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Down Here, They Sometimes Call It 'Boy'

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Re: Down Here, They Sometimes Call It 'Boy'

#21
post #15

Earlier quoted context omitted.

I think there's more variance to it than just that. I wouldn't call my experience with them "extensive", but neither am I a blushing naïf, and I've never found them to be pleasurable for their own sake. Granted, this may in part be due to the fact that my only encounter with heroin was as part of a luckily failed attempt at sexual assault, but it's not as if I've never tried prescription opiates for recreational purp…

i think your experience is idiosyncratic; for most people, opiates feel very pleasurable

There is substantial genetic variation in responsiveness to opiates. For some (an estimated 1% in Norway, at least [0]) the standard dosing comes with all the side effects and none of the benefits.

When I was recovering from sinus surgery, my wife handed me oxy on the prescribed schedule, and it was worse than nothing — pain still there, plus brain fog and massive constipation. Tylenol worked an absolute wonder, though.

Pain is a bitch. I hope we come up with something better than these blunt instruments soon.

[0]: https://partner.sciencenorway.no/forskningno-norway-ntnu/gen...

Re: Down Here, They Sometimes Call It 'Boy'

#22
post #6

Ironically as I started to read this I was holding my Oxycodone vial and contemplating taking one. And now I am. At least my impulse is because of post-surgical pain, and hopefully will fade with the pain.

Most likely. It's not the drug that feels good; it's the respite from pain, and that only by contrast. Lacking that contrast, the drug induces only a profound, if temporary, physical and emotional numbness. It's not pleasurable, because it's not anything; it's as close as anyone alive can get to being dead. Unless that's something you want, you need have little fear of prescription opiates - just as much as is consis…

This is very specific to the person and cannot really be generalized.

I LOATHE opiates. I mean really hate them. They make me feel like my brain is encased in concrete and they do nothing for my pain until you hit the hydromorphone level. And all hydromorphone does is suppress the pain enough that I go "Thanks. " and finally pass out. Lather, rinse, repeat every two hours until the surgeon finally cut me open.

However, that experience is not universally shared. I have met people just like me, but I have also met people who just LOVE oxycontin (which has zero upside for me--I'm still in pain and I can't think).

Addiction is very personal and specific.

Re: Down Here, They Sometimes Call It 'Boy'

#23
post #15

Earlier quoted context omitted.

i think your experience is idiosyncratic; for most people, opiates feel very pleasurable

There is substantial genetic variation in responsiveness to opiates. For some (an estimated 1% in Norway, at least [0]) the standard dosing comes with all the side effects and none of the benefits. When I was recovering from sinus surgery, my wife handed me oxy on the prescribed schedule, and it was worse than nothing — pain still there, plus brain fog and massive constipation. Tylenol worked an absolute wonder, thou…

For what it's worth, it's not that they don't suppress pain when I take them. They do, quite effectively; it's just that I don't find anything else about the experience to be at all pleasant.

To your point about genetic variation, I'm told I have an unusually high pain tolerance; at that same ER visit, when the doctor came in to discuss the CT results showing the size of the stone, she expressed some surprise that I hadn't done any screaming. My mother tells me that she's the same way. So maybe it's something to do with that? I really don't know. In any case, it's clear from the responses I've gotten that to generalize from my own experience here is unwise, and I won't repeat the error.

Re: Down Here, They Sometimes Call It 'Boy'

#24
post #10

Do we keep getting this wrong because of perverse incentives, malice, or just plain stupidity? Was it not expected that clamping down on legal opioids would cause an illegal market to flourish? We've been doing this sort of thing for decades now. We know what's going to happen. No need to do research. There's a mountain of empirical data. What alternatives were considered? There has to be a better approach.

I think it's a combination of all of the above. Politicians who see drug abuse and ignore experts when making policy. Politicians turning a blind eye thanks to lobbyists.

You don't need to look far to see folks who think they know better than medical experts, or who are motivated by greed and corruption.

Re: Down Here, They Sometimes Call It 'Boy'

#25
post #4

I was on heroin for a few years and I live in the UK. I had managed to keep it hidden for maybe 18 months but eventually it become obvious and my mother started organising help. Within a week we had some people from the local drugs outreach charity turn up at the house with free Naloxone IM kits and they trained us how to use them. A couple of weeks after that I was assigned a counsellor whom I would meet regularly a…

> No one wakes up first thing and thinks "Hmm, I think I'll try shooting heroin today". I couldn't help but remember the story of SpontaniousH on reddit. https://reddit.com/r/MuseumOfReddit/comments/68srty/spontane... > I've heard so much about it and how crazy addictive it is and seen it in the movies and TV (I'm thinking The Wire here, one of my favorite shows) and it really started to intrigue me. I've always wond…

In his later posts, he admits that was just a story he was telling himself and he was indeed using heroin to avoid dealing with deep rooted problems within himself.

Re: Down Here, They Sometimes Call It 'Boy'

#26

“Nobody cares, because of who is affected” My respect to the author for this careful and courageous article. Writing about the problems affecting working class white men in today's climate might warrant censure in some circles. To the matter at hand, one of my concerns is that the Sackler family will enjoy long, peaceful lives. I hope justice intervenes.

I agree with you about how taboo it is among a certain type of journalist to write about the considerable problems of poor and working class whites.

But in light of your comment about the Sackler family, I'll add another opinion that is unpopular these days: people with severe chronic pain deserve appropriate treatment. And they shouldn't be denied access to that treatment (like they are now) because addicts and corrupt doctors misused the product. Addicts deserve sympathy and compassionate treatment, but we shouldn't ban an entire class of useful medications because of the addicts' misuse (eg, we don't ban cars because some people drive drunk).

If you've never known serious chronic pain, all I can tell you is that it's a different world than the one I knew before I got sick.

Re: Down Here, They Sometimes Call It 'Boy'

#27
post #4

I was on heroin for a few years and I live in the UK. I had managed to keep it hidden for maybe 18 months but eventually it become obvious and my mother started organising help. Within a week we had some people from the local drugs outreach charity turn up at the house with free Naloxone IM kits and they trained us how to use them. A couple of weeks after that I was assigned a counsellor whom I would meet regularly a…

> There are almost always deep-rooted issues that the addiction hides,

All crime is a consequence of deep-rooted personal issues.[1] Part of the purpose of making something a crime is to put somebody on notice about when personal choices are likely to result in intolerable injury to the public and, hopefully, induce them to reassess their needs and expectations, including recognizing their need for help. And that's the logic of making drugs like heroin illegal.

I think I understand your point, but it's a point that is really difficult to articulate coherently. There are many subtleties in arguments that propose more compassionate--for lack of better phrasing--public responses to addiction. And it starkly exposes some paradoxes at the heart of human legal systems, including notions of volition and accountability. I think that's why it's such a difficult public policy issue. But if don't appreciate the inherent tensions at play we'll never understand why the other person doesn't agree with whatever proposal we put forth.

[1] Where issues == dysfunction, otherwise we're just restating a more general truism that all behaviors are consequences of each person's history and state.

Re: Down Here, They Sometimes Call It 'Boy'

#28
post #13
post #6

Ironically as I started to read this I was holding my Oxycodone vial and contemplating taking one. And now I am. At least my impulse is because of post-surgical pain, and hopefully will fade with the pain.

I don't know the details of your surgery but I've been prescribed narcotics three times post-surgery and have always halved my prescribed dosage after day 2 and stopped completely by day 5. Then we bring the extras To get destroyed at a drug drop off (local pharmacies offer this here)

I was also very cautious when given opioids after my wisdom teeth extraction. As it turned out they gave me painful, uncontrollable hiccups that persisted for days and days. The experience was extremely unpleasant, but also a bit of a relief, as I knew there was no chance I'd keep taking those pills post-recovery. I learned later that opioid-induced hiccups are rare, but not totally unheard of:

https://pubmed.ncbi.nlm.nih.gov/10202603/

Re: Down Here, They Sometimes Call It 'Boy'

#29
post #6

Ironically as I started to read this I was holding my Oxycodone vial and contemplating taking one. And now I am. At least my impulse is because of post-surgical pain, and hopefully will fade with the pain.

Most likely. It's not the drug that feels good; it's the respite from pain, and that only by contrast. Lacking that contrast, the drug induces only a profound, if temporary, physical and emotional numbness. It's not pleasurable, because it's not anything; it's as close as anyone alive can get to being dead. Unless that's something you want, you need have little fear of prescription opiates - just as much as is consis…

I don't know if that is consistent. The first time I ever had vicodin (which isn't really that strong a drug in the grand scheme of things, I guess), I felt good. Not just no pain, but more relaxed, carefree, happy than I can remember ever feeling naturally.

My immediate reaction was to say out loud to my girlfriend "Umm, not taking any more of this, because oh my god this is way too good." Oddly enough, since then (it's been 20 years now, I've had vicodin a few times) it doesn't ever have the same effect. Just that once. Now it's just pain relief. Which is a relief.

Re: Down Here, They Sometimes Call It 'Boy'

#30
Read this when it was in National Review 4 years ago [0]. If you enjoy this, you might also like:

"Chaos in the Family, Chaos in the State: The White Working Class’s Dysfunction" https://www.nationalreview.com/2016/03/donald-trump-white-wo...

"I am cancer" https://www.nationalreview.com/2017/05/underclass-character-...

These are all variations on a theme, which is the rot at the heart of rural America.

[0] https://www.nationalreview.com/2016/02/heroin-prescription-p...

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