Sunday, July 27, 2008

Is heroin really that bad after all?

The NYT Magazine this weekend has an article about Afghanistan's poppy problem written by an American drug warrior entitled "Is Afghanistan a Narco-State?". The article chronicles the failure of the anti-poppy efforts, and the author concludes – in the words of Jacob Sullum – that the problem "is everyone else's fault." But what I find most interesting about the article is that its premise – that "the evils of heroin" are truly evil – is uncritically accepted from the get-go, and the author doesn't even feel the need to explain why heroin is so evil. So, I'll try to take a stab.

First of all, heroin is expensive. Drug addicts end up having to steal and do other unscrupulous things (prostitution, perhaps?) to acquire the drug. But why is it expensive? Because it's illegal.

Second of all, intravenous drug use can lead to diseases like HIV and Hepatitis C. Why? Because users share needles. Why do users share needles? Because it's illegal to get them without a prescription, and in America, having a heroin addiction won't get you a prescription.

Thirdly, heroin is notoriously impure. Dealers cut it with all sorts of things, including things much more deadly than heroin itself. Pure heroin is virtually impossible to overdose on, especially for the addicted user. The vast majority of deaths due to "overdoses" are actually deaths due to either impure product or a lethal combination of alcohol or benzodiazepines and heroin. And why do heroin dealers cut their product, while pharmacies dispensing morphine don't? Because heroin is illegal.

A fourth reason that heroin is detrimental is that heroin addicts often have damaged kidneys. However, researchers aren't sure that this is a result of heroin use, or if it's a result of the adulterants that dealers use to increase their product's salable weight. Again, you can chalk this up to heroin's illegality.

And the fifth reason – and only reason that's not directly attributable to heroin's illegality – is that heroin causes chronic constipation. Yep, you heard it here first (probably) – heroin's only proven long-term health consequence, other than physical dependence, is constipation.

So, out of the four major consequences of heroin use, all of the really bad consequences are due not to the drug itself, but the environment that governments create when they ban the drug. The only real health consequence – constipation – is a minor irritation at best compared to the harm caused by the larger war on drugs.


Anonymous said...

i read a scientific article on heroin long ago:

there are no registered death of overdose by it:

it is always alcohol or barbiturates present in the system COMBINED with smack

known are facts when 10times dose did not cause death

smack is BAD but refusal of establishment to INFORM - kills


i found your comment on congressman Weldon in pajamas: u are so right

weldon brought Lunev to congress hearing- he was long ago targeted

but he is a smuck: they got his daughter thru giving her money and - here we o- corruption surfaced

Raționalitate said...

I think it might be a bit of an exaggeration to say there are NO known deaths by opiates without adulterants, but I'd agree that it's probably rare. And when it does happen, it's most often by accident, where the user didn't know the strength of the drug because of poor black market quality control. But, again, this is attributable to heroin being illegal – the margin of error in dosage between intoxication and death is much more forgiving for heroin than it is with, say, alcohol.

Anonymous said...

are you crazy those are the only dangerous things about heroin?

you forgot the single most dangerous aspect to any opium based drug, addiction. if you stop taking it you can die!. to a narcotics addict getting high is the ONLY priority. people will do anything for a narcotics addiction(waste their life savings then steal or do other illegal activities to support their habit). believe me i know several people who have completely ruined their lives and their children's lives to stay high. and this would have been the same if they were addicted to oxy and could buy it in a store

also it causes infections of the heart linings and over time can be extremely damaging to your heart. it can also damage your liver.

i dont know where you are from but where i live heroin is MUCH less expensive than prescription alternatives(oxy,morphine).

yes heroin is terrible for you

smoke pot

Brighid said...
This comment has been removed by the author.
Anonymous said...

This article is way off the mark. "Drug addicts end up having to steal." That is ridiculous. I am a heroin addict and have never stolen anything in my life. I don't steal, lie, sell my body, beg, borrow, cheat or any of the things the stereotypical heroin user does. You know how I afford it? I work. Yes, really. It is entirely possible to hold down a full-time job, even a career, while being addicted to heroin. The government don't want people to realise this because they want to demonise heroin. The thieving addicts don't want people to realise this because they want a lighter sentence for their crimes. People who steal to fund their habits will have to steal a lot. When they get caught, it's a big newspaper story. But a heroin addict who works for a living, keeps to himself and never bothers anyone, well, it doesn't make for a good newspaper story, does it.

Secondly, even if heroin was legal, it would still be expensive. If it got cheaper, an addict would simply end up increasing their dose to the point where the new higher dose would only have the same effect that the lower dose used to and would probably end up spending just as much money.

Thirdly, there is no reason why heroin addicts have to share needles. I know intravenous users who always use clean needles. If an addict has trouble getting a supply of needles, there is always the option of using disinfectants. The only reason for sharing needles is stupidity and laziness. Personally I only smoke the stuff. There is also the snorting option.

Fourthly, heroin is rarely cut with anything deadly. Think about it, why would a dealer want to put poisons in heroin? If they can use sugar, flour, baking soda and other cheap household products, why would they spend more money on poisons which could potentially kill their own customers, leading to criminal investigations which would end up with them in prison?

People die from heroin use because of the heroin itself. Sometimes they may have had a break and have a lower tolerance, and then overdose by using the same amount that they used to before the break. Sometimes they will be caught out by a new batch with LESS impurities than they are used to. There is also the possibility of dying from combining heroin with other drugs, such as cocaine, alcohol or benzodiazepines. You can also overdose by using heroin in a different house or room to where you usually do it, but that's a whole article in itself.

Fifthly, heroin is not very bad for the kidneys. Compared to alcohol, it is almost harmless. Heroin, in general, is almost harmless. A heroin user who has a good diet or uses vitamin and mineral supplements can have health as good as anybody.

Sixthly, heroin withdrawal is rarely fatal in a healthy adult. I believe methadone withdrawal may have resulted in a few deaths. Compared to withdrawal from alcohol and benzodiazepines, heroin withdrawal is medically trivial. It's just very unpleasant.

Seventhly, "to a narcotics addict getting high is the ONLY priority." Wrong. I enjoy spending time with friends and family. I enjoy stroking my cat, playing computer games, listening to and making music and have a very rewarding career. Smoking heroin by itself would be very boring. I do it so that I can enjoy doing other things more.

Eightly, heroin is not necessarily a bad idea. I have suffered with depression for most of my life until I discovered heroin. So long as you avoid the intravenous route and budget for it properly, life as a heroin user can be very rewarding.

I'm glad I had the chance to set the record straight. I expect most heroin users do not have internet access, so all you seem to find on the internet is lies, rumours and prejudice.

Raționalitate said...

Heroin doesn't ruin lives, it just dulls them. I don't know anything about your friends in particular, but I'd be willing to bet that what ruined their lives had more to do with coming up with the money to maintain a habit, rather than the heroin habit itself. And heroin is not intrinsically an expensive product – it's prohibition which drives its cost up (as a rule of thumb, market prices for drugs would almost always be less than one-tenth of current prices).

Anonymous said...

It's addiction that artificially drives up the price of heroin.

When I first started smoking, a £10 bag would last me three days, and those days would be pure bliss.

Compare that to a night out at the pub, spending £10 every 3 hours, having a crap time, vomitting, fighting, sleeping with an ugly random woman and feeling like crap the next morning.

Heroin starts off being good value for money, but an addict will generally push their addiction to whatever they can afford (or more than they can afford) and the body will adapt to that new level of use.

Even if the price halved tomorrow, before long, users would double their usage and still be experiencing the same effect.

Raționalitate said...

I don't see why addiction would drive up the price...alcohol and cigarettes would be dirt cheap without the taxes, and coffee and tea are already dirty cheap (unless you go for the premium stuff). How much is in a £10 bag of heroin – 0.1 grams? Can you think of any legal plant that costs that amount of money, addictive or not?

Anonymous said...

Coffee and tobacco can't really be compared to heroin. Compared to these, tolerance to heroin builds up extremely quickly and completely. A long-term intravenous user could inject enough to kill 3 or 4 non-users, yet those non-users could probably build up to that level of tolerance in around 3-4 weeks of continued usage, if they had the money and inclination to do so.

£10 is about 0.2g where I come from, However, it probably takes a considerable amount of plant material to make that. The poppies have to be cultivated and harvested, processed into opium, then into morphine, then into diacetylmorphine, then have adulterants added. The drug then has to be shipped half way around the world.

I agree that illegality makes it more expensive. People have to be paid more to do a job that risks a heavy jail sentence. My point is that the price doesn't matter in the long term. Addicts will ultimately spend as much as they can, and get quite a mild effect, regardless of what the price is.

Raționalitate said...

I agree with you that heroin addicts wouldn't get any higher, all I'm saying is that the reduction in cost would be so great that even if people ramp up their doses (which, frankly speaking, would have little health consequence so long as they build up to it), the cost wouldn't be so high that many have to turn to crime and live in terrible conditions to support their habits. I realize that most heroin addicts aren't criminals, but you have to admit that there is a higher rate of criminality among heroin addicts (other than drug use obviously).

Raționalitate said...

£10 is about 0.2g where I come from, However, it probably takes a considerable amount of plant material to make that. The poppies have to be cultivated and harvested, processed into opium, then into morphine, then into diacetylmorphine, then have adulterants added. The drug then has to be shipped half way around the world.

The process you've described isn't that different from most of the cheap shit you consume every day – assorted cheap plastic shit (made in China), processed foods (probably made with American commodities and processed somewhere and sent to Europe to be packaged), etc. Afghanistan and the Golden Triangle in Southeast Asia are very poor places, and if you look at the price of heroin and opium in Afghanistan, you'll see that it's dirt cheap by Western standards. Of course everything is cheaper in the Third World, but dope is especially cheap.

WoundedSword said...

Just to clarify, I am the author of the last three anonymous posts.I figured that it's only polite to create a user name, since this has become a discussion, rather than a weblog.

I don't entirely disagree with what you are saying. I personally don't believe that any drug should be illegal. If people, myself included, wish to harm themselves, they should be entitled to do so. No drug affects any two people in exactly the same way, so some people, myself included, may not find heroin to be as soul destroying as the media would have us believe that it is. Indeed, I believe that diacetylmorphine, along with other opiates, should be available on prescription to people suffering with depression and other mental illnesses.

However, I don't believe that by legalising heroin, you would see any reduction in crime rates. To explain why, I'll first dispel a few myths.

Myth 1 - Heroin makes people immoral
Despite the fact that I need heroin, both physically and, more importantly, psychologically, I would NEVER steal to support my habit. Having ones house burgled causes such financial and emotional hardship that I could never inflict such harm on anybody. If I lost my job, I would either use my credit card, temporarily switch to another, more affordable opiate, or give up completely. People who claim they "have to" steal must have been immoral people in the first place.

Myth 2 - Heroin is incompatible with a career.
I'm sure you've seen images of heroin users lying in a heap on the floor, barely aware of what is going on around them, and you would be right in thinking that nobody could go to work in that state. However, a regular heroin user will never get into this state without going well above their usual dose. Indeed, a heroin addict should never expect to reach such a state after the first few months of use. It would also be difficult to go to work while suffering from withdrawal symptoms, but with careful budgeting, there is no reason to ever run out.

Myth 3 - It is impossible for an addict to regulate their habit.
Any addict with a grain of intelligence will quickly realise that the only way to regularly get high with heroin is to continually increase their dose. They will also realise there is no way to continually increase their dose without spending all their money, selling all their possessions and committing a great deal of crime. This logically leads to three sustainable options:
i. Give up heroin completely.
ii. Use heroin regularly, and accept that they will never, or rarely, get "high", and learn to appreciate the more moderate effects of the drug.
iii. Use heroin very occasionally, perhaps weekly or fortnightly, and get "high" every time. With such an addictive drug, this option is perhaps the hardest.

The conclusion that one should draw from this is those who are stealing to support their habits are lazy, immoral and have addictive personalities. Even if the price of heroin was slashed to a tenth of its price, these people would still be criminals. They would become addicted to crack, amphetamine, alcohol and other drugs, and continue their one-man crimewaves, because that is the only way that these people know how to live, and they will always feel the need to push their drug habits one step further.

Having said all this, I still see no reason for heroin to be illegal. I am living proof that it is possible to self-medicate with heroin without feeling the need to resort to crime. Heroin cannot be evil. It is essentially just some powdered plant extract. What is evil is the people that would rather ruin other people's lives through crime than work for a living to support their habit. Let's execute or imprison for life those who commit crimes and let otherwise law-abiding people do what they want with their own bodies.

michael said...

people might say that my brother is living proof that heroin is bad. well, they'd be only half-right.

Paul D said...

I think for some people the drug is just too addictive. But I would bet that most people would not become addicted to heroin after trying it once.