> “My heroin use is as rational as my alcohol use”
What an incredibly dangerous idea to promote. Do not mess with opioids. You think you are in control, until you are not.
What an incredibly dangerous idea to promote. Do not mess with opioids. You think you are in control, until you are not.
Otherwise the people who inevitably will/do use, only hear and have only heard, 'don't do it to start' or get ostracized instead of getting the help they need or the education they need to know when they are overdoing it or not in control any more.
We also need more clinics and support for safely quitting or managing drugs and tools for it similar to what we have for tobacco.
Shamefully, here in Canada, some of these clinics in Vancouver are getting shut down, rather than more of them popping up, during the worst opioid crisis this country has ever seen.
These closures are a direct result of a 'don't ever do/touch drugs' policy and the stigma and ostracization that come with it.
Speaking from experience...education is better than 'don't'. I have had friends who have died from using drugs, and I have many, many friends who are regular users but not abusers - pull an insane variety of different full-time jobs. (And well!)
The huge difference between these two groups of people for me is education (for instance, preexisting mental health conditions that would be made worse by a particular substance and the knowledge to avoid it), and having a support system, etc..
It is fascinating and inspiring that someone has chosen to put themselves in the very vulnerable position of coming out about their personal use, and I believe the intention is to help remove the stigma around drug use, so education can be bettered. :)
Edit: Maybe better to say 'Drugs can be extremely harmful and addictive. If you choose to use them, please be sure you are educated, safe, and have someone nearby.'
In fact, that doesn't seem dissimilar to the surgeon general warnings on cigarette packs, anyway.
What kind of warning labels will we see on cocaine, heroin, etc - in countries where its sale will inevitably be legalized? These are the kinds of statements we should be making rather than 'just stay away from opioids.'
for existing users. We should not tempt people who would have otherwise never used them with false fantasies that they will be able to dabble and remain in control without getting addicted
Right, but this is harm-denial.
It's not nearly as addictive. It's not nearly as deadly. It's much easier to control dosage. It has modes of consumption that are non-pathological.
This is typical of the distorted anglo-saxon view of alcohol as a tool for getting flat-out drunk. This is not how most of the world relates to alcohol, nor is it a healthy relationship with it.
Honestly, this says more about you than about booze.
Strangely I know more ex-heroin addicts than ex-alcoholics, and there are way more alcoholics out there, but that's just anecdotal data I guess :)
> It's not nearly as deadly.
Maybe if you leave out all of the DUI and accidents where alcohol played a role, you'd be right, but overall alcohol causes way more damage than heroin. While David Nutt ranked heroin as more addictive than alcohol, overall he found alcohol more harmful.[0] Precisely because even though it doesn't harm one as much as heroin, it's way more likely that you harm others with alcohol.
> It's much easier to control dosage.
Actually no. Lots of things affect gastrointestinal absorption of alcohol. Just compare a few shots on empty stomach vs after a meal. Also don't get me started with the absurdly long and not always obvious list of drug interactions that alcohol has.
Heroin, assuming known purity, will work roughly the same, either snorted, smoked or injected. If you make a point about its purity, that's a consequence of its legal status. Most, if not all of the interactions are self-evident (other CNS depressants).
> It has modes of consumption that are non-pathological.
I guess you have preconceptions about what heroin use implies. How is unwinding after work a pathological use of heroin vs whiskey?
> Honestly, this says more about you than about booze.
Ah, ad hominem to finish, a classic.
Indeed it is! You conveniently ignore all alcohol consumers except the ones with dependency problems.
>Actually no.
Actually, yes! You're arguing that there is variance in absorbtion, and you are right. That is different, however, from e.g. the LD50 or the ability of people to measure dosage accurately.
>I guess you have preconceptions about what heroin use implies.
You're conveniently ignoring that non-pathological use of heroin is extremely small. It's a rounding error when compared to alcohol usage. You are cherry-picking.
> Strangely I know more ex-heroin addicts than ex-alcoholics, and there are way more alcoholics out there, but that's just anecdotal data I guess :)
Good thing this has been formally studied
>Maybe if you leave out all of the DUI and accidents where alcohol played a role, you'd be right [...]
Yes, and people with pools in their back-yards experience more drowning. Color me surprised.
You're also leaving out all the incidental damage from heroin use in your analysis. Shall we factor in drug-related murders? How about secondary complications like pneumonia?
Again, cherry-picking.
>Ah, ad hominem to finish, a classic.
An observation, actually. I've rarely seen this level of bad-faith argumentation.
Actually a significant part of alcohol users have dependency problems, roughly 10% as someone already mentioned.
> Actually, yes! You're arguing that there is variance in absorbtion, and you are right. That is different, however, from e.g. the LD50 or the ability of people to measure dosage accurately.
So... no? Unless you ignore all that I said, that is. Active to LD50 ratio for alcohol it's 0.1, for heroin it's 0.17, in the same ballpark. When you factor in the variability of oral administration, alcohol is way more dangerous. Most overdoses in heroin are due to fentanyl or changes in purity; in case of alcohol it's due to wanting to get drunk fast, and doing it too fast (plus interactions).
> You're also leaving out all the incidental damage from heroin use in your analysis.
There is a lot of it, it's just that alcohol is bigger. People on heroin don't usually go driving or picking up fights, they're usually just lying on the couch.
> Shall we factor in drug-related murders?
I wouldn't factor anything external to the use/abuse of the substance, like its legal status. It'd be interesting to compare them with roughly 25% of vehicle deaths that can be attributed to alcohol.
> How about secondary complications like pneumonia?
Which was already accounted for in Nutt's analysis.
> An observation, actually. I've rarely seen this level of bad-faith argumentation.
I could say the same, it feels like you have a horse in this race, pun intended.
You should also examine the proportion of heroin "users" who become abusers. You should then do the same comparison for alcohol use.
I'm willing to entertain the notion that the risks of heroin are overblown. I'm even willing to believe it. What seems entirely unsupported by evidence is the notion that alcohol and heroin are in remotely the same league.
That's an orthogonal concern. That being said, I don't understand your reasoning.
Firstly, this is opioid abuse. Granted, the responsibility for this abuse falls on the prescriber rather than the user, but it is nevertheless a pathological pattern of use.
Secondly, you've substituted "heroin" for "pharmaceutical-grade opiates" in your argument. The irony is that this supports my position more than yours because it demonstrates that the slope is particularly slippery, even with medical-grade opioids. This point bears repeating: the addictive and toxicological potential of opioid medicine is greater than alcohol. The trend is even less in your favor when we return to the topic at hand: heroin.
I share your concern about opioid-based medication, but this argues against your point.
Doctors are rationally ok with such prescriptions because the effects are not as bad as alcohol.
Simply put: opiate abusers and users don't need liver transplants or get such severe brain damage; alcohol is more damaging in a myriad of ways for both uses and abusers. There is plenty of data supporting this, and it is valid to use data regarding medical grade opiates.
The risks of heroin are almost entirely side-effects of the war on drugs rather than the drug itself.