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

Them Witches said:
Grossing those figures from MAT Methadone & Suboxone, the racket of felony drug charge fines in court, the racket of sending addicts to jail, court based drug program fees, and paying the government & city workers their salaries -- all adds up to whats the rush to remove Fentanyl, Tranq-Dope, etc. The longer the fentanyl nightmare goes on, it is more money for their pockets. At some point the US will wonder where did all the prime military stock go.
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You forgot to mention all the settlements from the pharmacies that only filled the scripts written by Drs. They had to pay for their part in this as well. Money supposedly distributed to states to use for use to combat the epidemic.
 
notsmokeymcpot42088 said:
I still question if there is more opioid use in western civilization or if it is simply highlighted and stigmatized. Any real data on that?
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I havnt done a ton of searching yet to answer this and only limited it to South America. Data is sparse but I found this. Anyone wanna compare it to the USs numbers?

In countries such as Mexico and Guatemala, no cases of opium misuse had been reported by the 1990s, despite the existence of opium poppy crops in those countries (22). In turn, the National Survey on Psychoactive Drugs, conducted in Argentina in 2017 with the population ages 12–65 years, reported a lifetime prevalence of 0.1% for use of heroin, opium, and morphine (23). A somewhat similar result was obtained in Colombia (18) in 2013, where only 1.07% of the population had ever used opiates and no differences were found in use by gender. Those ages 18–34 years reported the most use. In that study, 0.14% of the respondents had used heroin at least once, and 0.03% reported use during the prior year (18).
Researchers at the San Vicente Foundation University Hospital in Medellin, Colombia, reviewed the medical history of patients diagnosed as dependent on prescribed opioids between 2011 and 2014. Of a total of 3,332 medical records, 60 patients (1.8%) met criteria for opioid dependence, although 33% of those had been misdiagnosed. Eighty-eight percent of the sample started consumption after receiving prescribed pain medication, although the pain severity was minimal in 25% of the patients. Inappropriate use of opioids may thus have persisted because of self-medication to relieve pain. Only 4 of 60 individuals (7%) had a cancer diagnosis. The most consumed substances were tramadol and morphine (6 of 37, 16%), oxycodone, and others; mean duration of consumption was 48 months (range 1–240 months). For one quarter of the sample, opioid use was associated with consumption of other psychotropic substances. Fifty-five percent had started replacement treatment with methadone after years with the diagnosis of polydrug abuse, and 40% were undergoing another treatment (24).
Puerto Rico shows a proportionately higher incidence of opioid misuse compared with Latin American countries, with approximately 60,000 people with opioid misuse problems; among those, a significant number are in jail (25). These findings make the island part of the U.S. opioid epidemic, which has been triggered by the increase in legally prescribed analgesics and illegally obtained opioids.
 
F.U.B.A.R. said:
F.U.B.A.R. said:
Codeine and didydrocodeine are OTC in the UK (albeit it limited doses and in combination with paracetamol), and we have no opioid addiction problems here...

😉
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Here in America Our drugs Are much much more powerful than yours.

our codiene tablets are like 60mg of Codiene
while your OTC tablets contain 8-12mg codiene

(UK) Dihydrocodeine is weaker than Morphine
(US) Hydrocodone is about equal to Morphine

Pharmaceutical companies know we have stronger opioids in America so they market aggressively. UK has the NHS which means stricter advertising laws & tighter control on central guidelines so drug reps can't sell directly to GPs like in America.
Also, U.S. had a profit driven system with little central control in the 90's. That's when the makers of oxycontin downplayed its addiction risks to us so we inherently defaulted to strong drugs earlier on & the UK just didn't build that pipeline. U.S. doctors have had patient satisfaction surveys tied to income & the pharmacies were hardly flagged until things turnt into an epidemic. Lack of affordable rehab in America worsens the blow amongst lax oversight on our drug industry as a whole and bam! U get 2025 america baby
this isn't good lol
 
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mirsNeedsHisItch said:
Here in America Our drugs Are much much more powerful than yours.

our codiene tablets are like 60mg of Codiene
while your OTC tablets contain 8mg codiene

(UK) Dihydrocodeine is weaker than Morphine
(US) Hydrocodone is about equal to Morphine

Pharmaceutical companies know we have stronger opioids in America so they market aggressively. UK has the NHS which means stricter advertising laws & tighter control on central guidelines so drug reps can't sell directly to GPs like in America.
Also, U.S. had a profit driven system with little central control in the 90's. That's when the makers of oxycontin downplayed its addiction risks to us so we inherently defaulted to strong drugs earlier on & the UK just didn't build that pipeline. U.S. doctors have had patient satisfaction surveys tied to income & the pharmacies were hardly flagged until things turnt into an epidemic. Lack of affordable rehab in America worsens the blow amongst lax oversight on our drug industry as an whole
All this isn't good lol
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And that kind of proves my point that countries with OTC opioids do not have an 'absence of addiction'.
 
F.U.B.A.R. said:
And that kind of proves my point that countries with OTC opioids do not have an 'absence of addiction'.
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Absence of addiction & Opioid Addiction crisis are 2 different things.
I agree your country faces its troubles with addiction but it's certainly not much of a cultural issue as it is in 🇺🇸
 
mirsNeedsHisItch said:
the pharmacies were hardly flagged until things turnt into an epidemic. Lack of affordable rehab in America worsens the blow amongst lax oversight on our drug industry as an whole
All this isn't good lol
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This is kinda against what my point was in this thread. There is nothing lax anbout our oversight in the US. People are dying of cancer, living with obliterated spines, and undergoing major surgeries without opioids.

I was reading on a Texas thread about the recent ban of THC on Reddit and there were users commenting that post surgical opioid take homes are de facto banned now. Hysterectomy patient said she had zero medication for pain after. California where I live has been ok relative to other states…..still very strict but not an out right defacto ban.
 
LucidSDreamr said:
This is kinda against what my point was in this thread. There is nothing lax anbout our oversight in the US. People are dying of cancer, living with obliterated spines, and undergoing major surgeries without opioids.

I was reading on a Texas thread about the recent ban of THC on Reddit and there were users commenting that post surgical opioid take homes are de facto banned now. Hysterectomy patient said she had zero medication for pain after. California where I live has been ok relative to other states…..still very strict but not an out right defacto ban.
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No I was describing the prequel to how we got here. Nowadays you can't even get prescribed ibuprofen. I asked my dentist for pain meds bro looks at me like I'm asking for Animal euthanasia. I can't disagree with anything u just said cuz its just the truth lol


I live in Florida, we were the state fucking around with pills during that early 2000s pill crisis. Nowadays they don't trust themselves and They'll prescribe you gabapentin for a car accident it seems like but in the streets the pill game is crazy so its almost like they want people to overdose
 
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F.U.B.A.R. said:
And we both have OTC opioids available.

So your point is? 😃
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America doesn't have OTC opioids lol
the point was your country isnt dealing with what america is dealing with 😀
I literally said "I agree your country faces its troubles with addiction but it's certainly not much of a cultural issue as it is in 🇺🇸"
 
mirsNeedsHisItch said:
America doesn't have OTC opioids lol
the point was your country isnt dealing with what america is dealing with 😀
I literally said "I agree your country faces its troubles with addiction but it's certainly not much of a cultural issue as it is in 🇺🇸"
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OK, we agree your country is a total fuckup from big pharma overprescribing.

Also, the OP's post seems to be conflating 'The west' with 'The US'.

There are many 'western' countries with OTC opioids available. The fact that addiction is 'rampant' in the US is irrelevant :\

Anyway, I thought that the likes of Vicodin was OTC there? Maybe not...
 
F.U.B.A.R. said:
OK, we agree your country is a total fuckup from big pharma overprescribing.

Also, the OP's post seems to be conflating 'The west' with 'The US'.

There are many 'western' countries with OTC opioids available. The fact that addiction is 'rampant' in the US is irrelevant :\

Anyway, I thought that the likes of Vicodin was OTC there? Maybe not...
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Vicodin isn't OTC either
& I wouldn't say my country Is a total fuck up
1. We are number 1 in the global tech sector (Apple, Google, Meta, and Microsoft are good ol boys in blue we host them and they are central to global innovation. we outpace Europe in producing high-value startups and unicorns)
2. One in Military power (goes unsaid largest defense budget on planet earth, most aircraft carriers)
3. Education (American universities are among forefront of global education. Institutions such as Harvard, MIT, and Stanford consistently rank among the world's top universities. I know I know all Americans are dumb like meeee!!!)
4. Oxford Economics ranked NYC the best city in the world for 2025
5. We lead the world in Pharmaceutical development practically (insane FDA approvals with a insane number of new drug start ups)
6. We are number 1 for GDP nominal even though China leads with PPP
7. More Nobel prizes than any country, Most billionaires is, most olympics won
8. Culturally dominant (Music, film &social media trends being exported at an higher rate than any country)
9. Pushing Humanity (NASA & SpaceX leads commercial space travel as of june 1st 2025)
10. Capital (majority of Venture capital Investment orignates from the states)

Different countries deal with different problems due to culture etc.
( Canada as of recently is dealing with fentanyl but its different cuz the country is different )
The vast majority of western countries don't allow OTC opioids the ones that do I can recall Is like New Zealand , Ireland , Europe & I think 1 more.
The united states is THEE western country so my previous post I consider very relevant 👍
 
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helpingout said:
I’d say the United States is indivorcibld from its appetite for heroin because so much of our culture loves and celebrates how good heroin is. Which if true and great and yes hew for horse. But opium transport to China was a major source of wealth in early America and when China said don’t bring us anymore we went ahead and brought it to the big cities of the northeast. People could buy pharmacists preparations of opiates or just buy opium. Likewise in the west many immigrants brought with them a taste for opium. This led to one of the first drug laws in the country when San Francisco made illegal opium and only permitted its use by prescription.

The long and short is that a lot of the gentry in the United States participate in actively addicting certain neighborhoods and regions. There likely aren’t forces in these countries whom use the poppy as a means of control like here in the USA. We’ve been slinging brown for a long time.

Yee haw I love me some haroon.
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I fuckin wish I could get real heroin. It’s just been fent here for years now
 
F.U.B.A.R. said:
OK, we agree your country is a total fuckup from big pharma overprescribing.

Also, the OP's post seems to be conflating 'The west' with 'The US'.

There are many 'western' countries with OTC opioids available. The fact that addiction is 'rampant' in the US is irrelevant :\

Anyway, I thought that the likes of Vicodin was OTC there? Maybe not...
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You can even buy opium extract in the UK. It would need a miricle of smufring to acquire a useful amount, but it's out there.

There is a big argument as to the UK keeping weak opioids as [P] medications but in the US people were taking huge doses of loperamide to avoid AWS. Loperamide has a particularly nasty issue in that it demonstrates a two-phase dose-reponse curve.

In essence, the brain actively pumps loperamide out of the brain but when you overwhelm that ABC-transport, suddenly it does accumulate in the brain. I've read a lot of forsensic papers on unlucky punters who went from using 200mg/day to 250mg/day. I knew someone who died from it and another who ended up in an ICU due to compartment syndrome.

In the US both mitragynine and tianeptine have popped up and I forecast that if they are banned, someone will sell eseroline. While it demonstrates toxicity in animal models, so does loperamide so I don't think that will stop sellers.

You can essentially go on forever finding more and more hazardous hacks for all this, but each time it's a worse solution.

Hard to know if the UK has people who have used codeine to get off stronger stuff. I suspect it does occur. You won't feel good but you won't rattle as hard. So I consider the current UK position to be reasonable - given the example of the US.
 
4DQSAR said:
You can even buy opium extract in the UK. It would need a miricle of smufring to acquire a useful amount, but it's out there.

There is a big argument as to the UK keeping weak opioids as [P] medications but in the US people were taking huge doses of loperamide to avoid AWS. Loperamide has a particularly nasty issue in that it demonstrates a two-phase dose-reponse curve.

In essence, the brain actively pumps loperamide out of the brain but when you overwhelm that ABC-transport, suddenly it does accumulate in the brain. I've read a lot of forsensic papers on unlucky punters who went from using 200mg/day to 250mg/day. I knew someone who died from it and another who ended up in an ICU due to compartment syndrome.

In the US both mitragynine and tianeptine have popped up and I forecast that if they are banned, someone will sell eseroline. While it demonstrates toxicity in animal models, so does loperamide so I don't think that will stop sellers.

You can essentially go on forever finding more and more hazardous hacks for all this, but each time it's a worse solution.

Hard to know if the UK has people who have used codeine to get off stronger stuff. I suspect it does occur. You won't feel good but you won't rattle as hard. So I consider the current UK position to be reasonable - given the example of the US.
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That was fucking cogent doggie.

Excellent approach to the question and a very well constructed answer.

I can tell you that in the US out of desperation I tried everything to taper off of heroin outside of the medical system. Today I’m at a place where I use opiates and they don’t fix the things wrong with me anymore because my lapses taught me strategies to deal with triggers. Now it’s basically heartbreak that drives me to opiates. I don’t really know the solution now that I know opiates can kind of fill the gap of where love used to be. But also I know that that’s illusory and because it fills the gap when it’s no longer filling the gap I’ll have to deal with that shit anyway. So why fucking drug about it. When I could just deal with my shit.

But yeah. Having substances to jump down from hard drugs is really really really really helpful in reducing g the harm and allowing people a way out. I would bet thousands of addicts in the uk have at least prevented full blown withdrawal which likely keeps the employment rate a bit higher than if that same 10% opiate using populace just had to kick unaided every time there was a supply problem. Going to work is a lot easier on codeine than it is to raw dog the sickness and try to be at work. I mean I can’t imagine vomiting and ahitting at work
 
helpingout said:
That was fucking cogent doggie.

Excellent approach to the question and a very well constructed answer.

I can tell you that in the US out of desperation I tried everything to taper off of heroin outside of the medical system. Today I’m at a place where I use opiates and they don’t fix the things wrong with me anymore because my lapses taught me strategies to deal with triggers. Now it’s basically heartbreak that drives me to opiates. I don’t really know the solution now that I know opiates can kind of fill the gap of where love used to be. But also I know that that’s illusory and because it fills the gap when it’s no longer filling the gap I’ll have to deal with that shit anyway. So why fucking drug about it. When I could just deal with my shit.

But yeah. Having substances to jump down from hard drugs is really really really really helpful in reducing g the harm and allowing people a way out. I would bet thousands of addicts in the uk have at least prevented full blown withdrawal which likely keeps the employment rate a bit higher than if that same 10% opiate using populace just had to kick unaided every time there was a supply problem. Going to work is a lot easier on codeine than it is to raw dog the sickness and try to be at work. I mean I can’t imagine vomiting and ahitting at work
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In America You can walk in Any smoke shop and buy dozens of
7-OHhmg which is the potent alkaloid in kratom & arguably much more powerful than morphine in some user experiences, other says is an oxy-like hypnotic. You can also buy THCA or THCP in the right shop which is basically synthesized marijuana. I think Americas issue isn't about jumping drug to drug because we've done that more times than I can count (barbs to benzos. downers to opiates cigs to vapes weed to synthetics etc)
The problem is that money prevents people from accessing a good therapist n' rehabilitation & addiction prevents people from accessing the pain relief they need.
We need to unwove the weaves we webbed retrace our steps and solve systemic issues we always talk about when it comes to Big Pharma. The only reason it isn't happening is because drugs are another cog in the federal government that keeps money flow and nothing is scarier to the number 1 GDP on the planet than losing a profit to make a profit. They won't do it cuz its money lost even though its a "drug crisis"
I love America. We have the most creative and free foundation in the world. We can capture modernism the most because of that. Its just a with great power comes great responsibility & humans aren't without incompetence
 
I have noted many US BLers who mention they use kratom and are concerned that the US government will eventually bring the product under legal control.

I don't kbow how potent kratom is but reports on 7-OH mitragynone are sketchy. Of the three routes I know of that oxidize mitragynine to 7-OHmitragynine, two use heavy metals, one uses an explosive hypervalent iodine compound, I note dubious labs that actually offer testing for heavy metals... so who knows if contamination with heavy metals is common and if so, how serious is it?

But it's not as if such laws appear overnight. You get a lot of warning so I would ASSUME that those products will become controlled at some point in the future and seek to detoxify now, not when you have to. Just like buprenorphine, if you simply park omeone on an opioid, it's only ever going to make detoxification harder. So if you are otherwise in good health and are otherwise in a good position, better to detox now rather than at some future time when you may have other problems to contend with.
 
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