Genuinely curious: this doesn't really mesh with my understanding. I think opioids are extremely addictive (more so than tobacco or even cocaine or amphetamine) and as a result it's nearly impossible to be a "casual" user (and therefore I don't ever intend to try any opioids). Is there evidence that opioids can be "moderately" used?
The actual drugs here - I’m talking pure, regulated pharmaceutical versions - are pretty benign physiologically. Constipation is about the worst of it.
The combination products (opioid plus something else) are a bit worse - but in those cases it’s the other thing (usually Tylenol) that’s actually hard on your body, especially the liver.
Although it’s much less common these days due to all the regulation, many doctors kept a up successful practices for decades while self medicating heavily.
What gets people killed are either things sold as other things (e.g. heroin laced with fentanyl, which is much stronger) or propel who quit for a while and then go right back to their old dose and OF because their tolerance is gone.
https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1360-0443....
This paper is a great read on the topic. Some suggest more than 50% of heroin users are casual users.
I wonder about the truth of this. I've done a lot of reading at places like Bluelight (for research and curiosity), and it seems there really are a lot of people who set strict guidelines for their drug use and are able to use opioids periodically without addiction.