H - The surprising truth about heroin and addiction
reason.com
reason.com
The article also fails to mention that once addicted, and then having returned their lives to some base level where they are able to seek help (assuming they have not died of an overdose), 90% of patients that start on the methadone program are still on it 10 years later- in Australia the methadone program grows at about 4-6% per year, representing new people coming on and no-one really leaving. Not cool, and not a good lifestyle!
Those numbers for the methadone program could be purely from population growth, but then considering the state of the world its probably not entirely either. (Not that I'd know)
1. Is chronic methadone usage really that bad? It's never great to be dependent on a substance to function, but if all it takes is a trip to the methadone clinic for your daily dose, but the rest of your life is relatively normal, is that so bad considering the alternative?
2. I've heard methadone withdrawal is much worse than withdrawal from heroin. Heroin WD symptoms are very intense, but last about a week. Methadone WD symptoms aren't that intense, but they last for months. It take an impressive amount of willpower to put up with being tired, weak and "sick" for months.
with regard to 2, I don't know about methadone withdrawal being worse than heroin; worse here is perhaps relative; you are exactly spot-on regarding the aspects of both of them in terms of length - heroin withdrawal only lasts around a week, and incredibly you can't die from it, although it may feel like you will! - as an aside, the only drug you can withdraw from that can kill you is Alcohol (Delirium Tremens causing convulsions and death)
-- EDIT -- This image http://img546.imageshack.us/img546/9791/422a.jpg shows the biochemical effect of opiate withdrawal. This image shows enzyme activity levels in a specific part of the brain associated with perception of pain - Pain relief is correlated with the initial decrease in cAMP formation. However within a short period AC increases leading to cAMP returning to normal levels, and thus the return of pain; amplified by sudden withdrawal of the opiate - now AC acts uninhibited, there is a massive increase in cAMP and thus the 'pain' of withdrawal is experienced as physical pain, as real as being cut open
http://www.npr.org/blogs/money/2012/07/31/157665908/episode-...
1. Physiological dependence as evidenced by tolerance and withdrawal symptoms; and
2. Psychological addiction.
(2) can manifest itself in many ways that go well beyond drugs--gambling, adrenalin junkies, even Farmville.
The danger of some hard drugs is that they can, for some unfortunate segment of the population, be a potent mix of (1) and (2).
Further to (1) is that genes seem to play a role [1]. My personal view is that like many complex "traits", genetics will give certain people a predisposition to addiction.
The real danger of certain hard drugs (IMHO) is that you often don't you're predisposed to something until it's too late. It's almost certainly the exception rather than the norm but (I believe) you can get addicted to certain drugs very very quickly.
You may be able to use them just fine and not get addicted. Or you may not. Is it really worth the risk in case you turn into one of those people who spends the rest of their (much shortened) lives chasing that initial high?
[1]: http://learn.genetics.utah.edu/content/addiction/genetics/
Nobody is actually saying that being an alcoholic is any good at all; that's a straw man. But we do have some level of cultural accommodation to and regulation of alcohol. By now we have nearly the same level of facility in dealing with marijuana, which is also a drug of abuse which is not that hard to use safely.
But every compound is unique. Taken in the ways they are almost always taken, alcohol and marijuana are pretty mellow and easy to dose and don't have wild side effects like immediately blinding you or shutting down your lungs if you screw up slightly. But they are not the same as each other and neither is the same as datura or belladonna. Many psychoactives are blow-your-head-off powerful tools that should never be used in the casual, vacuous party-time way that our culture likes to do for the last 60 years or so. And many, it's just prudent never to use at all.
Heroin is (or was) legal for UK hospitals to use in killing pain and I believe in its usefulness for that reason. But I am not going to defend high-dose, party-time heroin use as a reasonable and prudent practice any more than I am going to defend promiscuous, unprotected sex with many HIV+ individuals (which also has a very surprisingly low per-instance probability of doing anything - yet that is exactly how it continues to spread and ruin people's lives).
In any case, saying 'alcoholism is also bad' is certainly not a reason to suppose that heroin addiction is not bad.
Really? Try doing a straw poll of everyone over the age of 50 in a British pub at the weekend, see how many of them think alcohol is addictive. Then ask how many of them drink every day.
I think you are repeating the party line boogey man mantra regarding "hard drugs", alcohol does far more harm than any other drug, so how do you draw the line for "hard"? Not based on harm, clearly, not based on lethality, but instead based on... what?
But the term 'addiction' does not correspond to any natural scientific category. Because unless it is made impossibly rare and unlike our folk concept, any definition will drag in all routine motivated behavior to the point where a lot is included which we all like and find healthy and normal.
There is no actual distinction between 'physiological dependence' and 'psychological addiction.' The relevant phenomena are all psychological and all have biological basis - just as one's behavioral responses to hunger, dehydration, embarrassment or sexual arousal do. Avoiding withdrawal might be more or less motivating depending on the drug - for example, cocaine doesn't really have much of a withdrawal compared to heroin. But the fundamental reason people use heroin isn't because of withdrawal, it's because they love it. The situation where one takes heroin simply to avoid symptoms is just not the primary mechanism of heroin addiction. And since heroin is the paradigm case for this kind of explanation, it is just generally not a good one. We have confused the different phenomenology of the cravings with a spurious major distinction between physical and ghostly causes, when we should really be considering the specific neural systems which are engaged by the different drugs.
I appreciate that what I am saying sounds controversial. If what I say is true, why do people keep talking about addiction? Because the word has an important function OUTSIDE of science - it applies a specific kind of pressure, an important feature of which is the appearance of being scientific. It is an implicit value judgement said in a scientific tone of voice, making it more legally and secularly palatable.
Addiction is nothing more than the pathologized version of desire or enjoyment. If you wish to cast shadows on anything people enjoy doing, simply call it an addiction. In particular if you wish to conflate social disapproval of an activity with a scientific judgement of unhealthiness, call the activity an addiction.
Suppose, for example, that a certain person goes to a bondage club on a weekly basis... so easy to make this into an addiction. Doing the same thing with 'normal' sex is just significantly harder. (Though still possible - in a situation where someone has an interest in pathologizing sex)
it all depends on your personality. if you can get high and be responsible you can probably cope with using in moderation. unfortunately, i imagine a majority of people are not like that. i know several friends that have very addictive personalities and getting into junk would have ruined their lives.
a lot of it depends on how its taken as well. mainlining vs snorting vs smoking are all significantly different experiences, the amount taken as well. one can function when its only a small amount taken, increase the dose and you'll be lying around not being able or wanting to move.
i've tried everything under the moon though and i consider heroin pretty dangerous. i would not advise anyone to try it unless they have a very strong head. it is also one of the most amazing experiences i have ever had. the singer of sublime thought he could jump in and get out when he wanted, he overdosed, quite a sad story.
If your life is going well and your not under a lot of stress, I could see certain people who could use heroin recreationally. Now have those same people lose their job, get divorced or have a depressive episode and watch their drug use spiral out of control. I've seen it before.
The studies cited in the article seem to challenge that assumption.
The article specifically refutes that. It cites studies that show the majority of heroin users are able to use heroin in moderation.
Also you should edit your post to make it a bit easier to read. It's quite long for just one sentence.
My response is challenging the implicit assumption in the article (and in your reply) that the moderate use of heroin is worthwhile in light of the real risks that are entailed in that use. In other words, is the high really worth the chance of becoming dependent and/or possibly dying from overdose? At what point does that risk become so suboptimal that deciding to go forward with a decision to use for the first time (when the individual cannot know for certain how he or she will react) is considered folly?
And I would try to edit that long sentence, but I cannot figure out a way to break it up without losing the intent. If only there were some symbols I could use to express the same thing mathematically in a way that would be more easily understood . . .
Oh I don't think that moderate use of heroin is worthwhile--I simply think it is possible.
I don't disagree that for most people the inherent risks of using heroin outweigh the benefits, but that doesn't preclude from believing that the risks of using heroin are still exaggerated.
For instance, I believe that it would be optimal if the majority of 10th graders didn't have sex, but I don't believe we should tell them sex will likely result in death.
Present the actual risks, not exaggerated propaganda.
I'm not sure if you're from the US, but here we have an anti drug program called D.A.R.E where police officers talk to young kids about the dangers of drugs.
The dangers presented are so ridiculously exaggerated, that when kids inevitably learn that smoking marijuana doesn't necessarily lead to death and destruction--they begin to question everything else they learned from the program. Lying in order to persuade children is almost never a good option.
i speak from experience and have seen the results of what happens to kids that mainline h. if you smoke or even ingest heroin its way way easier to do it in moderation because you don't reach the highs that shooting it produces.
most kids that shoot, try to get to a state of almost pure euphoria where your body is in pure ecstasy and you come in and out of lucid dreams. once you try that all other forms of consumption seem like a waste.
i don't believe its easy to shoot up in moderation.
But ultimately, despite the physical dependance, it was easy to quit because I wanted to. Most people that fail to get off opiates fail because they don't entirely want to get off. They may think they want off, or think the need to get off, but at some level they still want the drug, and that is the essence of addiction.
When drawing conclusions about why people have trouble getting off opiates, I'd suggest taking the same care comparing your experience to heroin addiction as you would take comparing your weird dreams to a schizophrenic's psychotic episodes.
Compare that to cigarettes. I once heard from a foreign cigarette manufacture that the cost of manufacture for a pack of cigarettes if 50 cents. A pack of cigarettes contains 20 doses of nicotine and costs around 14 dollars (in New York City, American Spirit Brand). Each dose (cigarette) costs 70 cents inflated and took only two cents to produce. Nicotine suffers from a 35 times price inflation due to legalization.
These look like two industries that are ripe for disruption.
Heroin is expensive to compensate for the high risk of government punishment at each stage of the manufacturing/retail process.
("Inflated" or "inflation" is the wrong term anyway but it makes no difference here)
its not immoral (for an entity should be allowed to price their product at any price they want to), but i want to believe that a free market _should_ control abnormally high markup, so that all produce will cost only slightly more than it takes to produce it.
Please go on— how would one disrupt these industries?
I kicked everything except cigarettes for nearly 20 years, then went back to some of them during a difficult time. I was hooked again for longer than I intended, and it was much harder to kick again when I was older. (I've been abstinent again for some years now, including cigarettes (after 30 years ... finally!!).)
The vast majority of those who experiment never become addicted. But for those who do, it is very costly, and fatal frequently enough that it is not worth the risk, at least from my minority experience perspective. There are lots of other ways to relieve stress and/or alter your consciousness.
I have a libertarian bent, and think drug laws have mostly accomplished the militarization of the police forces in America. They certainly have not reduced the availability of high-quality drugs. But that does not mean I agree with the idea that using heroin is just some harmless fun to be had from time to time. Reserve that category for things like skydiving or working out in a gym or getting a massage or writing some code.
(What's that? Writing code isn't fun, it's something you have to do? Maybe it's time for you to kick the habit then.)
Are you talking about heroin, or alcohol?
Yes, this is one anecdote. But I bet you my anecdote is a fuck load more common than that of the successful New York business man cited in the article.
You see the ones that ends up fucking up for one reason or another. You don't see the ones that manage, so you don't know whether nobody manages to deal with it, or if lots of people do.
(the other aspect of this is that his personal ruin, while facilitated by a heroin addiction, was triggered by the legal regime surrounding heroin that made it impossible for him to get at a low, predictable price; I've gradually come to believe that outlawing most drugs is ethically indefensible)
To memory-quote from a pregnancy leaflet we got a few years back:
- You should avoid drinking alcohol during pregnancy, because it can cause harm to the child's nervous system in the early stages.
- You should avoid smoking tobacco during pregnancy, because it can cause oxygen deficiency and low muscle mass in the child.
- You should avoid smoking hashish during pregnancy, because it is illegal.
I'm not exaggerating - that was literally all the evils of hashish they could list.
But still, they should at least say that. "The effects of hashish on the fetus are not well studied, and doctors heavily recommend abstinence."
There are also people who use these as a means of escape or have limited coping resources. It is not that the cigarette is bad, or the pain killer is bad, or sex is bad.
In saying that, having a methadone dispensary four doors down from where I am sitting, I see first hand the obvious effects of drug addiction and how people struggle to escape it's grasp.
This experiment was not well-received in its day, but in recent years, the line of thought is becoming popular, as people who work in drug treatment realize that the paradigm is very helpful when treating people in recovery (ie, you have to identify the reason why people feel compelled to seek external relief, be it anorexia/bullemia/marijuana/alcohol/heroin, or else you're just patching over the symptoms).
As for your last point, I'd point out that what most people don't ever see are the people who use drugs responsibly and without any problem - there's a selection bias afoot which causes society to overestimate the harms associated with drugs (and underestimate the harms of the policies associated with them, since they also never see the people locked away).
I also wonder how his control of heroin would hold should he lose his job or his wife.
Isn't the danger of such drugs in the things they whisper to your ears when you're beholding the abyss?
Would uncut, correctly dosed heroin have an effect on those?
http://www.amazon.com/Saying-Yes-Defense-Drug-Use/dp/1585422...
Maybe libertarians sometimes feel silly telling people "I know this would destroy people's lives and society would decay but it is immoral for the government to do anything about anything." I don't know why ... :)
You can argue with libertarians all you want about whether you think their proposed actions will help or hurt society, but stop acting like libertarians are monsters who don't care about the welfare of others.
>"I know this would destroy people's lives and society would decay but it is immoral for the government to do anything about anything."
You seem to have fallen for the reddit caricature of libertarians. Again you can argue with the methods, but stop acting like libertarians are heartless bastards. As a group they believe that reducing regulations and limiting government will help society.
It is a convenient ploy to pretend all these things in the article or simply make counter-intuitive statements. I think a libertarian should be more like "Oh, so heroin actually makes you more productive and a better person? Well, I don't really care but the government should stay out of it."
A true libertarian view is that the government should just stay out of it, whether it harms or not. I am not making a judgment about that basic position. I think that people that proclaim to be libertarians don't want to state their true beliefs because they know they are going to be made fun or at least not taken seriously in practical society.
The closest thing you could get to a "pure" libertarian philosophy is that libertarians are against coercion.
Whether that coercion is public or private has no bearing. You seem to have distilled libertarians beliefs down to "government bad"--a clear caricature.
Many (in my experience most) libertarians support the existence of government to provide services they believe the private sector can't--some don't. And yes, Most libertarians want to limit government and supplement it with voluntary association, but only because they believe that is what's best for mankind, not because of some irrational hatred of government.
"Government bad" is not the central tenant of libertarian philosophy, that you think it is.
But you seem to know more about what libertarians think than libertarians themselves. Let's take a look at some of your wording.
>I just actually know what libertarianism is
> I think a libertarian should be...
>A true libertarian view is...
>I think that people that proclaim to be libertarians don't want to state their true beliefs...
The beliefs that fall under the term libertarianism are so varied that libertarians themselves can't agree on a definition--How can you possibly come here and decide what is and isn't a libertarian view? Libertarian beliefs range from anarcho-capitalists to libertarian socialists. Everyone from tea party protesters to Noam Chomsky call themselves libertarians.
Libertarians haven't been able to agree on these issues for decades, so it's very kind of you to come here and clear it up so nicely.
Since this would result in a reduction in government (with the end of the War On Drugs), this is actually a Libertarian argument.
How Libertarians react to this says a lot about just how much of a caricature they are.
Why do you think provision of drugs is necessary to minimize harm?
If drugs were legal (and not heavily taxed) the prices would drop to a level that even indigent beggars could afford.
Are you saying that drugs specifically should be provided, or are you arguing that in general all basic needs should be provided?
Because if that's the case, I'm not opposed to a guaranteed minimum income of the type supported by Milton Friedman in lieu of the current welfare system.
Incidentally, I think that by guaranteeing a minimum income we would be free to remove much of the regulation that ineffectually attempts the same outcome--resulting in an overall reduction in the size and scope of government.
Sounds like no one should defend H because no one defends H.
One possible reason is that people are squeamish about needles and uncomfortable consuming drugs intravenously.
(anecdotally I would wonder about impact on lifestyle, but killing yourself with pot would be pretty tough, and expensive)
This is a big contrast from serious downers which put the happy zone right next to the off switch, and build up tolerance...
It seems to be impossible to actually overdose from the THC contained in marijuana. No one has actually managed to kill a large mammal with THC, but they have managed to kill small rodents.
Extrapolating up it seems that you might be able to obtain a lethal dose of THC by consuming somewhere between 1/3 of your body weight and 1500 lbs of marijuana (all at once).
As far as I know there's not a single death directly caused by the substance yet.
Also, nearly all "normal" tasks can be done stoned on pot but you can hardly talk when you're on heroine.
But almost none of them stop using, ever.