Busted ankle and Opioids

[frozenchief]

Originally Posted by SupDock

so your claim is that you do not risk a physical opiate addiction unless you take the medication for months? That's just completely false

Here is a CDC article addressing this
https://www.cdc.gov/mmwr/volumes/66/wr/mm6610a1.htm

For some reason it posted my answer before I finished and it's just easier to put this in one place. No, my claim is that the risks that someone will develop an addiction to opioids based solely upon a script for post-surgical pain is small, certainly small enough to not be in pain for fear of addiction. The article you supplied actually supports my position in several ways.

First, the article addresses how many people, having started opioids, are still using them a year later. The article notes that about only 6% of people are using opioids a year later. Second, the article just focuses upon use to manage pain and does not focus upon withdrawal symptoms should someone quit. If you need to continue taking the pills because you are still in pain, then I think it's better to keep taking the pills. But if you are taking the pills because it is pleasurable, because you have some psychological need to or you suffer withdrawal symptoms, then it is better to quit taking the medications. The article does not address this distinction.

The article notes that crucial days are the fifth and thirtieth, meaning that continuing to take the meds after those days demonstrates a higher risk (again, not a certainty) of having to continue to use the medications. This makes sense from a pain standpoint: if your body hasn't adjusted after thirty days, then its odds of adjusting are quite low.

One reason I expect we disagree is because we are looking at the data from two different fields of study. In my field of study, mere use a year after an injury would not mean addiction. If someone were in a horrible car crash and crushed several vertebrae, pelvis and legs, I would not be surprised if that person needed pain management for the rest of their life. But that it because of the physical condition of their body, not because they are demonstrating drug-seeking behavior.

One reason for my skepticism is I see DEA agents, the CDC and National Office of Drug Policy (or whatever their name is) put out ads that really do not reflect the reality of recreational/addictive drug use. "One Hit of Meth (or fill in the drug) Will Make You An Addict!!!!" scream the headlines. The reality is far different. Most people don't start recreational drug use by using meth. And most people who are willing to recreationally use meth/heroin/cocaine/oxy have already heavily dabbled in drug use and are thus more at risk for drug-seeking behavior.

One deficiency with the paper you posted is that participants had to not abuse substances for the previous six months. That says to me that the participants in that study are more likely to be using opioids because they actually need pain meds than because they are exhibiting drug-seeking behavior.

To sum, then, I do not think that OP's finishing his script of oxys to address pain after surgery will suddenly convert him into a mindless drug-seeker, destroying his life as he seeks more and more drugs. And I think that our current drug scare about addiction has done more harm than good by causing some people who legitimately are in pain because of injury/accident/surgery to avoid pain meds for fear they will suddenly turn into addicts.

I do recognize that abuse of oxys is higher right now than it has been. By abuse, I mean use of a drug for non-medicinal purposes. Taking 10+ a day is an indication of abuse. Grinding them up and snorting them is an indication of abuse. SMoking them is an indication of abuse. None of these were covered in your article and I seriously doubt that OP will be doing this by the time he finishes his prescription.

Such behavior is occurring more with oxys now because compared to some other drugs, oxys are currently easier to obtain. Demand for recreational drugs is similar to a balloon. It stays constant* while prohibition efforts tend to focus upon one drug at the expense of others. You can think of this as squeezing one end of the balloon. Yes, it will get smaller but the other end will bulge out of your hand. So prohibition enforcement focuses on heroin and meth becuase popular. THey focus on meth and oxys become popular. Oxys are likely to remain popular anyway because they come from pharmaceutical companies and thus their dosage is known and any fillers are safe for human consumption.

Since your article does not address any of those circumstances and appears instead to focus upon those who are legitimately using opioids, I do not find it relevant when discussing whether a short-term use of opioids will create drug-seeking behavior and I therefore stand by my earlier statements.


* since passage of the Harrison Narcotics Act of 1913, about 1.5% of the American population has demonstrated drug-seeking or addictive behavior. THat might rise a bit to 1.7%. Might fall to 1.25%. but its generally been a pretty straight line.