heroin

heroin

TOC:

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)

Short Summary

  • 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

Medium Summary

  • 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.

Opioid treatment involves methadone or suboxone. Reversal of acute opioid overdose requires naloxone.

Documentaries

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

LA Times

‘You want a description of hell?’ Oxycontin's 12-hour problem

May 5, 2016

http://static.latimes.com/oxycontin-part1/

Frontline

Chasing Heroin (2 hours)

February 23, 2016

Focuses on Seattle opioid issues.

http://www.pbs.org/wgbh/frontline/film/chasing-heroin/

Fusion

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

https://www.youtube.com/playlist?list=PLxd0bZ1RXEzvzMKVJSB40AG78v6FvmR6Z

HBO

Heroin: Cape Cod, USA (1 hour, 15 minutes)

December 28, 2015

Preview: https://www.youtube.com/watch?v=QxpGYyHOtvc

https://www.youtube.com/watch?v=YW3lRKbQqpY

Official site: http://www.hbo.com/documentaries/heroin-cape-cod-USA

Vanguard

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.

https://www.youtube.com/watch?v=wGZEvXNqzkM

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

Daily Motion source: http://www.dailymotion.com/video/xjfjt0_vanguard-gateway-to-heroin-s05-e01_shortfilms

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/

Overview site: http://www.11alive.com/story/news/2016/02/25/inside-triangle/80756752/

The original URL has so much advertising garbage it barely plays the video, so I've copied the videos here for easier viewing:

Slideshow: http://www.11alive.com/media/cinematic/gallery/80871356/young-addicted-and-dead/

Overview: http://www.11alive.com/local/heroin-triangle/

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."

https://www.youtube.com/watch?v=WkkF9M9h3XA

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).

https://www.youtube.com/watch?v=hwtSvHb_PRk

Article: http://www.jsonline.com/watchdog/watchdogreports/what-happened-to-the-poster-children-of-oxycontin-r65r0lo-169056206.html

Additional educational videos: http://www.supportprop.org/resource/video/

Minnesota Department of Health

Heroin at Home (25 minutes)

July 30, 2013

https://www.youtube.com/watch?v=nXAu_pWg0ss

Attorney General of Virginia

Heroin: The Hardest Hit (45 minutes)

December 10, 2015

"a documentary on heroin and prescription drug abuse in Virginia"

https://www.youtube.com/watch?v=kVd8rxe-bBA

Official site: http://ag.virginia.gov/index.php/hardesthit

Westchester News 12

Hooked on Heroin (1 hour)

March 11, 2014

https://www.youtube.com/watch?v=6-Bc8gAeoqI

Waterford, Michigan

The Heroin Epidemic (1 hour)

April 3, 2015

https://www.youtube.com/watch?v=dR9ysgcK4Gs

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/

ABC News

Fighting a New Heroin War (10 minutes)

October 29, 2014

https://www.youtube.com/watch?v=qbIjeOA0vqE

The New Face of Heroin Addiction (9 minutes)

October 29, 2010

https://www.youtube.com/watch?v=cskq_zGVSZs

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)

2009

https://www.youtube.com/watch?v=qzcUd5kgt0Y

BBC

Undercover Inside America's Heroin Epidemic (9 minutes)

March 21, 2014

Focus on Chicago.

https://www.youtube.com/watch?v=SsYhC_OPwVU

Forbes

Uncrushable and Non-Dissolvable Pills to Deter Partial Abuse (5 minutes)

April 17, 2015

https://www.youtube.com/watch?v=4AvlakXi3fY

Canadian Global News

Fentanyl Abuse (9 minutes)

January 28, 2013

Covers potency differences between fentanyl and heroin.

https://www.youtube.com/watch?v=1mN8okFdz6A

Charlie Beauchamp

Florida Blues - An Oxycodone Documentary (9 minutes)

September 9, 2011

short low budget research project.

https://www.youtube.com/watch?v=qUYi3RSA5Y0

VICE

Heroin's Antidote (Narcan / naloxone) (15 minutes)

December 2, 2014

https://www.youtube.com/watch?v=ANseEroeSsg

South Wales Teenage Heroin Epidemic (1 hour)

2009/2010

https://www.youtube.com/watch?v=aIbpt1aDFqM

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.)

https://www.youtube.com/watch?v=LjpD41mMG8o

Paper on benzo/opioid co-abuse (2012): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351/