers coming back from the U.S. Civil War addicted to opiates. All of this opiate use caused a lot of problems, which is what led to opiate use being severely restricted in the early 20th century. The “overwhelming stigma and taboo” (as the OP put it) comes from the problems that 19th century society had to deal with as a result of widespread opiate use. Although to be fair, there is probably a fair amount of Puritan style morality thrown into it that has always existed in this country, but really became prominent in the prohibition era.
If opiates weren’t any worse than starbucks, there wouldn’t have been all of these problems in the 1800s. How many yuppies have you heard of losing their job because they spent their entire day in starbucks and won’t go to work or do anything but drink coffee?
One of my patients was a long term heroin addict. He was a dealer, as well, which I understand is fairly odd for the heroin trade - usually developing an addiction to your product is a good way to undermine your profits. He was essentially successful at it, kept a day job, family never realized it (they thought he was an alcoholic, because he’d come home staggering and slurring, but he rarely drank more than a mouthful. He’d gargle with Jack Daniels before he went home to encourage their misconception.) and still chose to quit eventually.
Why? Cause it only feels good while you’re doing it. You feel like shit the rest of the time, and continue to feel like shit until you can do more drugs. Most people can’t afford - financially, socially or vocationally - to be high all the time, and the more you do, the more you need to do.
But I don’t think that’s why the societal fear. I think that’s got deep, perhaps unconscious racist roots, in that Opium was the “stinking Chinaman’s” drug of choice back in the day. White people’s psychoactive drugs have always been alcohol and caffeine, and all others are Bad by default.
Is opiate tolerance a cumulative thing over a long period of time? Say if you build up a tolerance then go off for a couple years, do you still need the same dosage to get the same effect, or can you go with a lower dose?
I ask because before my wife got her knee replacement, she was using Vicodin on a regular basis to control the pain. They tried to use Vicodin after the surgery but it was useless because she had built up a tolerance. So they put her on different medication, Opana (which is opiate based as well, I think), and she got addicted to that.
Now she’s off everything. But her other knee will need replacing in a few more years and I was hoping that they could use the Vicodin again.
I had a similar experience with Vicodin, which I was given each of the three times I had a kidney stone. The kidney stone episodes were separated by several years, and each time, I only took two or three Vicodins over the course of the episode.
The first time I took Vicodin, it absolutely laid me on my ass for four hours. Completely unconscious.
Two years later, with the second stone, I took Vicodin. It took away the pain, but I was able to focus, more or less, and operate as a functional person (though I wouldn’t have wanted to drive).
Three years later, on the third stone, I took a Vicodin during a painful period, and it didn’t do much of anything – the stone still hurt like a mofo. I read the prescription label, which said, “take one or two tablets for pain”. I figured, “hey, it’s Saturday morning, I’m not going anywhere, I’ll take a second one.” That took the edge off the pain, but it was still there, and I never felt particularly drowsy or spacey.
Three years ago (and 10 years after the last kidney stone), I finally had my wisdom teeth removed (at age 44). The oral surgeon was going to give me a prescription for Vicodin, and I told him, “better make it for something else…I already have a tolerance for Vicodin.”
First hand experience here and a WAG to go along with it, but…
No, in my experience, if you are addicted at a high level and quit and several years pass, a normal dosage would have the normal effect. At least physically. Psychologically, its a crap shoot.
I suppose its possible that long term use could mess with the opiod receptors in your brain, so no matter what happens you’d always need a higher dose. But I can’t really comment on that with any expertise.
Too true. When my son could no longer get them from doctors, he got them wherever he could, including stealing them from the pharmacy in the nursing home where he worked. He was arrested and fired from the job, leaving him with a wife, two children and no income. Happily, he was able to come back from all that and is still clean after four years.
Although, had they been legal, he would not have had this problem.
In truth, I don’t think that opioids really change people that much. I’m sure he wouldn’t have stolen them off a patient who was in pain. It is just that he was seeing them like a starving person saw food, and I think we all agree a waiter with no other means of eating would be ethically justified in stealing a bit of food from their employer, if there was no other option.
My experience is “family week in rehab” - which convinced me that you really don’t want to be an addict at all. After eight weeks, many of the addicts where already planing on how to get their drug of choice between the center and the airport after release, it didn’t seem “easy to kick.” And the locked rooms with howling patients going through first stages of withdrawal…yeah, “discomfort…”
Now, if you want to take the libertarian view that its their life to ruin, that’s great. But family week is a good time to recognize that mom and dad are involved when their 21 year old daughter has been selling her body to get high, or the teenage kids are involved when Mom is drunk and drives them and their friends into a tree (thank God no one was seriously hurt) to get her into rehab. And that’s what most temperance movements tend to be focused on - not the damage a person does to themselves, but the collateral damage.
Right. He would have just been a strung-out opiate junkie who was unable to function or hold a decent job that wasn’t minimum wage. He swears he never took meds intended for patients, but only sample packs from the pharmacy. Legality is meaningless when you can’t afford to buy them, by the way. So I suspect he would have resorted to shoplifting them with likely the same result.
A girl I went to school with had an opiate addiction (I say had because she’s dead) and was a nurse. She stole from work. She OD’d at work. She lost her license rather than admit she had a problem and enter rehab. She put her patients in jeopardy because she was looking for a fix.
