Opioids (Heroin, Fentanyl & Codeine, oh my!)

“Imagine if the government chased sick people with diabetes, put a tax on insulin and drove it into the black market, told doctors they couldn’t treat them, then sent them to jail . . . we do practically the same thing every day in the week to sick people hooked on drugs. The jails are full and the problem is getting worse every day.” (Billie Holiday, 1956).

Heroin could cost $2 per gram, and all of the profits could go directly towards drug treatment and risk reduction. But instead it costs more than $200 per gram and all of the profits go to drug dealers, manufacturers and traffickers.

It could be pure heroin, tested by the FDA and dispensed by a pharmacy. Instead it is unregulated & diluted with dangerous adulterants.

The latest cutting agent, Fentanyl, is half the price of heroin and 10 times stronger. Now dealers are cutting their heroin with even more of the same shit as before--baby formula, sugar, powdered milk, vitamin C--and then adding Fentanyl to increase the potency. The problem is, since a normal dose of heroin is smaller than a pencil erasure, it is incredibly difficult to get the mix just right, or to make sure the Fentanyl is evenly distributed. Sometimes the home-brew sold by street dealers winds up being too strong.

Think about your drug of choice--wine, beer, coffee, soda, weed, nicotine or even acetaminophen--and imagine cracking one when you really need it--after a long day of work or a rough night of sleep. Imagine you take a long swig (or puff)--feels good right? So you take a second, and maybe even a third. Your drug will hit you soon, and you have made sure you catch a decent buzz right away. It feels like AAAAaaahhhhhhhhh.

Now imagine that someone has replaced your low-grade beer/wine/coffee/nicotine with something 10-20 times stronger with the exact same flavor. Your 3 swigs are about to kick in, but you have actually consumed 30 swigs, or 30 puffs. You are about to be in big trouble! With all of these drugs, except THC, you may even need to head to the hospital.

Heroin users seldom overdose accidentally if we are using just heroin. But when we are forced to buy unregulated dope on the streets, we are doomed to deal with clever assholes trying to make a profit by juicing up their product.

Heroin production is straightforward. But just like with all unregulated (illegal) drugs, the government wont allow legitimate operations, so shadetree manufacturers use good-enough supplies to produce a final product that is pretty-much, like, kind of, sort of heroin.

If it comes from Mexico, it is probably Black Tar Heroin (left), which is just a nice name for garbage that hasn't been properly distilled. Black Tar Heroin is usually less than 25% heroin, along with some morphine. Everything else is leftovers from shitty production. The DEA actually claims that Black Tar is safer than powder heroin because Fentanyl is hard to knead into a blog of gooey gum.The war on drugs has made the cheap, watered-down version safer than the good stuff.

If you get the good stuff--heroin #4 (pic right), you are still likely to have a bag more than half-full of something that is not heroin. The average potency of street heroin in the United States is around 32%. Most of your dope is not dope. It's shit added by dealers.

Most of the heroin #4 sold in the United States comes from Columbia. Back tar heroin is basically heroin #4 that hasn't gone through the final stages of processing.

Heroin base, or brown heroin, also sometimes shows up in user’s product, and it looks, smells and tastes like heroin #4 aside from the slightly darker color. The war on drugs fucks users by ensuring products are unlabeled and don't have any instructions--we can't know how to use them.

Heroin base (pic right) requires an acid to dissolve it in water, so you can’t shoot it up unless you add a small amount of something like ascorbic acid (vitamin C) before heating. If you put your heroin in water and notice clumps, you either have something that is not heroin, or you have heroin base, which can’t be injected safely without proper preparation using an acid like lemon juice, vinegar, or Vitamin C. This is dangerous because the solvent that dissolves your drugs also, to some degree, dissolves your veins. Users wouldn't use this method if we could purchase reliable heroin #4 and just use water.

Thanks to the war on drugs, we end up with multiple forms of the drug that all look the same--like a white or light-brown powder. Black Tar heroin can also be cut with lactose, so it too can appear as a powdery substance (pic above). But each form requires its own unique method of preparation. The war on drugs sets users up to make life-threatening mistakes, or to use life-threatening methods of ingestion. The structural challenges to responsible use are far more dangerous than the drugs.

As with most drugs, including heroin, morphine, marijuana, alcohol, cocaine, psilocybin, kratom, and caffeine, the chemicals that get us high are easily extracted and distilled from natural ingredients. Check out this clip of a VICE documentary where Thomas Morton follows addicted folks to the poppy fields of the Czech Republic, where they spend a few weeks every year living off the land, making morphine from poppies that the government claims don't have enough morphine to get you high.

Our problem in the United States isn't poison drugs or ignorant users. Its capitalistic profit and lack of knowledge. Even when we want to be responsible, we find ourselves faced with barriers that should not be there. Information about potency, half-life, methods of administration, combinations of drugs, risk-reduction strategies, and a host of other important topics is hard to come by. The data in the photograph below was painstakingly collected from individual medical journals because I couldn't find anything like this in a single publication.

Let's be real: we can never stop people from using drugs. We have been waging war against drug users and their suppliers for more than a century, and nothing has changed except how dangerous--deadly--it is to use drugs in the land of the free. The US has fallen behind our neighbors, in areas of both Canada and parts of Europe, who have decriminalized drugs and moved toward a model that emphasizes compassion and quality-of-life.

It might sound bizarre, but once drug users and addicted people don't have to worry about finding our next fix (& the cash to secure it), we start to evaluate our positions in life, and to make plans for the future. And often we reduce our use or stop using outright, without a judge ordering it or a family tough-loving us into a rehab program.

“Life as we find it is too hard for us; it entails too much pain, too many disappointments, impossible tasks. We cannot do without palliative remedies . . . pain is only sensation; it only exists in so far as we feel it . . . the crudest of methods for influencing the body, but also the most effective, is the chemical one: that of intoxication." Sigmund Freud

One last thing... A decade ago, a lifesaving dose of Naloxone cost $1. Today, that same dose costs $150 for the nasal spray. A Naloxone auto-injector--it talks in a computerized voice as it delivers medication, was approved in 2016. It costs $4,500. This is how the war on drugs puts money into the pockets of both legal and illegal drug dealers at the expense of drug users.