I guess looking at movies and books, I could see where you'd get this idea, but it really isn't accurate.

There are different types of feeling good, and the purely chemical good isn't particularly rewarding. There are the moments in life where you are happy because you are living the life you want to live, and those are way better than just feeling good from drugs. Sometimes life goals and drugs come together, and that gets really interesting. It's reasonably common for people to do MDMA and have a glimpse of their life without anxiety and trauma, or LSD and looking at their own existence objectively.

For me, the best moments in my life are around building connections with people.

Lotta people talking about heroin in this thread, but lets be clear, unless you have tried heroin, or are otherwise intimately familiar with its affects, you are probably not qualified to talk about what it feels like.

Not trying to single out parent, just felt like it should be mentioned.

As someone who's done quite a bit of heroin...All of these comments are sort of correct in their own way. On its own turf, no, nothing will ever feel as good as heroin. Normal life experiences can't compete with that, not directly. But there is a one-dimensionality to its goodness that allows you to have experiences that, though i'm not sure they feel "better" than heroin, feel good in different ways that can be more satisfying, while also being sustainable.

It's sort of like the fact that nothing tastes better than cheesecake (or insert your favorite dessert here), but that doesn't mean you can't enjoy life or even other food without it.

As someone who's been through many different addictions, I'm starting to appreciate freedom from craving (a specific form of inner peace) more than the pleasure of indulging in a craving. (As well as the subtle benefits to mind and mood that come with it!)

Ya. It's sort of hard to explain to people who haven't experienced it, right? They like to ask "does not cheesecake ever taste as good as cheesecake?" and of course the answer is no: Cheesecake always tastes better than not-cheesecake. But there are other dimensions to experience that aren't captured by the immediacy of taste in that sense.

I am not misenjoying your non-shallow depth of double negatives (JK, love your observations)

I was trying to get to this with good versus rewarding, but it's one of those things that is so obvious when you feel it, but hard to communicate with people who haven't.

As far as drugs go though, there is a lot of personal preference involved too. For me, MDMA in unhealthy quantities is still the best that I've ever felt, and I know some other people prefer the meth high, but I don't think that's exactly what you are arguing against :)

The dimensionality is the key part. It's not just a metaphor, it's a physical quantity. Like cheesecake, the neurological response to heroin follows a specific profile of activation. However, (most) humans find fulfillment in far more dimensions than any single activity provides.

Life would be empty without cheesecake though.

Then I really don't recommend you experiment with heroin :)

I am a very very fat guy trying to eat properly and it’s excruciating, even after 5 weeks away from most of my daily life. Damned if I haven’t toyed briefly and desperately with the idea of some kind of pharmaceutical intervention. But my lifelong policy with drugs has always been if I can’t even handle Mountain Dew Throwback, I won’t have a chance with speed or coke or pot

Unsolicited tip. Something I find has helped me a lot with challenges like you are facing is to stop looking at them as difficult or choices and simply understanding it what you have to and are going to do. Remove the choice from the equation. I had some pretty destructive habits when I was younger and now people comment on my strong mental discipline. This approach has really helped. I recently had to cut all starch from my diet due to an auto-immune diagnosis and went through ketosis. The discipline has now become the habit. It never occurred to me to not follow through even in the deepest keto flu period. It's possible to achieve and once you've beaten one hurdle the next one becomes easier until you control fully your thoughts and not the other way around.

Definitely second this. Choices are hard, but decisions are easy. If you make hard rules for yourself and decide to follow them without exception, it is much easier to stick to, at least, that's what i've found for myself as well.

Much obliged. It’s a surprisingly alien concept for me with food, yet not elsewhere in my life. Odd, come to think of it.

Interesting. I will try to think that way. BTW I’m quite self-disciplined pretty much every other way and I never thought much about it, but I think that’s how I normally am. If it’s not food or caffeine...

Hah, I try to avoid it.

I'm writing from personal experience. Well, I've never done heavy opiates in a basement, so maybe going subterranean makes all the difference.

That makes it sound as if we should let people that only have a few days to live take all the heroin they want, actually. Maybe we should.

To a lesser extent, that's part of what hospice / palliative care is. Not to the extent that it's purely recreational, but often involve continued use of opiods for pain management.

https://en.wikipedia.org/wiki/Palliative_care#Physical_pain

If I get to choose the way I die it will be with an unlimited morphine drip slamming on the button repetitively. I had morphine back as a kid for a ruptured appendix and damn that stuff was good. I'll never forget the day they came in and I was expecting to get my daily shot and they told me I was being switched over to Tylenol lest I become addicted. I was 8, and I still remember thinking of saying "Oh I'm not becoming addicted but can we do it for 1 more day" haha...

> I had morphine back as a kid for a ruptured appendix and damn that stuff was good.

I suppose this varies a lot from individual to individual. I had morphine a few months ago for a shoulder reduction, and I felt horrible enough that I almost wish I'd just done it without painkillers at all.

Sadly there's still some prohibition on giving the patient enough to comfortably OD and voluntarily end their suffering in a lot of places. I've heard nurses say that they're instructed to try and keep the patient optimistic, even when all that life means to them anymore is continued suffering. Gotta squeeze every last dollar out of them or something I suppose.

There is a less cynical explanation: if you make it too easy for people to kill themselves then you run the risk of old people being coerced into taking that option by, for example, greedy relatives eyeing their inheritance.

And it could be seen as a perverse incentive for governments to make it too easy for people who are an economic and budgetary burden to end their own lives.

I believe this approach is also present in the UK where the patient isn't paying for their treatment directly. So I doubt it is to do with making money.

The patient may not be paying, but is the question is if the hospital still gets paid for his continued use of their services.

Wouldn't that be the argument of legitimate medical use though? You're mitigating the pain of people who literally have less than a year to live.

There is extensive research and clinical practice on the topic of comfort-measure care at the end of life. Opioids are, indeed, often felt to be helpful at the very end.

Depending on the condition of the patient and the specifics of the palliative care prescribed, that's exactly what happens. Just using morphine minus the extra additves used to make heroin. Add pure oxygen to the mix and I'm not sure the patient notices much of a difference - they're high as a kite regardless.

This is already part of palliative care. Fentanyl is synthetic heroine and is orders of magnitude more potent.

Terminal patients are often given lethal doses of morphine near the end.

From what I heard it is a bit of a lawyerish distinction at that point - that euthanasia is never the intent but may be the end result. If they arecterminally ill or mortally injured with instructions to treat by giving enough that they don't have pain. If it is a level that they can just slumber peacefully 22 hours a day they are to go with that. If they are 95% third degree burnt and they need more than that and it eventually stops their breathing it is an unfortunate side effect of treating their pain but still the best option sadly and not malpractice - sometimes needed treatments can kill even when everything is done right.

The evasion and mental gymnastics does have some point at least - it isn't the doctor deciding to take the life of a patient because of a judgement and well any student of the 20th century knows how /that/ can end.

The mental gymnastics are due to the legal environment in the US and in particular on laws in many states that could send physicians who prescribe a drug for the purpose of ending a patient's life to jail.

But there are lots of drugs that have the possible side effect of death, and plenty of patients who decide that the risk-benefit of taking a drug is warranted even though it might kill them.

So therefore, everything has to be described in terms of "pain management" and "comfort" where the cessation of breathing is just a... potential side effect. If that, combined with the patient's standing orders not to intubate or perform any sort of resuscitative action in the event that they stop breathing, leads to death... well...

The euphemism that is frequently used is "palliative sedation" (or "terminal sedation", although that seems to be used mostly by people of the thou-must-maximally-suffer school of thought).

That pretty much already happens with painkillers in many cases.

I don't buy that. I'm not sure where that information came from, but it's not the case for all users. Heroin feels amazing, but there's a ton of things in life that past users can find even better--even more rewarding. Russell Brand has a good book about this, it's called "Recovery"

Throughout highschool and college I knew a decent amount of people who experimented with drugs. But only a few who injected heroin, and all of them expressed that they weren't sure they were ever going to be happy again without heroin. And now most(maybe all) of them are dead.

I'm sure that's not true of every user, but enough of them that I really think heroin(and strong opioids in general) is a different beast.