Harm Reduction ⫸Should I Try HEROIN?⫷

[Burnt Offerings]

If someone offered to give me a ride somewhere, then mentioned that there was something of a 20-30% chance that I'd be seriously injured or killed in a car accident, I probably wouldn't take the ride with them. That's how I look at the issue...so, the answer to the question posed in the OP title is, again, unequivocably "no".

However, it's also true that, if you were to take a snapshot of the overall using population at any given time, the large majority of users are not addicts. And it's also true that the distortions in the socioeconomic context created by prohibition are so immense that it's difficult to make reliable assessments of diamorphine's addictive potential or social harm outside of the context that use occurs in. So in that sense I feel like the heterodox, HR-affiliated voices on the issue like Mate, Hari, Peele, Hart etc. (all of whom I originally heard of through this website) contribute something valuable to the discourse, other than just triple-underlining how terrible this or that drug is with the requisite junkie sob stories. Does anyone believe that such stories actually prevent people from trying a drug? Think about your own personal experience when answering that question. I don't look down on anyone for whatever they choose to do with their own body and their own life, how could I, I did all that dumb stuff in my past and I'm not going to throw any stones from my massive glass mansion...and, if anyone cared to ask for my opinion, I would clearly and in no uncertain terms urge them to not consume potentially addictive/destructive illegal drugs...but some of the issues that have been brought up recently are very real and are worthy of serious discussion (although they may not be so appropriate for the focus of this particular thread, I'm willing to admit), and I don't think it's good to assume bad faith on the part of whoever you're debating with on this topic.

 

[Pickledlemons]

this dare and related programs need to tell the truth. as soon as a kid learns something they were taught is wrong, they throw everything else through the window. they told me addiction / dependence happens after 1 use and its just not true... probably one of the reasons I ended up so fucked.. that and my dad never discouraged drug use infact he was always right there next to me, asking for a line. Used to think that was so cool. now... ??? kinda embarrassing.

 

[Olivia Nicole]

this dare and related programs need to tell the truth.

Special Senate Committee on Illegal Drugs (37th Parliament, 1st Session)

Special Senate Committee on Illegal Drugs

sencanada.ca

Short version below.

"Structure of the argument...

Claim A: All or most people who use heroin or cocaine beyond a certain minimum amount become addicted
Claim B: No matter what portion of users of heroin and cocaine become addicted, their addiction is due to exposure to the drug

Conclusion

I hope that this short review is sufficient to show that the conventional belief that heroin and cocaine cause addiction is very far from an empirically supported fact. By the normal, skeptical standards of science, Claim A is false and Claim B is an unsubstantiated hypothesis.

Moreover, the conventional belief in drug-induced addiction appears to persist because it serves personal, social, professional, commercial, and political needs. I do not mean to imply, however, that these needs are unimportant. Empirical science is not the only road to truth--conventional wisdom must be evaluated pragmatically as well as scientifically. However, at this point in history, the conventional belief in drug-induced addiction may be doing more harm than good.

There was a time when society spoke with unshakable certainty of the terrifying dangers that resulted from even a word of religious heresy and of the incurable consequences of occasional childhood masturbation (Bullough, 1987). At the time, terrifying rhetoric seemed necessary to frighten people away from socially unacceptable behaviours. But the consequences were brutal. Moreover, the scare tactics eventually lost their power anyway. Much the same seems to be occurring now, as both the brutality and the futility of the "War on Drugs" are becoming more and more evident. There are times in history when society is better served by dispassionate information than by manufactured fear.

My hope is that this quick survey of the illusory scientific support for the conventional belief that heroin and cocaine cause addiction can help to show why society should turn away from this unsupported belief. Understanding that there may not be any inherent addictive power in drugs could help to turn us toward a broader, more efficacious formulation of the causes of addiction in our time, and of the huge, dismal saga of tragedy that it produces."

-Blake K. Alexander, Department of Psychology, Simon Fraser University

 

[JessFR]

That article argues 2 points.

1. It disputes that everyone will become addicted to a drug with prolonged use. This isn't a contested proposition. To my knowledge nobody here is arguing that everyone is vulnerable to addiction to every drug.

2. It disputes that there are individuals who are vulnerable to certain drugs. It suggests that perhaps some people just decide they love drugs and keep using them by choice among other explanations.

"A non-deterministic explanation is logically just as plausible as a deterministic one. It is possible that a small percentage of people choose, consciously or unconsciously, to adopt drug use permanently following an initial experience, in the same way that other people, following an initial experience, commit themselves strongly and permanently to a religion, a political position, a mate, a life of crime, or a thousand other lifestyle commitments which sometimes have catastrophic consequences (Alexander, 1990; Schaler, 2000).

This is complete crap. And I assert that anyone who believes it that doesn't have the first clue what they're talking about and has little to know experience. They've either never been addicted or it's early in and they're still believing whatever they wanna believe.

@Olivia Nicole I'm gonna be direct. You've been arguing this, near as I can tell a shockingly long time now. What's your deal?
Why would someone be so adamant about downplaying the dangers of heroin in the face of SOOO many people with SOOO much combined experience insisting that the dangers are very real.
Are you a heroin user? If you are, for how long?

I mean it's your choice to answer this, I can't make you., and if you refuse to answer I probably won't bother to ask again. But you strike me as someone in the first few years of an addiction (I'd count this to be maybe 2-4 years but it can vary). Maybe that's not the case but this all just screams of junkie excuse making to justify continued use. With nothing else to go on that's what I'd assume.

I don't mean to sound like I'm attacking you or anything here, I just wanna understand. Why would anyone devote this much effort to downplaying the risks of heroin? In spite of piles of addicts with probably hundreds of years of combined experience arguing different.

Frankly, I can't say I much care much what some university article's has to say about why people keep using heroin. The people who write that shit have absolutely zero first hand experience. They're like the doctors who call withdrawal "like a bad flu" because that's their impression of the textbook definition of the symptoms. They don't have a clue. There's only so much a textual definition can tell you about how something feels.

 

[dalpat077]

I got so much to add here but cannot right now.

But for now: I smell a rat of sorts. I’ve had this same article referenced in another thread. And I distinctly remember commenting on the date. This was two fucking decades ago. Nothing in between until this Carl Hart character came onto the scene. And who now seems to have become the ultimate authority among, and according to, a certain few. Couple that with a thread denying the existence of the opioid epidemic. And calling most, if not all, figures and statistics released by various bodies into question under various guises. And then slipping the Spanish and Portuguese models in somewhere (cheap shot). Coincidence? Maybe.

 

[Burnt Offerings]

The experience in Portugal has long been cited on this website and other sites with a similar focus.

I guess the challenge is trying to draw a balance between highlighting the very real dangers associated with the use of this or that drug illegal drug, while simultaneously avoiding the propaganda and rhetorical strategies used by federal agencies and programs to support a debased system built on demonstrable lies (prohibition). The idea that addiction is the result of a confluence of factors, and can't just be reduced down to cause-effect biochemical reaction, is something I wouldn't feel is terribly controversial around here, in fact I'd consider it to be "party line" on a site like BL, based on the authors and books I've seen commonly cited here over the years.

 

[JessFR]

The experience in Portugal has long been cited on this website and other sites with a similar focus.

I guess the challenge is trying to draw a balance between highlighting the very real dangers associated with the use of this or that drug illegal drug, while simultaneously avoiding the propaganda and rhetorical strategies used by federal agencies and programs to support a debased system built on demonstrable lies (prohibition). The idea that addiction is the result of a confluence of factors, and can't just be reduced down to cause-effect biochemical reaction, is something I wouldn't feel is terribly controversial around here, in fact I'd consider it to be "party line" on a site like BL, based on the authors and books I've seen commonly cited here over the years.

Indeed, the balance is found by being as honest as possible with oneself in explaining what addiction is like.

And in being as honest as I can, my position is you should avoid opioids like crazy. If you're not in severe pain, either physical or mental, don't try them, at all. Don't touch them. You may not get addicted if you try them, but it's not worth the risk.

Some people of course just seem almost destined to try this stuff. They are in emotional pain and it's like a part of their soul is missing and calling out for something like opioids to fill it.

Which is why I never feel regret for trying heroin. I regret what I did and how I hurt people in my addiction, but I don't regret trying it because I don't think there's any chance I'd ever have not.

I was extremely depressed when I started heroin. I'd experienced an abusive childhood, and felt depressed and often suicidal. At the time I was already self harming with cutting and shit. And I didn't expect to live that long anyway so there was no reason for me not to try drugs, and I actively wanted something to help with the pain.

People in that kind of situation, or something similar to it, You can, and I do, try to convince them they shouldn't try opioids, but I don't really think it's likely that it'll make a difference. I think some people are just on a path where it's all but inevitable. All the cries of how destructive it's likely to be don't help with you have no self worth or hopes to start with.

But for everyone else.. stay the fuck away from opioids. Stay away from amphetamines too. Some people are just highly vulnerable to these categories of drugs. And once they try them, it's like a switch gets flipped. And their brains suddenly go "this is what I've been missing my whole life". Essentially like they're addicted straight away.

Other people it takes longer, addiction forms more gradually.

And some have no vulnerability to addiction at all. But you can't know until you try, and once you try it it's too late. You can't un-experience it.

That's what I'd say about drugs like heroin and meth. No, it doesn't addict everyone who tries it. But it addicts some of them and the destruction it causes can be catastrophic, if not fatal.

 

[dalpat077]

The experience in Portugal has long been cited on this website and other sites with a similar focus.

I guess the challenge is trying to draw a balance between highlighting the very real dangers associated with the use of this or that drug illegal drug, while simultaneously avoiding the propaganda and rhetorical strategies used by federal agencies and programs to support a debased system built on demonstrable lies (prohibition). The idea that addiction is the result of a confluence of factors, and can't just be reduced down to cause-effect biochemical reaction, is something I wouldn't feel is terribly controversial around here, in fact I'd consider it to be "party line" on a site like BL, based on the authors and books I've seen commonly cited here over the years.

Agreed. What I meant is that in the context of certain individuals around here and threads that are downplaying the potential dangers of H and then to throw in those models in order to justify their stance doesn’t sit right with me.

Point is that decriminalisation and providing harm reduction sites and resources and taking care of addicts is a totally different and honourable and worthwhile cause and should be effected. Downplaying the dangers of addiction and almost bordering on advocating the experimentation with something like H is something different. Hope that makes sense i.e. not sure if I’m making my point nicely or explaining correctly.

And been thinking about this upon seeing these numerous threads that are running simultaneously. So for the sake of argument we’ve now read all the new and old research and accepted it as being correct and that all of the old notions have been debunked and everyone is aware and well versed on the issue. What has that now accomplished in the real world? On this thread alone the number of addicts that have posted about their less than ideal outcomes and regrets outnumber the enlightened pundits by an absolutely huge margin. Would this enlightenment have changed any one of those stories if applied retroactively? I don’t think so personally. I think this thread, and the others, would just be many more pages long but with the exact same general theme.

 

[AutoTripper]

Agreed. What I meant is that in the context of certain individuals around here and threads that are downplaying the potential dangers of H and then to throw in those models in order to justify their stance doesn’t sit right with me.

Point is that decriminalisation and providing harm reduction sites and resources and taking care of addicts is a totally different and honourable and worthwhile cause and should be effected. Downplaying the dangers of addiction and almost bordering on advocating the experimentation with something like H is something different. Hope that makes sense i.e. not sure if I’m making my point nicely or explaining correctly.

And been thinking about this upon seeing these numerous threads that are running simultaneously. So for the sake of argument we’ve now read all the new and old research and accepted it as being correct and that all of the old notions have been debunked and everyone is aware and well versed on the issue. What has that now accomplished in the real world? On this thread alone the number of addicts that have posted about their less than ideal outcomes and regrets outnumber the enlightened pundits by an absolutely huge margin. Would this enlightenment have changed any one of those stories if applied retroactively? I don’t think so personally. I think this thread, and the others, would just be many more pages long but with the exact same general theme.

I actually think that yes, you were making your point more nicely, seemingly I mean, not inferring anything other than the logic that you have accrued the odd warning point (still an alien concept to very cheeky, tongue rolling not always nice at all me lol), so you maybe are conscious of how your passionately conveyed points may be taken, which I would understand.

But on that, I think you sailed perfectly within the margins here.

I was making the point in the warning point thread, it’s so possible to spill your true heart and mind, without ever being warned, banned, considered offensive.

Right, gotta dash check on baking sweet potatoes....

 

[Burnt Offerings]

And been thinking about this upon seeing these numerous threads that are running simultaneously. So for the sake of argument we’ve now read all the new and old research and accepted it as being correct and that all of the old notions have been debunked and everyone is aware and well versed on the issue. What has that now accomplished in the real world? On this thread alone the number of addicts that have posted about their less than ideal outcomes and regrets outnumber the enlightened pundits by an absolutely huge margin. Would this enlightenment have changed any one of those stories if applied retroactively? I don’t think so personally. I think this thread, and the others, would just be many more pages long but with the exact same general theme.

Well, an outcome that has taken place in the real world is the consistent undermining of the propositions which gird the prohibitionist system. We've seen that first with cannabis but it's also spread to other drug classes in recent years. So in that case our collective experience with prohibition, what we've learned from our mistakes and successes through the historical context of our public policy, has had a real, tangible effect in the world at large. The HR and/or anti-prohibitionist narratives have never been stronger than they are right now imo, especially in the Americas but also in Europe etc.

As far as "what would've changed in the lives of individual addicts, if they had lived under a different system with a different focus than the one they live under now"...I guess I'd just draw an analogy that I drew earlier in this thread, and say that, to completely ignore the public policy, criminal justice and/or socioeconomic context that illegal drug use occurs within would be similar to someone observing a person who went blind from methanol poisoning in the 1920's and saying, "eh, they probably would've went blind anyway if alcohol were legal". The propagandists who favor a "war on drugs" have been pretty effective at depicting this feedback loop, in which they create these persecuted underclass (illegal drug users) who are subject to every aspect of the criminal justice system, then point to them when they're deprived of employment, education, social standing etc. and say "see how destructive drug use is?" Thankfully they haven't been totally effective, though, as people increasingly see through their lies and obfuscation regarding this issue, and we can see that with the increased popularity of the decriminalization/HR agenda

 

[December Flower]

The experience in Portugal has long been cited on this website and other sites with a similar focus.

I guess the challenge is trying to draw a balance between highlighting the very real dangers associated with the use of this or that drug illegal drug, while simultaneously avoiding the propaganda and rhetorical strategies used by federal agencies and programs to support a debased system built on demonstrable lies (prohibition). The idea that addiction is the result of a confluence of factors, and can't just be reduced down to cause-effect biochemical reaction, is something I wouldn't feel is terribly controversial around here, in fact I'd consider it to be "party line" on a site like BL, based on the authors and books I've seen commonly cited here over the years.

The funny thing about Portugal is that it's a shithole.
You can tell me all you want how great the country now is having decriminalized everything,
but the addicts just lie on the streets now instead of hiding. Cool

Serious drop in crime? Yeah, that's because most crime is the police picking up random people,
who happen to have drugs with them. That's like saying "Since it's snowing we have had a shocking decrease in flowers"

I've been to Portugal in 2012 for 1 1/2 months, and the country is fucked up.
It's really really fucked up, you can tell me all you want or send me newsletters.
I've seen this country, and it's fucked.

 

[December Flower]

Honestly. You're making good points @Olivia Nicole
but you're making them in the wrong forum.

Why hook people who are not on heroin?
What you're doing right now, if you were German, I could actually sue you,
because it counts as negligent manslaughter.

Like if you would tell someone they will travel to a distant planet when they kill themselves,
so you urge them to kill themselves. Because they didn't know what they would do to themselves, since they were told bullshit,
this cannot be counted as suicide.

Please just go to HR and actually help people. TDS, there's so many sub-forums that need people with your experience, to tell them how to control their opioid use. But no, in order to do that you would have to admit that 90% of ppl who take heroin WANT OUT ASAP, so you gotta talk to people who are not addicts yet and try everything to make them addicts. Why are you ONLY interested in making new addicts? What's your gain here? Do you even know? I'm starting to theorize that Olivia Nicole is just a dealer.

You know, I think you don't talk to other heroin addicts, because other heroin addicts think you're full of shit. And they're probably right. You're likely just honeymooning, until something truly bad happens, or you can't use your body anymore to get heroin. And then you will be seriously fucked, because you can't stop. There's enough honeymooners that made it 5-10 years, it's nothing abnormal. Ofc heroin is easy to handle if you always have the money to pay for it. Wait until you don't, then we'll see.

 

[Burnt Offerings]

Well I haven't been to Portugal, but I do know how to type "Portugal drug decriminalization" into a search engine and read the first link, from October of last year:

After decriminalization, the number of people in Portugal receiving drug addiction treatment rose, according to a study by Hannah Laqueur, an assistant professor in the Department of Emergency Medicine at the University of California, Davis. Moreover, as of 2008, three-quarters of those with opioid use disorder were receiving medication-assisted treatment. Though that’s considered the best approach, less than half of Americans who could benefit from medication-assisted treatment for opioid addiction receive it.

“Most accounts of the Portugal experiment have focused on decriminalization, but decriminalization was part of a broader effort intended to encourage treatment,” Professor Laqueur said.

In turn, the country made financial investments in harm reduction and treatment services. Research in the United States shows a dollar spent on treatment saves more than a dollar in crime reduction.

Opioid overdose deaths fell after Portugal’s policy change. So did new cases of diseases associated with injection drug use, such as hepatitis C and H.I.V. This latter change could also be a result of increases in needle exchange programs in the country. Those programs often meet opposition in the United States, but a cost-effectiveness analysis published in 2014 replicated the research of others in finding that a dollar invested in syringe exchange programs in the United States saves at least six dollars in avoided costs associated with H.I.V. alone.

Harm reduction through needle exchanges and greater treatment availability are among the reasons for the wide disparity in drug overdose deaths between the United States (with a rising and staggering total of nearly 72,000 last year) and European countries like Portugal (which typically has well below 100 such deaths a year). These reflect a different mind-set on addiction; in Portugal, it’s treated strictly as a disease.

etc. That certainly makes it sound like decriminalization was combined with substantial outreach on the part of the state. Not a utopia, not some idealized perfect solution or panacea to the issue of substance abuse, but a more sane policy than the pigshit ignorant one we have in the USA? Yeah, absolutely.

Pointers From Portugal on Addiction and the Drug War (Published 2020)

Decriminalization involves trade-offs, but treating addiction as a disease yields a clear gain, research suggests.

www.nytimes.com

 

[December Flower]

Well I haven't been to Portugal, but I do know how to type "Portugal drug decriminalization" into a search engine and read the first link, from October of last year:



etc. That certainly makes it sound like decriminalization was combined with substantial outreach on the part of the state. Not a utopia, not some idealized perfect solution or panacea to the issue of substance abuse, but a more sane policy than the pigshit ignorant one we have in the USA? Yeah, absolutely.

Pointers From Portugal on Addiction and the Drug War (Published 2020)

Decriminalization involves trade-offs, but treating addiction as a disease yields a clear gain, research suggests.

www.nytimes.com

I understand it in Portugal. They're flooded with Opium from Marokko.
They needed something like this, but not to be some idealist country, but because it was just too much to handle.

There's shitloads of addicts in Portugal, and they are everywhere. It's definitely not a Utopia,
and no argument for drugs, rather against ever taking anything ever.

 

[Erikmen]

Help!!

 

[JessFR]

Help!!

How can we help?

 

[silver darling]

80% of people who use heroin don't become dependant

Studies I read give a rough 90% average not-dependent figure. Roughly 90% of people are fine taking drugs - whatever the drug - 10% of users develop a life limiting addiction - whether that's weed, wine, opiates whatever*. The classic study is US soldiers returning from Vietnam where they'd been using heroin and opium regularly. Most ex-soldiers quit. 10% continued an addiction. Similar figures are coming out for weed use now it's lost the drippy hippy everythings groovy tag. The alcohol industry works on the basis that 10% of addicted users generate 40% of profits.

That 90/10 split DOES NOT APPLY to people on these boards. We are not average drug users. The average drug user gets drunk a bit when they are younger, maybe smokes some weed, has some beers in the fridge. We have an active interest in heroin. We are self selected 10% candidates if not yet active 10 percenters. The other 9 people with beer in the fridge are not here trying to figure out how high they can get vis a vis acceptable life damage.

So if you are here asking if you should try heroin and thinking about addiction probability I would say for you = very high probability. If you were on facebook wondering about going into hospital and getting opiate pain killers I would say don't worry, get it while you can, beg for more, you wont like it that much anyway and the chances of you spending endless hours obsessing about it = low probability. Other comments here make a similar point.

*crude claim, plenty other variables I'm sure, but one in ten people seems to be basis.

 

[December Flower]

Studies I read give a rough 90% average not-dependent figure. Roughly 90% of people are fine taking drugs - whatever the drug - 10% of users develop a life limiting addiction - whether that's weed, wine, opiates whatever*. The classic study is US soldiers returning from Vietnam where they'd been using heroin and opium regularly. Most ex-soldiers quit. 10% continued an addiction. Similar figures are coming out for weed use now it's lost the drippy hippy everythings groovy tag. The alcohol industry works on the basis that 10% of addicted users generate 40% of profits.

That 90/10 split DOES NOT APPLY to people on these boards. We are not average drug users. The average drug user gets drunk a bit when they are younger, maybe smokes some weed, has some beers in the fridge. We have an active interest in heroin. We are self selected 10% candidates if not yet active 10 percenters. The other 9 people with beer in the fridge are not here trying to figure out how high they can get vis a vis acceptable life damage.

So if you are here asking if you should try heroin and thinking about addiction probability I would say for you = very high probability. If you were on facebook wondering about going into hospital and getting opiate pain killers I would say don't worry, get it while you can, beg for more, you wont like it that much anyway and the chances of you spending endless hours obsessing about it = low probability. Other comments here make a similar point.

*crude claim, plenty other variables I'm sure, but one in ten people seems to be basis.

Yknow that's just such bullshit. I don't think there's 80% of people who take heroin and are not dependant. There might be 80% who THINK they are not dependant, because it has to be mostly honeymooners, right? Most older users are long dead, usually. Also I need to read that study, or the number is pure coincidental, anecdotal nonsense to me, sorry.

 

[dalpat077]

I saw @silver darling's post yesterday and have been thinking about it since. And now your post @December Flower (and you know we're in agreement on this particular topic).

I must admit: I've been wondering about these figures myself as well as the extent of the actual problem. And if the truth be told: this as a direct result of the Chauvin trial thread (believe it or not i.e. upon first reading that statement you may think I'm off of my rocker).

Hear me out.

Does it not stand to reason that serious users and addicts will congregate on a site such as this? In other words: there could be 10 000 fold the number of H users in America and that use now and then for recreational purposes only. We're only seeing, let's say, hardcore here? It's a question and a musing not a statement by the way.

Don't get me wrong. My stance has not changed at all. But such stance is based purely on what I've read here in the past year or so.

I suppose what I'm getting at (and to explain my reference to the Chauvin trial thread): the actual number of police shootings in the USA, regardless of race or anything else, isn't even close to a material number when seen in relation to the total population (it was less than 0.5% in 2019 according to statistics if memory serves me correctly) (memory easily refreshed though and but a click away). In other words: due to various factors there are TEN mountains being made of a SINGLE molehill. Does that not apply here?

To reiterate: not changing my stance on this topic. Still think the Professor is doing the world an injustice with his rhetoric. And the above by no means statements of fact. Purely for conjecture. And, as I say, something I have indeed been wondering about for a while now (@silver darling's post just prompted me to finally post on this now).

I still wouldn't go near the stuff if you paid me. Mostly due to the stories I've seen/read/heard over the years (and obviously here too) i.e. fear. And it just wouldn't be my thing anyway.

Also important to note that I'm talking about smack here and nothing else. I do believe there's a far bigger issue (numbers) when it comes to prescription pharmaceuticals/opioids.

The possible flaw here, though, is the money that the smack business is worth. But is that a result of addiction mainly or mainly due overall recreational use?

And no: this not an invitation for a-n-other member to chime in and start extolling the virtues of taking up H as a hobby! Also not an extension of the Chauvin trial thread either i.e. merely an analogy being made in order to postulate a theory.

 

[December Flower]

IAlso important to note that I'm talking about smack here and nothing else. I do believe there's a far bigger issue (numbers) when it comes to prescription pharmaceuticals/opioids.

Thanks for mentioning this. I would definitely agree with 80% non-dependant on opioids in general. That's a number I can believe, especially because many people dabble in weak/prescription opioids for quite some time before they.."upgrade"

Another thing is the admittal of dependence. I really need to see this study, or it's utter BS to me :/
I need actual numbers. Who are they asking? Are they asking people "Hey, do you take Heroin? O, that's nice, are you dependant?" ....uh, yeah ofc anyone would answer that truthfully if asked on the street, or even in a medical setting. Many people are ashamed of this shit, and don't just blurt it out to everyone

If you only get official medical data, it's the next issue: You're only going to see the hardcore addicts in a hospital, just as dalpat said. You're going to find the ones that want out but can't, or the ones that OD themselves in order for their little pleasure cruise and start risking death for it.