Tag: opiates

Give Me Misery or Give Me Death?

 

Doctors retire. That’s the context of my recent experiment in “detoxing” from two prescriptions, both of which strike me (but not yet the FDA) as good candidates for over-the-counter (OTC) sale. (Most striking detox effect so far: a massive earache.) One is Celecoxib, an anti-arthritis drug. The other is Montelukast, an anti-asthma and anti-allergy drug. What’s scary about selling both these drugs OTC is allegedly death.

Celecoxib is a Cox-2 inhibitor, and those drugs as a class still haven’t completely aired out the stink of death brought on by Vioxx. Montelukast maybe sometimes cause psychiatric side-effects, according to postmarketing reports, raising the specter of suicide (though postmarketing reports could report anything as a side-effect, short of “pet turtle died”). But the most frightening thing about Montelukast appears to be that it’s an effective asthma control medicine, and the FDA is apparently nervous about making effective asthma control medicines available to consumers directly.

Dreamland – A Review

 

Billed as “the true tale of America’s Opiate epidemic,” Sam Quinones’s Dreamland is a pretty quick read considering it’s about 350 pages. The blurbs on the back promise “expert storytelling,” and I suppose it is. The storytelling is good enough to make me wonder how heavily Quinones selected for stuff that would make a good story, while other stuff, equally true and relevant, but less dramatic, got discarded along the way. Quinones focuses on the marketing of OxyContin as a safe prescription drug, its subsequent abuse, the spread of a new means of dealing black tar heroin, and the connection between these, telling the tale of several colorful characters along the way.

To Quinones, the spread of opiate use to white America – not just to impoverished “rust belt” regions, but also to the offspring of the wealthy, managerial class – is fraught with moral meaning, though perhaps contradictory moral meaning. Heroin tempts us when we’re too wealthy, when we’re too poor, because we feel entitled to pain relief, because we don’t feel entitled to stop when it hurts but instead succumb to pressure to tough it out by any means necessary; it tempts us when we’re underwhelmed by life, it tempts us when we’re overwhelmed… Opiates are both the new party drug and the new drug of social isolation… Addiction is simultaneously a moral indictment of American consumerist excess during the pre-crash boom, a testament to post-crash misery, and an illness which deserves less moral stigma than it gets. Forgive me for suspecting at times that, to Quinones, opiates serve mostly as a random moral generator.

Which isn’t to say Dreamland is a bad book. There seems to be plenty of impressive journalism in here, crime journalism especially, although the science journalism falls rather short: there are multiple errors in describing how drugs are metabolized; in describing the drugs derived from the opium poppy (in particular, using “the morphine molecule” as shorthand for all of them); and sometimes there’s just illiterate wording, like calling what’s not statistical mechanics “statistical mechanics” or calling a lumbar sprain “a sprained lumbar” (a sprained lumbar… what?). Still, for someone like me – someone who uses opioids conservatively as part of a pain-management regimen, considering them a not-very-fun occasional treatment reserved for pain that inhibits productivity even more than being doped up would – Dreamland is a tour of a world Quinones, if his story is to be believed, claims I could easily have become a part of, yet haven’t.

Member Post

 

We typically avoid talking about maddening and infantilizing enteric distress, but there’s a good chance most of us have experienced it at some point. Many a home medicine cabinet contains Imodium (active ingredient, loperamide), and some of us may have had a doctor recommend a newer prescription agent, eluxadoline, for problems that occur with greater […]

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