I've smoked opium a handful of times. It smells wonderfully.
And yet, if I take any drug regularly, I'm using something with THC in it (hash or pot, in general). I currently do not, however, and tend to have a few drinks and get high on the weekends. Not a big deal if I don't, though.
I've had medical grade heroin in the hospital (morphine didn't take care of the pain). No withdrawal, though I was wonderfully high. Haven't gone to a morphine habit.
The prudent thing to do is not to say, "opioids are instantly addictive", but to give folks safe ways to detox from them and give folks information on signs of addiction - because not everyone has such experiences.
No, the 'vast majority' do not. I've supervised medical grade opioid administration to more than a few people, both acutely and chronically, and *folks without a pre-existing substance use problem* do not often develop one, especially if it's over the short term. The idea that "I give you an opioid and then BAM I want more!" is highly divergent from my clinical experience.
Use != Misuse, but use for pleasure is a direct precursor of misuse.
The grand-parent comment to which I am replying describes near-instant addiction in the context of an opioid prescribed for pain control.
Would I do opium again? Sure. It was fun. Would I do medical grade heroin or morphine again, under controlled circumstances with a nursing staff dosing me? Yeah. It was fun. Did I have some weird urge to go out and do it frequently? Nope. But to be fair, lots of folks drink on more than one occasion as well. They get high more than once. They might even have more than one drink or hit in one day. Simply wanting to do something again doesn't mean anything. I've done acid more times than I can count, and I wouldn't call it a habit. The only drug that I'd probably do more often if it were not dangerous to do too often is MDMA because it feels spectacular (better than opioids, to me anyway), but I'd not even call it a strong urge.
This isn't addiction, nor is it anything uncontrollable in general.
Unless you are implying that folks get uncontrollable urges, and in that case, please back that up with facts. Though I've met my share of addicts, most things just aren't instantly addictive. Even heroin isn't that way - especially if you actually improve an addicts like (hence, troops addicted to heroin in wars came home to be non-addicts).
With as much respect as I can offer I think you should consider the following notion, which in my personal experience is an actual fact:
"Until and unless you have been an addict you truly cannot understand the experience. And subsequently you are not able to point out what is and is not addiction."
I believe the most-essential factor is this: loss-of-control over the behavior in question.
IOW, when the behavior takes places in spite of the individual wishing to stop, or committing to stopping -- then it is almost certainly "an addiction". It is the behavior that is most important, not 'substances' particularly.
The trouble is that it is very, very difficult for someone to recognize AND admit that they are unable to control some aspect of their behavior.
Most of us will create elaborate explanations to avoid admitting (to ourselves mostly) that sometimes we window up in a situations where we are completely powerless to control our behavior.
Do you have a source for this assertion? I'm just a physician with a particular specialty in medically managed (as opposed to procedurally managed) pain, and I've never seen a "I took it once and was instantly addicted." I don't mean to undercut your subjective experience, but I've seen a few folks on pain killers, and if what you described was more common than "very rare", I would have by now.
After a couple of days he was experiencing identical symptoms as the GP.
I'm not trying to chime in on how strictly we're interpreting "instantly," but for me I will definitely do my best to avoid opiods. Taking the prescribed amount for 2-3 days, and literally not taking the rest of the pills (both GP and my brother), and having serious physical withdrawals--that's fast enough that I would rather avoid it.
They may be instantly addictive for you, but they are not for everyone.
After I had a pleurodesis, the nurse sat me down in the chair next to the hospital bed and gave me a little controller I could use to release morphine into my saline solution if the pain became unbearable (and it did). It was the strangest sensation—I could 'feel' the pain, in a sense, but it was like I was on a different plane, and it didn't quite bother me.
But to say it was instantly addictive—nope. Not at all. Have had no desire to try anything like that again outside of a hospital setting. Maybe some people are just not prone to it.
FWIW, good on you for recognizing that you're one of the third group and getting off of it entirely before the addiction gets even worse.
This is the kind of FUD that TFA is specifically addressing. Namely, that this is not always a true statement.
Of course, for many people, it is, which is why people make such sweeping (and incorrect) statements. Your warning is valid, your claimed facts are not.
Here's one showing only 5% of people filling opioid scripts go on to long term use.[1]
Another older study citing 2% of US adults regularly using opioids, while a further 29% use them infrequently. Other more recent studies I seen hold this pretty constant. [2]
Here [3] only 13% of elective surgery patients fill opioid scripts beyond 90 days, and "mental health disorders, and tobacco dependence or abuse were associated with prolonged opioid use". It's well known that people with one substance abuse issue tend to be at higher risk for developing others.
You could go on and on finding studies that show that relatively few people with high risk medical/mental health history go on to develop opioid addiction after using these substances. There doesn't seem to be any support for the idea that the average person can take these drugs once and become "hooked".
All that said, they are dangerous and have strong addictive potential so caution is warranted.
[1] https://link.springer.com/article/10.1007/s11606-016-3810-3?...
[2]https://www.sciencedirect.com/science/article/abs/pii/S03043...
[3] https://www.sciencedirect.com/science/article/abs/pii/S03635...
And for what?
It is an incredibly slippery slope for people to walk out on. It would be incredibly hard for someone to say whether or not they will spiral out of control if they try it and the consequences of becoming heavily addicted are life destroying. It seems like playing Russian roulette and I'm not sure it's a good thing to raise the idea that one can potentially manage it. Also, the person being interviewed could be one of the people that can't control it and will spiral out of control or him saying he manages it well and it's possible to do so could be a facade and he could be trying to do whatever possible to keep his habit alive, but we just don't know. Many people manage it fine for years without anyone knowing until they start their sharp decline towards bottom.
Wherw do you think he got these assertions? There have already been studies about how often heroin users are addicts or what the addiction rate of prescription opioids are.
He's very clearly advising against getting addicted, something most opiate users accomplish.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
"Treat every gun as if it were loaded" is the traditional advice, and is a wonderful attitude to have about firearms. But if it's not loaded, it's not loaded, those are the facts.
Perhaps the same with opiods: treat them as if they are highly addictive, in a rapid manner. But if (for you) they aren't, they aren't.
And I say this as someone who's plenty happy with drugs legalization, who likes the occasional MDMA, and who drinks plenty of alcohol. I guess I'm lucky I never run the risk of opiates addiction, because despite all that I have no desire to every touch the stuff again.
Edit: Just to clarify, she was not prescribed any opioids/drugs to be taken post surgery, it was purely the anesthetics.
Of these drugs, the only ones that might cause withdrawal symptoms would be the benzo or the opioid. The benzo, if it's even given at all, is going to be tiny. Even if we were to hypothesize that a single unusually large dose of an opioid could induce dependency, a surgery where the patient isn't even given opioids to take home wouldn't warrant such a dose in the OR.
In short, your second-hand account makes no sense.
I am fuzzy on the details, because the person was just an acquaintance. There was a huge investigation on her history, looking for substance abuse. They found nothing.
Is that true generally, or just for a subset of people who have some predisposition to addiction?
While it could just be Purdue Pharma propaganda, I vaguely recall hearing that the "instant addiction" was a myth. However, people like you have experiences like yours, so there must be some truth to the "instant addiction" idea.
Edit for downvoters: I think it totally makes sense for everyone treat opioids like a loaded gun, like another poster said, if some people are vulnerable to an instant addiction effect. I just want to clarify what the actual situation is (for me and all the other people who were told it was a myth).
A prerequisite for addiction is that one must believe the drug makes them feel “normal” or functional in some way. “I can’t live with this pain - I need it.”
If instead you as a user go into the drug experience with the mindset that you are entering a temporary state, one that is reserved for special occasions, you’re far less likely to become addicted.
Where did come up with this? This is not accurate.
My cousin is a social worker, dealing with addicts. I've done heroin myself. I know heroin addicts, though not as many as he does.
We both agree: almost all addicts have a backdrop of broken families, poverty, unemployment, some kind of trauma or just a general lack of opportunities in life. Heroin makes all that go away... for a while. How could they NOT become addicted?
The myth is about shifting blame from social inequality onto a drug. The addiction is but a symptom of a societal disease.
LOL no. Some people here, most of them highly educated, are spewing myths like it's "instantly addictive", lies laid out to try to curb the epidemic from the 80s.
It takes relatively long daily use for one to become dependent, and basically you only do that if you don't have a job or anything you value waiting for you after the high, really. Sure, there are exceptions, but that's the norm. The fact that drug abuse heavily correlates with economic recessions and unemployment increases should give everyone a hint. [0]
In 2020, we know roughly 80% of the users never become dependent. [1] In the same ballpark as alcohol, unsurprisingly.
And it's normal. Because it's bliss, but then it's pretty shitty. For a few hours of high you have a few hours of nausea and general discomfort.
> You have to be seld destructive to even try.
No, you just have to be curious and know how to evaluate risks and benefits. It's not a "starter happy drug", but it's not the devil. In 2020, the people doing heroin know a good deal more what they're doing than the ones from the 80s.
Harm prevention and reduction has moved on a lot too. There are high precision scales for very cheap. There are testing kits, too. In the 80s pharmacies in most countries were told not to sell syringes to addicts, again to curb the epidemic, causing them to share needles with all the associated problems (HIV expansion, needles leaving more bruises, sepsis...). Now most countries with a sane drug policies provide free needles to addicts, when not straight up supplying heroin to them [2]. Unsurprisingly such countries have lower problematic drug use than the US, where the problem is policed rather than treated.
[0] https://www.sciencedirect.com/science/article/pii/S095539591... [1] https://drugpolicy.org/drug-facts/can-using-heroin-once-make... [2] https://en.wikipedia.org/wiki/Heroin-assisted_treatment
If it were true that it was instantly physically addictive, then literally every human being that has ever had any kind of surgery or been to the ER for trauma would be a rabid opioid zombie. But they aren’t.
Some people are definitely more prone or vulnerable to becoming addicted to it. Im lucky, I guess.
I've been through plenty of addictions, but quitting Oxy after surgery is the closest thing to hell I've experienced so far.
When the pain subsided, I stopped taking them, and within a day I found myself curled up in a ball and wanting to rip my own skin off. It's really true when addicts describe it as "being uncomfortable in your own skin".
The moment I realized I was experiencing withdrawal, I flushed the meds down the toilet and just suffered through it for a couple days.
Never ever touch heroin. Stay away from prescription opioids unless it's really really needed, and make sure it's short term only.