100,000 dead in the last year from drug overdoses. It is a milestone that has never been reached before. I wonder how many of those who were counted in the covid figures also died of overdoses. This is not a heroin issue, nor really a drug issue, this is all down to the fentanyl issue. Fentanyl is in everything from tainted cocaine taking out comedians at Los Angeles parties, to every single counterfeit pressed pill, from xanax to oxy. Even years ago it was more or less guaranteed that illicit pills contained fentanyl. Entire threads on drug support forums were devoted to the fact that the 50s were all fentanyl and were taking people not just down and under, but OUT of this world at an alarming rate.
Billy had a legal script for his morphine and oxycodone, tramadol, gabapentin and phenibut, due to the fact he had a brain tumor, post stroke pain and multiple other very painful health issues. Getting hold of his medication, despite the fact he had a growing and untreatable brain tumor, became harder and harder. He was told ‘everybody has to put up with a little bit of pain’ when he explained to the doctor that his headaches were unbearable. Taking a person with a life limiting condition off their pain meds, not giving enough to cope with the physical addiction built up over time, let alone the escalating pain, is an unbearable state of affairs. He ended up drinking again to try and cope with the pain. If his pain had been adequately controlled, instead of denied adequate pain relief by a doctor who was leery of his previous drug and booze addiction, conversely he would have done a lot better.
Opiates are not controllable – not even when they are used for legitimate purposes. There is this often touted hierarchy of the addict and the medical patient. The medical patient being the socially acceptable addict, and the ‘recreational’ addict, who is self medicating for other types of pain, whether untreated medical pain for which they have no hope of getting treatment, or the emotional pain of existing past some kind of trauma or abuse, being society’s whipping boy.
We all want to defend those we love. It is the stigma of addiction, and recreational drug use that is to blame for this fake separation between the two groups that is not helping to fix the issue at all.
Opiates are necessary, they are the best form of pain relief we have. Opiates do not distinguish between those using for a ‘legitimate’ socially accepted reason, and those using for reasons that society looks down on. Anyone who does an opiate gets physically addicted. Take them in the amount the doctor provides and suggests, and the physical addiction will still kick in. There is a little amount of time for the novice user before it gets unbearable to come off them, but that piper has to be paid, medical user or recreational junkie. The piper still has to be paid. Swallow them, snort them, plug em or shoot em, it really doesn’t matter. The medical user will form both a tolerance which means they need a greater quantity to kill the pain, and a larger and larger amount to feel ‘well’ and not sick from the daily withdrawal symptoms. People cannot be kept on the same amount, or stepped down without withdrawals kicking in. The amount prescribed should be slowly increased over time to get the same effect and not have that medical user running to the dealers to get ENOUGH of what they NEED.
If the medics didn’t want to create stone cold junkies then they needed to be more pragmatic, more practical, and less judgmental. An illicit drug user, at risk from their drugs being tainted with poorly dosed fentanyl is at a far greater risk of death, social harm and physical danger, than an opiate user who is given their appropriate dose, that keeps them from any withdrawal and pain. Seriously, we all know someone who blows through their pain pill script in a week and then spends three weeks eating the dog’s tramadol! Heck, fido can go jones, if I was using, which I am not (I’ve been clean since 2017), fido, grandma, would have to cough up, and that would still not be enough to keep me going. I would have to go to a dealer.
I live in daily chronic pain from injuries caused by the abuse perpetrated on me by my husband. I can’t afford medical care. The pain is so bad that it limits what I can do. It wakes me up. It stops me getting around as well as I should. I am middle aged, but not so old that a trip to the Bay means every step hurts. I would not consider pain meds even if I had a legal script, not yet. I know for a fact that the only hope I would have of being even vaguely ok would be to go on the dreaded methadone on maintenance treatment. I am not suggesting everyone go on methadone, but doctors would do well to look at whether or not the pain is long term and severe, and if it is to go towards maintenance instead of their useless pain clinics and meditation. The push towards getting people off their medications is what is killing people.
For the ‘junkies’ those users who rely on illicit supplies to medical users upset that the opioid ‘epidemic’ means that they are facing their scripts being removed, everyone who uses drugs that don’t come from the doctor, is in danger. As an aside, it is not the junkie’s fault. The junkies have always been there, their legions are pretty stable, and decreasing, since the quality of what they desire is hardly worth the risk.
Instead to blame instead, is the tactics used by doctors, putting people on these needed meds, then taking them away abruptly is creating a whole generation of fiends who are ill-equipped to handle the hard drug scene and the vagaries of dealing with a supply that is not constant in quality, content and price. They think they are buying norcos but instead get little pressed nuggets of fentanyl, then either get a raging habit they are not prepared for or else pass away from either overdose, or the dangers that surround getting their medication.
The trade in pods and seeds to make ‘tea’ out of which tided over many medical users when their scripts became not enough to keep them from being forced to live in a life destroying state of withdrawal, was shut down. They are now impossible to get. Even prescribing these to junkies and medical users would have been a better solution then sending people towards a tainted and lethal drug supply.
The real problem here is the fentanyl and the fact it has seeped into every drug on the market from benzos to pills and even cocaine. If the government want to save lives, shutting down the trade in precursors for this lethal drug should be a priority. Out there somewehere are an entire army of smack-driven walter whites creating death and destruction for 100,000 American lives and those of the people they left behind.
I know no one is listening to me, but my recipe for fighting the opioid issues would be unacceptable but I don’t think it could be worse than the current prohibition.
- Easily accessed maintenance therapy using drugs that people actually want. If their drug of choice is oxy, give it to them. If they need tramadol, get them tramadol. If they require diamorphine, give them diamorphine. Not everyone suits methadone. Suboxone is not an adequate pain medication.
- Acknowledge that anyone prescribed opiates has the potential to be a life long opioid patient and instead of fighting it, as long as they need and want the drugs, give them a clean safe supply.
- That clean safe supply must accept that tolerance exists as a scientific reality. People get addicted at any level of use of opioids. With use comes tolerance. Tolerance means more and more is needed over time to stay well and function in society. Give people as much as they need so they can focus on living instead of ensuring their needs are met with regards to the drug they require in order to live.
- No putting people into levels of ‘innocence’. There is no shame in being an opioid user and needing that drug to survive. Medical users are not superior to those who started using for other reasons. It is a need that requires fulfillment, otherwise people will die from tainted dangerous supply. Throw shame out the door. It is killing people.
- Respect people’s preferred route of administration. If they inject they inject. Give them drugs that are safe to use in the way they want to use them, do not push them towards easily shootable illicit supply. As it currently stands, the ‘anti abuse technology’ in pills is causing limb loss and suffering. It stops no one injecting that wants to inject. Make drugs as SAFE as possible, not dangerous.
- To that end provide the things people need to use safely. I support safe injection clinics, but let’s face it, who wants to get high in a ‘clinic’. Make things low barrier. Let people take their drugs home. Yes, some people will die, but these are those who would have died anyway and who have always passed from addiction. I find, my self included, with a safe supply, people tend to use less, not more. Feast and famine mentality is lethal when talking about opiates.
- Shut down the manufacture of chemicals used to make fentanyl. Fight the fent. Get rid of it, apart from needed medical useage under supervision. This would be my only caveat to the freedom manifesto. No fent.
The death and destruction can’t be halted with this current tactic of prohibition, judgement, and control. People can live functional lives and be users of opiates. Help, instead of censure. I don’t see it happening. People always like to feel superior, and that addictive feeling of being ‘better than’ others is killing innocent human beings. Isn’t it time that we as a society kicked it to the curb?