A lot of drugs out there, crack, heroin, cocaine, heck, even MDMA will do damage eventually if you use it in large enough doses. For that matter, legal drugs like smoked cigarettes and alcohol have long time negative consequences with regular use.

I agree with the parent, this whole desire to vilify the monster-du-jour sometimes gets out of the hand, with the MSM frequently playing the willing companion to whatever government propaganda of the day is in vogue.

Can these drugs do damage if abused? Yes. So teach people not to abuse them, and, those who do, or become addicted, have medical issues that should be treated as such.

I'm willing to wager that not only would drug abuse come down, as light was shone on addicts rather than making them hide in the dark, but we'd also see reduced prison populations, and entirely eliminate a major source of income to criminal gangs.

This is probably the 1 Billionth+ time someone has made this argument on a forum though, so I don't hold out to much hope until the winds of sanity for, whatever strange reason they do, blow in that particular direction.

Just to add a little factoid that doesn't disagree with your comment, but which some folks might find interesting: while heroin is an extremely bad thing you shouldn't get into and goes hand in hand with a lot of other bad things, it has a frighteningly minimal impact to the body/organs on its own. Physical dependence + tolerance and no small level of constipation in the short term, but not much else.

Years ago I heard Dr. Dean Edell(a U.S. Doctor, media personality, and a rational guy--whom other doctors admit to listening to-), say this,

'If I was going to be addicted to any drug--it would probally be Opioids? It does the least damage.'

I'll always remember that statement, but I think he meant in a perfect world(where you could get legal, pharmaceutical grade product)? The addicts, I know, have so many ancillary diseases, and health problems--I don't think I would ever try it--even once. (I imagine the health problems are due to dirty needles, and unknown handling, and "cutting" of the drug?)

My vote would go to caffeine, not only is the damage minimal (at low doses) to your body, its LD50 is also really hard to hit without trying exceptionally hard (though not unheard of). Lots of people OD on heroin and die accidentally, its extraordinarily rare for someone on tea/coffee to OD and die.

I agree that heroin is a really bad idea. But the reasons people die by accidental overdose are:

1) they've recently tried to quit and thus have a lower threshold.

2) they've somehow got much purer product than they're used to.

http://www.bbc.co.uk/news/uk-england-nottinghamshire-3312699...

Heroin for addicts could be much safer than it is now.

Adrenal insufficiency or Fatigue as they call it is a real problem from coffee OD though, Instead of caffeine i recommend Piracetam, far far lower LD50 score than caffeine and it's virtually impossible to OD or die from taking too much from this stuff.

Indeed - it looks like the LD50 for Piracetam is about 15x that of caffeine in terms of mg/kg body mass.

http://www.sciencelab.com/msds.php?msdsId=9926585 - caffeine Toxicological Data on Ingredients: Piracetam: ORAL (LD50): Acute: 2000 mg/kg [Mouse].

http://www.sciencelab.com/msds.php?msdsId=9927475 - Piracetam Caffeine LD50 Acute: 192 mg/kg [Rat]. 127 mg/kg [Mouse]. 224 mg/kg [ Rabbit].

Presuming human equivalence to mice - A 185 pound person would need to ingest about 168 grams of piracetam as compared to around 10 grams of caffeine.

But - it's really important to note that both are toxic to the point of being fatal in easily digestible, relatively small amounts. Caffeine, in particular, can creep up on you pretty quickly - penguin mints are 1/2 gram per tin. (75 * 7 mg/mint).

Didn't work out well for China. There's a reason Asian countries have zero tolerance

Yeah, brutal authoritarian governments with no concern for human life. A drunk/high citizen is a slave that cannot work.

Yes, I'm sure the Chinese have no experience and concern with the societal effects of opium which turned the whole country into slaves

I'm sure that what the British did to China doesn't justify the death penalty for simple drug possession or use. Especially when it's a hot-button issue that almost guarantees the lack of a fair trial.

Besides, it seems wider than just China and its descendants.

The thing is - I don't think "heroin is an extremely bad thing" - I know a bunch of ex-heroin users, and even a few current users. The current users I know basically just maintain, and are otherwise completely competent and normal people - You honestly would have zero clue that they were current users.

The problems with heroin are usually in conjunction with alcohol or other depressants, people using too much, throwing up, and then drowning on their own vomit, not having a clean rig, or, god forbid, sharing needles.. And, of course, using too much, and then dying from the toxicity.

The toxicity thing typically comes from the legal element - people don't know how pure a component they are using; also they do it alone with nobody around to help them when they get into trouble. If they did know the purity, and their tolerance, and shot up in a safe, clean and social manner - overdose deaths for existing users drop to zero if there is someone around to revive a person who is ODing. http://www.theglobeandmail.com/life/health-and-fitness/vanco...

But coming back to my main point - we can't have reasonable conversations about this, because "oooh, Heroin, Crack, Cocaine - scary evil monsters" - and all rational discourse goes out the window. If you brought this into the public light, then when people meet heroin addicts, become familiar with their situation, and realized what a stupid and possibly expensive addiction it is - you treat it like a disease and have zero interest in touching the stuff.

I will note, that I know an ex-heroin user who also quit smoking, and he said kicking the smoking habit was 10x harder than heroin.

> ... So teach people not to abuse them, and, those who do, or become addicted, have medical issues that should be treated as such.

Therein lies the problem: addiction does not readily yield to teaching not to abuse the drug. In the US there has been an intensive 50 year campaign to educate people not to use tobacco, yet nicotine dependence remains a top public health problem.

Addiction research has shown compulsive drug use is associated with actual alterations in brain structure and functional circuitry. Treating addictions has proven to be a notoriously difficult problem to solve, meaning prevention is a far higher priority than attempting to cure.

I believe the scientists studying the matter would disagree that rate of drug abuse would decrease solely on the basis of education, especially among the subset of the population that is most vulnerable to developing compulsive use in the first place.

Trouble is, drug response, including bad effects, is probabilistic. Exposing large populations to a drug with predictable harmful effects in a substantial subset, it's really a crap shoot who will wind up in trouble. Minimizing initial exposure to the drug may be a reasonable preventative strategy.

But don't take my word for any of it. Check out the scientific info sources for yourself, see: http://www.drugabuse.gov/

The states permitting wider use of cannabis admit it's a kind of experiment, a bet on the hypothesis that the harmful effects of it (abuse/dependence, MVAs, health problems, more child/adolescent use) will be offset by decreased burdens imposed by criminal justice systems. The jury's out on the question, we'll have to wait a few years before the verdict is in.

>Therein lies the problem: addiction does not readily yield to teaching not to abuse the drug. In the US there has been an intensive 50 year campaign to educate people not to use tobacco, yet nicotine dependence remains a top public health problem.

Cigarette use among teens is half of what it used to be 20 years ago.

Harm Reduction absolutely makes a difference. Many people develop unhealthy habits with drugs for the same reasons people develop unhealthy habits with food. They don't know any better and draw norms from the environment around them. Most people quit drugs within a decade anyways. In a way it's a problem that solves itself if you manage the destructive social/health outcomes of drug use(most of which are a product of drugs being illegal).

>But don't take my word for any of it. Check out the scientific info sources for yourself, see: http://www.drugabuse.gov/

Which sources for which claims? Posting to the front page of a blog isn't a source.

Yes it will,if you do 5 grams a day - which is a ridiculous amount. If you are doing that much, you might in fact be a horse.

https://en.wikipedia.org/wiki/Ketamine#Urinary_tract_effects

> All reported cases where the user consumed greater than 5 g/day reported symptoms of the lower urinary tract.

That only implies that if you do 5g/day, you will with near certainty get urinary tract problems. You can definitely get get urinary tract problems with much lower dosages.

You don't have to do anything close to that for it to destroy your UT. More like a couple years of occasional recreational use. It's a huge problem with younger people who use the drug recreationally.

I'm pretty sure the way in which you deliver the drug is the biggest variable as to how much damage it causes. The article briefly touched upon it; most illegal ketamine comes in a crystal form and needs rehydrating (cooking), most people do not rehydrate the ketamine and instead just crush it. Taking this instead of hydrated ketamine is much more detrimental to the bladder/ut.

I think you might have it backwards.

Legitimately manufactured ketamine is typically in sterile saline solution at a fixed quantity per dose. This is because the usual medical route of administration is intra-muscular or intravenous injection.

For recreational use, (afaik) the majority is insufflated, or snorted. For this you need the dry, crystallised form.

You can either purchase it as crystal from your friendly neighbourhood drug dealer, or they may be able to supply you with vials diverted from veterinary or medical suppliers. To get this to a powder, you boil off the water "Cooking" and are left with a mixture of ketamine and salt.

The 2 biggest problems are trying to either rehydrate crystal powder for injection (because ensuring sterility and consistent dosage is hard), and that crystals are much easier to cut with other ingredients (because the legit. vials usually have tamperproof seals like other legitimate drugs).

The other point is that most people won't be injecting it right from the beginning. Only once they become tolerant and require high doses does the appeal of IM/IV's increased 'efficiency' (bioavailability) tend to override the common wisdom of not sticking needles in oneself.

From what I recall, most of the research has shown that long-term administration of high doses is where the damage is predominantly done, and even very high doses (1000mg would be a plausible dose for 'short term surgical anesthesia (15-25 mins) of an 80kg adult), if given very rarely, are not likely to cause harm.

But injecting that sort of quantity, multiple times a day, for weeks or months, is absolutely going to lead to problems, and even more of them if you're getting impurities or bacteria/spores along due to contamination.

I'm only speaking from personal experience, unfortunately I have friends that have been abusing this drugs for almost 2 decades (none that inject so I can not speak about that).

I might have my terminology mixed up, but there is definitely a difference between crystallised and that which has been cooked (possibly again). Some of it might possibly be myth on there behalf, as in they don't get as bad a "k belly" or irritated bladder after a binge on the latter.

As well as the bladder/ut issues, snorting (anything) also leads to the corrosion of the septum and also the bone(s) that supports teeth.. Basically excessive use leads to teeth falling out.

It is a pretty standard problem with people that get heavy into ketamine though.

Nah, I've had plenty of mates that have done far far less than that (a few grammes on the weekend for a while) that have totally fucked their bladders.

Alcohol can damage the bladder and bladder control in several different ways.