# Opioid Addiction



## Milkman (Feb 2, 2006)

As I was walking up my front steps just now, my neighbor informed me that his son had just died from an opioid (fentanyl they think) overdose.

The father who is a christian minister of some sort found him in his tent while they were camping nearby.

He looked understandably shattered, thousand yard stare sort of thing.

It's shocking to me and I suppose to many who don't use these heavy stone drugs that people continue taking the drugs when they see their friends overdosing with surprising frequency all around them.

I guess it's a disease, not a crime.

The thought of one of my kids passing away from, well anything, is a nightmare.


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## BlueRocker (Jan 5, 2020)

If you're with any two of your friends, neighbours, or co-workers one of you probably has a substance abuse problem. This is not an exaggeration - take it from someone with experience.


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## guitarman2 (Aug 25, 2006)

I live with this nightmare every day of my life. My 32 year old son has been addicted to opiods about 14 years. He also suffers from schizophrenia. It breaks my heart to see him a hollow shell of what he used to be. I honestly can't believe he's lasted this long without overdosing. I know I'll get that call someday.


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## Milkman (Feb 2, 2006)

guitarman2 said:


> I live with this nightmare every day of my life. My 32 year old son has been addicted to opiods about 14 years. He also suffers from schizophrenia. It breaks my heart to see him a hollow shell of what he used to be. I honestly can't believe he's lasted this long without overdosing. I know I'll get that call someday.



Jeez I hope not. I'm sorry to hear this. It has to be a terrible burden and worry.

I use weed and derivatives pretty much daily but that's it. When I had surgery last fall they sent me home with a bottle of hydromorphone (Dilaudid). I knew how addictive that stuff is so I was really happy that I didn't have pain that made taking it necessary.

I happily returned it unopened. Tylenol was enough for me.


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## guitarman2 (Aug 25, 2006)

Milkman said:


> Jeez I hope not. I'm sorry to hear this. It has to be a terrible burden and worry.
> 
> I use weed and derivatives pretty much daily but that's it. When I had surgery last fall they sent me home with a bottle of hydromorphone (Dilaudid). I knew how addictive that stuff is so I was really happy that I didn't have pain that made taking it necessary.
> 
> I happily returned it unopened. Tylenol was enough for me.


Yes my sons addiction all started after an accident where a friend of his stupidly drove his car up on to the sidewalk running over my sons ankle. Doctors prescribed pain meds and thats how it started.


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## Ship of fools (Nov 17, 2007)

My that sucks but I get it it effects a lot more then folks know including our household. It is time for the feds to bring in a clean drug act and provide it for free as it is a medical issue and NOT a criminal one.
Here's hoping your son makes it out of this in one piece my thoughts are with you.


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## Milkman (Feb 2, 2006)

guitarman2 said:


> Yes my sons addiction all started after an accident where a friend of his stupidly drove his car up on to the sidewalk running over my sons ankle. Doctors prescribed pain meds and thats how it started.


Yup, that how it so often happens. I think it's really hard to avoid.

Knowing my nature I saw that risk and was adamant that I would not take it unless I really needed it.

I have a pretty good tolerance of pain or in other words a high pain threshold. Maybe it's a no brain = no pain thing, but for tattoos I almost fall asleep. I have dozed off in the dentist chair more than once while they worked on me (no gas, just light freezing). If it sounds like I'm boasting I'm not. It's just the way it is. I can "turn off" parts of my body in terms of what I feel to an extent, if that makes sense.

But, after surgery of course I did need some narcotics for the first few days. I didn't like them at all. That's not "high". That's fucking hammered.

I don't like being that out of control. Even booze feels too heavy for me. After they weaned me off the narcotics and onto Tylenol (four days) I remember being much more comfortable with the pain than the detached, spaced out feeling I had with the drugs.

I'm sorry you have to face this. I know all too well how it is to deal with a troubled son.


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## Milkman (Feb 2, 2006)

I just found his Obituary. He was 43 and had a son. He worked as a drywaller.


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## Sneaky (Feb 14, 2006)

I dabbled with opioids in the 80’s. Percodan, Percocet, NovahistexDH, Tussonex, etc. It was all pharmaceutical quality, not some random dude with a pill press and a bag of Fentanyl or Carfentanyl. Had fun from what I can remember, but I could tell when it started getting a grip on me and got the hell out of that scene. Switched to coke, which was another story, and literally moved across the country to get away from that. The only way I would touch opioids now is if I was ready to die.


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## Milkman (Feb 2, 2006)

I seem to remember Percocets as one of the last ones they gave me before I got off them completely. I actually got very sick off of those as I recall, but you're pretty f$%ked up after that kind of surgery so maybe I was just sick because.....

Anyway, I'm glad you survived it.


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## Strung_Out (Sep 30, 2009)

guitarman2 said:


> I live with this nightmare every day of my life. My 32 year old son has been addicted to opiods about 14 years. He also suffers from schizophrenia. It breaks my heart to see him a hollow shell of what he used to be. I honestly can't believe he's lasted this long without overdosing. I know I'll get that call someday.


This is such a heavy weight to carry. I'm truly sorry. Hopefully your son one day gets the help he needs to kick such a dangerous habit. I couldn't imagine having to live with this understanding as a father, or a friend of someone with an opiod addiction.


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## Sketchy Jeff (Jan 12, 2019)

Milkman said:


> The father ... found him in his tent while they were camping


That's got to be a tough road to travel, especially for someone whose family, work, and spirituality overlap that much

You could be a point of support for him if you're open to it. Nearby. Not too connected. At a distance from his work/faith/family knot. 

My oldest kid will move away from home in two weeks. My parents were concerned about me. I'll be concerned about him. 

j


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## sulphur (Jun 2, 2011)

A lot of people start on pharmaceuticles then the presciptions run out, turn to street drugs.

It should be treated as a health issue, not a criminal one.
The Portugal model is the best practice, yet most countries don't follow the lead.


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## Mooh (Mar 7, 2007)

I'm sorry about this. Often we care more than we're aware about our neighbours, even when we don't know them well. They are close so we feel for them by sheer proximity. This is heartbreaking stuff. I can't imagine losing a child, no matter how it happens. Drugs are places we can predict and lots of places we can't predict, or don't expect, or are blind to....and our ability to get hooked is matched by our ability to deny. 

I hope his family can find hope and peace in the face of their loss.


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## Milkman (Feb 2, 2006)

I know they had trouble with him. The cops have been next door many times for various issues. He stole to feed his habit, that sort of thing.

We tend to stick to our knitting as the saying goes. We maintain cordial and respectful relations with all of our neighbors. We don't have disputes with any of them and have lived here for twenty-five years.

But, we're not over there socially et cetera.

It's very much a live and let live neighborhood, which I would hope and think is typical.

Anyway. It happened August 2. I learned about it today.

That explains why the father has looked so shattered the last couple of times I saw him. He looked right through me.


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## mhammer (Nov 30, 2007)

Not to discount how many people become addicted and maintain an addiction to opioids via prescriptions, one of the scary things is how little fentanyl or carfentanyl it takes to have lethal effects. Those who seek to profit off the sale of such substances are partly attracted to it by virtue of that tiny physical volume, whether for smuggling or storage. Think of how much space it takes to transport $1,000,000 worth of weed, vs the same value in carfentanyl. And it's not as if those supplying or using such substances take pains to measure dosages or composition with any great precision.

This is exacerbated by the manner in which conditioned tolerance ( Conditioned tolerance in human opiate addicts - PubMed ) leads the user to assume that greater and greater amounts of the depended-upon substance are required. If you think you need "more" of something, can't measure it with any certainty or precision, and it takes very very little of it to kill you, the risks for overdose are beyond huge.


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## Milkman (Feb 2, 2006)

mhammer said:


> Not to discount how many people become addicted and maintain an addiction to opioids via prescriptions, one of the scary things is how little fentanyl or carfentanyl it takes to have lethal effects. Those who seek to profit off the sale of such substances are partly attracted to it by virtue of that tiny physical volume, whether for smuggling or storage. Think of how much space it takes to transport $1,000,000 worth of weed, vs the same value in carfentanyl. And it's not as if those supplying or using such substances take pains to measure dosages or composition with any great precision.
> 
> This is exacerbated by the manner in which conditioned tolerance ( Conditioned tolerance in human opiate addicts - PubMed ) leads the user to assume that greater and greater amounts of the depended-upon substance are required. If you think you need "more" of something, can't measure it with any certainty or precision, and it takes very very little of it to kill you, the risks for overdose are beyond huge.


Yes, I agree. These drugs are dangerously potent and the effects are easily fatal.

I remember reading somewhere back when drugs were less lethal, that LSD was one of the most powerful drugs known to man. The actual amount of LSD that constitutes a normal dose is really quite tiny.

But, you might go on a weird trip with acid. You're not likely to die. 

These synthetic opioids are not unlike the game of Russian Roulette made so famous in the Deer Hunter.


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## Ship of fools (Nov 17, 2007)

OH that wonderful drug and yes after a very short while you do need more as with any pain scripts. Eventually they just don't have the same effect so after several weeks you take an extra one to help with the pain and then several weeks later you need to take 2 extra ones to help stop the pain and after 4-6 months you need so much more that the doctor gives you even something stronger.
So at this point you might as well call yourself a junkie because you are now addicted.
Milkman I know exactly what your neighbour has gone through and it breaks my heart to know other families have to go through this with no support from any government be it city or federal and it really does take a toll on how much it costs it terms of theft/medical and all that goes with addiction and then one day there's a police officer at your door telling you that you lost a child that you have raised and loved. 
Should never happen but does far to often and it just breaks my heart when ever we loose someone younger.
guitarman2 we have not seen our son for over 8 years and his mothers heart is well you already know.


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## Milkman (Feb 2, 2006)

Ship of fools said:


> OH that wonderful drug and yes after a very short while you do need more as with any pain scripts. Eventually they just don't have the same effect so after several weeks you take an extra one to help with the pain and then several weeks later you need to take 2 extra ones to help stop the pain and after 4-6 months you need so much more that the doctor gives you even something stronger.
> So at this point you might as well call yourself a junkie because you are now addicted.
> Milkman I know exactly what your neighbour has gone through and it breaks my heart to know other families have to go through this with no support from any government be it city or federal and it really does take a toll on how much it costs it terms of theft/medical and all that goes with addiction and then one day there's a police officer at your door telling you that you lost a child that you have raised and loved.
> Should never happen but does far to often and it just breaks my heart when ever we loose someone younger.
> guitarman2 we have not seen our son for over 8 years and his mothers heart is well you already know.



I'm sorry. I seem to have exposed some painful wounds.

What a nightmare and although I'm definitely not a person of faith in the context of religion, the phrase, "there but for the grace of god..." seems close.


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## mhammer (Nov 30, 2007)

One of the aspects of conditioned drug tolerance is that the less "punctate" (i.e., distinct "on" and "off") the drug effect, the less likely a tolerance is to develop. So, substances or forms of administration of a substance, that is slow to be absorbed, and wears off equally slowly, tend to result in either very slowly developed conditioned tolerance, or else no tolerance at all. This contrasts with substances that have very clear, rapid, and almost immediate onset of effects, where conditioned tolerance develops quickly and strongly. That's why things snorted or injected are more likely to lead to a dependency than the same thing swallowed.


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## Diablo (Dec 20, 2007)

sulphur said:


> A lot of people start on pharmaceuticles then the presciptions run out, turn to street drugs.
> 
> It should be treated as a health issue, not a criminal one.
> The Portugal model is the best practice, yet most countries don't follow the lead.


a couple of months ago shortly after the pandemic effects took place, I was talking with some older relatives who, shall I say, are far more "politically entrenched" than I am....I remarked about how odd it seemed that with so many businesses forced to close, the LCBO remained open...they justified it by casually saying "...well, all the alcoholics need something for their addiction..."...and I just thought "since when do any of our governments give a shit about people with addictions, and what makes alcoholics so special?"


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## Cardamonfrost (Dec 12, 2018)

Well, I can see it both ways - criminal vs social problem. 3 weeks ago a good friend for 25 years died of overdose, he was 41. It was actually the pain meds that the doctors prescribed to combat the pain from the atrophied muscles, a side effect of his heroin addiction.

This guy was an amazing person. Caring, smart, funny the whole package. He had been busted several times for possession, been checked into the fanciest of rehabs and the lowest of rehabs.

I, like others in his family, feel that if they had actually put him in jail when he was picked up in dealers houses, he may still be alive, or at the least, there would be more time available to try and cure the addiction he had been fighting for about 10 years. I do not support safe injection, etc etc. The only way to solve it is to get rid of the drugs. Start hanging dealers. The current Federal plan to decrim some hard drugs blows my mind.

Without access, there is no abuse. Simple.

C


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## Milkman (Feb 2, 2006)

Cardamonfrost said:


> The only way to solve it is to get rid of the drugs. Start hanging dealers. The current Federal plan to decrim some hard drugs blows my mind.
> 
> Without access, there is no abuse. Simple.
> 
> C


I think that hard line approach has been tried in many countries with limited or no success.

Without access to one drug, an addict will find another.

We can't hang all the addicts.


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## Cardamonfrost (Dec 12, 2018)

Milkman said:


> I think that hard line approach has been tried in many countries with limited or no success.
> 
> Without access to one drug, an addict will find another.
> 
> We can't hang all the addicts.


 Its not the addicts fault, I said hang the dealers.
C


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## laristotle (Aug 29, 2019)




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## Milkman (Feb 2, 2006)

Cardamonfrost said:


> Its not the addicts fault, I said hang the dealers.
> C


Honestly, do you think hanging the dealers will prevent new dealers from popping up? Unless you eliminate the demand, you will never eliminate new suppliers from replacing the old.


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## tdotrob (Feb 24, 2019)

Cardamonfrost said:


> Its not the addicts fault, I said hang the dealers.
> C


You mean like Pfizer and other multi billion dollar drug pushers? The pill mill doctors that overprescribe those drugs for a quick buck and flood the streets with them? 

Hang the dealers seems like a pretty simple minded solution to very complex problem.

I feel for all those struggling or with loved ones struggling. Been there and it sucks.


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## mhammer (Nov 30, 2007)

Cardamonfrost said:


> Well, I can see it both ways - criminal vs social problem. 3 weeks ago a good friend for 25 years died of overdose, he was 41. It was actually the pain meds that the doctors prescribed to combat the pain from the atrophied muscles, a side effect of his heroin addiction.
> 
> This guy was an amazing person. Caring, smart, funny the whole package. He had been busted several times for possession, been checked into the fanciest of rehabs and the lowest of rehabs.
> 
> ...


1) This just goes to illustrate that people with drug dependencies can be lovely, caring, kind, creative people. We would do well to avoid thinking of dependent people as some sort of "other".

2) People CAN have forms of physical pain that make activities of daily living difficult if not impossible, requiring effective pain medication. And the need for "outside assistance" to control the pain is not something that will ever go away, regardless of what the substance-de-jour happens to be. 
The problem lies not in prescribing and supplying such substances, but in doing so without any guidance or monitoring. When when _knows_ that a substance entails some risk of developing dependency, you don't just write a prescription for it and the job is done. The prescribing physician is not likely trained in what to do next, so I think any prescription for an opioid ought to be accompanied by a referral to a monitoring individual who regularly checks up on you and assists in the pharmacological and psychological management of chronic pain so as to avoid dependencies developing. Their job would be to be all up in your business and ask if the current dosage is enough, let me see your bottle, and let's figure out ways to keep your dosage to a blessed minimum.

3) It's not entirely clear to me that there are "addictive personalities". There_ are_ certainly more and less impulsive people, folks whose metabolizing of certain psychoactive substances is faster and slower, and folks who are better and worse at coping with stress and discomfort. Those who are more impusive, less effective copers, and don't metabolize things quickly ARE at greater risk of developing dependencies, but "risk" is not a forgone conclusion. Context is a powerful determinant of what happens.
Jail is not, and never has been, an effective method for teaching people how to be less impulsive and cope more effectively. In some respects, simply being older when you get out can play a role, since people, as a group, do tend to become less impulsive and slightly better copers the older they get. But 3 years behind bars is unlikely to accomplish that particular mission.

4) "Rehab" and its relative success with this person or that, is a bit like being a parent. All parents say they love their kids, but that does not prevent them from doing a shitty job in how they implement that "love". Two parents can declare their love for their child the exact same amount, with one kid turning out an absolute self-centered prick with a criminal career, and the other someone who is civic-minded, generous and a delight to spend time with. It's not the fact of one's declared love or the fact that something calls itself "rehab"; it's what gets done each and every day that makes the difference. True, the person does have to want to change and improve their life, but competent rehab has to spot the weak links, assess them, seal them up, and figure out alternative strategies that will be more effective. Otherwise it's a bit like your doctor saying "I told him to take two aspirin, but it doesn't seem to be working. I'm out of ideas." Not particularly professional.

5) Is decriminalization of "hard" drugs a good strategy? Such radical changes to criminal law always need to take into account the social, historical, legal, and geopolitical context they are occurring in. Portugal did it, yes, but they are a fairly small nation (a little over 10 million compared to 14.5M for Ontario alone). Like Canada, they are bordered by only one other country (Spain), but it's a relatively short and easily monitored border. The American federal drug policy is decidedly stricter than Canada's at the moment. I don't know how Spain and Portugal compare. There is also the matter of how their respective health-care systems function. Single-payer systems are more adept at handling decriminalization than private-sector insurers.
Note that decriminalization is for possession and use only, and NOT for illegal trade in such drugs. Portugal has sympathy for you if you are hooked, but not if you have a basement meth lab. The idea of decriminalization is that those with dependencies need to have:
a) assurance of the purity and dosage of any substances they are dependent on,
b) have a safe means of taking such substances,
c) have regular monitoring of their use,
d) some form of access to rehabilitation and losing their dependency,
e) a reason NOT to turn to crime to support a habit that private-sector interests wish to exploit.
Guilt only gives someone who already feels badly about the state of their life one more reason to feel bad, and another reason to want something to take their mind off those bad feelings.
Admittedly, it is always appropriate to ask about harm-reduction programs "Am I helping this person, or am I only sustaining their behaviour and problem?" That's an entirely fair question and concern. But then, you can *never* help those who are motivated by law to keep their dependency from being discovered by others.


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## sulphur (Jun 2, 2011)

Cardamonfrost said:


> Its not the addicts fault, I said hang the dealers.
> C


So the doctors and big pharma too?

The hard line approach just drives it underground, it's been tried already to little affect.


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## Diablo (Dec 20, 2007)

I actually believe very strongly in the concept of addictive personalities and suspect that as time goes on, more evidence of a genetic component will surface, theres often patterns of it being intergenerational. but its not the only factor of course...theres also most definitely an emotional/psychological aspect to it, as we often see addictions in people who've suffered extreme trauma/stress...rape victims, war survivors, difficulty coping with loss/bereavement etc.. And yet many of us go through those things and don't fall victim to addictions. maybe that experience is what triggers the genetic component in some? chicken or egg...hard to say.

purely anecdotally, *many of the people ive know to have addictions, have multiple addictions, even simple ones, like coffee AND cigarettes, gambling and drinking, or they often swap one addiction for another....for example, in celebrities, we often see someone who previously had substance issues become obsessive with physical fitness, well beyond what the average person would do. they seem to always need to be "doing" something, and the best treatment may be to get them to move to a less self destructive addiction. Robert Downey jr, Britney Spears, Fergie come to mind.


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## mhammer (Nov 30, 2007)

Diablo said:


> I actually believe very strongly in the concept of addictive personalities and suspect that as time goes on, more evidence of a genetic component will surface, theres often patterns of it being intergenerational. but its not the only factor of course...theres also most definitely an emotional/psychological aspect to it, as we often see addictions in people who've suffered extreme trauma/stress...rape victims, war survivors, difficulty coping with loss/bereavement etc.. And yet many of us go through those things and don't fall victim to addictions. maybe that experience is what triggers the genetic component in some? chicken or egg...hard to say.
> 
> purely anecdotally, *many of the people ive know to have addictions, have multiple addictions, even simple ones, like coffee AND cigarettes, gambling and drinking, or they often swap one addiction for another....for example, in celebrities, we often see someone who previously had substance issues become obsessive with physical fitness, well beyond what the average person would do. they seem to always need to be "doing" something, and the best treatment may be to get them to move to a less self destructive addiction. Robert Downey jr, Britney Spears, Fergie come to mind.


Nah. There is certainly a heritable component to excitability, impulsiveness, and sensation-seeking (all connected to extroversion), but precious little evidence that would suggest any sort of _direct_ path to drug dependencies. A great many "celebrities" and people in the general entertainment industry have difficulties with impulse control. That's precisely why they are courted by managers and industry people. They know that individuals who can go way out on a limb or do the unexpected are appealing to audiences/consumers.

As for familial patterns, we see that better and worse coping strategies are taught to children by the grownups around them. If one's parent/s is/are shitty copers, and turn to intoxication, or lashing out, or other minimally effective strategies, that's not a particularly helpful lesson for the children in their midst. It's not unlike observing children with dyslexia in a family whose sole reading material may be the TV listing.We certainly come up with many of our _own_ coping strategies, but we don't invent every single last one of them. And we certainly learn to do dumb stuff as much as we learn to do smart stuff. Familial patterns can occur in many ways that have not the slightest chance of being heritable. For instance how on earth could denial have a heritable basis? It's something you _learn_ from those around you.

The way people have learned to cope, throughout their childhood and adulthood, is a big part of why horrible things can happen to some people and barely dent them, psychologically. One of my favourite stress theorists was a guy named Aaron Antonovsky who, unlike his North American counterparts that were studying mostly upset undergrads, studied concentration-camp survivors. As you might expect, he found about 90% were effed up 20 ways from Sunday, but a small nucleus of about 10% of survivors came through the experience relatively unscathed, and this made him curious about what distinguished that subgroup. He described the difference as stemming from what he called a "sense of coherence" ( Your Sense of Coherence ). One of the things that made the concept more appealing to me than other models of successful coping was that, where it was widely accepted that having a sense of control ("internal locus of control", to use the lingo) over things generally results in less stress, for many people the sources of stress in their lives are things they can have absolutely NO control over. This includes not only camp/genocide survivors, but victims of other trauma, people whose lives are demolished by natural disasters, war, or other catastrophes, victims of domestic abuse, those suffering terrible incurable diseases, etc. If you can't exert control, and denial is no bloody good or any better than getting wasted, what do you do? Antonovsky noted that it was the interpretation of both the past and the future that allowed his camp survivors to emerge largely intact. Other researchers who study stress and coping in later life note that older adults can and do make productive use of reminiscence, and are generally less depressed than you'd predict given all the losses they experience. Reminiscence allows the person to think "I've been through things like this, or even worse, before, and it all turned out alright, or at least not nearly as bad as I feared it would." When my mother passed away, we figured my grandmother would pass within weeks, because my mom was her favourite. But she told me "Some people never even have _any_ children. I was lucky to have eight." She made it make sense in her own mind.

Of course, that particular tool is largely unavailable to much younger persons, which is part of why they can easily find themselves stressed to the breaking point and turning to substances.

But I'll go back to my earlier point. It's not that opioids exist but that they are available for prescribed and unprescribed use without any sort of followup to guide sound use in a way so as to avoid dependency-development. If an oral surgeon gives me a couple of Tylenol 3s to manage pain, after getting 4 wisdom teeth removed, that's one thing. The pain is managed, I use up the pills, and a few days later everything is tickety-boo and I simply avoid chewing carrot sticks and popcorn. If I have a renewable prescription for a month's worth and I'm left to manage that entirely on my own, that's quite another.


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## torndownunit (May 14, 2006)

An issue that a lot of people who write off opiod addicts don't realize is that they really aren't even getting high at a point. They have to have the opioid just to not get dope sick. Being dope sick is literally hell. It's a miserable existence that no one wants, but without help they are trapped.

I am a migraine sufferer and have had migraines since I was 7. Percocet is one of the few medications I can take that both stops the pain, and allows me to be functional. I am seriously careful about abuse. There's a heavy stigma attached to it though, even the pharmacists tend to give me looks.


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## Diablo (Dec 20, 2007)

"Nah"???
That's as condescending and dismissive as "ssshhh-ing" someone. and most educated people know its something dullards do, because it actually causes people to tune out the rest of their points, thus making their arguments unpersuasive.

There's actually lots of evidence that suggests a complicated genetic role in addiction, as in many other forms of mental illness.








The Genetic Basis of Addictive Disorders







www.ncbi.nlm.nih.gov












The Genetics of Addiction - Is Addiction a Disease?







www.addictionsandrecovery.org












Is Addiction Hereditary? - Willingway


When examining whether someone is prone to substance abuse because a blood relative suffers from it, it's important to understand the full context of all contributing risk factors.




willingway.com












Genes matter in addiction


Understanding the complex interactions between the factors involved in drug abuse and addiction is critical to their effective prevention and treatment, and at least half of a person's susceptibility to drug addiction can be linked to genetic factors.




www.apa.org





but I know those weaned on the teat of some branches of psychology hate to hear it, so they cherrypick their studies. Nurture, nurture, nurture, they say.
it isn't as simple as nature vs nurture. Its usually nature + nurture. but IMO, theres a lot more nature lurking underneath than we have the ability to discover at this time, whereas the nurture stuff is pretty much all tapped out and getting kind of thin.


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## mhammer (Nov 30, 2007)

My "nah" was really a shoulder shrug. If it helps, I'll replace it with "I'd disagree with that."

I'm a contextualist, and tend to reject "nature" explanations because they tend to be both mechanistic (i.e., people are just like machines, whose behavior can be predicted like billiard balls, irrespective of their history) and quasi magical at times. Nature simply provides a physical context.within which certain outcomes, and effects of experience, are more and less likely to occur. It's always worth knowing more about what those circumstances are, but it's never a full explanation. As I noted earlier, if one metabolizes some substances faster, or possibly slower, that can alter the "context" within which drug effects can be more or less appealing to a person, and more and less punctate. For instance, we've known for years that nicotine is more noxious for females than for males. Tobacco companies got over this hurdle by designing cigarettes "for women" that were milder, in the hopes they too would become lifelong customers, just like the men who could tolerate more intense tobacco effects without feeling nauseous. But they still had to encourage women to _want_ to smoke cigarettes. You've fallen a long way, baby.

Far from cherry-picking, I tend to adopt a much wider scope, and probably a wider scope within psychology than most people in the field, simply because of how many corners of it I have been involved in, studied, or worked in. I'm fortunate in that I never got to specialize and somehow cut myself off from other subfields. Gives me a lot more flexibility in how to size up issues. When you ARE a hammer, you learn the world consists of more than nails. 

The APA is correct to note the heritability component, but again, what is "inheritted"? It certainly isn't any sort of immutable fate. It's a set of circumstances and different futures are possible within those circumstances. Does an ES-335 coax different things out of a player than a Telecaster does, because of the physical and sonic context it provides? Sure, and we'd be foolish to think such differences didn't matter. But is the guitar the music and choice of phrasing itself? Nah. That's given by the song you're playing at the moment, the venue, the amp you're working with, the pedals you may be using, whether or not you got a paper cut yesterday, how developed your callouses are, your bandmates, etc. etc. Nature never acts _in spite of _nurture but in concert with it. Good to be aware of it, at least to know what you have to work with, but it's never the last word.

If genes were "fate", there'd be no point in rehabilitation...for anything or anyone. I'm a little more hopeful than that.


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## SaucyJack (Mar 8, 2017)

I know two people who both had relatively minor operations. They were given oxy on their way out the door. They both eventually lost everything including their families. They had great jobs, nice houses and from all accounts, good kids and spouses.

Both killed themselves.


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## sulphur (Jun 2, 2011)

The family behind OxyContin pocketed $10.7 billion from Purdue Pharma. Meet the Sacklers, who built their $13 billion fortune off the controversial opioid.


Many say that OxyContin, the source of the Sackler family's enormous wealth, has fueled the US opioid crisis.




www.businessinsider.com


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## mhammer (Nov 30, 2007)

SaucyJack said:


> I know two people who both had relatively minor operations. They were given oxy on their way out the door. They both eventually lost everything including their families. They had great jobs, nice houses and from all accounts, good kids and spouses.
> 
> Both killed themselves.


They probably needed _something_ as strong and effective as oxy for pain control, because an extra-strength Advil or Aspirin wasn't going to cut it. But they *also* needed someone to monitor and guide their use of it, not just hand them a bottle and a prescription, and wish them good luck. Strong painkillers are an absolute blessing for those dealing with severe pain, but they are NOT something to be doled out or used carelessly or in unregulated fashion. Seems like several people fell down on the job. Shitty ending to that story.

My best friend through high school and university had a congenital form of skin cancer that was pretty severe and required frequent skin grafts and reconstructive facial surgery. When he passed away, he was awaiting reconstructive surgery to replace his nose and upper lip, He was prescribed some heavy duty pain-relief medication. This was the early '80s so I don't know what it was. It was strong enough that he was concerned about developing a dependency, so he cut back, and learned to live with the pain. In the meantime, an entirely different form of cancer had developed (never learned what it was, but he was a smoker). His first indication something was amiss was some lower back pain. Heating pads and such wasn't doing it, so he checked into the hospital. They opened him up, closed him up, and two weeks later he was gone. Part of what let this happen, was that he needed to control the pain from his missing nose and lip, and the discomfort from whatever was growing inside him went unnoticed, because he was managing pain in a general way (i.e., whole body), rather than locally.

Pain control is a tricky thing. We certainly can't live our lives and be there for others when we're *in* pain. But at the same time, the things we use for managing pain can be a source of danger in themselves. The Sacklers and Purdue made every effort to simply manufacture, distribute, and encourage widespread use of oxycontin. They didn't lift finger one to provide for wise, controlled, and conscientious use of it. If there was ever a poster child for "big pharma" as demon, Purdue is it.


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## torndownunit (May 14, 2006)

mhammer said:


> They probably needed _something_ as strong and effective as oxy for pain control, because an extra-strength Advil or Aspirin wasn't going to cut it. But they *also* needed someone to monitor and guide their use of it, not just hand them a bottle and a prescription, and wish them good luck. Strong painkillers are an absolute blessing for those dealing with severe pain, but they are NOT something to be doled out or used carelessly or in unregulated fashion. Seems like several people fell down on the job. Shitty ending to that story.
> 
> My best friend through high school and university had a congenital form of skin cancer that was pretty severe and required frequent skin grafts and reconstructive facial surgery. When he passed away, he was awaiting reconstructive surgery to replace his nose and upper lip, He was prescribed some heavy duty pain-relief medication. This was the early '80s so I don't know what it was. It was strong enough that he was concerned about developing a dependency, so he cut back, and learned to live with the pain. In the meantime, an entirely different form of cancer had developed (never learned what it was, but he was a smoker). His first indication something was amiss was some lower back pain. Heating pads and such wasn't doing it, so he checked into the hospital. They opened him up, closed him up, and two weeks later he was gone. Part of what let this happen, was that he needed to control the pain from his missing nose and lip, and the discomfort from whatever was growing inside him went unnoticed, because he was managing pain in a general way (i.e., whole body), rather than locally.
> 
> Pain control is a tricky thing. We certainly can't live our lives and be there for others when we're *in* pain. But at the same time, the things we use for managing pain can be a source of danger in themselves. The Sacklers and Purdue made every effort to simply manufacture, distribute, and encourage widespread use of oxycontin. They didn't lift finger one to provide for wise, controlled, and conscientious use of it. If there was ever a poster child for "big pharma" as demon, Purdue is it.


The issue with how dr's prescribe meds is a huge one. I mentioned I take Percocet for migraines. My Dr VERY closely monitors my usage. I have a friend who was in a car accident and had concussion issues. He was not only given almost 3 times the amount of pills I get for a month, he was also given Ativan with practically no instructions whatsoever other than the general instructions on the bottle. He was given no warnings about withdrawal symptoms whatsoever. So basically, he took Percocet and Ativan up to 3 times a day for almost 2 months. You can imagine what happened when he tried to stop taking both an opiate and a benzo at the same time, he was a mess. 

The meds can be a very valuable tool, and they are for someone like me. But not if a Dr doesn't give a shit about how they prescribe them.


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## Ship of fools (Nov 17, 2007)

Torndownunit oh my god he must have been completely fucked up stopping both is ( or could be ) a killer. Not sure that the doctors don't give a shit. I think its more like they them self's don't know how to control the opioids and really what to do for those that get addicted. Thats something the big parms don't talk to the doctors about, seems they give them no guidance as to how to control the dosages or anything about the after effects. 
I have had many of discussions with so many doctors about this that it makes my head spin with the lack of info given to them by the sales person who work off of percentage/salary , so of course they don't give a shit.
Its a very sad situation for many families and many loved one who have to go through this.


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## torndownunit (May 14, 2006)

Ship of fools said:


> Torndownunit oh my god he must have been completely fucked up stopping both is ( or could be ) a killer. Not sure that the doctors don't give a shit. I think its more like they them self's don't know how to control the opioids and really what to do for those that get addicted. Thats something the big parms don't talk to the doctors about, seems they give them no guidance as to how to control the dosages or anything about the after effects.
> I have had many of discussions with so many doctors about this that it makes my head spin with the lack of info given to them by the sales person who work off of percentage/salary , so of course they don't give a shit.
> Its a very sad situation for many families and many loved one who have to go through this.


It's definitely not a blanket statement about all dr's though I mistakenly worded it that way. My Dr is fantastic and super careful about researching any medication she gave me. In the case of my friend, his Dr was older and fee years from retirement at the time. He had just checked out I think. 

I don't know if you are familiar with Immovane, it's a short term sleeping aid. The same Dr who prescribed those other meds had him on that for a year! When he got a new Dr, the doctor was like 'what the hell' . Honestly, he's lucky he's either not dead or without any lasting complications. I lived with him at the time, and due to my pain history I knew all about these meds. I told him what the Dr was prescribing was crazy. So there are some good awful dr's around.


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## colchar (May 22, 2010)

Diablo said:


> a couple of months ago shortly after the pandemic effects took place, I was talking with some older relatives who, shall I say, are far more "politically entrenched" than I am....I remarked about how odd it seemed that with so many businesses forced to close, the LCBO remained open...they justified it by casually saying "...well, all the alcoholics need something for their addiction..."...and I just thought "since when do any of our governments give a shit about people with addictions, and what makes alcoholics so special?"
> View attachment 324879



That was actually one of the reasons trotted out by a provincial government (cannot remember which one).


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## colchar (May 22, 2010)

Milkman said:


> I think that hard line approach has been tried in many countries with limited or no success.


Enabling them isn't working either.


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## colchar (May 22, 2010)

mhammer said:


> My "nah" was really a shoulder shrug. If it helps, I'll replace it with "I'd disagree with that."



Experts (you know, people with actual knowledge in the field) disagree with you:


*Genes Involved in Addiction*
_
An international group of over 100 scientists used a comprehensive database to collect information on smoking and alcohol use behaviors. They measured behaviors such as age when smoking was initiated, age when smoking cessation occurred, number of cigarettes per day, and drinks per week. The scientists then cross-checked those findings with life events (like years of education); physical characteristics (like heart rate or cholesterol level); and diseases suffered (such as mental illnesses, or Type 2 diabetes). The investigators correlated those results with specific genes suspected in various types of substance use. They found that there were over 400 locations in the genome and at least 566 variants within these locations that influence smoking or alcohol use, bringing science closer to identifying clusters of genes that could play a part in addiction. The study even identified new genes and functions not expected to be important in addiction. Three of the genetic locations (identified as CUL3, PDE4B, PTGER3) mapped to all of the smoking and alcohol phenotypes measured. _

.....................................................................


_Both genetic and environmental variables contribute to the initiation of use of addictive agents and to the transition from use to addiction. Addictions are moderately to highly heritable. Family, adoption, and twin studies reveal that an individual’s risk tends to be proportional to the degree of genetic relationship to an addicted relative _










Genes and Addictions







www.ncbi.nlm.nih.gov






.....................................................................

_
Studies show that alcoholism is approximately 50 percent attributable to genetics. _






__





Genetics Of Alcoholism


Studies show that a person with a history of alcoholism within their family has a higher risk of developing alcoholism.




www.addictioncenter.com






.....................................................................

_
At least half of a person's susceptibility to drug addiction can be linked to genetic factors. Presenters at an April 8 congressional hearing outlined new research on the genetic basis for addiction and recommended ways to incorporate those findings into treatment. The hearing was organized by APA's Science Government Relations Office. _










Genes matter in addiction


Understanding the complex interactions between the factors involved in drug abuse and addiction is critical to their effective prevention and treatment, and at least half of a person's susceptibility to drug addiction can be linked to genetic factors.




www.apa.org












> The APA is correct to note the heritability component, but again, what is "inheritted"?



The genetic predisposition. That does not mean that one will become addicted, but it does make it far more likely therefore addictive personalities are a real thing despite your attempts to dismiss them.


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## colchar (May 22, 2010)

torndownunit said:


> The issue with how dr's prescribe meds is a huge one. I mentioned I take Percocet for migraines. My Dr VERY closely monitors my usage. I have a friend who was in a car accident and had concussion issues. He was not only given almost 3 times the amount of pills I get for a month, he was also given Ativan with practically no instructions whatsoever other than the general instructions on the bottle. He was given no warnings about withdrawal symptoms whatsoever.  So basically, he took Percocet and Ativan up to 3 times a day for almost 2 months. You can imagine what happened when he tried to stop taking both an opiate and a benzo at the same time, he was a mess.
> 
> The meds can be a very valuable tool, and they are for someone like me. But not if a Dr doesn't give a shit about how they prescribe them.



About five years ago I went through a bout of flesh-eating disease and nearly had to have my foot/lower leg amputated. When I finally went to the emergency room the doctor prescribed percocet, and gave me 25 of them. When I went to my family doctor (he had been on vacation prior to this), he prescribed 50 at a time. They were literally throwing the stuff at me like candy. Luckily, I was smart enough not to become addicted and actually took less than 10 of them. I didn't touch the remainder until I had hernia surgery and was in severe pain. I then took them for a couple of days before stopping again.

Someone (it might have been you) mentioned Tylenol #3 upthread and I had to laugh as my family doctor prescribes those to me 100 at a time.


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## mhammer (Nov 30, 2007)

colchar said:


> Experts (you know, people with actual knowledge in the field) disagree with you:
> 
> *Genes Involved in Addiction*
> 
> ...


Genes are *not* destiny. Once upon a time phenylketonuria (PKU, as it is known), a "congenital condition" and one of many disorders stemming from an inability to either break down certain compounds or eliminate their storage in cells, was an express route to serious cognitive deficits and a lifetime of institutionalization. Then we figured out how to regulate diet in such individuals (including labelling foods that posed risk) and the incidence of clinical deficits associated with the syndrome dropped significantly.

What is discussed by "experts" as being heritable is actually associated *risk*. That is, how often, relatively speaking A is found in conjunction with B. Causation never enters the picture, no matter which sources you cite, and no matter what those sources claim. "Attributable to" is highly speculative on the writer's part, while "linked to" and "could play a part" are more reasonable and aligned with the actual strength of the evidence. Remember, no matter how many molecular biologists we assign to such research, and no matter how many millions of dollars their lab gets in grant money to buy the equipment to zoom in on the genome, these are ALWAYS *observational *studies. In other words, we get a bunch of people, split them up into those with and without some outcome, and look at their cells. To the best of my knowledge, we do NOT, take 1000 newborns, look for this gene on this chromosome, and follow them for the next 40 years to see what happens to people with this or that genetic difference. No government could ever afford to do that, or be willing to. And knowing that these people differ from those with respect to genes A, B, and C doesn't really tell you more about what to expect and how it came to be than knowing I'm wearing a purple t-shirt at the moment tells you about what I'm going to write.

Here's something to ponder: one of the best predictors of adolescent smoking is parental smoking. My guess is it's probably because the parents can't smell how bad you stink when you come in the house, and if they weren't smokers themselves they'd scrunch up their nose and ask "What IS that gawdawful smell?" and ground the offending teen, truncating a burgeoning habit. Will their (teenager) genes be similar to their parents'? Sure. But what, in this instance, is the mechanism of taking up tobacco use? Is it genes somehow "causing" the habit, or is it the parents' behaviour providing a hospitable context for engaging in something that would be discouraged early in other children's families?

When I taught, I would regularly have to fight against the highly simplistic notions students came to class with about about how genes and heritability work. Heritability is *always* a complex multidetermined potential, and not an unavoidable directive.

These days, human genome work and neuroscience have turned into the phrenology of the 21st century, and are too often used as rhetorical devices. I certainly have great respect for the fields of genetics and molecular biology, and dearly miss my days working in the neurosciences, but the manner in which both kinds of research are pitched these days, in places outside their respective disciplines, is eerily reminiscent of the way the phrase "computer-designed" was batted around in the later '80s and early '90s; to convince people that they ought not to question the power, truthfulness, and validity of what those who "computer-designed" some service or commercial device was trying to sell you. What, you mean _computers_ were used to match me up with this prospective date? Computers were used to design this fishing lure? Say no more! SAY NO MORE!! I'm sold!

As valuable and useful as the fields may be, and as absolutely fascinating as they are, knowing something about heritability when it comes to a problem social behaviour tells me precious little about how to fix it. Does this person have certain genes frequently (and again, that's _frequently_, not always) associated with a dependency on such and such a drug? Great. Okay, NOW what do I do about it? What does the community do about it? Will making me change the colour of my t-shirt change the views I espouse here? No. It's certainly _interesting_ to know at least a little about a person's identified genetic risk, but it doesn't put me any further ahead in terms of fixing their life, and giving them and those who love them, the future that any human being deserves. If it was something as "simple" and straightforward as PKU (which ALL children are now screened for at birth), certainly understanding the molecular and cellular mechanisms of the disorder DO put me farther ahead. But social/behavioural issues operate by very different principles. Heritability tells you about as much about that as knowing the molecular structure of mahogany cells and fibres tells you about why Les Pauls sound as they do and how to make them sound even better.

When the late Nobel Laureate in Medicine Roger Sperry ( Roger Wolcott Sperry - Wikipedia ) came to our department to give a week-long series of master workshops, that I was fortunate to attend, he said something that stuck with me and has shaped my thinking. His take on reductionism was that "You don't understand the behaviour of a bouncing rubber ball by looking at the molecular structure of rubber. You understand it by looking at the level of the physics of balls." His view was that reductionism itself was no panacea or necessarily productive direction to take. You study a phenomena at the explanatory level that yields the most answers to the problems you seek to solve. And if mentalistic or social explanations do that, great. If they aren't enough, then feel free to look at lower levels and be a little more reductionistic.

I'm not saying that genes are pish-posh. I'm saying they are not the appropriate level of analysis and explanation for the social phenomenon of drug dependencies.


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## mhammer (Nov 30, 2007)

colchar said:


> About five years ago I went through a bout of flesh-eating disease and nearly had to have my foot/lower leg amputated. When I finally went to the emergency room the doctor prescribed percocet, and gave me 25 of them. When I went to my family doctor (he had been on vacation prior to this), he prescribed 50 at a time. They were literally throwing the stuff at me like candy. Luckily, I was smart enough not to become addicted and actually took less than 10 of them. I didn't touch the remainder until I had hernia surgery and was in severe pain. I then took them for a couple of days before stopping again.
> 
> Someone (it might have been you) mentioned Tylenol #3 upthread and I had to laugh as my family doctor prescribes those to me 100 at a time.


Like I said, it's a good thing that such drugs exist for pain-management in such situations. It's a bad thing that they are distributed in the unmonitored fashion they are. I'm assuming that the dispensing physician meant no harm, but it wasn't the smartest thing to do. They probably figure that a) you're a grownup and can act responsibly, and b) no point in underprescribing and obliging the patient to have to come back for another 5 and another 5, etc. In some universes this makes sense, and as far as we know, you didn't become an addict. But man oh man, that was risky on their part.

Glad your leg and foot were saved. I forget whether you actually mentioned that horrible incident at the time. Must have been a helluva scare.


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## Milkman (Feb 2, 2006)

colchar said:


> Enabling them isn't working either.


To the extent that we have enabled addicts, maybe not.

If there was a safe, regulated supply of heroin, free from fentanyl, carfentanyl and all of the other garbage the greedy dealers / distributors have always used to stomp on the drugs and rip off their users, would that not reduce the number and severity of overdoses?

Frankly, I'm not sure what the solution is, but I doubt very much that getting tough is going to do much other than make things worse.


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## sulphur (Jun 2, 2011)

People seem to forget, or not recognize that alcohol is a drug.
Are the beer stores and LCBOs enabling the drinkers?
Are Tim Hortins enabling the coffee fanatics?

If there's no safe injection site, for example, your whole city becomes an injection site.
Getting a hold on the problem saves the tax payer in the long run through healthcare and policing.

Just read up on the Portugal model, it's no joke.


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## torndownunit (May 14, 2006)

Milkman said:


> To the extent that we have enabled addicts, maybe not.
> 
> If there was a safe, regulated supply of heroin, free from fentanyl, carfentanyl and all of the other garbage the greedy dealers / distributors have always used to stomp on the drugs and rip off their users, would that not reduce the number and severity of overdoses?
> 
> Frankly, I'm not sure what the solution is, but I doubt very much that getting tough is going to do much other than make things worse.


The 'war on drugs' is completely futile. There are other countries who have accepted this. So options like you mention are the only real option. They aren't stopping drug flow, and they aren't eliminating drug addicts. Never going to happen.


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## Milkman (Feb 2, 2006)

sulphur said:


> People seem to forget, or not recognize that alcohol is a drug.
> Are the beer stores and LCBOs enabling the drinkers?
> Are Tim Hortins enabling the coffee fanatics?
> 
> ...



Yeah I think we've had a pretty shitty double standard on the alcohol front for too long.

I don't like booze. I don't like the effect it has on many people and in particular, the effect it seems to have on crowds of people. In terms of the effect on me, it's a heavy sedative.

And it has certainly been a major factor in the deaths of many people, including several of my friends.

But, it's not up to me to tell others which drug the should take for recreation or any other reason.

I also don't like the effect narcotics have, but as we all know, the way it is right now, addicts really have no way in most cases to have any knowledge of what is in the substance they are about to inject, and even if they did, they would probably have to take it anyway to avoid getting sick.


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## torndownunit (May 14, 2006)

Milkman said:


> Yeah I think we've had a pretty shitty double standard on the alcohol front for too long.
> 
> I don't like booze. I don't like the effect it has on many people and in particular, the effect it seems to have on crowds of people. In terms of the effect on me, it's a heavy sedative.
> 
> ...


Every single person in my life knows someone who has died from alcohol abuse, or has been affected by issues like drunk driving. I had family members die of abuse, and my brother was killed by a drunk driver. I even had a relative die from alcohol withdrawal. The double standard is indeed pretty ridiculous.


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## mhammer (Nov 30, 2007)

Again, I encourage folks to read up on the conditioned tolerance model of drug dependency. It is remarkable how well drug dependencies conform to all classic Pavlovian conditioning principles.

One of them is that learned/acquired/"conditioned" compensatory responses (i.e., bodily responses that counteract the drug effect so as to restore homeostasis/balance) develop over repeated administration of the drug, gradually requiring stronger and stronger dosage of whatever the drug is to achieve the desired effect. HOWEVER, what prompts the compensatory response is a relatively consistent administration "ritual". It's not the sort of thing one is necessarily _consciously_ aware of, but people *are* consciously aware that the amount they took last time didn't seem to be enough so they probably need a little more this time. Steadily increasing dosage sort of works fine as long as the drug administration ritual is fairly consistent enough to elicit the bodily compensation that counteracts the drug effects. But what addiction researchers often find is that, overdose deaths more frequently occur when the individual is administering the drug in a novel location on their body, or in a novel way, or a novel place/neighbourhood. They're taking the dosage that _conscious_ experience dictates is now required, but the circumstances and changed "ritual" do not elicit the bodily compensatory response that prompted the need for ever-higher dosages in the first place and might normally serve to reduce the physical effect of that dosage. Higher doses without adequate bodily compensation leads to overdose.

One of the virtues of safe injection sites is that not only are clean needles, drug testing/verification, and other safeguards in place, but it represents a consistent injection place and ritual that, by itself, reduces risk of overdose. Those of you in the vicinity of London, take a course from Dr. Riley Hinson at Western, who participated in some of the groundbreaking work at McMaster in the '70s and continues to study factors affecting drug-taking.

The so-called "war on drugs" has always been a rather misguided effort. That war has never really been on drug-dependency itself, but rather danced around the issue in various ways. Eliminating a drug in particular doesn't fix anything, because those who feel the need to self-medicate have a wide array of alternative substances to choose from. Some of you are likely old enough to remember the term "rubby" - a term used to refer to hopeless (and generally homeless) derelicts who had sunk to the level of drinking rubbing alcohol from the drug store, when drinkable alcohol was well beyond their budget. Those who could not afford or obtain more "ideal" substances would always opt for some substitute that posed its own risks and harms. Attempting to attack mere possession ended up penalizing scads of unfortunates and filling up the courts and jails, often in a discriminatory fashion, and costing a regrettable chunk of the federal budget. Going after providers, who stood to lose big money and were desperate because of that risk, was not only dangerous, but posed many legal dilemmas in terms of cross-border actions and "cooperation" between nations. Stopping "the pusherman" sure sounded sensible when Steppenwolf sang about it, but it didn't manage to put a dent in the problem.

The "war" should be on how to reduce and eventually stop drug dependency itself, but that has never been where government and police efforts have been directed. Approaches like that in Portugal, and to a lesser extent, the UK (where heroin addiction is considered a medical problem), seem to be working out better. I hasten to distinguish between simple decriminalization, and a dependency-reduction strategy. Certainly if no one gets arrested or fined for drug possession and use, and that's where you leave it, abuse and dependency will still surely develop, and all you do is reduce jail-occupancy. So mere decriminalization is no solution whatsoever (as we see in those instances where people were legally provided with more oxycontin than anyone probably requires). But decriminalization IS an essential part of dependency-reduction. I can't help you to get your life together and get off whatever "the stuff" is if you feel the need to hide from the law. Decriminalization, if managed properly, also reduces the market for illegal providers. But dependency-reduction, much like reducing child abuse and domestic violence, requires enormous resources, planning, and coordination, in addition to public and political will.


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## Markus 1 (Feb 1, 2019)

guitarman2 said:


> I live with this nightmare every day of my life. My 32 year old son has been addicted to opiods about 14 years. He also suffers from schizophrenia. It breaks my heart to see him a hollow shell of what he used to be. I honestly can't believe he's lasted this long without overdosing. I know I'll get that call someday.



Oh man . This is just heart breaking. I don't know you but that just choked me up


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## mhammer (Nov 30, 2007)

guitarman2 said:


> I live with this nightmare every day of my life. My 32 year old son has been addicted to opiods about 14 years. He also suffers from schizophrenia. It breaks my heart to see him a hollow shell of what he used to be. I honestly can't believe he's lasted this long without overdosing. I know I'll get that call someday.


Do the opioids stop intrusive thoughts, voices, and such for him? I'm trying to think of what the appeal of opioids would be to someone with psychosis. If it does seem to him to keep the demons away, there are other drugs that can do the same thing for him, or even do a better job, that do not pose nearly the overdose risk that opioids do. If he has had bad experiences with such drugs before, every year there are better ones out on the market that can offer him the opportunity to level out without endangering himself, not to mention more knowledge about how to manage dosage so that people get to feel their best normal.


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## Morkolo (Dec 9, 2010)

I was prescribed tramadol after knee surgery and needed the pills for pain management after the surgery. Funny enough it didn't really kill the pain so much as it calmed me down so much that it didn't bother me. But coming off those pills was worse than any hangover I've ever had in my life.


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## guitarman2 (Aug 25, 2006)

mhammer said:


> Do the opioids stop intrusive thoughts, voices, and such for him? I'm trying to think of what the appeal of opioids would be to someone with psychosis. If it does seem to him to keep the demons away, there are other drugs that can do the same thing for him, or even do a better job, that do not pose nearly the overdose risk that opioids do. If he has had bad experiences with such drugs before, every year there are better ones out on the market that can offer him the opportunity to level out without endangering himself, not to mention more knowledge about how to manage dosage so that people get to feel their best normal.


The opiod addiction stemmed from his accident. The Schizophrenia is another issue altogether. Both issues together make things very complicated. My wife and I spent many years trying to keep him on his medication for schizophrenia. It was a losing battle. He's supposed to go to the hospital once a month for shots as taking pills every day just didn't work. The schedule of the hospital and trying to get my son to go were just so hard. When this covid thing hit it was pretty much impossible.


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## mhammer (Nov 30, 2007)

guitarman2 said:


> The opiod addiction stemmed from his accident. The Schizophrenia is another issue altogether. Both issues together make things very complicated. My wife and I spent many years trying to keep him on his medication for schizophrenia. It was a losing battle. He's supposed to go to the hospital once a month for shots as taking pills every day just didn't work. The schedule of the hospital and trying to get my son to go were just so hard. When this covid thing hit it was pretty much impossible.


Jeez, what a simply awful situation. I cannot begin to imagine the torment you and your wife have gone through and are continuing to go through. I wish my sympathies were all it took to fix this, or at least give some respite. I'm saddened that they can't. When it comes to family in trouble, most folks are not deterred by "hard", "difficult", "gonna take a lot". But "helpless" is a whole other thing.


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## GuitarT (Nov 23, 2010)

I had a good friend who had an opioid addiction. He was a responsible, hard working family man who ran his own business. It started with a back injury. My guess is he relied too much on the pain killers, being self employed time off work can be financially disastrous. Over the next few years it cascaded into a downward spiral that permeated every aspect of his life and finally lead to suicide.


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## Ship of fools (Nov 17, 2007)

I also don't like the effect narcotics have, but as we all know, the way it is right now, addicts really have no way in most cases to have any knowledge of what is in the substance they are about to inject, and even if they did, they would probably have to take it anyway to avoid getting sick.
[/QUOTE]
Actually they do have a way of having their dope checked before using at the Overdose Prevention Site ( at Saint Pauls hospital ) {Program: Overdose Prevention Site } , but as you said even knowing that its loaded with other shit they still inject them self's.
There is no right way nor any wrong way its just what it is and no matter how many studies they do regarding addiction there is no way they can ever say it is this or that. Far to many variables for any one to pin point as to why subject 1 becomes addicted where as subject 2 doesn't with the same back grounds and same genes as we have seen in many identical twins one does and the other doesn't.
The same reason why subject 1 can break his addiction and subject 2 can't. I look at it as a dog chasing his tail we can really only speculate as to why.


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