Prescription Painkillers Seen as a Gateway to Heroin (NYT)

[jsr]

http://www.nytimes.com/2014/02/11/health/prescription-painkillers-seen-as-a-gateway-to-heroin.html

Prescription Painkillers Seen as a Gateway to Heroin
By BENEDICT CAREY | FEB. 10, 2014

The life of a heroin addict is not the same as it was 20 years ago, and the biggest reason is what some doctors call “heroin lite”: prescription opiates. These medications are more available than ever, and reliably whet an appetite that, once formed, never entirely fades.

Details are still emerging about the last days of Philip Seymour Hoffman, the actor who died last week at 46 of an apparent heroin overdose. Yet Mr. Hoffman’s case, despite its uncertainties, highlights some new truths about addiction and several long-known risks for overdose.

The actor, who quit heroin more than 20 years ago, reportedly struggled to break a prescription painkiller habit last year. Experts in addiction say that the use of medications like Vicodin, OxyContin and Oxycodone — all opiates like heroin — has altered the landscape of addiction and relapse, in ways that affect both current users and former ones.

“The old-school user, pre-1990s, mostly used just heroin, and if there was none around, went through withdrawal,” said Stephen E. Lankenau, a sociologist at Drexel University who has surveyed young addicts. Today, he said, “users switch back and forth, to pills then back to heroin when it’s available, and back again. The two have become integrated.”

[Rex]

1. But but but...POT!!! POT!!! POT!!!!

It is harder to smell prescription drugs in a car when the cops pull you over.

[joeybee12]

3. Beat me to it!

That's been the mantra for years...pot leads to cocaine and heroin...bs, but say it enough, sheep believe it.

[Comrade Grumpy]

2. Duh.

[Warpy]

4. Only for people who buy them illegally and use them for fun

People who are in pain don't abuse them. People in pain just want to function normally, not sleep their lives away.

Articles like this one don't distinguish between the two groups.

In any case, interdiction and incarceration aimed at stopping heroin addiction haven't worked. All it's gotten us is more heroin.

[Warren DeMontague]

11. Personally, I'd rather have doctors vigorously manage the pain of people who need it

than have people suffer because of the danger that someone might catch an unauthorized buzz.

If the choice is between some prescription drug abuse and under-management of chronic pain, I'll take the chance the there will be abuse.

Far more sane than the situation we have now, where we throw people like Richard Paey in prison for 25 years for managing his own spinal pain, because some authoritarian fuckwit decided that the guy with crippling pain in the wheelchair took "too many pills".

[TheFrenchRazor]

15. word. nt

[RedCappedBandit]

5. Well duh. OCs are basically the same thing. nt

[TeeYiYi]

6. Pot for pain...

I think most people who take pain pills are legitimately in pain. I also know 'somehow' that pot helps to alleviate pain.

I believe that if pot were legalized in all 50 states, there would be a decrease in opiate/heroin addiction.

To clarify: I think if pot were legal, people would turn to pot instead of heroin in cases where they run out of pain pills; and/or use pot to manage their pain along with the pills.

TYY

[RainDog]

7. I think "gateway" is misleading.

Because the reality is that the DEA has been targeting prescription drug abuse, so those who cannot access prescription drugs who are hooked on them will switch to heroin - which is cheaper than the prescription anyway.

It indicates to me that addicts are going to use as long as they are addicts. What they use will depend upon availability and their ability to pay.

[Warren DeMontague]

9. Yeah, and then the DEA can switch over to the "heroin crisis"

until it's time to change the channel back to prescription drugs again.

There is a lot of turf to protect, a large gravy train that needs to be defended.

All the while hoping that no one notices that the majority of their budget still goes towards fighting pot smoking.

[RainDog]

10. yeah. same as it ever was

people who think they are going to stop drug abuse in a relatively free society are hallucinating pink elephants.

How to make a society that makes drug abuse less likely is the real issue - that no one wants to address b/c it would mean taxing the rich and re-allocating money toward improving quality of life for everyone.

[Warren DeMontague]

12. I think I've brought that point up re: meth, or at least someone has.

A lot of the folks involved in the "meth epidemic" aren't doing this crap because they're having a woo-hoo fun time, they're doing it to manage 3 minimum wage jobs with a relatively cheap energy boost.

And I suspect it works, for a little while- until they go nuts with paranoia, their teeth fall out, and their life goes to shit.

[RainDog]

13. Yes.

While Wall Street still prefers cocaine...

[hunter]

8. U.S.A. is AWESOME!!!

What other nation has the smarts to turn a public health problem into an unwinnable perpetual war?

I mean with armored vehicles, big money, shooting, blood in the streets, dead bodies in plastic bags, and everything!!!

WOO!!!! WOO!!!! U.S.A.!!!!!! U.S.A.!!!!

[brewens]

14. I've been on hydrocodone twice for weeks at a time for knee surgeries. I liked the stuff

and I'm not opposed to abusing drugs at all. The first thing I learned was that the stuff wouldn't really let me sleep well. That was when the plan formed. Since I couldn't sleep anyway, stop the dosage at night as soon as I could possibly gut it out, using ice to keep it numb and get as much sleep as I could. That also had the benefit of allowing a somewhat normal bowell movement in the morning which was another side effect I didn't enjoy.

So now I had extra pills to take to get a nice buzz during the day! I was also told to break them in half or chunk them up even more to defeat the time-release. I can't say for sure that enhanced anything. I really enjoyed it!! Then came the day they cut me off. Though I think I could have whined about the pain and got one more refill maybe, I knew better both times. My doctor anyway has the timing down about right. The next day or so, I didn't feel so good. Kind of like flue symptoms I'd say. I went so far as to inquire where to get some illegally and found out it would be $2.50 per pill if I remember right but never bought any. I'm glad I didn't. I sure went through the weed though for awhile!

I've also heard it's not unusual for pill heads and heroin addicts to switch to meth. Maybe the meth high helps defeat the withdrawal from opiates? Not recommended I'm sure.