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I think a lot of this can be attributed to these drugs being used in a completely ad hoc manner. There's no usage guidelines on a bag of cocaine. There's no 'Active Ingredient' percentage listed. You dont know what it is. You can't compare it to another until you've had it. Any pill that's an upper is called 'molly'

Somehow the vast majority of people who take legal hard drugs such as vicodin or dilaudid, don't overdose on them. There's a culture built around taking these drugs responsibly according to their directions. We have that very strongly ingrained in our culture about alcohol. I think that same culture would develop if your cocaine came in a box from CVS with proper instructions on when you can take it and what side effects to look for.

Of course people are going to make mistakes. They are going to abuse drugs. But that is happening today. Trying to solve that by keeping the drugs away sounds like the same policies in the war on drugs that we are saying aren't working and leading to legalization

As a (former? never say never) injecting drug user of Heroin, methamphetamine, and quite a few other water soluble substances, I fully agree with the parent comment.

I never bothered getting addicted to Heroin. You have to stick to the rules: never use more than two days in a row and don’t use it consistently, if in doubt half your dose, and never use alone but always with at least one other who knows how to administer breathing assistance until paramedics arrive. Don’t take your dose at the same time as your buddy, wait to see if the first user has trouble staying conscious, 15 to 20 minutes should do it.

Edit: fixed a word

Sensible and honest advice like this saves lives

Yes! And it works in practice:

A friend overdose in my loungeroom one evening. He’d taken a lot of Valium, a little bit of a alcohol, and then half the heroin I sold him. After a 15 minute argument he took the rest of the Heroin. I tried to tell him he’d already taken some but couldn’t remember.

Anyway, he started going a bit blue: Cyanosis. Became progressively and rapidly more difficult for him to speak and stay alert.

Called the ambulance, put him in the stable side position, watched his breathing, he was ok. Ambulance arrived, started administering breathing assistance and naltrexone. They commented he required a lot of naltrexone. He came to, they took him to hospital for observation over night. I rode with him in the ambulance and sat with him in hospital for a few hours.

No long term harm. Still friends, and I like to joke he owes me his life.

Friends don’t let friends die from overdosing on opiates.

Doesn’t that show how much easier it is to overdose on heroin than alcohol?

>Somehow the vast majority of people who take legal hard drugs such as vicodin or dilaudid, don't overdose on them. There's a culture built around taking these drugs responsibly according to their directions.

And yet there are tons of addicts on those:

https://en.wikipedia.org/wiki/Opioid_epidemic

My understanding of the opioid crisis differs from what you've implied.

Typically, it starts with someone being prescribed opiates. Maybe they use them as prescribed, maybe they don't. If they don't, or they have the kind of genes or psychological issues that make it more likely for them to get hooked, they get hooked. Once they're addicted to the opiate, and discover how much cheaper heroin or fentanyl is on the street, compared to their oxy prescription, they start using them instead, upping their risk a ton.

From there it's all downhill unless the right kind of intervention happens, and the psychological issues underlying that addiction are resolved.

Because I can't edit my comment using this app:

A big contributing factor, I think, is the overprescription of opiates to treat pain when it isn't 100% necessary

I wonder how many overdoses were just suicides

My childhood best friend has been a heroin addict for perhaps a decade.

I’ve tried to help her over the years.

She tried going to an Ibogain clinic in Mexico and was sexually assaulted by a nurse while there. I paid for her to give it a second try for her and her boyfriend (also an addict) but after a few days clean they went back to their old life and relationships and couldn’t stay clean.

Her underlying trauma was sexual abuse as a teenager.

She’s spent most of her adult life living with her parents, using heroin, and committing petty crimes or doing sex work to stay high.

She told me that every time she’s OD’d, she knew she was going to and a part of her kind of took over and did more heroin than she knew she should but she just didn’t care.

She’s been brought back to life several times.

She’s still alive, so that gives me hope she might have some insight or be able to try Iboga again with a better supportive context for integration.

Her 10 year old son is going to have a lot of work to do as an adult to heal from this.

EDIT: as stated above, I belive in drug legalization with tax revenue going to Support free access to trauma healing centers for everyone along with an educational program that helps people understand the link between trauma and addiction.

> legal hard drugs such as vicodin

Isn't vicodin designed in such a way that the secondary ingredient would kill you before you'd get high on the primary one?

It does work that way but I don't know if it was intentional, acetaminophen is a very valid anti-inflammatory and (non-opiod based) painkiller.

I have no idea how Vicodin was designed; however, paracetamol (acetaminophen) wouldn't do that. It is liver toxic in higher doses, and can certainly kill your liver and you eventually, but that takes weeks.

Tylenol aka paracetamol. Take one every six hours, as directed, and you'll be fine. Take two every six hours and you die painfully over the course of the next month. 500 deaths a year in the US alone... despite basically every house in the developed world having a bottle of it in a drawer. And it doesn't even have huge black warning labels with skulls and poison symbols! Street-quality Tylenol would kill people the way street-quality fentanyl does. Probably more.

Something like 10% of users will be addicted to any given drug (less for psychedelics which can actually free people of addiction by helping release the underlying trauma). The majority of drug users of any substance are not addicts.

Overdose is most common from adulterants and from not knowing the dosage one is taking due to lack of purity information.

If your goal is to stop ODs, allowing cheap access to taxed pharma grade Drugs is your first step.

The next step is using the taxes to make access to trauma healing / education free. Trauma is the root cause of addiction, so healing frees one of the need for the addictive behavior.

Somatic based therapies, psychedelic therapy, and an environment that supports healthy living.

I work with people regularly who are able to gently walk away from addictions because they’ve healed the underlying trauma.

The benefit of this is that we will also rid ourselves of the problems we face from other addictive behaviors like sex addiction, status / money addiction, religious righteousness, etc. (See the book The Perfect Pandemic for a detailed breakdown of the various dopamine triggers we humans use).

I disagree. You can easily overdose alcohol with spirits and "pushing the tempo". Many teenagers died during stupid drinking games. If you drink "normally" it would be difficult, but that is the same with other drugs. If you stick to guidelines you should be fine. Problem with other drugs is that you don't know purity and even what's really in them, as each dealer in the chain adds something to get more weight.

On the other hand, even if you don't die right away alcohol's no slouch in the finding ways to kill you and ruining lives department.

> I cant say i've ever heard of anyone ever using heroine responsibly.

I don't think its the sort of thing people will advertise. Apparently only around 10% of users become addicts

Do you have a source for that? I recall reading it was about as addictive as nicotine which I'm sure gets well over 10% of smokers addicted.

I know a person who used Heroin occasionally. He is well and fine, was first officer on some large ship and is now finishing for masters degree which would allow him to work on land related to shipping.