Monday, October 15, 2012

Don't Inject Pills Pt.1

There is the perception that pills are safer than heroin.  To some extent this is true, with pills you get an exact dosage of a known opiate.  With heroin you are likely getting some mixture of heroin, 6-acetyl-morphine, morphine and some trace codeines in addition to adulterants.  And you don't know the dosage.
    Heroin has two major advantages over pills though.  For one its cheaper.  Secondly it's usually cut with substances than can be injected.  Is it sometimes cut with things you wouldn't want to inject?  Of course, it's an unregulated substance.  My point is that given the prevalence of heroin injecting if most dope was cut with overly toxic adulterants we would see a lot more medical problems among the heroin injecting population (not that they don't suffer from greater than average health problems).
    Which brings me to my next point.  PILLS ARE FOR EATING NOT INJECTING!  Or maybe snorting.    The FDA released this recently:

[10-11-2012] The U.S. Food and Drug Administration (FDA) recently became aware of cases of a serious blood disorder that occurred in individuals abusing the prescription pain medicine Opana ER (oxymorphone hydrochloride extended-release tablets) by injecting the drug into their bloodstream. This serious blood disorder, called thrombotic thrombocytopenic purpura (TTP), resulted in kidney failure requiring dialysis in some cases, and at least one death.
In TTP, blood clots form in small blood vessels throughout the body. The clots can limit or block blood flow to the body’s organs, such as the kidneys, brain, and heart. Certain blood cells called platelets help the blood to clot. In TTP, as platelets clump together in the blood clots, fewer platelets are available in the blood in other parts of the body to help with clotting there. This can lead to bleeding under the skin and purple-colored spots called purpura, or to bleeding inside the body. TTP can cause death or lead to other complications with permanent damage, such as kidney failure, brain damage, or stroke.
TTP appears to occur with Opana ER only when it is abused and injected intravenously. Opana ER is meant to be taken orally, and should only be taken when prescribed and as directed. Taking it any other way may result in serious adverse events, including death.

Given the worldwide campaign against opiates and the brutan suppression of opiophiles there are basically only three ways to get your hand on opiates. 
1. Illicit heroin
2. Pharmaceutical Opiates 
3. Grow your own or use Kratom
Heroin has achieved mythic status as the most evil of a number of evil drugs (although methamphetamine has been replacing it lately).  Anyway a lot of people don't dig heroin but really like their pills.  Some people like to inject those pills.  I basically think there are only two reasons to inject opiates, to increase the 'rush' or increase bioavailability (and therefore get more for your money).  Unfortunately pills are cut with all shorts of shit that isn't soluble nor sterile.  
The pharmaceutical companies see people injecting pills and what do they do?  Well they could make pills safer to inject so users experience less health problem, but that would be encouraging drug 'abuse.'  So instead they make pills harder to dissolve and more dangerous to inject.  Enter the OPs.  Opana oxycodone and oxymorphone is formulated as a special 'abuse-resistant' tablet.  

The argument for making pills more difficult to inject are the same arguments against making sterile syringes more accessable, that they encourage drug 'abuse.'  As if there exists a large population of opiate users who are thinking "I would start injecting my drugs if only it was safer."

Studies indicate that providing addicts with clean syringes reduces the harms of IV drug use without encouraging drug use.  The notion that providing addicts with clean syringes is somehow encouraging
drug use is throughly discredited, and yet the same logic is not applied to the formulations of tablet opiate medications.  Why not formulate opiate medications in such a way that they are safer to snort or inject?
It would have no effect on those that take the pills orally while improving the health of IV users.  Is there any evidence that the abuse-resistant pills discourage drug use?

If there is evidence that they do discourage drug use it must be balanced against the harms caused by people who continue to use.  How many cases of TTP are worth discouraging injection drug use?  How many IV users need to die to send the message that drug abuse is wrong?

Ok, so maybe you shouldn't inject OPs.  But what if you are that junkie who's addicted to the needle as much as the dope and HAS to inject everything?  I've never been that guy but I know the type.  Well, as far as the US government is concerned, you can go fuck yourself.  You see using opiates is immoral and if you go and get some horrible disease you deserve it.  After all you did it to yourself, didn't you?  How many citizens are aware of the FDA announcement?  Of the percentage of those who are junkies how many are aware that injecting OP's can result in TPP?  
This isn't harm reduction but HARM MAXIMIZATION.  Opiates are remarkably safe, even when injected.  It's shit like this that makes doing opiates dangerous.  Be smart and be safe.

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