Here's why there are no 'good' or 'bad' drugs – not even heroin

[Chip (OP)]

source: https://www.theguardian.com/commentisfree/2016/jul/14/drugs-policy-heroin-psychoactive-substances

Here's why there are no 'good' or 'bad' drugs – not even heroin

As Allison’s story shows, with any psychoactive substance, the balance between help and harm depends on the person and the circumstances


Collection of Pills in Glass, head-shaped. Image shot 2008. Exact date unknown.

Before she found heroin, Allison could not get out of bed most mornings. She contemplated suicide. She saw herself as “a shitty lazy person who felt like crap all the time”. She was deeply depressed, and no wonder. As she explained in an interview with NPR last month, in slow, halting sentences, she’d been molested by three family members by the age of 15. One of the three was her father.

Listening to Allison recount the horrors of her young life, most of us feel great pity. If we were psychiatrists, we’d need little justification to prescribe any drug that might help alleviate her suffering. We’d probably start at one end of the long list of approved antidepressants – and keep going. But heroin?

Heroin, Allison explained, “made me feel as if I could get up and do something”. She could function. “I was great at my job ... and I was doing art on the side. I had energy for the first time in I don’t know how long.” In other words, she had vanquished her depression – with an illegal, highly addictive, “recreational” drug that she bought off the street.

It would be wrong to deny that many heroin users suffer great harm as a result of the position their addiction places them in. And I would advise anyone who experiences debilitating depression to seek professional help. But it would also be wrong to classify strong opioid drugs, and other substances currently disparaged by our society, as intrinsically “bad” or “evil”.

In some parts of the world, people seem to be getting smarter about recreational drugs. For a couple generations, “soft” drugs like marijuana and hashish have been increasingly tolerated, more broadly viewed as socially acceptable and, finally, in several European countries and a few American states, legalized.

And why not? These drugs help people relax, enjoy music and philosophize. In fact, pot is far safer than booze in every respect. It makes you silly but not aggressive, it has none of the well-documented health risks of alcohol, it’s far less likely to lead to accidents, and it’s not generally addictive, psychologically or otherwise. (Some people do end up with a cannabis habit that hampers clear thinking and short-term memory, but these effects disappear when they cut down or stop.)

Then come the psychedelic drugs: LSD, psilocybin mushrooms, mescaline and the currently stylish (in some circles) ayahuasca. There is ongoing debate about whether psychedelics are good, bad, safe or unsafe. But compare that dialogue to the tyrannical edicts of the 60s. When I was an 18-year-old in Berkeley, California, in 1969, my friends and I had wrenchingly beautiful interactions with forests, seascapes, music, and each other – on acid. Like Aldous Huxley and other intellectuals, we saw psychedelics as a gateway to a more inclusive, less self-centered sense of reality. We generally couldn’t share those views with our parents nor, certainly, with the police or the courts. Yet despite that, societal views were in flux.

In fact, the promise of psychedelic psychotherapy has intrigued scientists and clinicians for decades. A recent wave of research suggests that psychedelics can relieve psychological suffering, from depression, anxiety, PTSD and alcoholism to end-of-life fears. Presently, thousands of young people from North America and Europe are trying ayahuasca, a powerful psychedelic used for self-growth and healing by indigenous cultures in the Amazon region. Like their hippie predecessors, many of these “psychonauts” feel they’ve gained something essential from the experience: a broader vision of reality, connection with other people and cultures, a bond with the planet and a commitment to its wellbeing.

Well, maybe the soft drugs are better than booze, and psychedelics have greater potential for good than for harm. But what about drugs such as heroin, methamphetamine and cocaine? In keeping with the punitive policies of the DEA, and the battle cry of the “war on drugs”, most of us still see these drugs as unequivocally bad.

Indeed, heroin and meth lead to addiction – and to misbehaviours ranging from lying and petty theft to full on criminality. After years as an addiction expert and a one-time addict, I recognize how dangerous these drugs can be. And I know that the cycling of desire, acquisition and loss leads not only to compulsive drug seeking (and associated brain changes) but also to a narrowing spiral of social isolation, shame, and remorse. Can there be anything good about drugs that are often too attractive to resist?

For Allison, the good was undeniable. Heroin helped her overcome a depression that very likely arose from her history of sexual abuse, a trauma that left PTSD in its wake and drained her life of joy, functionality, and any semblance of normality. Allison represents the rule rather than the exception. PTSD often triggers anxiety and depression, and substance abuse is as high as 60–80% among those with PTSD. In fact, the largest epidemiological study ever conducted found an extremely strong correlation between the degree of childhood adversity and injection drug use.

When Allison got tired of heroin, she was able to quit, as most addicts eventually do. She found a psychiatrist and learned to live without it, though she reports that she continues to rely on antidepressants. The point is that, for her, heroin was an antidepressant – a very effective one.

It shouldn’t be surprising that a powerful opiate can help people overcome psychological pain. Opioids are critical neurochemicals, helping mammals to function in spite of pain, stress and panic. Rodents play and socialize far more easily after being given opiates. Opioids are even present in mother’s milk: they are nature’s way of ensuring an emotional bond between infant and mother. Opiates might be too attractive for some people some of the time; obviously addiction is a serious concern. But that doesn’t make opiates intrinsically bad.

I doubt whether there’s much to recommend meth for today’s youth, and clearly meth and coke can destroy lives. But coca leaves were used to overcome fatigue in Latin America for centuries before Europeans figured out how to turn them into cocaine. Like opiates, it seems that stimulants can be of benefit in particular contexts.

It becomes impossible to define the “goodness” or “badness” of drugs according to drug type – in the abstract. Rather, the balance between potential help and potential harm depends on the person and the circumstances.

The human nervous system is an incredibly complicated chemistry set, and we experiment with it continuously through our actions, our loves, the things we eat and drink, and, yes, the substances we ingest for that specific purpose. Tinkering with our nervous system is a direct expression of our ingenuity and our fundamental drive for self-improvement. We’re not likely to give those up.

The failure of the “war on drugs” should help us recognize that people will never willingly stop taking drugs and exploring their benefits and limitations. It’s ridiculous to deal with this human proclivity by labelling most or all drugs as “bad”. And it’s absurd to mete out punishment as a means for eliminating the drugs we don’t like. Instead, let’s expand our knowledge of drugs through research and subjective reports, let’s protect ourselves against the dangers of overdose and addiction, and let’s improve the lives of children raised in ghastly circumstances.

Then the problem of “bad drugs” will no longer be a problem.

[Griffin]

That is exactly how I felt before I tried opiates, worthless, depressed, tired, weak, no energy or motivation, anxious, non social, pissed off, and scared. After the first dose I knew I was going to be addicted, to have all that go away all the angst and sadness I had dealt wit for the past decade gone and was replaced by everything that I wanted to be. No more panic attacks, suicidal ideation, isolating myself, and hating the world, I felt like a normal person for the first time in my life that I could fit in, and get out of bed.

I have always thought that the people who were like that before tend to get addicted, I have noticed that for the people who opiates give energy too instead of knocking them out are way more prone to addiction, and feel normal after taking it, kind of like when adderal calms people down or makes them tired. I believe in the mental benefits from psychedelics too, after taking shrooms the first time my anxiety and panic attacks lessened and my suicidal ideation disappeared for nearly a year.

[bleakview]

Good article. One thing that has always annoyed me about certain sections of the psychedelic community is their instant dismissal of opiates as "dumb drugs" with no value.

[FreedomOrBust]

That is exactly how I felt before I tried opiates, worthless, depressed, tired, weak, no energy or motivation, anxious, non social, pissed off, and scared. After the first dose I knew I was going to be addicted, to have all that go away all the angst and sadness I had dealt wit for the past decade gone and was replaced by everything that I wanted to be. No more panic attacks, suicidal ideation, isolating myself, and hating the world, I felt like a normal person for the first time in my life that I could fit in, and get out of bed.

I have always thought that the people who were like that before tend to get addicted, I have noticed that for the people who opiates give energy too instead of knocking them out are way more prone to addiction, and feel normal after taking it, kind of like when adderal calms people down or makes them tired. I believe in the mental benefits from psychedelics too, after taking shrooms the first time my anxiety and panic attacks lessened and my suicidal ideation disappeared for nearly a year.

Same here.  The first time I consumed a prescribed opiate, I remember thinking: "so this is what normal healthy people feel like".  Realizing I could feel this way all the time, I started growing them and consuming opium straight from the pod.  I knew where it was going to lead, but to me, I didn't feel like there was much choice.  I was anxious and miserable inside my own skin, and a dose of opiates could change my outlook and bring me  moral calm that was not achievable to me in any other way.

If we believe that diseases can be caused by chemical imbalances, I don't see what is so far-fetched about the idea that some of us just cannot create enough dopamine, endorphins, or serotonin on our own to feel right?

Sure, life traumas play a part in all of this, but I've yet to see any comprehensive therapy that can address the damage caused by traumas and eliminate the desire for drugs to ease the consequences of trauma.  There are a few exceptions - back on Ophile, I recall a young lady that used ibogaine therapy to successfully eliminate a heroin habit.  I hope she is still okay and hasn't relapsed.  But, there are plenty of other people that have tried ibogaine and not had as much luck with it.

Point being, sometimes the drug is the only option and no one should be criminalized for taking this path.  If we stop this prohibition nonsense, cheap, clean gear would become available everywhere and drug-related crime would mostly stop.  Yes, you'd still have the consequences of drug abuse, but we have those now, even with the most stringent drug laws in the history of mankind.

I say we decriminalize all drugs and just extend all of our regulations on alcohol and apply them to drugs - that keeps them out of the hands of minors and allows consenting adults to make their own choices.

[Bodytec]

Wow what a great point made by everyone! I of course am one of the people that opiates gives energy to as well as it stops my life-long depression and anxiety. My wife has recognized this fact for years but at first she didn't understand. When she first saw how more 'me' opiates made me feel,she has always tried to help me acquire whatever remedy was available,wether it was oxy,heroin or while I used Suboxone as well as Methadone during the years I went the treatment/maintenance route. Of course there is a ceiling on 'done and subs and I don't feel that they give all the social abilities back to the user that full 'open-door' opiates do. However,those two are able to give great relief from most problems like depression and lack of motivation.

I think that all reasonably strong opiates should be on the arsenal of psychiatrists as weapons to combat these problems. If one person responds great and is satisfied with hydrocodone,then prescribe hydrocodone. If it takes oxymorphone to alleviate another's symptoms,then oxymorphone should be able to be prescribed. Obviously extreme pain would not be the complaint at a psychiatrists office so things such as fentinyl would not be prescribed.

Just an idea...

[Daughter of Dionysus]

The easy answer
To that statement
Is
B/c inanimate objects
Do not possess the abilty
To be good or bad
It's what people do with them
That determines
If they are good or bad

[Zoops]

You know, a huge part of the "problem" is that most people would never acknowledge that one might be helped by an opiate, in a non-medical setting, for a psychological complaint.

The medical community is well-aware of the psychological benefits of opiates. Maybe someday soon we'll see an FDA-approved indication for anxiety or depression for an opiate drug. It would probably be some new synthetic shit with SSRI activity built into it too like tramadol. Surprised they didn't seek an indication for depression when Ultram hit the US market.

[LadyKalma]

I see this thread is two years or more old, no need to point that out. And rip zoops. But the info is still relevant.

I hope this view is becoming more mainstream, but pretty much everyone i talk to knows all about prohibition and the war on drugs, and how that creates the real issue. Even since junkies are buying into the myth that they have problems cause they do drugs that are "bad" and therefore are bad people. This kind of bullshit keeps people addicted, so the jokes on those spreading such ideas. They're generally the people who are bothered by heroin use.

I never felt like doing anything before opiates, that's not even much of an exaggeration. Of course, I was obsessed with ang that might change your mind state before I had any opiates. Started by stealing diet pills around age 9. Anyways, all that apathy and exhaustion was pretty much not a problem anymore with opiates. From the age I started using til I had to stop, I had motivation, was driven, was seen as accomplished and smart. All As in school, went to the honours college of my state on full scholarship, was moving to in the restuarant field and became sous chef, had my own projects in life, bought a house, went on trips, etc

Sure, I was in withdrawal at times, but the more I see how effective it was in my life and how much I've fallen off since not using everyday, man, it seems like such a waste of my life to be clean. I have been having a harder time getting access keeping a job clean then ever before. And I've been using a lot more of other drugs that don't have as positive of effects in my life at all.

Anyone who could feel this could not tell me it'sa black and white issue, it's bigger than a question of legality. That's why it breaks my heart that they still sell that idea that clean is the only way your life can be good. I might just be depressed right now (not surprisingly) but I seriously feel like I'm wreaking havoc on my life and potential to succeed without opiates in my life regularly.

[bignasty]

Obviously extreme pain would not be the complaint at a psychiatrists office so things such as fentinyl would not be prescribed.

Just an idea...

Why no fent for depression? I'd rather have a 100mcg gel patch to chew and/or a 400mcg fentora or two to suck on than a shot of heroin. Fent gives me more energy and a better buzz than any other opioid I've ever tried.

Well, except dilaudid's rush when I had a smaller tolerance. If I could have it my way, I'd start out every single day with a fat, high-dose shot of hydromorphone followed by a bunch of fentora's to suck on all day and then a fat shot of H before bed so I won't have to get up every few hours to suck on a fentora or shoot some dilaudid.