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Monday, December 4, 2017

WHAT ARE OPIOIDS?

Are you now or have you ever taken Robitussin A-C, Tylenol with Codeine, Vicodin, morphine and Resistor, or been anesthetized?  If yes, you took an opioid.

Medically, there are differences in these terms:

  • Opiate:  natural substances that come from opium (from the poppy flower), and includes morphine, heroin and codeine.
  • Opioid:  synthetic compounds like fentanyl and methadone.
  • Narcotic:  an agent that produces insensibility and narcosis.  Has generally fallen out of medical use.
Here is how to relate them:  an OPIATE is a subclass of OPIOID, which in turn is a subclass of NARCOTICS.  However, the term OPIOID is generally today used to cover all of them.

Opioids are taken mostly to relieve pain, but also to suppress diarrhea and coughing.  Some enjoy the sense of euphoria, resulting in recreational use, leading to addiction.  An overdose can result in death, usually from respiratory depression.  For these reasons most opioids are controlled.

Opioids have a sedative effect, but they disrupt sleep cycles.  Sleeping pills themselves are not opioids.  However, a combination of the two is associated with a greater risk of overdose.  Similarly, benzodiazepines (Xanax, Librium, Valium), which are not opioids, provide anxiety relief, are hypnotic and highly abused.

Of the following, cannabis or marijuana is not considered to be an opiate, but is illegal by Federal Law.  Many states have, of course, made this derivative from the flowers of a kind of hemp plant legal.  The active ingredients are THC and CBD, which you can Google should you wish.

Amphetamines are also not considered to be opioids.  They have been around for more than a century and are used as an aphrodisiac and to gain euphoria by some, also enhancing performance by athletes and musicians.  It was first sold as Benzedrine.  More recently, a way has been found in any lab to add a methyl complex, which makes this drug faster acting and more potent, increasing the level of dopamine in our blood by up to a thousand times.  There is intense pleasure and clarity.    The effect can last for as long as 12 hours, but the after effects the next day will hurt your decision-making and give you a headache.  It's relatively easy to make and is definitely habit forming, but not as much as heroin or smoking.  Methamphetamine is more popularly known as Crystal Meth or ICE.

By now you surely must be confused about what are, and are not, opioids.  Doesn't matter, the following are all illegal (save for the non-opioid marijuana or cannabis, here and there legally allowed by local legislation or not prosecuted, as in Amsterdam):
Global estimates of illegal drug users in 2014
(in millions of users)[91]

SubstanceBest
estimate
Low
estimate
High
estimate
Amphetamine-
type stimulants
35.6515.3455.90
Cannabis182.50127.54233.65
Cocaine18.2614.8822.08
Ecstasy19.409.8929.01
Opiates17.4413.7421.59
Opioids33.1228.5738.52
So what is this opioid crisis all about?  Two decades ago, Big Pharma convinced the medical community that patients would not become addicted to prescription opioid pain relievers.  In 2015, 33,000 Americans died from opioid overdose and an estimated 2 million from substance-use disorder of some kind.  A little more than a quarter of them from heroin (also called diamorphine), for there seems to be a direct link from a prescribed opioid to this dangerous drug.  Heroin:
  • Purified from morphine (opium/poppy).
  • Produced mostly (69%-90%) in Afghanistan, but also in Myanmar and other areas.
  • Afghan opium kills 100,000 annually worldwide.
  • Afghan cultivation of opium reached a peak in 1999 when 350 square miles of poppies were sown, dropping to 30 square miles in 2001 when the Taliban banned cultivation, only to grow back to nearly 300 square miles when the Taliban was removed, with the interim government encouraging this economic crop.
  • While you might have thought heroin was a dreaded drug that went away, nope:
  • Further, there are now more heroin overdose deaths than gun homicides in the USA.
  • Then there is cocaine, illegal, from coca leaves, mostly from South America.  This is not an opioid.  Why?  Who really cares.
  • Ecstasy (MDMA) is one of a range of recreational drugs and is also not an opioid and certainly illegal.
  • Also still around is LSD, which is unpredictable.  Not considered to be an opioid.
  • Subsys (Fentanyl)          $6,729 (30 spray bottles)
  • Oxaydo (Oxycodone)     $   845  (90 tablets, 7.5 mg)
  • Morphine (once/day)    $    425 (30 capsules, once daily)
  • Opium                            $    274 (for diarrhea, very confusing 
  •                                                        prescription amount)
  • Oxycontin                      $    260 (60 capsules, 10 mg)
  • Codeine                        $      28 (90 tablets, 30 mg)
  • Morphine                     $      26 (120 tablets, 15mg)
  • Crystal Meth (ICE)      $    100 (gram--a 40 mg snort can 
  •                                                     make you high, but some use 
  •                                                      a gram/day at a cost of 
  •                                                      $36,500/year)
  • Heroin                           $    200 (gram, but a single dose is 
  •                                                       0.1 gram, although a hard core 
  •                                                       habit will cost $200/day 
  •                                                       or $72,500/year)
  • Ecstasy                         $      19 (per pill)
  • LSD                               $    5-20 (per trip, which is 
  •                                                      50-150 micrograms)
Fentanyl is a hundred times more potent than Morphine.  However, there is something called Gray Death, which is heroin mixed with drugs used to tranquilize elephants, said to be 10,000 times stronger than Morphine.

Mississippi has the lowest drug costs, while Hawaii is the highest at around 50% more.  Walmart's average cost is about half that of Walgreens'.

Ninety tablets of Ibuprofen (as for example Advil) at 800 mg cost around $10:

According to the National Safety Council, 200mg of ibuprofen plus 500mg of acetaminophen is the most effective pain relief combination for acute pain—two out of three patients get pain relief from this drug combination compared to only two out of nine treated with 15mg of Oxycodone.  200mg of ibuprofen provides as much pain relief as a 10mg morphine shot.

The last time I was truly sick was almost three years ago when I caught the flu.  I also had a severe ear ache, so I took two tablets of Advil.  That's the only time I ever took pills to neutralize pain.  Not only did my ear ache go away, my flu ended after two days.

So why are opioids a danger to society?  They are habit-forming, ruining lives and families, driving up medical costs.  More than half of major crimes are linked to opioids.  However, the menace is more than from them, for there are ICE, the full range of recreational options and a range of other medically prescribed pills.  The worst part of all is that the problem is getting worse.

Well, the Dow Jones Industrial Average rose 58 to 24,290, yes, breaking another all-time record.

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