Harm Reduction drug fillers and body damage - why?

[cdin]

Why is it that drug manufacturers, when producing a substance WIDELY known to be injected illicitly are able to fill pills with tons of material that is directly toxic/damaging to individuals. As someone who suffers from COPD due to dilaudid abuse, it's concerning. Why hasn't a class action lawsuit been filed against merck/pfizer etc? We know which drugs these are, keep the time releases. Just why use talc, mag stearate and a slew of others that are well known for damaging effects?!

(I get the "it's cheap" and "junky lives are cheap" argument) but you know what isn't cheap - keeping people ok through 20 years of dying at the end of their life in hospice care due to drug additives! Also - if someone had told me at the start - SHOOTING PILLS WILL DESTROY YOUR LUNGS - I would have thought twice, never have I heard that from a harm reduction organization. It always stops at "dont shoot pills, abscesses etc." Think we could do better getting this message out.

 

[Slow_Mobius]

Is that first part a serious question? You're wondering why someone hasn't explicitly warned you about all of the dangers associated with shooting your pills? And then you're wondering why they haven't been sued for adding abuse deterrents?

I have a hard time believing anyone wouldn't be aware of the many dangers that go along with shooting pills that are intended for oral consumption. I mean, a quick Google search will turn up plenty of horror stories of people losing lives and limbs.

Unfortunately the just say no programs have created obscurity with between propaganda and serious danger, but I still think it should be glaringly obvious that you shouldnt be injecting your pills, and I promise they have plenty of warnings on the information pamphlets.

 

[cdin]

sure there's warnings, but people are GOING to do it, this is known. There are plenty of inert things you could make pills out of. im talking especially about pills with NO abuse deterrent - IR dilaudid for example has no safeguards and is full of talc. They should be required to use biologically inert fillers in IR pills.

 

[burn out]

How many dilaudeds did you shoot to get COPD?

 

[Slow_Mobius]

The talc is biologically "inert" and won't cause any problems when it's consumed in those tiny doses. And no, no one expects anyone to shoot Dilaudid the whole "people will do it anyways and you know it" argument is bogus IMO. I think that no one of sound mind would shoot pills if they understood what they were doing, but people dive in without giving it a second thought. I disagree with you in that this is the pharma company's fault. Big pharma is pretty corrupt, but they have fingers pointed at then for a lot of unfair things like this.

Again, I think that there needs to be better education about the real risks of drug abuse. Just say no and scare tactics are awful strategies that have been failing for decades. Fortunately, sites such as bluelight are making it easier for us to spread the word.

But should the pharmaceutical companies design their pills in such a way that they're all safe to inject because an extremely small percentage of customers will inject then inspire of the many warnings not too? Ot course not. Drug delivery systems are complicated, and the chemical engineering behind producing extremely consistent products are not simple processes that can be easily tweaked. Alot of time and money is spent to create oral drug delivery systems that are consistent and effective.

 

[Solipsis]

sure there's warnings, but people are GOING to do it, this is known. There are plenty of inert things you could make pills out of. im talking especially about pills with NO abuse deterrent - IR dilaudid for example has no safeguards and is full of talc. They should be required to use biologically inert fillers in IR pills.

True, but that is not how taking responsibility works I guess - ever seen a disclaimer?
You're talking about enabling abuse, even if for the sake of harm reduction or being realistic. How do you think that will pan out and the outrage from the fallout?

Also considering how they usually try to work hard to keep quiet on the bad sides of pharms like SSRI suicidal side effects or even acknowledging the many people who have falled to opioid dependency following prescription (addiction was long seen as something resulting from being weak willed rather than doctors prescribing too many addictive pharms as big part of the problem - even epidemic right now)...
If they could get away with that kind of thing you're talking about they would probably try to - as it would be wonderful for their business.

I guess the HR left is proper informing, on this specific matter...
Not sure what is a preferred alternative to the situation since tamper-proof formulations do seem to lead to people just switching to illicit pills like fake oxies and the many fent / fent analogue containing ones, which seem disastrous in their own right.

 

[cdin]

Exactly, it's all disastrous. I know there are disclaimers, I know you aren't supposed to, but they have a whole syndrome called "ritalin lung" - so the medical community is aware. Switching the binder from talc/mag stear etc. to an amino acid or something else that is easily absorbed by the body would not make it any easier or less easy to abuse than the current pills. If you make an IR pill that can be easily crushed to powder and thrown in water, you are not supposed to rely on deadly binders as an abuse deterrent! I honestly am kind of floored by the responses i'm getting. It's like if someone put a little cyanide in rice, put a disclaimer on it and then was like "what are you doing eating two plates? now you're gonna die." I am not advocating making pills easier to abuse, or stopping abuse deterring formulations. All I'm saying is if part of your marketing(looking at you purdue) relies on marketing and massive sales of a pill with no abuse deterrent and a substance people have been clamoring to inject for a hundred years, you should, in fact take responsibility for that and just use goddamn b vitamins or something else that won't kill people.

And harm reduction groups need to step up and REALLY talk about this. No one, in my history of working for/with harm reduction said anything beyond "don't ever shoot pills, you'll get abscesses etc." The lung issue has never been at the forefront, I guess because everyone assumes you won't make it that long??? And correct me if I'm wrong, you guys are arguing: in IR pills with HIGHLY sought after known drugs of abuse, it's just on the user(who often times is black market and has no doctor info) to read inserts that don't specifically mention COPD etc and decide as they're getting dope sick they'll just kick this time, cause you know, the danger?!??!?

If you make your money (billions) marketing this shit, im sorry, the responsibility is on you to use some reasonable ingredients. I'm certain there are plenty that could be obtained equally cheap. Or perhaps some that are large enough to be adequately filtered by cotton.

 

[cdin]

and to answer burn out : 20 years weed/cigs and 3 - 4 years 4 - 5 times a week shooting 1 - 3 pills at a time, filtered through cotton.

 

[Slow_Mobius]

Exactly, it's all disastrous. I know there are disclaimers, I know you aren't supposed to, but they have a whole syndrome called "ritalin lung" - so the medical community is aware. Switching the binder from talc/mag stear etc. to an amino acid or something else that is easily absorbed by the body would not make it any easier or less easy to abuse than the current pills. If you make an IR pill that can be easily crushed to powder and thrown in water, you are not supposed to rely on deadly binders as an abuse deterrent! I honestly am kind of floored by the responses i'm getting. It's like if someone put a little cyanide in rice, put a disclaimer on it and then was like "what are you doing eating two plates? now you're gonna die." I am not advocating making pills easier to abuse, or stopping abuse deterring formulations. All I'm saying is if part of your marketing(looking at you purdue) relies on marketing and massive sales of a pill with no abuse deterrent and a substance people have been clamoring to inject for a hundred years, you should, in fact take responsibility for that and just use goddamn b vitamins or something else that won't kill people.

And harm reduction groups need to step up and REALLY talk about this. No one, in my history of working for/with harm reduction said anything beyond "don't ever shoot pills, you'll get abscesses etc." The lung issue has never been at the forefront, I guess because everyone assumes you won't make it that long??? And correct me if I'm wrong, you guys are arguing: in IR pills with HIGHLY sought after known drugs of abuse, it's just on the user(who often times is black market and has no doctor info) to read inserts that don't specifically mention COPD etc and decide as they're getting dope sick they'll just kick this time, cause you know, the danger?!??!?

If you make your money (billions) marketing this shit, im sorry, the responsibility is on you to use some reasonable ingredients. I'm certain there are plenty that could be obtained equally cheap. Or perhaps some that are large enough to be adequately filtered by cotton.

You're kind of missing the point. A lot of these fillers aren't added to cause lung problems in users who inject. They're added because they're a cost-effective filler that won't cause any problems when people use the drugs the way they're supposed to.

Hell, if you were to give every risk associated with every incorrect ROA, the information sheet is going to be 3x longer. Lung problems aren't even the most serious risk associated with IVing pills. I think you're 100% right in that people need better HR education when it comes to abusing pills, but I still think it's totally bogus to put it on the pharma companies.

 

[burn out]

and to answer burn out : 20 years weed/cigs and 3 - 4 years 4 - 5 times a week shooting 1 - 3 pills at a time, filtered through cotton.

Thanks, I'm sorry to hear about your condition. I used to shoot hydromorphones too but I don't notice any lung problems. What symptoms do you experience?

 

[burn out]

You're kind of missing the point. A lot of these fillers aren't added to cause lung problems in users who inject. They're added because they're a cost-effective filler that won't cause any problems when people use the drugs the way they're supposed to.

Hell, if you were to give every risk associated with every incorrect ROA, the information sheet is going to be 3x longer. Lung problems aren't even the most serious risk associated with IVing pills. I think you're 100% right in that people need better HR education when it comes to abusing pills, but I still think it's totally bogus to put it on the pharma companies.

I disagree, partially. While I don't think we can blame the pharmaceutical companies for this in the way they can be blamed for their many crimes against humanity, I think that when the medical community recognizes that a sizeable number of people are shooting pills then common decency would dictate that the pills either be made abuse resistant so they can't be shot, or made so they can be shot safely. The problem is our society has the attitude that the health/lives of drug addicts don't matter because "they did it to themselves", which aside from being heartless (we all make mistakes) is also impractical because as the OP pointed out this also effects non drug users as well when you realize the costs of caring for people with COPD.

In other words, if making a small change to formulation could save the health/lives of many people then I'd argue the moral impetus is on you to make that change, unless you think a compassionless society is a good thing.

 

[CruelBri]

I shoot pills, but only with a Wheel filter/ Micron Filter .22 UM

I feel as though when you take precautions *Using a micron filter, New syringes, Rotating sites* Your doing less damage then say shooting dope everyday without a filter.


If your USING A MICRON FILTER what is passing through that can harm you.

 

[Slow_Mobius]

I disagree, partially. While I don't think we can blame the pharmaceutical companies for this in the way they can be blamed for their many crimes against humanity, I think that when the medical community recognizes that a sizeable number of people are shooting pills then common decency would dictate that the pills either be made abuse resistant so they can't be shot, or made so they can be shot safely. The problem is our society has the attitude that the health/lives of drug addicts don't matter because "they did it to themselves", which aside from being heartless (we all make mistakes) is also impractical because as the OP pointed out this also effects non drug users as well when you realize the costs of caring for people with COPD.

In other words, if making a small change to formulation could save the health/lives of many people then I'd argue the moral impetus is on you to make that change, unless you think a compassionless society is a good thing.

It's really not that simple to make something that can't be abused. If it was possible for them to make pills that couldn't be shot or snorted, they would. In fact they've tried and they're still working on it as we speak, but people find a way to do it anyways.

I'm just trying to say that these fillers aren't just random compounds they're putting in there. They have to be things that won't elicit an immune response, and alot of biomolecules that might be safer to inject will carry a much higher risk. Its alot more important to protect a small percentage of people that need a medicine from having an allergic response to inactive ingredients than it is protecting a small percentage of people who are going to shoot and snort the pills regardless of the many risk factors beyond complications from the fillers.

Moreover, drug delivery can be very complex, and it's nearly asking for the impossible to make a completely novel tablet that is unable to be abused and still effectively delivers the drug.

I'm sure we'll get there, but it's not something that the pharma companies can easily fix like you guys are suggesting, and I personally don't think it should be a priority. If anything, I think the problem stems from extensive criminalization of drug abuse, draconian drug laws, and improper education.

 

[burn out]

The Oxy OPs cant be abused. I mean, yes I know there are teks online but anything where you have to go through so much trouble to abuse it, is pretty effective imo. Its not that hard to make pills that cant be shot, or they could just make them shootable as I said. I really dont see why it should be so hard when illegal drug rings can make shootable heroin. All that have to do would be switch to capsules for example. Put powder hydromorphone in a gel cap and that way the folks who want to take it orally are happy, the folks who want to sniff it are happy and the folks who want to IV it are happy (just open the capsule and empty the powder in a spoon). How hard is that?

 

[CruelBri]

Someone please tell me, if you use a wheel filter/micron filter, what harm are you doing to your body, i know infections and shit you gotta worry about unless you use alch wipes and new needles, but if you use a micron filter for ever pill you were to take, what is mainly going to cause long term damage.

 

[Slow_Mobius]

The Oxy OPs cant be abused. I mean, yes I know there are teks online but anything where you have to go through so much trouble to abuse it, is pretty effective imo. Its not that hard to make pills that cant be shot, or they could just make them shootable as I said. I really dont see why it should be so hard when illegal drug rings can make shootable heroin. All that have to do would be switch to capsules for example. Put powder hydromorphone in a gel cap and that way the folks who want to take it orally are happy, the folks who want to sniff it are happy and the folks who want to IV it are happy (just open the capsule and empty the powder in a spoon). How hard is that?

The filler in tablets can play a role in shelf life and absorption. When it comes to pain management (which is why they're prescribed), it's actually desirable to have something that won't quickly peak in plasma concentration. Having higher highs and lower lows reinforces addictive behavior and causes more rapid increases in tolerance, so just putting a tiny bit of pure powder in a capsule would be a less desirable delivery method than a pressed tablet. It may also require more expensive manufacturing techniques to accurately put such a small amount of powder into a capsule.

Actually, oxycontin's initial appeal was that it offered stable pain relief over 12 hours. Of course, it was a lie that was pushed through by Purdue and ignored by the FDA. If you're going to be mad at pharma companies, be mad at them for things like that! They were fined millions of dollars after billions in revenue.

Also if you want to blame addiction and its consequences on someone, the outdated free market is a bigger problem. Currently, you pay for all the research done to develop a drug, and the pharma companies sweep in to steal all the profit. So the public makes the bulk investment while the rich and the corrupt get richer and more powerful. We are perpetually boned by pharma companies, but I don't think these claims are well founded.

 

[Slow_Mobius]

Someone please tell me, if you use a wheel filter/micron filter, what harm are you doing to your body, i know infections and shit you gotta worry about unless you use alch wipes and new needles, but if you use a micron filter for ever pill you were to take, what is mainly going to cause long term damage.

You said it yourself. Infection. Micron filters will almost eliminate the other concerns we're talking about. It's still not a safe practice though. Especially considering most IV drug users haven't had formal training on maintaining sterile technique.

I also want to add that I'm not trying to say that addiction is your own fault and that pharma companies are innocent in all this. Addiction is an unnecessary consequence of a lot of underlying issues with our society and the legal system in the US and much of the rest of the world. No one wants to be addicted to anything, and I think most of us are medicating some underlying issue. A select few are just having fun, but theyre less likely to have their use turn into an addiction. I just want to clarify that there's no simple fix via drug manufacturing or delivery that will solve the problem of IV drug abuse.

I think this is a great discussion though and I'm interested in hearing other people's opinions

 

[burn out]

The filler in tablets can play a role in shelf life and absorption. When it comes to pain management (which is why they're prescribed), it's actually desirable to have something that won't quickly peak in plasma concentration. Having higher highs and lower lows reinforces addictive behavior and causes more rapid increases in tolerance, so just putting a tiny bit of pure powder in a capsule would be a less desirable delivery method than a pressed tablet. It may also require more expensive manufacturing techniques to accurately put such a small amount of powder into a capsule.

Actually, oxycontin's initial appeal was that it offered stable pain relief over 12 hours. Of course, it was a lie that was pushed through by Purdue and ignored by the FDA. If you're going to be mad at pharma companies, be mad at them for things like that! They were fined millions of dollars after billions in revenue.

Also if you want to blame addiction and its consequences on someone, the outdated free market is a bigger problem. Currently, you pay for all the research done to develop a drug, and the pharma companies sweep in to steal all the profit. So the public makes the bulk investment while the rich and the corrupt get richer and more powerful. We are perpetually boned by pharma companies, but I don't think these claims are well founded.

the difference between a pill and powder is not very big, certainly not worth losing lives over. for me crushed pills never hit much quicker than whole ones. also it would not be expensive to measure out powder for capsules. if the powder is very small, it can be cut with an injection safe cutting agents. trust me if street dealers can do this I'm sure pharmaceutical companies can figure it out.

 

[w0w0mg]

Pills are not meant for injection regardless if people use it. They make OP to prevent such things but people still find ways to do it. Should they be prosecuted for that too? I find this a tad silly, no offense.

 

[cdin]

I was not suggesting they are being used as an abuse deterrent - just that if your main profit business is making IR versions of drugs that historically have been IVd by everyone and their dog, you should do some research to find a stable, harmless compound to use as filler for your pills. I don't think what I'm suggesting is at all outrageous.