Misc How Are OD's on Prescription Drugs So Common?

[ChemicallyEnhanced]

First off, I apologise if this comes across as ignorant, that is not my intention.

I just don't understand how serious/fatal overdoses on prescription drugs are so common? Like, twice as many as heroin and cocaine combined?
And I don't mean like street fent or fake pressed pills, I mean genuine prescription drugs?
Because you literally know EXACTLY what you are taking and EXACTLY how much?

I've been addicted to prescription drugs (primarily opioids, but also benzo's, barbs, muscle relaxers, amphetamines, sleeping pills etc) for 14 years and have never OD'd*. I mean, I've absolutely taken too much and like blacked out on benzos (like when you get blackout-drunk) or fallen asleep** but never a serious or dangerous OD. Never stopped breathing, had to go to hospital, or needed narcan or any kind of medical intervention.

Surely you'd have to knowingly even take a much higher dose than usual, or mix shit you've never mixed before?

*accidentally, I mean

**I actually have a small cluster of circular scars below my collar bone from falling asleep with a lit cigarette in my mouth

 

[Jnowhere]

Like my father use to say, you only die if your trying to get high.( about prescription drugs) Also suicides

 

[Antares]

Forgot you took your pills already, so you take them all again. Depending on what cocktail of drugs you're on, and your own individual health issues, that could be all it takes. I've heard some wild stories from a pharmacist about how badly some people can legit misunderstand how they're meant to take their new prescriptions, too.

I haven't seen the data, but I wouldn't be surprised if a greater number of the overdoses on prescribed meds happened in the 50+ age groups. Your body gets weaker as you age, so things like this are more likely to have serious effects. Not that there aren't people who are just trying to get high, obviously, but I do think there's a lot of genuine accidents that happen.

 

[paranoid android]

I get morphine, clonazepam, bromazepam and zopiclone all prescribed. I have never come close to a overdose from my script meds but i have had a minor od on coke before but iv coke is a different beast altogether. Also you can only fit 60mg's of morphine in one syringe which isnt enough for anyone with any tolerance to od on

 

[fairnymph]

1. Stupidity. It’s harder to get illicit drugs than be prescribed legit meds (assuming you need them & you live in the right area - being old helps too).
2. Bad health, thus people not being in the best state to determine how much they need.
3. There are a lot more people on Rx drugs than illicit ones, so purely statistically ODs will be more.
4. Acetaminophen (in many Rx opiate formulations) contamination leading to liver damage. Most taking Rx opiates don’t know about APAP toxicity. I’m convinced that heavy APAP use leads to liver damage over time, so people become less able to metabolise other drugs too, & more prone to OD.

 

[Keif' Richards]

Don't worry it's not ignorant. This is one of those instances where statistics and hard data do not take into account the psychology of substance abuse and addiction. It's extremely difficult for a responsible individual with no prior issues with substances to understand.

For instance, I hear non-addicts discussing safe-injection sites all the time. "Why don't people just go to the injection site to use? Then, if they overdose, they can be saved!" Yes, in theory, that's great. Most addicts will have a hard time waiting 60 seconds to begin using their drugs after buying them. I'm a personal believer that safe-injection sites are a misguided attempt by the aforementioned non-addicts, using their well-meaning but misguided logic to try to solve the problem. They just do not understand. No addict is going to take a bus to downtown just to fix their drugs and use. You'll find it's outliers in the community who use these safe sites regularly or otherwise folks who happen to be in their proximity already.

When people start using drugs, caution and common sense are eroded. When you're taking 3-4 2mg Alprazolam tablets every day, combined with some Opioids and maybe going to get a few drinks with your friends... it's not as if there is some kind of accurate counter going on in their heads regarding how much they've consumed. Speaking from experience, once addicts are integrated into the lifestyle, they're going to be operating more on how they feel and what their body tells them to do, with the concept of tracking their intake being a distant third place.

That is addiction though. It's a loss of control. It's a gradual shifting of all mental and physical resources toward the drug. Like a computer with limited processing speed, things like safety, hygiene and of course, sympathy/empathy go out the window.

 

[Survival0200]

^Yes. You lose control when you just want to get higher and higher, and end up taking excessive amounts - and often multiple substances.

 

[TheUltimateFixx]

I'm gonna add to what's already been mentioned is that some people entertain the idiotic idea that just because it's legal and came out of a pill packet, it can't possibly off you.

 

[ChemicallyEnhanced]

1. Stupidity. It’s harder to get illicit drugs than be prescribed legit meds (assuming you need them & you live in the right area - being old helps too).
2. Bad health, thus people not being in the best state to determine how much they need.
3. There are a lot more people on Rx drugs than illicit ones, so purely statistically ODs will be more.
4. Acetaminophen (in many Rx opiate formulations) contamination leading to liver damage. Most taking Rx opiates don’t know about APAP toxicity. I’m convinced that heavy APAP use leads to liver damage over time, so people become less able to metabolise other drugs too, & more prone to OD.

Yeah, people (mostly older people, like 60+) have died from liver failure from just taking the CORRECT dose (ie no more than 4000mg/day) for several years or even several months.
I can see that sort of thing happening to people who are addicted to like Vicodin or Percocet accidentally ODing on acetaminophen.

 

[Jen X]

Easy, you keep taking more chasing a high and overdue it. My first od was on scripted oxy

 

[Antares]

Just as a random anecdote that might help people understand the accidental side of this:

I'm prescribed the maximum possible daily does of gabapentin, and I've been recommend by my physician and pharmacist to get my kidney function checked every now and them. The drug is processed by the kidneys, so if your kidney function gets worse gradully, you'll get more of the drug in your body while still taking the same dose, and you might have no other symptoms that point towards your kidneys being messed up. Gabapentin is not exactly super dangerous in overdose, but if you replace that with a different drug and its respective processing-organ, you can kind of see how easily you could end up with an overdose before even realizing your organ function has decreased.

 

[Jnowhere]

Don't worry it's not ignorant. This is one of those instances where statistics and hard data do not take into account the psychology of substance abuse and addiction. It's extremely difficult for a responsible individual with no prior issues with substances to understand.

For instance, I hear non-addicts discussing safe-injection sites all the time. "Why don't people just go to the injection site to use? Then, if they overdose, they can be saved!" Yes, in theory, that's great. Most addicts will have a hard time waiting 60 seconds to begin using their drugs after buying them. I'm a personal believer that safe-injection sites are a misguided attempt by the aforementioned non-addicts, using their well-meaning but misguided logic to try to solve the problem. They just do not understand. No addict is going to take a bus to downtown just to fix their drugs and use. You'll find it's outliers in the community who use these safe sites regularly or otherwise folks who happen to be in their proximity already.

When people start using drugs, caution and common sense are eroded. When you're taking 3-4 2mg Alprazolam tablets every day, combined with some Opioids and maybe going to get a few drinks with your friends... it's not as if there is some kind of accurate counter going on in their heads regarding how much they've consumed. Speaking from experience, once addicts are integrated into the lifestyle, they're going to be operating more on how they feel and what their body tells them to do, with the concept of tracking their intake being a distant third place.

That is addiction though. It's a loss of control. It's a gradual shifting of all mental and physical resources toward the drug. Like a computer with limited processing speed, things like safety, hygiene and of course, sympathy/empathy go out the window.

Try telling that to to Canadians. It will work, because they, when it fails they will blame someone or something else. There is no heroin, and apparently from what,I have read fent users need to shoot up more frequently. So is a person just going to ride back and forth all day from a bus to shoot up and back again all day long. Seems like that might get in the way of getting, the needed money. Besides, who to ride the wants bus, subway, train all day? Back and forth, yeah right, I will not even go outsides to smoke a cigarette.

 

[Jen X]

Try telling that to to Canadians. It will work, because they, when it fails they will blame someone or something else. There is no heroin, and apparently from what,I have read fent users need to shoot up more frequently. So is a person just going to ride back and forth all day from a bus to shoot up and back again all day long. Seems like that might get in the way of getting, the needed money. Besides, who to ride the wants bus, subway, train all day? Back and forth, yeah right, I will not even go outsides to smoke a cigarette.

Don't know why you claim to know so much about Canadians or your beef with us. Injection sites are in areas with homeless drug users.

 

[Jnowhere]

I gonna stick with what' keif Richard's' said. There is no way I would hope on a bus and go back to the same place 4-10 times a day.
Screw that, If I shot dope, I would not get off my ass, just to not be sick.
Why, waste the time or money, not every IV drug user lives in East Vancouver. In fact, that area looks a lot less crowded that it did in documentaries I saw 10 years ago.
What beef?

 

[DeathIndustrial88]

I've been an opioid addict for 16, almost 17 years.
I also did a lot of cocaine, crank, xtc, shrooms, etc.. when I was a teenager.
Lots & lots of meth through out my 20's, along with benzos, opioids, alcohol & DXM.

I found that I didn't like alcohol when I had opioids or better drugs though. So if I had opioids or even good bud, I'd often skip drinking.
I didn't like the way alcohol mucked up the feeling of other drugs either.


I think it's because our shitty education system doesn't teach people the reality of drugs. "Just say no" doesn't teach people the dangers of poly-drug use. So people end up drinking & popping pills & doing whatever without realizing they're endangering themselves.

Most people who OD often have alcohol in their bodies at the same time. People think because alcohol is legal, that it must be "safer" than other drugs, when it's really not.

There's also the fact that many street drugs can be contaminated.

Then there's people who get sober from things like heroin due to incarceration, or not being able to find any & then think once they start using again they can just go back to taking the same amount that they did when their tolerance was higher.


The reason people like us are less likely to OD is because we're more educated. We know how to assess our tolerance. I also don't drink, so alcohol doesn't play a role in my usage.


I think there could be more to it too. I dunno. I mean, I've done things like mix DXM with meth & tramadol (incredibly dangerous, nobody should EVER think about doing this). And yet I've done this at least 10 times in my 20's. I don't think I'd be able to handle doing something like this at my age now but I do wonder how the hell I survived doing that so many times. No seizures, no overdose. I think my brain & body were more resilient in my 20's. Maybe it did do some damage though that I'm not even aware of.

Never overdosed on heroin or anything either.

Only time I came come to feeling like I was gonna OD was one of the first times I tried fentanyl. That shit had me nodding so hard that it felt like my consciousness was slipping from me. I didn't like it at all. Never have I ever felt that way while nodding on heroin or other opioids, only fentanyl. It wasn't a very good feeling honestly & I could see how people would OD from it if they did even just a little bit more than they should.



I think a persons mind state also plays a role. Most of the time I use drugs just to help me function & get me through my day. But there are people (including myself) at times who use drugs as a form of masochistic self destruction. So they go out & take as much as they can & do whatever drug they can find just to get more & more fucked up. And if you approach drugs in this way, then an OD is almost inevitable. It's the difference between some one like me who uses opioids & weed to improve mood & function every day & some one who just uses to get as fucked up as possible.

 

[Jnowhere]

Don't know why you claim to know so much about Canadians or your beef with us. Injection sites are in areas with homeless drug users.

There are homeless addicts all over the place, and there is no beef with Canadians, just laughable laws; without the them, digging into this is just to make it look like they care. They don't. Politicians are people with too much ambition to sell used cars, but not honest enough.

 

[Jnowhere]

Forgot you took your pills already, so you take them all again. Depending on what cocktail of drugs you're on, and your own individual health issues, that could be all it takes. I've heard some wild stories from a pharmacist about how badly some people can legit misunderstand how they're meant to take their new prescriptions, too.

I haven't seen the data, but I wouldn't be surprised if a greater number of the overdoses on prescribed meds happened in the 50+ age groups. Your body gets weaker as you age, so things like this are more likely to have serious effects. Not that there aren't people who are just trying to get high, obviously, but I do think there's a lot of genuine accidents that happen.

Yeah, old people get the best stuff, and they forget when they take it.
Then the coroner writes natural causes. What, senility is a cause. People die all the time from senility.

 

[Juniper Bruhmomentius]

Bruder still doesnt understand the concept of varying tolerances

 

[Jnowhere]

Bruder still doesnt understand the concept of varying tolerances

Not many do anymore, not many do

 

[tryptakid]

Don't worry it's not ignorant. This is one of those instances where statistics and hard data do not take into account the psychology of substance abuse and addiction. It's extremely difficult for a responsible individual with no prior issues with substances to understand.

For instance, I hear non-addicts discussing safe-injection sites all the time. "Why don't people just go to the injection site to use? Then, if they overdose, they can be saved!" Yes, in theory, that's great. Most addicts will have a hard time waiting 60 seconds to begin using their drugs after buying them. I'm a personal believer that safe-injection sites are a misguided attempt by the aforementioned non-addicts, using their well-meaning but misguided logic to try to solve the problem. They just do not understand. No addict is going to take a bus to downtown just to fix their drugs and use. You'll find it's outliers in the community who use these safe sites regularly or otherwise folks who happen to be in their proximity already.

When people start using drugs, caution and common sense are eroded. When you're taking 3-4 2mg Alprazolam tablets every day, combined with some Opioids and maybe going to get a few drinks with your friends... it's not as if there is some kind of accurate counter going on in their heads regarding how much they've consumed. Speaking from experience, once addicts are integrated into the lifestyle, they're going to be operating more on how they feel and what their body tells them to do, with the concept of tracking their intake being a distant third place.

That is addiction though. It's a loss of control. It's a gradual shifting of all mental and physical resources toward the drug. Like a computer with limited processing speed, things like safety, hygiene and of course, sympathy/empathy go out the window.

I often wonder if I'd have used a SCS had they been available when I was doing dope. I'm sure I would have checked one out eventually, but I was much more likely to use in a friend's living room, in my bedroom, etc. I was also fortunate to have access to those places, and frankly, most of the time I would drive around looking for Dunks bathrooms that had a single toilet/sink with a door lock. There were definitely days where I'd have probably gone to a site to get well in peace. For most of the folks I work with, they use outside in public or in public restrooms. Some places that provide services for drug users are known to be relatively non-judgemental about what one does inside of a restroom, so long as they aren't in there forever.

To me, the idea of a standalone SCS makes no sense for all of the reasons you stated. On the flip side, a community center with a mixture of resources and recreational space, that happens to provide private space for substance use, would be a much better option. Give people a safe place that offers connection to community, connections to resources, and privacy, and I do think that would be likely to be utilized. Just drive by any of the existing needle exchange/drug checking places and you'll definitely see people just hanging out and chilling nearby.

The Harm Reduction Coalition has a semi-annual conference that I've attended a few times, and I was invited into a room that was being used for safe consumption. It was pretty amazing to see something, run unofficially and by volunteers, creating an environment for people to use in safety. I even joked that I was drinking a beer and so I was participating, which had the room laughing. The only thing you weren't able to do was smoke anything due to it being a non-smoking room. It wasn't perfect, but it was good to know that it was there for people who wanted to use and still be able to attend the conference, and it helped to ensure that people weren't filling the bathroom toilets with used gizzies.

SCS won't fix the root causes of our current predicament, but they will take some of the air out of the room, and might be a good start point for more extensive community based engagement programming. We need pathways into stable housing and treatment just as much as we need safe spaces for people to use, without negatively impacting the community in ways that public drug use very much does.