Your Brain On Drugs

Jared Dillian's picture
Rank: King Kong | 1,779

I debated putting two articles about this two days in a row, but as I started to dig a little deeper into this opiates epidemic, it really is nothing short of horrifying. I had a sense it was bad, but not this bad.

Let me include a chart that I got from my friend Brent, so you can see how bad things are:


Source: NIH

Heroin overdoses are up 6x since 2001, most of it coming in the last few years. What happens is that people will tear their ACL, get surgery, the doc will prescribe oxys, people get hooked on the oxys, eventually you can't get them legally so they turn to the street drugs. Happens over and over and over again.

Funny, when I had knee surgery, I knew about this problem, so I told the doc, no narcotics for me, I will take Advil. One day after surgery I was calling, begging for narcotics. But I only took them for three days and then threw them out, because I knew how addictive they were. Oddly enough, I was in so much pain from the surgery, the pills didn't even make a dent.

I had an eye infection that turned out to be a problem (you may remember this from 2012) and I went to the hospital. They weren't able to do anything for me, but they gave me a huge prescription for Vicodin. I said, you lazy bastards, you don't even know what's wrong with my eye, but you are going to load me up with Vicodin so I just go away and get out of your hair (I told you the state of medicine around here is not good).

We have millions upon millions of people addicted to these things. The interesting thing about it has affected everyone, rich/poor/young/old/everyone in between. Don't construe this as some kind of moral failing, because like I said, many people get themselves into a position where they have surgery or where they have to manage pain, and they are prescribed this stuff. Someone who has no addictive tendencies is now and addict. Really scary stuff.

This could be worse than AIDS and crack combined. We are just now starting to scratch the surface.

Opiates are no joke. They unleash a powerful physical addiction. The thing that has always puzzled me is how little medical professionals know about addiction; practically nothing at all. Like I said yesterday, we are going to be really sorry that we did not catch this earlier. And I imagine that the cure (prohibition) is going to be worse than the disease. Prepare to hear lots more about this in the next 5-10 years. Only the beginning.

Mod Note (Andy): This post is a reprint from the April 27th edition of Jared's Daily Dirtnap Newsletter. If you'd like to read more, WSO readers qualify for a $100 discount to his Daily Dirtnap daily market newsletter...just email [email protected] and mention "WSO Monkey Discount". You can follow Jared on twitter at @dailydirtnap..

Comments (19)

May 12, 2016

I'm in my late 20's and have had 7 friends or acquaintances die in the past 10 years from opiate overdosing. It has been an epidemic, only now famous people are dying so its important.

May 12, 2016

I'm 22 and have had 2 close high school friends die from opiate overdosing. One just got hooked by being with a shady crowd, but the other had no significant history of drug usage.

I went to a tiny high school, my class size was about 70~ people. With those 2 friends and 1 additional classmate who overdosed, 3/70 of my high school class has died from opiates by age 22. It's quite startling, a lot of people addicted aren't the type to make bad life decisions like that. It's powerful stuff.

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May 12, 2016

No argument that lethal overdoses have seen a dramatic increase over the past several years, and if you or someone you know has been directly effected it is very tragic. However, I'm going to refrain from correcting all of the inaccuracies and false narratives in this post; rather, I highly recommend that the Mod, OP, and anyone else reading this post pick up and read a book called "High Price" by Dr. Carl Hart.

There is a dearth of actual scientific information contained in this post (as well as the conversation on all drugs, nationally), which only serves to further a false narrative.

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May 12, 2016
ODoyleRules:

No argument that lethal overdoses have seen a dramatic increase over the past several years, and if you or someone you know has been directly effected it is very tragic. However, I'm going to refrain from correcting all of the inaccuracies and false narratives in this post; rather, I highly recommend that the Mod, OP, and anyone else reading this post pick up and read a book called "High Price" by Dr. Carl Hart.

There is a dearth of actual scientific information contained in this post (as well as the conversation on all drugs, nationally), which only serves to further a false narrative.

Why are you refraining? If you have something to say, just go ahead and do so.

May 13, 2016

I've refrained as there is nowhere to end the dissection of the post. OP has cited one national statistic (increase in heroin overdoses), thrown in two personal experiences (eye surgery and knee surgery), and then formed and posted a series of uneducated, ridiculously oversimplified, unscientific, and indefensible insinuations and/or conclusions which are, in no particular order: (i) prescriptions given for actual pain lead to dependency and abuse, (ii) heroin/opiate related problems today could be worse than AIDS and crack (??), (iii) doctors and the medical community know "practically nothing at all" about addiction, and (iv) opiates unleash a powerful physical addiction.

To be oversimplified while still being accurate and technically correct is one thing; however, to post something so blatantly lacking in substance, science, and fact (while attempting to legitimize an opinion) reflects the worst type of ignorance. Fox News and MSNBC do a great job with these kind of topics: cite a plethora of marginally-related pseudo statistics, throw in a few generalities, and highlight one or two worst case stories.

Discussion should really begin by defining what "addiction" really means.

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May 12, 2016
ODoyleRules:

No argument that lethal overdoses have seen a dramatic increase over the past several years, and if you or someone you know has been directly effected it is very tragic. However, I'm going to refrain from correcting all of the inaccuracies and false narratives in this post; rather, I highly recommend that the Mod, OP, and anyone else reading this post pick up and read a book called "High Price" by Dr. Carl Hart.

There is a dearth of actual scientific information contained in this post (as well as the conversation on all drugs, nationally), which only serves to further a false narrative.

SB'd

May 12, 2016

Prescription drug abuse might be one of the most overlooked epidemics in America. There is no valid reason for doctors to be prescribing medication this powerful with as many doses as they do for relatively non-invasive operations.

Seriously, if you can get away with Advil after your procedure, do it and flush the oxies down the toilet.

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Jul 19, 2016
dj_clem:

Prescription drug abuse might be one of the most overlooked epidemics in America. There is no valid reason for doctors to be prescribing medication this powerful with as many doses as they do for relatively non-invasive operations.

Seriously, if you can get away with Advil after your procedure, do it and flush the oxies down the toilet.

You're stupid,

May 12, 2016

(Note: Quote button isn't working for some reason)

"What happens is that people will tear their ACL, get surgery, the doc will prescribe oxys, people get hooked on the oxys, eventually you can't get them legally so they turn to the street drugs. Happens over and over and over again."

This is a drastic oversimplification and common misconception. Millions of people are prescribed opiates every year, a subset of whom are on IV morphine 24/7 for extended periods of time, and only a fraction end up as addicts. No question the opiate epidemic - and it is an epidemic - is a tragedy, but it's a symptom and a reflection of a greater societal problem that no one has had the courage to tackle.

Kurzgesagt does a great job (as usual) of revealing truth: https://www.youtube.com/watch?v=ao8L-0nSYzg - not the whole truth, but a piece of it in an easily digestible format.

I like your writing Jared, but please stop spreading misinformation as you're effectively adding to the problem by demonizing an entire profession (sound familiar? I remember something similar around 2008 or so).

May 12, 2016
CuriousCharacter:

please stop spreading misinformation as you're effectively adding to the problem by demonizing an entire profession (sound familiar? I remember something similar around 2008 or so).

Wait, who was demonized in 2008? Riiiight....me. I almost forgot.

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Best Response
May 12, 2016

It's a 300-word post on Wall Street Oasis. It's designed to generate discussion, not to be the last word on the subject. Of course it's going to be an oversimplification.

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May 14, 2016

Thanks for recognizing you're wrong and not focusing on the single defensible sentence fragment :S

May 12, 2016

I had a friend who was lucky enough to be resuscitated after legally being pronounced dead from an overdose. He is now heroine free. I can't help but think they're must be better/less risky treatment options out there.

May 12, 2016

I spoke with a guy who works for the DEA a few years ago, like 2013, and he said heroin use is up because people are using prescription drugs and they get too expensive. At the time he said something like to overdoses from heroin, cocaine, meth, crack combined are a fraction of the overdoses from prescription drugs. That totally shocked me. I agree that it is a problem.

May 13, 2016

Thank you for posting this. I learned that an old friend of mine who recently passed away had an opiate addiction that was ruining his life. Total white-collar guy, you would have never guessed he was shooting up.

May 15, 2016

Ex-GS SA-->3rd Year Medical Student / Aspiring Addiction Psychiatrist here.

I can speak to the dearth of opioid or addiction teaching in medical school. I can also speak to the challenges for the medical system when treating addicts. These people are very difficult to manage and the medical community is not reimbursed for properly treating them (don't weep for the doctors, just understand that there is no incentive to properly detox and treat addicts). Expecting doctors to give ample time and attention to addicts requires a few extra hours at the hospital from physicians who are already spread too thin. For no extra pay and more headaches.

What is more, these addicts are experiencing real pain. More opioids-->upregulation of pain receptors-->increased sensitivity to everyday aches / pains-->huge amount of pain when off opioids.

Hopefully a few developments will help:
1. Better use of drugs that combat addiction drive (Topiramate, SSRIs, SNRIs, Naltrexone, Buprenorphine, Anti-Mu Opioid Receptor antibody)
2. Increased mental health funding (non-sarcastic "THANKS OBAMA")
3. Public awareness / understanding of mental health issues
4. Physician understanding and training
5. Tweak the Alcoholics Anonymous model to incorporate some modern developments in addiction science
6. Develop lab tests to measure neurobiological markers indicative of brain stress, brain inflammation, acute psychotic states
7. Utilize our colleagues in neurosurgery to use Deep Brain Stimulation and TMS (brain magnets) for refractory cases

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May 15, 2016

This is actually very accurate. No one starts on heroin. Kids get exposed through the vicodin they're given or through friends, and they start fiending for their friends old half used vicodin that they received from their wisdom teeth, etc. High quality opiates are hard to find, and as they start to use more, they either can't find any more vicodin or run out of money. From there they try research chemicals, other opiates, etc til they make their way to H. Once they're on H, it's over. No one takes the time to buy pure product off the dark net, and street H is ridiculously impure. The deaths come when they finally get pure stuff and don't realize how much they're doing or they get something cut with fentanyl.

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May 16, 2016
Comment

schmooze or lose