I personally knew 5 people who have died from a drug overdose, and that drug was heroin in all 5 cases.

They all actually started off by abusing prescription opiates, but moved to heroin after they ran out of money.

However, my area is known for being a heroin hot spot. I live in a decent middle class town about 15 minutes away from Camden, NJ. My high school was known as "heroin high".

The problem with heroin is that there's very poor quality control. Overdoses seem to occur under one of the two following circumstances:

1. The person just gets released from rehab and relapses. Their tolerance isn't what it used to be, so their body gets shocked.

2. There's a sudden spike in the strength of the heroin that is "going around". The person may be used to a certain strength, so the more powerful batch can be enough to send them over the edge.

Just figured I'd add my own personal data points since it seemed like you were trying to deemphasize the danger of heroin by pointing out that you don't know anyone who died from it. Maybe, that wasn't your intention, so forgive me if so.

I was in downtown Camden, NJ once a couple years ago, being given a tour by a black pastor who's focus was on helping the poor of Camden turn away from drug addictions. (Point being, he knew the city very well, and knew its drug problem very well.)

It was an absolutely astonishing time. Camden literally felt like it had just been through a war: desolate buildings, so many people homeless on the streets, people desperate for food. It's hard to describe just how bad this city was.

I can't diagnose all the root causes behind why Camden is so messed-up, but this pastor pointed to the heroin epidemic primarily.

If you haven't seen any of his work, Chris Hedges has written and spoken pretty extensively on Camden and Camdenesque cities. Heartbreaking stuff.

You know, it always stuck in my craw that so much of the heroin in the new epidemic came/comes from Afghanistan... Shades of Vietnam.

I'm not familiar with his work, I'll have to check it out. Thanks for the suggestion!

Mhm. I'll bite. Got a source? Government wants kill people who use a lot of Oxycontin to kill the people who snort it or something?

I could not verify this particular claim in under an hour of online searching. Relevant facts:

Oxycontin used to contain talc, and this came with prominent health warnings. Shooting up dissolved oxycontin pills containing talc is dangerous. See http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/020... ("with parenteral abuse, the [inactive ingredients], especially talc, can be expected to result in [many bad things]").

As of some time in 2014, oxycontin no longer contains talc -- it has been replaced by magnesium stearate. However, that health warning that parenteral abuse causes many bad things has not been altered except to remove the phrase "especially talc". Pulmonary granulomas are still specifically called out as something bad that will happen to you if you inject oxycontin. See the current usage information at http://app.purduepharma.com/xmlpublishing/pi.aspx?id=o .

SPECULATIVELY: this means that while talc is no longer present, oxycontin might still contain legally-mandated adulteration. I found no evidence for a legal mandate, but this was not a comprehensive investigation.

It has long been the explicit policy of the United States that people who abuse otherwise legal chemicals deserve to be poisoned to death, and we have had and do have laws to this effect. See http://www.slate.com/articles/health_and_science/medical_exa... .

It's that last point that makes me hesitate to slam your parent comment for fearmongering.

It was not simply the consolidation of our petroleum interests we were after, no? Hamid Karzai (our man) afforded us unprecedented access to humans favorite narcotic. Poof! An unprecedented alkaloid epidemic.

Acetaminophen is added to many prescription opiates in part to prevent abuse. (There's some question as to whether it aids in pain reduction beyond what the opiate would provide, but it certainly has near term implications for severe abuse.)

There's no question. Unlike, say, ibuprofen and acetaminophen, there is no "synergy bonus".

The added pain reduction effect of acetaminophen stands in no relation to what the opioid is doing. There's no research anywhere showing that the combined effect is any more than the literal addition of taking both (for which there would be no reason if you could just as easily take a tiny bit more of the opioid that you'd be taking any way).

All it does is take away an addict's choice not to wreck their liver. And the system encourages the availability of this unnecessarily dangerous substance by awarding it a less restrictive drug schedule.

The incentives are rather twisted in this particular case.

edit

> but it certainly has near term implications for severe abuse.

the implications being death and permanent liver damage (it's not actually stopping addicts). but looking only at the numbers, it seems to limit abuse, even in the near term. ugh.

edit 2 seeing some of the other comments, apparently it's not just this particular case. I only knew about this one

Heroin: 4 Alcohol: 3

Just because you don't know anyone that heroin has killed, doesn't mean it isn't a problem.

How about the friends who died of the drug as a fraction of the friends who used the drug? If you don't know anyone who uses heroin, this post is meaningless.