Opioid/heroin crisis?

[Beagle333]

I agree with MaryB, some people just have more addictive traits than others. I take opioids for acute pain (Tramodol and Percodan), and have done so for years. I take breaks so that it doesn't lose effectiveness and I don't take more now than when I started. My pain management doc watches my doses and my refills so that he'd also know if I was using more than he wanted me to. I have no problems keeping my doses low and do not have any withdrawals during my breaks in dosage. I don't feel that I am a threat to become addicted, nor to move to any stronger drugs, especially any unregulated and questionable potency street drugs. My pain is acute, not chronic, which means that it flares up fast and strong and it needs a drug that reacts the same way. So moving to a daily regimented dosage of a non-narcotic is not a good treatment option. I don't need pain meds when I'm not in a wave of bad pain, so the opioids are wonderful in their fast action for acute pain. I agree that it's not for everybody, because some can't take it that way without going too far, but don't ban it for people who are able to use it with supervision and moderation, as sometimes it is their only relief option from pain so severe that most cannot comprehend.

[jimlj]

I think opioids are over prescribed.
I had a hernia operation 4 weeks ago. The doctor gave me a prescription for Percocet. The directions said to take 1 or 2 pills every 6 hours for pain as needed. I ended up taking 3 pills the first day, 3 the next and 2 the following day. The prescription was for 45 pills.
I think the prescription should have been for 10 pills with a refill if needed. I think it should be made a bit harder to have these drugs in front of you. I know if I had needed more, the thought of driving across town and waiting in line at the pharmacy would have made me wonder if the pain was bad enough for the trouble.

[Thundarstick]

Hit the nail on the head!

[Battis]

Blaming a Dr for prescribing too many pills is like blaming Budweiser for putting too many bottles of beer in a six pack, or blaming Lays for putting too many chips in a bag, or blaming Winchester for putting too many cartridges in a box. Don't need them, then don't use them.
It comes down to individual responsibility. I was taking Percocet during radiation treatment (35 sessions). I hear stories of all these tough guys that don't need the pain pills but I challenge anyone to attempt the radiation treatment that I went through without opioids. No one can do it.
When the treatments ended, and the pain lessened, I cut back, then quit the pills.
Heroin is another story. The first time you use heroin, you're a criminal. The next time, you're an addict. As far as I know, in the past century, heroin has never been prescribed for pain, therefore it's all on the user.

[Nobade]

Blaming a Dr for prescribing too many pills is like blaming Budweiser for putting too many bottles of beer in a six pack, or blaming Lays for putting too many chips in a bag, or blaming Winchester for putting too many cartridges in a box. Don't need them, then don't use them.
It comes down to individual responsibility. I was taking Percocet during radiation treatment (35 sessions). I hear stories of all these tough guys that don't need the pain pills but I challenge anyone to attempt the radiation treatment that I went through without opioids. No one can do it.
When the treatments ended, and the pain lessened, I cut back, then quit the pills.
Heroin is another story. The first time you use heroin, you're a criminal. The next time, you're an addict. As far as I know, in the past century, heroin has never been prescribed for pain, therefore it's all on the user.

Better check your sources. Morphine Hydrochloride is routinely used in hospitals for pain control. It's street name is heroin.

[Nobade]

As for blaming doctors, many are to blame. When you have 100 times the number of prescriptions written than the number of residents of a county, the doctor is a problem. There are numerous places in WV, VA, KY, TN, and other states where this is the case. When you have every single resident of a town high at the same time, every day, there is a problem. Oxy contin isn't called hillbilly heroin for no reason.

[RPRNY]

Every place that has legalized marijuana has seen opiate prescriptions and deaths from overdose drop considerably. People are switching to it for pain relief.

Going to have to ask for some substantiation for this claim because the chemistry simply isn’t there. The addictive properties of opioids simply do not allow for someone addicted to switch to or substitute canbabids. The chemical properties of the latter simply do not operate in the same way as the former. So, if the suggestion is that legalizing marijuana leads to opioid addicts switching to cannabids, physiology contradicts this.

[Battis]

OK, I'm not a doctor, though I played one on TV (No, I didn't). I think you know what I was getting at - illegal heroin has not been prescribed for pain. Filling a legal prescription for Percocet is not the same as seeking out heroin on the street.
And, from what I've read quickly online, there is a difference between morphine and street heroin:

https://www.therecoveryvillage.com/h...-and-morphine/
There are many similarities between heroin and morphine, but differences as well. One of the biggest differences between heroin and morphine is the fact that heroin is three times more potent than morphine, which can be shocking if you’ve ever been on morphine and see how powerful it is. Heroin, along with being three times more potent, is also semi-synthetic. Heroin is made when morphine is combined with chemical substances. There are also differences in how heroin and morphine are administered. Heroin is primarily injected, and it doesn’t have any medical uses in the U.S., while morphine is currently usually given as a pill or a suppository. Another one of the differences between heroin and morphine relates to how quickly they reach the brain. Both heroin and morphine can pass the blood-brain barrier, but heroin does it more quickly, and once it reaches the brain it’s converted to morphine. Generally, the more fast-acting a drug is, the more addictive it also is.With heroin and morphine, it’s also easier and cheaper to get heroin in most cases. The market is flooded with heroin, and much of it is poor quality or mixed with dangerous ingredients, while morphine is closely regulated, making it much less accessible.

"When you have every single resident of a town high at the same time, every day, there is a problem."
Again, personal choice. Were they force fed the drugs?

[Nobade]

I agree, it doesn't make sense on the surface. But every study I have read says the same thing, as do the FBI's published stats.

Going to have to ask for some substantiation for this claim because the chemistry simply isn’t there. The addictive properties of opioids simply do not allow for someone addicted to switch to or substitute canbabids. The chemical properties of the latter simply do not operate in the same way as the former. So, if the suggestion is that legalizing marijuana leads to opioid addicts switching to cannabids, physiology contradicts this.

[dragon813gt]

So, if the suggestion is that legalizing marijuana leads to opioid addicts switching to cannabids, physiology contradicts this.

I can tell you this is what my Mother is in the process of doing. She had botched surgery years ago and is in chronic pain. She’s tapered down her pills as much as she can physically handle. Technically she’s not addicted to them. She doesn’t want to take them anymore and cannabis was recently legalized for medical use. So she’s going to switch to see if cannabis helps for chronic pain.

Prescribing cannabis first for chronic pain has the potential to prevent people from ever becoming addicted to opioids. I can’t say I see addicts switching. Everyone’s body chemistry is different so what works for one may not work for another. Maybe if Ibogaine treatments were legal here we could drastically reduce the number of addicts? But that’s a different discussion.

[popper]

http://www.dailymail.co.uk/health/ar...tolerance.html
Interesting. Also interesting that of 260 ER patients, 27% are MJ users, additional 10% are hard drug users. Goes along pretty good with CDC numbers of 44% of drivers are hard users. Not going to change those numbers by ($1B) gov. advertising, like they did to RJ Reynolds. Yes, smoking is down in the US, due to the HIGH tax, not any ads or counseling.

[AggieEE]

About 10+ years ago my gallbladder wanted a divorce. Had a gall stone blocking the bile duct so I stayed in the hospital during that time. I was there a week and don't remember much of that week. I don't know what they gave me but my mom said I was awake and talking to the docs, can't prove it by me. After surgery, had some pretty intense pain. Got an injection a time or two then they started asking what pain level I was at. I gave them an honest answer and they were low balling me on the meds. Not giving me enough to work. Seeing how they played if I was a 7 I said 8 just to stay pretty much pain free. I did notice that pains that I would normally ignore I couldn't. When I went home had a script for pain killers, hydrocodone I think, anyway took one said I don't need this and didn't take any more. After about a week I started feeling like I'd been drunk. No headache or nausea just dead tired. My bp also headed for the basement. Got off of my bp meds for a while and started feeling better. I was off my meds for about a month and it was wonderful, bp started back up so back on the meds. Lost at least 10 pounds, that came back, in that week not that I would recommend that as a weight loss program.

[smokeywolf]

I agree with MaryB, some people just have more addictive traits than others. I take opioids for acute pain (Tramodol and Percodan), and have done so for years. I take breaks so that it doesn't lose effectiveness and I don't take more now than when I started. My pain management doc watches my doses and my refills so that he'd also know if I was using more than he wanted me to. I have no problems keeping my doses low and do not have any withdrawals during my breaks in dosage. I don't feel that I am a threat to become addicted, nor to move to any stronger drugs, especially any unregulated and questionable potency street drugs. My pain is acute, not chronic, which means that it flares up fast and strong and it needs a drug that reacts the same way. So moving to a daily regimented dosage of a non-narcotic is not a good treatment option. I don't need pain meds when I'm not in a wave of bad pain, so the opioids are wonderful in their fast action for acute pain. I agree that it's not for everybody, because some can't take it that way without going too far, but don't ban it for people who are able to use it with supervision and moderation, as sometimes it is their only relief option from pain so severe that most cannot comprehend.

Had to give Timber (my avatar) a Tramodol this morning, in addition to his Carprofen, for his joint pain in his left shoulder from his bone cancer.

[RPRNY]

It seems perfectly logical to me that if cannabids are the first port of call for treatment, rather than opioids, that will, over time, profoundly reduce opioid addiction, and is certainly a desirable outcome. As far as I know, while habituation can occur with marijuana and other cannabids (and so many other things ) there is no evidence of cannabids creating clinical addiction. My point is that if one is clinically addicted to opioids, substituting them with cannabids will not “unhook” the addict from the opioids.

[Mytmousemalibu]

I disagree, I have been using narcotic pain meds since 2007... mostly self managed minimal dose that lets be get moving for the day. 11 years, no upping the dose(in fact I have been lowering it!)... it depends on the person. Some people have personalities that let them become addicted easily.

Word for word, I couldn't say it better. Im in the same boat as Mary and MrWolf. My back is a train wreck and I depend on a pain med to manage my pain. Im 35 now and been in this boat since I was 20. The will power and self restraint or lack of has a lot to do with the problems surrounding opioid drugs. Some people don't have any or enough self control. I am not addicted nor an addict, I am disabled and dependent. There IS a BIG difference. If this is the boat in which you float, don't let anyone tell you otherwise. If you aren't in this lot then you don't understand. Please don't paint all of us with the same brush. I can't argue that the US has a prescription drug problem but understand it is a people problem with a certain group of people who abuse the means of the well to do folks. Same argument of the anti gunners. I'm tired of the circus act shoved down our throats because of the reckless abandonment of the abusers. Again a familiar tune.

[Silvercreek Farmer]

Silvercreek Farmer, if you're still imbibing regularly or even semi-regularly you should consult with your doctor about switching from Tylenol to ibuprofen.

Good point. Ibuprofen is my usual go to for aches and pains. I probably average 2 tablets a week unless something is injured or I am sick. Just added Tylenol to the ibuprophen post surgery (per the doctor), and I dried out before and after surgery. Even after surgery, I've only used less than half the maximum dose of either. No reason to go complicating things with stomach or liver issues! I really could have used the opiates the last few days (and probably should have), but toughed it out and things are much better now!

[smokeywolf]

I would venture to guess that most of those anti-opiate, lets ban opiates crowd, have never suffered from long term extreme pain. Just as opiates can mess up your mind, pain will eventually make you either crazy or terribly depressed.

I use the opiates when I absolutely have to. Don't like the feeling or the constipation.

Silvercreek Farmer, Tylenol is processed by the liver. Ibuprofen is processed by the kidneys. Be sure and don't consume alcohol when taking acetaminophen (Tylenol).

[Idaho45guy]

I'm extremely fortunate in that I'm still very healthy and have never had to deal with that sort of chronic pain.

I did have a pilonidal cyst removed in my 20's and the doc prescribed me Tylenol 3 and Demerol.

Both worked pretty well, but the Tylenol 3 gave me a headache, ironically, and the Demerol made me feel very, very happy and peaceful. Wonderful feeling. I can understand why people get hooked on it.

[MaryB]

I would venture to guess that most of those anti-opiate, lets ban opiates crowd, have never suffered from long term extreme pain. Just as opiates can mess up your mind, pain will eventually make you either crazy or terribly depressed.

I use the opiates when I absolutely have to. Don't like the feeling or the constipation.

Silvercreek Farmer, Tylenol is processed by the liver. Ibuprofen is processed by the kidneys. Be sure and don't consume alcohol when taking acetaminophen (Tylenol).

And long term use of either is VERY bad for your liver or kidneys! Percocet has acetaminophen and that is why I cut way back on it...

[Traffer]

I disagree, I have been using narcotic pain meds since 2007... mostly self managed minimal dose that lets be get moving for the day. 11 years, no upping the dose(in fact I have been lowering it!)... it depends on the person. Some people have personalities that let them become addicted easily.

I started taking pain medication on a regular basis when I got married 14 years ago. I have been in constant chronic pain since 1985. Before getting married, I would moan scream and cry out to God sometimes all night. I learned to sleep through it from sheer exhaustion. I had room mates in a fairly sound proof house back in the 90's. I learned to close the windows so as to not wake the neighbors with my moaning. But my roommates could hear. Several times I had one of them comment "had a rough night last night huh?" My reply was, "was I moaning"? "Oh yeah, you woke us all up". they said. I wasn't even aware of it....slept right through it.
So when I got married my new wife was freaking out (even though she was aware of my pain situation). It was far too stressful for her, so I agreed to go on pain medication. First it was vicodin...which worked well enough that I didn't make noise and mess up her life. But then we moved from Florida to Wisconsin and the first doctor we saw told me that he had to sign a statement that he would not prescribe narcotics for long term situations, so no more vicodin. He referred me to a pain clinic. The doc there said "Vicodin has had so much bad press lately that they won't let me prescribe it. We went through the exam stuff and he prescribed time release Morphine AND oxycodone for break out pain.
It has been about 7 years now on morphine and oxycodone. I recently had a bout with cancer. Had to have a kidney removed. Because my guts were slowed down so much by the opioids, I almost died with complications from CONSTIPATION. I was forced to try and go off of the opioids. I shucked oxycodone easy enough. But now it has been about 5 months that I have been trying to rid myself of Morphine. It is harder than I imagined. I need something for the pain. The pain is off the charts. Especially when I lay down to sleep. I may sleep for about 10 minutes then wake up screaming ...you see I can block the pain as long as I can concentrate but as soon as I let my guard down to sleep ...BANG the idea of sleep becomes a ridiculous notion. The only time I sleep is when I get so delirious I pass out. And that is usually sitting up.
But I have cut down morphine from 30mg twice a day to 30 in the evening and 15 during the day. I will quit the stuff ...and that is by God.