Comment by nullymcnull | Hacker News Reader

Comment by nullymcnull | Hacker News Reader

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There were a number of annoying factual inaccuracies in the article, particular with respect to heroin:

> ..time-killing properties of opium or heroin, but with none of the likelihood of it stopping his heart

Opiates do not stop your heart. The notion that every single usage of opium or heroin is like a game of russian roulette, that might stop your heart, is fantasy. Opiates are actually quite safe, as drugs go. It's not until you take far too much or mix them that you are screwed. And that's true of any opiate, prescription or otherwise.

> Heroin kills, and OxyContin, unless badly mishandled, does not.

Basically not true; injected oxy requires no more 'mishandling' than heroin to kill. Both will happily shut down your respiratory system and kill you if you administer too much. Of course one could argue that the pharma is of a consistent manufacture and dosage, whereas one batch of too-strong street opiates could kill someone used to weaker stuff, but the author of this piece seems far too clueless about the subject to be making such distinctions.

Then we have comparison of marijuana's 'addictiveness' to that of opiates. The difference between psychological dependence and physical dependence is one of kind, not degree.

Injected OxyContin is worse, actually. Being 2/3rds the strength of heroin, but being in pill form, means you're running the gauntlet with talcosis, and causing other terrible and fatal medical conditions due to the nature of what is put in the pills themselves.

Heroin and pure opiates are actually "safe" as far as drugs go. I'm clean, and even when addicted held down good jobs, earning good money, and no-one was the wiser. My vitals are still perfect to this day.

It's the addiction that gets you, unfortunately.

As a child I was once in a english class for people in rehab from heroin. This was Spain in the early 90s and most of them had been addicts fOr more than 10 years. They were definitely affected neurologically, they were like a bit in slow motion and could disengage from their sorroundings quite easily. They were in the last part of the therapy, almost ready to go home, but I can't tell if that was an effect of a substitution therapy( at the time it was methadone), or they had a permanent cognitive damage.

Methadone, at least in my experience, really does "zombify" you. It has really pronounced CNS depressant effects. It's basically no different from Heroin in how it affects your state of mind: that's why I personally chose Suboxone as my ORT drug.

I've done high-level cognitive activities like programming for 5 years of methadone therapy with little to no problems. I took the GRE on methadone therapy and did better than when I was on no opiates 10+ years ago. Used properly, methadone's side effects can be minimized to almost none in most patients. I tend to get sleepy after lunch, but I honestly can't tell if that's the methadone.

Most of the "zombified" methadone users are way overmedicated, usually because this is the state they are seeking.

  > Most of the "zombified" methadone users are way overmedicated, usually because this is the state they are seeking.

I agree entirely :)

> Opiates do not stop your heart. The notion that every single usage of opium or heroin is like a game of russian roulette, that might stop your heart, is fantasy. Opiates are actually quite safe, as drugs go.

They, in large doses, stop your breathing which is close enough and will kill you (like you later said), unlike, say a benzodiazepine which you can take to your hearts content and will just knock you out senseless without killing you (unless you add alcohol or another GABA receptor drug).

They also can send you into a hypotensive crisis if you're hypovolemic, which also will kill you. So I would really be hesistant to call them "quite safe, as drugs go" because they are definitely on the dangerous spectrum. We could list a ton of drugs I'd rank higher on the safety spectrum than opioids in terms of both short and long-term effects, with opioids only "redeeming" quality being their instant reverse agent (naloxone) or partial reverse agents (pentazocine or buprenorphine).

Did you read the quoted sentence before replying? I'm not unaware that the consequences of high doses are respiratory shutdown and death.

All I'm trying to get across is that taking a moderate dose of an opiate is exceedingly unlikely to suddenly kill the naive user, as the article suggests - less so than with say, coke or meth, which can interact poorly with a wider range of health conditions and other substances.

None of which is to say that I endorse the use of opiates or recommend them. I am generally all for responsible drug use, but nearly everyone who thinks they can responsibly 'manage' the use of heavy opiates ends up losing that gamble eventually. And the costs are very, very high.

Did you read my response where i said "like you later said" then went on to list another life threatening issue with opioids, as well as your statement that it's a pretty safe drug is actually very wrong when you compare its side effect and safety profile to the vast majority of drugs on the market?

My apologies, for both my tone and for overlooking your reference back.

I think 'vast majority' of drugs is overstating it a bit, but still - I very much understand where you're coming from and do not disagree.

I regret saying that "Opiates are actually quite safe, as drugs go." I think it has some validity in it's hastily-written context, mostly concerned with countering the article author's cluelessness on his subject. In moderate dosage and without mixing substances, it's basically true - though I'm admittedly coming at it from the perspective of a long-time recreational drug user, hardly that of an upstanding mentor to the young and impressionable here. It's obviously a reckless thing to say in any context, and I would certainly hope that no-one takes it as guidance.

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