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Why is opioid addiction almost absent in countries with OTC opioids but rampant in the west?

LucidSDreamr said:
These ppl can’t get it through their fucking head that these people can’t be rehabilitated EVER.
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Yeah - I think for once they really had made a serious fumble as neither methadone nor buprenorphine is going to help someone with a crazy fentanyl addition. I've read reports of chemists who broke RULE 1 and out of the five, two are dead, to are still suffering AWS a YEAR after stopping and one is in jail.

They all ended up whacking up enormous doses of fentanyl, beta hydroxy fentanyl (reckoned much more euphoric) and other homologues on a 20 minute schedule say and night. How to avoid WD while asleep? They all used syringe-drivers.

But it does seem that at the moment fentanyl is a one way street.

We KNOW of medicines that likely would fully substitute BUT the patent has run out. So nobody is going to produce them UNLESS they have a firm order and the US seems to deal with it's opiate poblems mainly on the state level. It would need a federal programme for it to be worth a manufacturer setting up a production-line and with the current US government, who can trust if a decision won't be reversed on a whim?
 
Gaz_hmmmm said:
Many state's in the US have codeine and dihydrocodeine (Possibly even very weak opium tincture too.) over the counter in pharmacies but they're like pseudoephedrine in that you can only buy a certain amount once a month and need ID and to write your name and address in a register when buying. You could build up a stash of dihydrocodeine though just incase.
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While by law yes still legal combined with some other active ingredients at <80mg per dose, this is just extremely common.

A 50+yr mom and pop store in rural Midwest or South, with a clerk old enough to know about this loophole, and an old enough customer.. maybe. Opium tincture isn't recognized by the FDA and while could be prescribed to treat rare conditions (legally), ive certainly never heard of it.


It would be much easier to build up a stash of Suboxone, hell it is easier to stockpile legal Ketamine now, than codeine. lol
 
4DQSAR said:
Yeah - I think for once they really had made a serious fumble as neither methadone nor buprenorphine is going to help someone with a crazy fentanyl addition. I've read reports of chemists who broke RULE 1 and out of the five, two are dead, to are still suffering AWS a YEAR after stopping and one is in jail.

They all ended up whacking up enormous doses of fentanyl, beta hydroxy fentanyl (reckoned much more euphoric) and other homologues on a 20 minute schedule say and night. How to avoid WD while asleep? They all used syringe-drivers.

But it does seem that at the moment fentanyl is a one way street.

We KNOW of medicines that likely would fully substitute BUT the patent has run out. So nobody is going to produce them UNLESS they have a firm order and the US seems to deal with it's opiate poblems mainly on the state level. It would need a federal programme for it to be worth a manufacturer setting up a production-line and with the current US government, who can trust if a decision won't be reversed on a whim?
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I mean people on fent need to just have the desire to get “clean” onto methadone and go through the withdrawl of fentanyl to methadone transfer.

The problem is not even that they want to but are scared of the withdrawl of getting on methadone….its that they literally do not want to. They prefer fent amd want to stay on it and that is never going to change for many people on it


Now if you offered them the transfer onto a more recreational drug, say IV hydromorphone…..I think more might be willing to withdrawl from fentanyl onto hydromorphone
 
Did you know that there was a loophole in the state law of the Northern Territory (Australia for US readers) where a pharmacist could, at their discression, give a customer strong opioids without needing a prescription? I guess if you are 1000 miles from the nearest hospital, it has it's place.

But an old sheephand told me that 'if you are ever real crook, go to the pharmacy and ask for <nickname forgotten> and drink it in one gulp. It will make you puke, but it WILL stop the pain'.

It was heroin in solution. So I BET it indeed stopped the pain.

But go to SE Asia or India - private prescriptions are so cheap and doctors so keen for ANY patients that they will pretty much write what you want'.

BTW In Gibalter you could still buy straight dihydrocodeine tablets from the pharmacy. Again - fly home or Spanish hospital?
 
hmm interesting loophole -- wonder why it makes you puke as heroin in water or brandy probably would not. (tolerance depending of course)

Wish I could afford travel and had the balls to bring it back haha
 
There ate loopholes EVERYWHERE.

Often pharmacies will jusfdge the (potential) customer and this is where being old and crippled pays off. I totter in a pharmacy and the staff are reaching for the strongest analgesia before I even speak!

I've learnt that. A few pharmacies wouldn't serve me because they correctly thought I was taking quite a lot of codine. Others would always serve me BECAUSE they thought I was taking quite a lot of codeine. It's their attitute towards you that matters. It took something like 20 years to be given adequate analgesia but pharmacists know this and obviously turn a blind eye if they seen someone so obviously in pain.
 
There was not a pill crisis at anytime in the USA, there was no heroin crisis, and no there is no fentanyl crisis today... How do I know ? It has been and is always available. Even when one form kicks someone's ass so bad, they have a safe replacement for that and the dope man is never late.

I should have been born in 1883, that would have timestamped graduating high school when Bayer starting selling Heroin. That would have been a nice 11 year stretch
 
Them Witches said:
There was not a pill crisis at anytime in the USA, there was no heroin crisis, and no there is no fentanyl crisis today... How do I know ? It has been and is always available. Even when one form kicks someone's ass so bad, they have a safe replacement for that and the dope man is never late.

I should have been born in 1883, that would have timestamped graduating high school when Bayer starting selling Heroin. That would have been a nice 11 year stretch
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I suggest a 'crisis' is when a journalist can go to an open air market and buy cold i.e the seller doesn't know them.

But price and availability are the key drivers in increasing numbers of people using the stuff.
 
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Gaz_hmmmm said:
Many state's in the US have codeine and dihydrocodeine (Possibly even very weak opium tincture too.) over the counter in pharmacies but they're like pseudoephedrine in that you can only buy a certain amount once a month and need ID and to write your name and address in a register when buying. You could build up a stash of dihydrocodeine though just incase.
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Are you sure ? I've never heard of that. Maybe one of those things that is no longer in practice.
 
pcplease said:
im not sure stocked anywhere but that came up as an approved OTC due to less than 80mg codeine per serving.
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That could well be but I would say it's probably in a country other than the US because we don't have OTC codeine, at least not in many years.
But I do sort of maybe remember taking phenaphren with codeine back in olden days 🤷
 
pcplease said:
im not sure stocked anywhere but that came up as an approved OTC due to less than 80mg codeine per serving.
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I assume you mean 8mg as 80 is quite a lot.

I don't recommend it but several medical profassionals have vouchsafed the fact that the rule for acetaminophen is 'no more than four grams in a twenty four hour period' i.e. one could eat eight at once. That's one reason I asked if it was a typo because 80 x 8 is a LOT. In fact I will go further, it's a lot of LOT.
 
LucidSDreamr said:
In like half the world tramadol and codiene (at least) are OTC. South American countries, carribean, Southeast Asia. All OTC. No heroin or fentanyl epidemics.

Why is the west so fucked despite the restrictions? Is it because of the restrictions? Or are there more issues at play like culture and socioeconomics?

This issue is not discussed in the academic research based on my searching.

You could also say the same for benzos.
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In some southeast Asian countries drug offenses can still get the death penalty. That might have some effect.
 
Gaz_hmmmm said:
Many state's in the US have codeine and dihydrocodeine (Possibly even very weak opium tincture too.) over the counter in pharmacies but they're like pseudoephedrine in that you can only buy a certain amount once a month and need ID and to write your name and address in a register when buying. You could build up a stash of dihydrocodeine though just incase.
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This is absolutely not true at all.
If codeine, DHC & opium tincture were as easy to access as psuedoephedrine, then everybody would be doing this.
Codeine, DHC & opium are all controlled/scheduled drugs in the US. Psuedoephedrine is not.

If a drug is controlled/scheduled,. then you can only obtain it with a doctors prescription in the US. There is no legal/over the counter DHC, Codeine or opium in the US.
The closest "over the counter" opioid one could access in the US is loperamide. That's it.

Trust me, in the throes of withdrawals, I've discovered every OTC drug out there that could possibly get one high. And there are no OTC opioids here in the US.

I'm pretty sure our neighbors to the north (Canada) have over the counter codeine though.
 
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SeekingOblivion said:
In some southeast Asian countries drug offenses can still get the death penalty. That might have some effect.
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China, Iran, Saudi Arabia, Singapore, and Vietnam.

Indeed they do but it seems the sentencing isn't applied equally. While a farang may recieve a long term of imprisonment, it's politically expedient not to execute citizens of nations who themselves do not use capital punishment. I mean, 20 years in a Vietnamese jail is quite likely to be a death sentence anyway.
 
I know it's just a movie, but has anyone seen "Running With The Devil?"

I think that even in movies we sometimes get a glimpse of the truth. Those people know things the average person probably doesn't. Check that shit out if you haven't seen it. Good flick.
 
4DQSAR said:
I assume you mean 8mg as 80 is quite a lot.
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Federal law dictates that codeine be a Schedule II controlled substance when used in products for pain relief that contain codeine alone or more than 80 mg per dosage unit. This could be a typo, or it might just be amother grey area. Dr's are not lawyers.
 
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