Prescription Pain Killers: The Real Gateway Drug

[_Gadianton]

oh by the way, having tried x before y doesn't mean x is a gateway to y.

Among those who take all kinds of drugs, "party animals" or also those with addictive personalities; risk takers, gamblers etc, who have taken every kind of drug under the sun; that pot might come before heroin would have to do with accessibility.

I tried vodka and whisky before I ever tried beer. they weren't gateways to beer.

[Guest]

They are both gateway drugs...it is a lifestyle change and a party attitude. I would bet far more heroin addicts smoked pot before they took prescription drugs.

The relationship you are talking about it as much sociological as pharmacological. Marijuana is and was illegal in most places. You walk down the side of the street where you can go to jail for possession, you've already crossed a line. I would argue that alcohol is more addictive and pharmacologically far more dangerous.

Here are some interesting statistics (2015):

Injury by Firearms 36,252
Alcohol-Induced Deaths 33,171
Homicide 17,793
Viral Hepatitis 7,461
Human Immunodeficiency Virus (HIV) Disease 6,465
Cannabis (Marijuana) 0

2016 Data Detailing Drug-Induced Deaths,
Breaking Out Specific Data for Natural and Semi-Synthetic Opioids (including Oxycodone), Synthetic Opioids (including Fentanyl), and Heroin,
as Reported by the CDC

Total Deaths Attributed to Drug Overdose 63,632
Overdose Deaths Involving Any Opioid 42,249
Overdose Deaths Involving Heroin 15,469
Overdose Deaths Involving Natural and Semi-Synthetic Opioids 14,487
Overdose Deaths Involving Methadone 3,373
Overdose Deaths Involving Synthetic Opioids Other Than Methadone 19,413

And again, people started turning to heroin when they couldn't get their oxy prescriptions. If you want to know how the heartland got hooked on heroin, the genesis is in the pharmacy records:

Between 2006 and 2016, out-of-state drug companies shipped nearly 21 million opioid painkillers to two pharmacies in Williamson, West Virginia, population 2,900.

by the way, I did the math on those numbers: 2 opiate pills per day, per person, for every man, woman and child in town every day for 10 years. Somehow I doubt the pill distribution was quite that equal.

Opiates addict you to opiates. Soft drugs do not addict you to hard drugs, but the experience with a soft drug might start an itch that you can't quite scratch. And in that sense, any recreational drug is a gateway drug. But if you look at the number of alcohol poisoning deaths compared to marijuana overdoses? It's not even a question. There is no debate. There is no number to discuss. There is no number.

[_Markk]

They are both gateway drugs...it is a lifestyle change and a party attitude. I would bet far more heroin addicts smoked pot before they took prescription drugs.

I'm not sure you expressed yourself correctly, but that sounds pretty ridiculous.

Anyway, I can tell you that my friend who died of a Heroin OD never smoked pot or smoked anything.

Do you smoke pot? How much have you smoked in your life...just curious.

I've never smoked pot, but interestingly, I've recently become acquainted with a retired Hollywood producer who tells me he's smoked pot for 50 years. Barely drinks and does nothing else. Has serious pain but I don't think he takes anything stronger than ibuprofen, he's implied he doesn't take enough of it, although I intend to ask him about it after these threads. He says someone needs to write a book about his various life successes as a defense for pot.

So, of all the heroin addicts that have died, the percentage that didn't smoke pot wouldn't even register as a percentage.

When you get into the inner cities, that is where you see the effects of pot. For every "successful" pot smoker, you will find more lazy kids not reaching their potential, sitting around the house waiting to see if Gilligan gets off the Island.

I hate the crap, I have seen it prevent potential in far too many peoples lives.

In street ministry, one common denominator you see, is that pot is a staple. Not everyone likes it, not all are chronic users...but it is just part of life in the inner city. Far too many drop out, and pot is a huge factor there.

Would you care if your kids or grand kids smoked pot? Are you okay with a dad coming home from a hard day of work and instead of drinking a beer, just take a few bong loads in his easy chair while the family is sitting around?

It is a hallucinogenic Glad, should acid be legal in small doses?

[_Markk]

They are both gateway drugs...it is a lifestyle change and a party attitude. I would bet far more heroin addicts smoked pot before they took prescription drugs.

The relationship you are talking about it as much sociological as pharmacological. Marijuana is and was illegal in most places. You walk down the side of the street where you can go to jail for possession, you've already crossed a line. I would argue that alcohol is more addictive and pharmacologically far more dangerous.

Here are some interesting statistics (2015):

Injury by Firearms 36,252
Alcohol-Induced Deaths 33,171
Homicide 17,793
Viral Hepatitis 7,461
Human Immunodeficiency Virus (HIV) Disease 6,465
Cannabis (Marijuana) 0

2016 Data Detailing Drug-Induced Deaths,
Breaking Out Specific Data for Natural and Semi-Synthetic Opioids (including Oxycodone), Synthetic Opioids (including Fentanyl), and Heroin,
as Reported by the CDC

Total Deaths Attributed to Drug Overdose 63,632
Overdose Deaths Involving Any Opioid 42,249
Overdose Deaths Involving Heroin 15,469
Overdose Deaths Involving Natural and Semi-Synthetic Opioids 14,487
Overdose Deaths Involving Methadone 3,373
Overdose Deaths Involving Synthetic Opioids Other Than Methadone 19,413

And again, people started turning to heroin when they couldn't get their oxy prescriptions. If you want to know how the heartland got hooked on heroin, the genesis is in the pharmacy records:

If you want to know how the opioid epidemic got so out of control, it’s hard to do better than this statistic: Between 2006 and 2016, out-of-state drug companies shipped nearly 21 million opioid painkillers to two pharmacies in Williamson, West Virginia, population 2,900.

Opiates addict you to opiates. Soft drugs do not addict you to hard drugs, but the experience with a soft drug might start an itch that you can't quite scratch. And in that sense, any recreational drug is a gateway drug. But I'm not sure how the argument can be made that marijuana is more dangerous than alcohol.

How many people have died after driving on pot? Pot stays in your system for something like 28 days, and it is tough to prove if one is under the influence of pot. Police are trying to refine testing methods from what I have read.

When I was around 17 I smoked some pot and smashed my dads new Honda (car) into the back of a pick up at a stop light. I didn't even have time to hit the brakes, I totaled the car. If someone had been with me who know what would have happened, or if I hit a kid.

Have you ever smoked pot or taken street drugs to any degree?

Smoking pot is a gateway drug in that it eases one into the drug culture, you have to understand that to understand my point.

[_EAllusion]

Marijuana is mildly addictive for most people and moderate to severely addictive for a small % of the population. It is far less dangerous than alcohol or cigarrettes.

The evidence that it acts as a gateway at all is modest, and it's simply incorrect to argue that it acts as a significant gateway drug in the sense that using it causes people in large numbers to progress to other drug use. Insofar as it functions as a primer to other drug use, it appears to do so by primarily by inculcating people into a culture of willing use of illicit substances, which itself is a byproduct of its own illegal status. That is to say, if you smoke weed, you probably hang out with people who have a culture of being Ok with using illegal drugs, and that makes you more likely to try using other illegal drugs. If you smoke marijuana sans that culture, there's not a lot of reason to think you are predisposing yourself to other drug use.

The fact that users of other drugs may also smoke weed does not demonstrate that it functions as a primer to potentially more dangerous drug use, though. This is about as clear of a correlation / causation fallacy as you could hope for. As Gad pointed out, maybe the sort of people who are the types to try snorting Oxys just overlap with the types who find smoking weed appealing. More than a simple correlation is needed to establish the gateway hypothesis.

But you could grant all the refeer madness assumptions about marijuana you want, and none of it would come close to outweighing the harms caused by trying to make it illegal.

[_honorentheos]

Maybe like instant success at meditation with a buzzy high to boot.

It's a good thing you didn't take it shortly before reading Moroni 10.

;)

In all honesty, as a TBM I would have also seen it as artificial as an experience. It wasn't transcendent in the way people talk about psychedelics but it created a sense of detachment that the closest analog I can think of from my own experience is deep meditation-like. But with a background buzz in there, too.

I've never had Oxy, but on the other thread I described my encounters with prescription narcs: doing minor surgeries awake etc. Didn't resonate with me.

I missed whatever thread you posted in. The only surgery-like events I ever underwent where a pain killer was involved but not general anesthesia was having my wisdom teeth removed. It was before leaving to serve a mission and my experience with whatever drug they used wasn't pleasant, either. My memory of it is one of mentally forcing myself to remain focused against the effects of the drug. No idea what it was but I didn't like how it made me feel at the time.

[_EAllusion]

That said, it is an empirical fact that prescription opioids are highly addictive.

Did you know that it's only about 20ish% of recreational users of heroin that would meet a clinical dependency definition? (I believe in the study I'm citing from memory, "recreational user" was defined as at least one use in the past 3 months.) In the overall scheme of addictive drugs, that makes it quite addictive. I certainly wouldn't recommend anyone take that kind of risk. At the same time, people sometimes imagine it has a mythic addictive quality that hooks anyone who dares try it. I think this is counter-productive because people who are exposed to heroin users end up getting exposed to people who manage to be responsible recreational users and end up thinking they can do that too. Only some of them totally can't and that's playing Russian roulette.

Along the same lines, it's worth noting that most people who get addicted to opiates through prescription drugs don't do so because of what was personally prescribed to them. Some do, but the route usually is intentional recreational use of other people's prescriptions. Moreover, lots of people who abuse prescription opiates recreationally manage to do so without developing an addiction. This, again, creates a tempting picture for people who may think they can manage because those people who claim it's a slippery slope to hell just don't know what they are talking about when you see all this recreational use going on that isn't out of hand.

If I could get one small thing through to drug culture, it would be to wipe out people thinking they can manage their drug use through willpower - that the difference between an addict and a responsible user is just having good character. It's not simple as that, and that siren song idea traps so many people.

[_karl61]

I think with all addictions it depends upon ones body chemistry or receptors or something like that. If you can picture a light bulb. With some people certain drugs cause the bulb/receptors to get really bright and it brings on a lot of energy, and for others it doesn't do a thing.

For many years I was prescribed temazepam for sleep. For me it just made me relaxed so I could go to sleep. When I moved to a new state the nurse practitioner dropped it and prescribed trazadone. I felt no type of withdrawals although I have read about people are addicted to it like heroin and main line it and go through bad withdrawls.

One day about 14 months ago I started getting a real bad pain on my left side. After a few hours I knew something was really wrong because I have never had that type of pain before. I ended up in the emergency room shaking and vomiting and found out I had a kidney stone stuck in one of my ureters. I was given some muscle relaxants and also a prescription for Oxycodone. I had heard bad things about Oxycodone and wanted to take a lot for the pain but just took one every four hours as prescribed. They should have given me a sugar pill as it did nothing for the pain. The next night I was back in the emergency room but this time they gave me some type of morphine and the pain went away and I was king of the hospital, in la la land. The admitted me and the next morning they did surgery and took out the stone and put in a stent and released me and I continued to take the Oxycodone for some discomfort but it really didn't do anything. I use to take one with a hot bath and eat a chocolate bar and I was relaxed. Ten days later they took out the stent (not fun, not fun, wow!) and I asked the doctor for a new prescription because they will only give you one per prescription with no refills and I ran out. I got a whole new prescription. I was still in discomfort for about four hours, took another pill but then I returned to normal and never took another one and eventually threw them all out. But I can see for others that they cause something that I never felt and if I felt what they did I too might get addicted too. For me they did nothing but for others they feel something I never experienced.

[_MeDotOrg]

How many people have died after driving on pot? Pot stays in your system for something like 28 days, and it is tough to prove if one is under the influence of pot. Police are trying to refine testing methods from what I have read.

When I was around 17 I smoked some pot and smashed my dads new Honda (car) into the back of a pick up at a stop light. I didn't even have time to hit the brakes, I totaled the car. If someone had been with me who know what would have happened, or if I hit a kid.

Have you ever smoked pot or taken street drugs to any degree?

Smoking pot is a gateway drug in that it eases one into the drug culture, you have to understand that to understand my point.

I would agree that coming up with reliable methods for detecting marijuana while driving or operating machinery is a problem and a challenge. I think this will be statistically important to after we get a few more years of legalization in Colorado, Washington, Oregon...

But again, alcohol is a central nervous system depressant. I am not saying that marijuana doesn't impair your driving ability. But people get 'falling down drunk'. For the most part, people don't get 'falling down stoned', unless you ingest too many brownies, but you really have to work at it.

But to answer your question: Yes, I smoke pot. In the past, I have sampled all of the major recreational drug groups: barbiturates, amphetamines, alcohol, cannibus, hallucinogens and opiates.

My big bad drugs were cocaine and alcohol. Haven't done either since 1985. I stopped smoking marijuana in my twenties, it made me feel paranoid and I did not enjoy it. Tried it about 4 years ago and like it again. I am familiar with the drug culture. I'm very familiar with the damage addiction can do. The there-but-for-the-grace-of-god-go-I drug for me? The drug I could have taken till it killed me? Speedballs (cocaine and heroin). A function of how depressed I was at the time and how good it made me feel. With a supply, I would have stayed in a room until it was gone, or I was gone.

But again Smoking pot is a gateway drug in that it eases one into the drug culture. Again, I will stipulate that the urge to try a recreational drug may not be enough for some people, and in that sense all recreational drugs are gateway drugs. If drinking alcohol does not lead you into the drug culture, it's because it's a legal drug. A lot of illegal drugs came in with illegal liquor in the Roaring Twenties. You could get 'reefer' and cocaine with your bootleg hootch if you so desired. If alcohol, not pot, were on the other side of the legal line, we'd be talking about alcohol as a gateway drug.

[_Analytics]

Interesting thread, Analytics. Thanks for starting it and sharing your friend's experience.

This last summer I experienced an injury from being stupid while recreating that required surgery and physical therapy to repair. I've never been big on pain killers and most of my life have avoided using them including Advil or aspirin-like over the counter drugs. I've had a few decent injuries from sports in my life (mostly soccer, really) but in most cases the use of a pain killer wasn't needed.

So when I went in for surgery and the operating doctor asked which pain killer I preferred I told him none, really. He got agitated and said he had to prescribe something and since I didn't have a preference or a known allergy he said he'd prescribe Oxy (or a type of oxy as I recall) and went off. I wasn't informed as a consumer and at the time just thought I'd end up not filling the prescription anyway so it didn't matter. But either getting older or this particular injury left me in enough pain that I couldn't sleep so I filled the prescription and began using it just to be able to recover.

And holy crap is that stuff scary. I don't know how to describe it but I knew immediately after the first time taking it that I was at risk of addiction. I deliberately tossed the bottle as soon as I could sleep through the night because it scared me how...again, I don't know how to describe it. Maybe like instant success at meditation with a buzzy high to boot.

The lesson I took from it was that I went into it as an uninformed consumer who had external knowledge of the risks of addiction from the wide-spread reporting but very limited professional discussion at the time it was prescribed to me that seems reckless having experienced the effects of the drug. That seems to be a problem that could be easily addressed and would have positive impacts on reducing the potential for addiction from doctor prescribed drugs but I am not sure how typical my experience is compared to others, either.

Wow! This is the kind of thing that pisses me off about the current system. If you would have been a little weaker, a little dumber, or perhaps a little more suseptible, then the drug company AND the doctor would have made a lot more money with you going back to get your hit of the drug they introduced you to.