Central Dogma of Opioids
- Brain has receptors for opioids, regardless of source.
- Prescription opioids have the same chemical structure as heroin.
- Brains habituated to opioids eventually end up at one of:
- increasing prescription usage to maintain baseline functioning (due to tolerance)
- abusing prescriptions (accelerating oral dosage or snorting/injecting)
- switching to street heroin (cheaper, but more dangerous)
- pain management drugs induce addiction and dependence
- people become addicted to their opioid prescription drugs (oxycodone/oxycontin/percocet/etc)
- prescription opioids are just professionally synthesized heroin
- heroin is cheaper than prescriptions, easier to access
- heroin is unregulated, has unpredictable strength, often with toxic fillers
- heroin is often cut with fentanyl, increasing the potency 50x to 100x
- unpredictable strength of dosage leads to respiration ceasing leads to death
- drug companies incentivize doctors to prescribe high value, high danger meds (lawsuit summary (2014), lawsuit dismissal summary (2015))
- In the USA, companies run direct-to-consumer advertisements for addictive opioid pain medication
- addictive drugs increase pharma profits (tautology, also see: tobacco)
- bad actors include, but are not limited to: Purdue Pharma (oxycodone/OxyContin, morphine/Dilaudid, hydrocodone), INSYS (fentanyl spray), Endo Pharma (oxycodone/percocet)
- opioid use changes the brain, causing physical addiction and dependence
- prescription opioid dependence requires increasingly strong prescriptions
- prescriptions are expensive
- heroin is cheaper than meds
- heroin triggers the same brain receptors as prescription opioid meds
- it would be more accurate to say prescriptions are "legally obtained heroin"
- heroin was first created in the late 1800s as a less addictive morphine. They were wrong.
- dealers often cut heroin with fentanyl (up to 100x stronger than heroin alone) resulting in unpredictable dosages and rapid onset death when unknowingly administered
In recent news (Feb 2016), CVS started allowing individuals to buy opioid blocker naloxone without needing a prescription. Naloxone (Narcan) "reverses" opioid overdoses resulting in restored consciousness and breathing. https://www.cvshealth.com/content/cvs-health-make-overdose-reversing-drug-available-without-prescription-all-cvs-pharmacy
If you're curious about basic brain pain science, a great introductory lecture on brain/pain/drug interactions (including some pharmacology of heroin/opioids and naloxone) is Pain and the Brain (90 minutes): https://www.youtube.com/watch?v=gQS0tdIbJ0w&t=3m0s (his previous lecture "The Bane of Pain Is Plainly in the Brain" from 2006 is slightly better, but it isn't online anymore and this one covers the same material.)
Opiates vs. Opioids: they are essentially the same. Opiate is a term used for anything derived from a natural poppy plant. Opioid describes any chemical capable of binding to brain opioid receptors regardless of whether it comes from a natural source or an artificially synthesized source.
The documentaries and reports below are weakly ordered from most to least informative with a bias towards newer reporting.
Drug abuse documentaries structure themselves as one or more of:
- Personal Story
- "a day in the life" of people habituated to drugs
- unwinding the personal story of "how they turned into this"
- "a day in the life" of family members for "how addictive behavior affects others"
- Corporate Story
- tracking the upstream causes of downstream abuse
- attempting to discover individuals responsible for society-level exploitation
- tracking the profit motive of getting populations addicted to expensive drugs
- Doctor Study
- investigations into doctors abusing prescription writing ability
- investigations into facilities trying to help people recover from abuse
‘You want a description of hell?’ Oxycontin's 12-hour problem
May 5, 2016
Chasing Heroin (2 hours)
February 23, 2016
Focuses on Seattle opioid issues.
Heroin, Fentanyl, Pharma Fraud, OxyContin, Narcan/naloxone (45 minutes total)
February 1, 2016
Part One (13 minutes): https://www.youtube.com/watch?v=vbl19waROcA
Part Two (6 minutes): https://www.youtube.com/watch?v=TEclE4-QIJo
Part Three (9 minutes): https://www.youtube.com/watch?v=wJ29FCBSvUA
Part Four (8 minutes): https://www.youtube.com/watch?v=YGfLbkWa5w0
Part Five (5 minutes): https://www.youtube.com/watch?v=37VYO7Yt4ao
Part Six (5 minutes): https://www.youtube.com/watch?v=ApQbJV0DvlM
The Heroin Trail (45 minutes total)
December 15, 2015
Heroin: Cape Cod, USA (1 hour, 15 minutes)
December 28, 2015
Official site: http://www.hbo.com/documentaries/heroin-cape-cod-USA
The OxyContin Express (50 minutes)
October 19, 2009
Focuses on Florida oversubscribing (e.g. 1500 pills prescribed by one doctor in less than two months) and how it bleeds into other states.
"9 million pills prescribed by 50 doctors in 6 months"
Covers prescription problems only.
Peabody Award for the episode: http://www.peabodyawards.com/award-profile/the-oxycontin-express
Gateway to Heroin (45 minutes)
June 20, 2011
OxyContin and Heroin in Boston.
"90% of the pills we find in Boston come from Florida."
YouTube source: https://www.youtube.com/watch?v=IwKqTAqm6Ww
Atlanta 11 Alive
Inside The Triangle (20 minutes)
February 25, 2016
Map of suburbs with heroin deaths.
Original video URL: http://www.11alive.com/videos/news/local/2016/02/29/81100456/
The original URL has so much advertising garbage it barely plays the video, so I've copied the videos here for easier viewing:
Canadian Broadcasting Corporation — CBC the fifth estate
OxyContin: Time Bomb (45 minutes)
March 9, 2013
Covers Canada, the OxyContin origin story in rural Virginia, tolerance, pharma lies and manipulation, and Canada moving to OxyNeo (a non-crushable OxyContin) away from direct OxyContin prescriptions.
Covers prescription problems only.
Official site: http://www.cbc.ca/fifth/episodes/2011-2012/time-bomb
YouTube copy: https://www.youtube.com/watch?v=iNOHAJs9dBY
Al Jazeera America
Opioid Wars (25 minutes)
January 16, 2016
Covers prescription to heroin pathways as well as how Purdue Pharma launched opioid painkillers as underplaying "fear of addiction" resulting in "population wide experiment on American citizens by giving them all opiates."
Physicians for Responsible Opioid Prescribing
OxyContin First Users, 15 Years Later (9 minutes)
September 9, 2012
A look into the first users of OxyContin and where their lives went (spoiler: death).
Additional educational videos: http://www.supportprop.org/resource/video/
Minnesota Department of Health
Heroin at Home (25 minutes)
July 30, 2013
Attorney General of Virginia
Heroin: The Hardest Hit (45 minutes)
December 10, 2015
"a documentary on heroin and prescription drug abuse in Virginia"
Official site: http://ag.virginia.gov/index.php/hardesthit
Westchester News 12
Hooked on Heroin (1 hour)
March 11, 2014
The Heroin Epidemic (1 hour)
April 3, 2015
What Happened Here
The Untold Story of Addiction on Cape Cod
February 3, 2015
Full version (1 hour): https://www.youtube.com/watch?v=R_1L4oH-RJg
Short version (25 minutes): https://www.youtube.com/watch?v=BrUEfqGFozk
Official site: http://www.whathappenedherefilm.com/
Fighting a New Heroin War (10 minutes)
October 29, 2014
The New Face of Heroin Addiction (9 minutes)
October 29, 2010
Milwaukee Fox 6
Dose of Reality (1 hour)
January 18, 2016
Six part series, all videos embedded in page: http://fox6now.com/2016/01/18/dose-of-reality-special-an-in-depth-look-at-the-heroin-crisis-plaguing-our-communities/
Heroin in the Suburbs (25 minutes)
Undercover Inside America's Heroin Epidemic (9 minutes)
March 21, 2014
Focus on Chicago.
Uncrushable and Non-Dissolvable Pills to Deter Partial Abuse (5 minutes)
April 17, 2015
Canadian Global News
Fentanyl Abuse (9 minutes)
January 28, 2013
Covers potency differences between fentanyl and heroin.
Florida Blues - An Oxycodone Documentary (9 minutes)
September 9, 2011
short low budget research project.
Heroin's Antidote (Narcan / naloxone) (15 minutes)
December 2, 2014
South Wales Teenage Heroin Epidemic (1 hour)
Australia Channel 7
Xanax - More Addictive Than Heroin (14 minutes)
July 15, 2012
(Xanax isn't an opioid (it's a benzo), but it's the same topical genre.)
Paper on benzo/opioid co-abuse (2012): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351/