The Pharmacracy of Consent

[minuspace]

It is surprising to learn how dangerous methadone and subutex are, as sanctioned alternatives to heroin I was expecting otherwise.  Then again, I think by now people should be starting to see the difference between legal and illegal drugs becoming less distinct.  When the metrics of quantity and quality also star to blur, I think the stigma against "illegal" drugs will become less prominent.  The question is then what to do when the opportunity presents itself.  If it were possible to legalize cocaine, heroin and marijuana, is there anyone here that would object?

[Telarus]

Low doses of pharmaceutical uppers (the methyphenidate family) aid the mind in quickly determining what is a "useless distraction" in order to quickly ignore it for the task at hand. Doses above a personal threshold apply an influence towards repetitive hyperfocus on a task, even if consistently returning bad results.


Study Pinpoints Effects of Different Doses of an ADHD Drug; Finds Higher Doses May Harm Learning
http://www.sciencedaily.com/releases/2012/03/120308153537.htm

Strikingly, dosage had a major and unexpected impact. "At a low dose, the performance scores improved because the monkeys could control their impulses and wait long enough to focus their eyes on the target. All three were calmer and could complete a significantly larger number of trials," says Populin, who collaborated with Jeffrey Henriques and graduate student Abigail Rajala on the study.

At the higher dose, "performance on the task is impaired," Populin says, "but the subjects don't seem to care, all three monkeys continued making the same errors over and over." The monkeys stayed on task more than twice as long at the higher dose, even though they had much more trouble performing the task.

...

The study results had another parallel with daily life, Populin says. Drug dosages may be set high enough to reduce the characteristic hyperactivity of ADHD, "but some children say that makes them feel less creative and spontaneous; more like a robot. If learning drops off as it did in our study, that dose may not be best for them. Our monkeys actually did act like robots at the higher doses, keeping at it for up to seven hours even though their performance was so low."

The logical way forward would involve a similar study with people diagnosed with ADHD, Populin says. With millions of children, and an increasing number of adults, taking medicines for the condition, "We have to be very careful about finding the right spot on the dose curve, or we may get changes in behavior that we don't want. People think these drugs help improve memory, but our data say, 'No, your memory is not getting better.' At the higher dose, you get a behavioral improvement at a price, and that price is cognitive ability."

[minuspace]

Doctors routinely overprescribe ADHD Meds.  More effective remedies are overlooked in favor of promoting novel delivery methods.  See vyvanse?

[navkat]

Ha ha. Not anymore. It's getting damned-near impossible to refill my ADD-PI meds at even the VA bc there's some political shit about a shortage of the precursors going down.

Methadone is horrible but it's not anywhere near a heroin addiction. Do I believe heroin should be legal decriminalized? I'm going to say a thought-out, hesitant, reserved, "yes." Why? because motherfuckers are going to take it anyway. Mise well take danger and arrest and fear of getting help out of the equation.

Do I agree that methadone is essentially more harmful than a heroin (or in many modern cases now, Oxycontin/Lortab) addiction? Fuck no. FUCK NO. I've watched someone kick, dude. You have no idea. If taking methadone as a tool to "step down" from that shit is working for some people, let them be.

I think there's a definite bias against methadone because it's what The State provides as a solution. Just because it's allowed, doesn't mean it's the worst.

FUN FACT:
On some people who are in methadone Tx for opiate addiction, other pharms have an "opiate-like" effect on them. Because the methadone is competing for the opiate receptors, the effect of benzodiazepines, and dissociatives like MXE and Ketamine have different pharmakokinetics and altered mechanisms of action. This is being researched more but there is a fuckton of anecdotal evidence from methadone Tx patients who swear that Moxie (MXE, Methoxetamine) gives them an opite-like high during Tx.

[Anna Mae Bollocks]

I saw something on TV in the 90's about a program in the UK where addicts could get maintenance doses of their drug of choice, be it heroin, coke, whatever, on the condition that they stay crime free, i.e., no theft, no scoring extra drugs, etc. From what they said, it seemed to be helping. Of course I never heard any more about it and I imagine it's defunct, for all the usual stupid reasons.

Methadone addicts take a train into the city to get their juice, heroin addicts land in prison for robbing banks and stuff, but I couldn't tell you how much of this is because heroin is worse and how much is because of the way things are set up. I tend to shy away from heroin junkies since I kind of like having electronics and stuff.

[minuspace]

What about the children?

[Xooxe]

I saw something on TV in the 90's about a program in the UK where addicts could get maintenance doses of their drug of choice, be it heroin, coke, whatever, on the condition that they stay crime free, i.e., no theft, no scoring extra drugs, etc.

Not sure about drugs other than heroin, but a slightly more recent example: http://news.bbc.co.uk/1/hi/uk/8255418.stm.

They're always trials, and they always seem to be effective. Not just in the UK, either.

[AFK]

It is surprising to learn how dangerous methadone and subutex are, as sanctioned alternatives to heroin I was expecting otherwise.  Then again, I think by now people should be starting to see the difference between legal and illegal drugs becoming less distinct.  When the metrics of quantity and quality also star to blur, I think the stigma against "illegal" drugs will become less prominent.  The question is then what to do when the opportunity presents itself.  If it were possible to legalize cocaine, heroin and marijuana, is there anyone here that would object?

In a lot of cases MAT (medication assisted treatment) is more or less a last ditch effort.  Some people are able to do okay with it and be functional, they can repair relationships with families, they can get a job, and so on.  But for sure, for others it just becomes another drug to get addicted to. 

An interesting tangent, here in Maine our Mainecare program has provided coverage to those in need for MAT.  The rate was $70/week but recent legislation that has gone through is going to cut that back to $60.  That covers the actual medicines as well as the counseling that may or may not be happening alongside the MAT.

[Forsooth]

Doctors routinely overprescribe ADHD Meds.  More effective remedies are overlooked in favor of promoting novel delivery methods.  See vyvanse?

Ha ha. Not anymore. It's getting damned-near impossible to refill my ADD-PI meds at even the VA bc there's some political shit about a shortage of the precursors going down.

(i'm a technician at a local retail pharm on nights and weekends)
'import limits' and bureaucratic stuff aside, I find that a majority of the people getting the stuff are over the age of 40, didn't start until a few years beforehand.

they take 40mg+ of Adder daily and bitch SUPERFUCKING hard when they're told its 'too early' or 'we're out of stock'. I blame shortages on them.

the people with children using the ADHD's? They all use the extended release stuffs (which was not on back order) and hardly complain when something goes wrong

Perhaps the old folks do indeed have ADHD and a legit need for meds, but how did they deal with it for 20+ years before?
Most appear to have a job/pill coverage, so they had to have been able to get some shit done without medificating

[Roly Poly Oly-Garch]

Do I agree that methadone is essentially more harmful than a heroin (or in many modern cases now, Oxycontin/Lortab) addiction? Fuck no. FUCK NO. I've watched someone kick, dude. You have no idea. If taking methadone as a tool to "step down" from that shit is working for some people, let them be.

I think there's a definite bias against methadone because it's what The State provides as a solution. Just because it's allowed, doesn't mean it's the worst.

...Then there's that damned unpredictable Instant-Kill-Quick potential Heroin has. Be hard to compare any real or imagined side-effects of Methadone to "whoopsy, I dead." Haven't read research knocking Methadone (cause I don't care), but even if it's more lethal than Heroin there's no way it's as unpredictable.

But on the other hand...FUCK THE MAN, MAAAAAN!

[AFK]

I think there is a lot of merit to the debate on both sides, the government being involved or not.  But we have to do something for those addicts for whom outpatient/inpatient/residential, etc. is just not going to do the trick.  I think you're right though, I think methadone, while not being a warm/fuzzy approach, is certainly going to provide a better outcome for the individual compared to a runaway train of unfettered heroin abuse. 

[BabylonHoruv]

Do I agree that methadone is essentially more harmful than a heroin (or in many modern cases now, Oxycontin/Lortab) addiction? Fuck no. FUCK NO. I've watched someone kick, dude. You have no idea. If taking methadone as a tool to "step down" from that shit is working for some people, let them be.

I think there's a definite bias against methadone because it's what The State provides as a solution. Just because it's allowed, doesn't mean it's the worst.

...Then there's that damned unpredictable Instant-Kill-Quick potential Heroin has. Be hard to compare any real or imagined side-effects of Methadone to "whoopsy, I dead." Haven't read research knocking Methadone (cause I don't care), but even if it's more lethal than Heroin there's no way it's as unpredictable.

But on the other hand...FUCK THE MAN, MAAAAAN!

That's mostly because heroin is illegal, so the dosage and purity isn't known.  Heroin of known dosage and purity isn't any more likely to kill someone than morphine is.

From what I've read methadone is more toxic than heroin, but it is also less addictive so it makes sense as a way to step off heroin.

[navkat]

Do I agree that methadone is essentially more harmful than a heroin (or in many modern cases now, Oxycontin/Lortab) addiction? Fuck no. FUCK NO. I've watched someone kick, dude. You have no idea. If taking methadone as a tool to "step down" from that shit is working for some people, let them be.

I think there's a definite bias against methadone because it's what The State provides as a solution. Just because it's allowed, doesn't mean it's the worst.

...Then there's that damned unpredictable Instant-Kill-Quick potential Heroin has. Be hard to compare any real or imagined side-effects of Methadone to "whoopsy, I dead." Haven't read research knocking Methadone (cause I don't care), but even if it's more lethal than Heroin there's no way it's as unpredictable.

But on the other hand...FUCK THE MAN, MAAAAAN!

That's mostly because heroin is illegal, so the dosage and purity isn't known.  Heroin of known dosage and purity isn't any more likely to kill someone than morphine is.

From what I've read methadone is more toxic than heroin, but it is also less addictive so it makes sense as a way to step off heroin.

What are you talking about? People fuck with their Oxy all the time and die. Opiates are CNS depressants, you take too much, your body forgets to do shit like uh, breathe and uh, pump blood, bruh.

Oxy and lortabs are of known dose and predictable pharmacokinetics to these patients. The problem is, they don't care and/or they aren't careful. They take too much, wrong route, take with alcohol, etc. Then they wind up on the back of a truck with someone like me pushing narcan into their ass.

[AFK]

That. 

[Roly Poly Oly-Garch]

Do I agree that methadone is essentially more harmful than a heroin (or in many modern cases now, Oxycontin/Lortab) addiction? Fuck no. FUCK NO. I've watched someone kick, dude. You have no idea. If taking methadone as a tool to "step down" from that shit is working for some people, let them be.

I think there's a definite bias against methadone because it's what The State provides as a solution. Just because it's allowed, doesn't mean it's the worst.

...Then there's that damned unpredictable Instant-Kill-Quick potential Heroin has. Be hard to compare any real or imagined side-effects of Methadone to "whoopsy, I dead." Haven't read research knocking Methadone (cause I don't care), but even if it's more lethal than Heroin there's no way it's as unpredictable.

But on the other hand...FUCK THE MAN, MAAAAAN!

That's mostly because heroin is illegal, so the dosage and purity isn't known.  Heroin of known dosage and purity isn't any more likely to kill someone than morphine is.

From what I've read methadone is more toxic than heroin, but it is also less addictive so it makes sense as a way to step off heroin.

What are you talking about? People fuck with their Oxy all the time and die. Opiates are CNS depressants, you take too much, your body forgets to do shit like uh, breathe and uh, pump blood, bruh.

Oxy and lortabs are of known dose and predictable pharmacokinetics to these patients. The problem is, they don't care and/or they aren't careful. They take too much, wrong route, take with alcohol, etc. Then they wind up on the back of a truck with someone like me pushing narcan into their ass.

You know your shit. I'm curious--if Heroin were legal and uniform and yada-yada, ya think the slower pharmacokinetics of something like oral Lortab might actually increase risk of accidental OD versus IV Junk? The hypothetical being, you kind of feel it kicking in, so you pop another one, feeling better, pop another one, kind of oblivious, pop another one...instead of slamming, where it's push the plunger and maybe get the needle out before you nod?