Prescription Pain Killers: The Real Gateway Drug

[_Analytics]

They are both gateway drugs...it is a lifestyle change and a party attitude. I would bet far more heroin addicts smoked pot before they took prescription drugs.

In the 70’s and 80’s, it was beer, pot, then reds and whites, acid, meth then heroin. When I was in Jr high you could get a “rack” of whites, or reds for a buck or two.

I’ll give you today PD are certainly a huge gateway drug. And a growing problem worse than pot in different ways.

Have you ever been addicted to any type of drugs? Have you ever been homeless, or been to jail?

Pot is very addictive mentally to many folks, and some just remain pot heads, other graduate...and others can just be a casual user...that is a reality.

Do you smoke pot? How much have you smoked in your life...just curious.

I've never been to jail. Never been homeless.

The first time I smoked pot was when I was 28--a few months after the first time I tried alcohol. While the effects of the alcohol were obvious and powerful, the effects of the pot were not. Over the last 20 years, I've probably tried pot a dozen times. Of those dozen times, there were only three times when there was an effect that I could notice. From my limited experience, whatever pot does to you is smooth and subtle. Unlike alcohol, it is very natural feeling. From my experience, pot is kind of like coffee--I had two cups of coffee today so far. Have they had an effect on me? Probably, but it isn't obvious.

One of the times when the pot had an obvious effect on me was particularly memorable. I had this feeling that some really cool ideas and insights were coming into my head, but then I would completely forget them before I could processes them and analyze them. I heard myself saying things like, "Wow! Dude! I just had the coolest idea! But I don't remember what it was! But it was amazing!" I keep on telling myself that I need to go to a dispensery the next time I'm in Colorado, but every time I'm there I'm too busy with other things and I totally forget until after I've left.

The thing is, all of these experiences have been in my friend groups that are successful guys. We all have great jobs. We all make above-average incomes. When somebody breaks out the pot almost everybody says "why not" and participates. And then they get up the next morning and go back to their jobs as the high-performance sales guy or the CFO or the attorney or the computer programmer, and they don't think about pot at all for months until the next party when somebody breaks it out. And then they take it again, and afterwards return to their high-performance lives without so much as a hangover. I've been observing this cycle for 20 years now. It never escalates. Of these people, none of them have a debilitating craving for pot. Not even close. Much less do they have a craving to kick it up to the next level and start doing Meth or Heroin or whatever.

In contrast, read the blog in the OP. I happen to know as a personal fact that the missionary from the OP was a much more self-disciplined guy that me. He served commendably in the marines for 4 years. He never broke a mission rule. He never slept in. When he fell in love with a girl, he didn't flirt with her or otherwise do anything inappropriate. He went to the mission president, told him everything. He never hit on her. Never kissed her. Never did anything. He just felt something, and then went to the mission president to deal with it.

So compare him and me. I broke of the mission rules at least once. When I fell in love with the same girl I had a fling with her as a missionary (and eventually went back and married her). I never confessed it--I just wasn't a guy who could open up in an interview with a bishop or mission president. I left the church. I am an atheist. I have a drink or two every day. I smoke pot whenever the opportunity arises (although that isn't very frequent--I'm too busy with other things and otherwise don't think about it). Ditto with smoking cigars.

So compare the casual-pot-smoking, alcohol drinking, undisciplined atheist to the straight-laced, self-disciplined Mormon firefighter who started taking prescription opioids in the aftermath of a horific accident. Which one is highly successful in life, and which one is a convicted fellon?

The reason why he is the one whose life has gone to crap is because he became addicted to opioids. The reason mine hasn't gone to crap is that I'm not suceptible to serious alcohol addiction, nor am I suceptible to marijuana addiction. As a matter of fact, being addicted to marijuana is barely even a thing--pot addiction is in the same universe as coffee addiction. That is a different universe than being addicted to opioids or meth.

[_Doctor Steuss]

I think with all addictions it depends upon ones body chemistry or receptors or something like that.

A personal anecdote to tie into this (since I seem to have a penchant for oversharing lately).

In my spring chicken days, prior to being properly diagnosed, and medicated, I “self-medicated” with a laundry list of substances. While I never did heroine, I've smoked opium, I’ve been prescribed Norco and Lortabs, and I have received Dilaudid injections at an ER before. Of all the things I have taken, there have only been two things that left me going through withdrawal and nearly uncontrollable cravings. Cigarettes, and Ritalin.

On the other side of the spectrum, a good friend of mine had only smoked pot twice (he didn’t like how it made him feel), and drank on occasion. He had never tried anything else. He was injured on the job (his back), and was prescribed opioids. Eventually, he was doing odd jobs, pawning his wife’s jewelry, and raiding his kids’ college accounts in order to pay for pills. Thankfully, he’s been off of opioids for three years now, and manages his pain through restorative yoga, and CBD.

[_cinepro]

Interesting thread, Analytics. Thanks for starting it and sharing your friend's experience.

This last summer I experienced an injury from being stupid while recreating that required surgery and physical therapy to repair....

Thanks for sharing your story. Last summer, I was invited to attend a panel with several Governors speaking about how they're battling the opoid crisis in their states, and it was really eye-opening about how big of a problem it is. Scott Walker was there, and he said they had to get the real estate agents on board and tell them to lock up the medicine cabinets when they do open houses because addicts were going to open houses to look for pain killers!

Another presenter talked about how his teenager had recently had their wisdom teeth out, and the doctor wanted to prescribe opoids but they were able to get by with just Advil. But if we're not aware of the problem, doctors are all too willing to prescribe powerful pain killers as the first option.

It's a tough problem, and unfortunately it looks like the pharmaceutical industry is going to have to be a key participant in solving it (both limiting supply and educating doctors). But they obviously don't want to.

Trump just announced his plan to try and abate the problem:

http://thehill.com/homenews/administrat ... ers-report

[_cacheman]

So, of all the heroin addicts that have died, the percentage that didn't smoke pot wouldn't even register as a percentage.

When you get into the inner cities, that is where you see the effects of pot. For every "successful" pot smoker, you will find more lazy kids not reaching their potential, sitting around the house waiting to see if Gilligan gets off the Island.

I hate the crap, I have seen it prevent potential in far too many peoples lives.

In street ministry, one common denominator you see, is that pot is a staple. Not everyone likes it, not all are chronic users...but it is just part of life in the inner city. Far too many drop out, and pot is a huge factor there.

Would you care if your kids or grand kids smoked pot? Are you okay with a dad coming home from a hard day of work and instead of drinking a beer, just take a few bong loads in his easy chair while the family is sitting around?

It is a hallucinogenic Glad, should acid be legal in small doses?

Hi Mark,


I use cannabis daily....a little before bed. Occasionally, I'll have some in the evening around the campfire. I've done this for decades, and have managed to be successful in my professional career and raise two well adjusted (now adult) children.

More than 25 years ago I was homeless for over a year. I did a short stint in jail, and was dropped off at the ER once after an OD. I was using whatever drugs I came across at the time. I was sent to a lockdown drug rehab for 30 days before going to a halfway house. I didn't change. Then I met my wife, and didn't need the self destructive habits anymore. I had responsibility and purpose from that time on, and over time realized that my primary issue was depression.

For the last 25 years, my life has been much different. I'm not attracted to the hard stuff (opioids or alcohol), but the small daily amounts of cannabis and the occasional psychadelic experience have, for the most part kept my depression in check. I, like many others, use responsibly.

Cannabis has never been a party drug for me, but just another tool in my toolbox. Alcohol was the gateway drug for me, and I wouldn't be surprised if that's true for most. I don't touch alcohol myself, but I know that people can use it responsibly. It would be presumptuous of me to assume that alcohol should be illegal based on the fact that I personally find no value in it.

-cacheman

[_Morley]

Nice thread. Thanks to all.

[_Jersey Girl]

Thankfully, he’s been off of opioids for three years now, and manages his pain through restorative yoga, and CBD.

Your above points directly to the thing that I think is often missed when discussing MJ, though you are using the example of pain management.

Mark views MJ as a gateway drug, where folks going off opioids rely on it's properties via various forms of delivery, (smoking/edibles/cannabis-hemp oils) to deal with withdrawal from opiates.

[_Jersey Girl]

Heroin. I can name 3 deceased heroin addicts, one fentanyl overdose death, and 3 currently recovering heroin addicts in my sphere of experience, if you will.

Seven people.

Every single one of these folks' hard drug use was a shock to me. They are and were all good folks. Some very well to do and others middle class. Out of the 3 deceased, 2 of those folks were athletic. Not one was what you'd think of as a bottom of the barrel "bum".

Some stories of the deceased...

One an Italian boy I went to school with. All the girls fawned over him, he was so good looking and athletic as well. Richer than god, owned part of the family business and it's enormous wealth, and very well educated. Just before C'mas one year, he decided to get clean. Went to a rapid detox facility, came home to his parent's house, used again and was found dead that evening.

Another my first bf. Middle class with a family. Went to a shore bar one evening with his wife. During the evening of drinking he went out to the parking lot, shot up in the car, and died. I always imagined that I'd run into him on one of my trips home, we'd meet up for coffee and share stories and pics of our kids. I had that conversation in a cemetery.

Another bf. Total jock. Good looking, athletic. Had a family, good job, served as a coach. Heroin overdose in NYC.

WTH.

I can't help but wonder--what if they had access to MJ to get off heroin? I can't claim that they would have opted for rehab, but what if?

The fentanyl overdose. This is the SO of a relative I sometimes mention who is struggling with PTSD. He was first responder to her death in his own home. He is trapped in that home with the memory of that night. I can't tell you how many hours I have spent with him.

What if she had known that MJ could help her out? Would they be growing old together?

These folks and their stories, not to mention the 3 living currently recovering heroin addicts that are all blood relatives, disturb me more than I care to admit.

And my understanding is that Sessions wants to curb MJ use and cuts in health care are going to make it near impossible for those in need to access rehab services.

wtf

On the other side of this is a disabled veteran who lives with chronic pain and who can no longer get opioids RX'd which he only ever used sparingly perhaps once a month.

Wtf are we doing in this country?

I'm heartsick over these people.

[_MeDotOrg]

Jersey Girl, I think your experiences show what the overprescription of opioids has done. It erased the line between heroin, illegal opioids and prescription opioids. Prior to the go-go nineties and oxycontin, the market for legal opioids was well-regulated, largely because heroin addicts had difficulty penetrating the structure. People with chronic pain had access to opioids. There was some abuse, but it was minor.

The overprescription of opioids followed by the subsequent reduction of opioid prescriptions has unleashed a generation of prescription opioid addicts onto the black market. That has created heroin inroads into parts of society that were heretofore difficult to reach, which has subsequently made it more difficult for legitimate chronic pain patients to receive relief.

I had a friend who was a Doctor who became a Vicodin addict. To save her license she went to rehab at a special clinic with a lot of other doctors. When you look at Doctors who become opioid addicts, it really shows you the power of the drug to ruin lives. These are the people with the keys to the supply cabinet. When they become addicts, there's rarely an economic or supply brake on the addiction process. The results are dramatic and devastating. One of her recovery group was an anesthesiologist who was addicted to Fentanyl. He really struggled, but washed out.

A tragic but funny story was about another Doctor Vicodin addict. She came from a small midwestern town, somewhat provincial, and wore Peter Pan Collars to group meetings when most people wore sweatshirts. Her addiction came to a head because of a delay between the pharmaceutical supply company, United Parcel Service, and her office. After no delivery for several days, the Peter Pan collared pillar of her community assaulted the UPS driver when he had no Vicodin. Only as she was being handcuffed and hauled off to jail did it occurred to her that she might have a problem.

It's funny and tragic, but it may have been a blessing in disguise. It gave her an opportunity to face her addiction.

[_cacheman]

Mark views MJ as a gateway drug, where folks going off opioids rely on it's properties via various forms of delivery, (smoking/edibles/cannabis-hemp oils) to deal with withdrawal from opiates.

Very true. Recent studies have also demonstrated this benefit...not to mention the uses of cannabinoids in a number of other medical applications.

My SIL lives in Colorado, and started having back problems a year or two ago. She's now addicted to prescribed opioids (oxycodone and now a patch....possibly fentanyl). She has no prior drug experience, and trusts her doctors implicitly. She adamantly refuses to even consider Cannabis as an option due to religious/cultural influenced preconceptions. She's at that scary stage where she's experiencing withdrawal symptoms between doses.

Meanwhile, we have pharmaceutical groups pumping money into anti Cannabis opposition groups fighting medical use legalization. We are experiencing that right now in our state.

I don't know that the legal availability of Cannabis would stop the opioid epidemic, but there's growing evidence that it could have a significant positive effect.

-cacheman

[_EAllusion]

That's a good point to bring up cacheman.

The published literature suggests that legalization of marijuana reduces recreational opiod use and overdose death. This is probably because people turn to marijuana as a pain killer and recreational drug alternative when it is more easily available.