Talk:Opioid/Archive 01

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Archive This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.

This is Archive 1, which cover discussions which began in 2004.

No Title

Two questions:

1) Should I create a redirect from pentazocine (on this page) to Talwin? (I know Talwin is not the best entry for the subject - but I don't have the knowledge to improve on it)

I think Talwin>>>pentazocine is better, best to have the article under the chemical name, since the patent on Talwin will eventually expire, but the chemical name will not. 'think long term'. cheers.Pedant 22:49, 2004 Nov 11 (UTC)
Thanks. [for doing it and for educating me] (I'm learning as I go.) CJewell 14:51, 26 Nov 2004 (UTC)

2) Aren't there 5 opioid receptors, not 3?

I remember the two pages mismatching to the point of being contradictory. They're clearer (and they match) now. CJewell 14:51, 26 Nov 2004 (UTC)

CJewell

Hi Fugg: recreational use of opioids is abuse. Period. JFW | T@lk 13:50, 5 Nov 2004 (UTC)

taken from here

Jfdwolff: I object to 'abuse' because it is pejorative. I see no reason to use it when 'recreational use' is a perfectly useful and neutral term. Fugg 03:01, 6 Nov 2004 (UTC)

See your talk. JFW | T@lk 11:42, 11 Nov 2004 (UTC)

"Recreational use"

I have reworded the article slightly for neutral point of view, not all addicts are 'recreational users' and not all recreational users are 'addicts', changed to user in one case rather than either recreational user or addict /changed another instance to chronic user as, addiction is not required for "ramp effect" and "ramp effect is not typically noted in the mere 'recreational user' , furthermore, the term "recreational" is misleading , see Recreation would prefer either simply user, when appropriate, or chronic user, or even non-medical user, but I think this version should feel good for all of us.Pedant 22:45, 2004 Nov 11 (UTC)
I'm quite happy with Pedant's re-write Fugg 05:18, 12 Nov 2004 (UTC)
Use of opioids for anything but analgesia is inappropriate use, whether recreational or not. I'm happy with Pedant's rewrite, but the article now needs more structure. JFW | T@lk 22:51, 13 Nov 2004 (UTC)
Agreed. I've done a subedit with a more clinically-oriented narrative and structure - hopefully it's still relatively NPOV. Techelf 03:45, 22 Nov 2004 (UTC)
Assume the opioid in question to be loperamide. With no further discussion, your viewpoints are proven invalid (to save you time, loperamide's 'on-label' use is to relieve diarrhoea). Now please immediately and completely recant them. It's safest to take no viewpoint -- also please know that darvocet can help hypersalivators or hypersecretors and any opioid can prevent a person from dying of dysentery. DrMorelos 00:38, 25 November 2006 (UTC)
Stating that non-medical use of opioids is abuse is clearly a POV statement -- namely the point of view of prohibitionists. Of interesting note is that during the Temperance movement, a number of alcohol prohibitionists found absolutely no problem with using opium and morphine as a replacement for alcohol. The only way to properly handle this NPOV issue is (as Wikipedia policy promotes) to provide both sides of the argument. That is that some consider all non-medical use of opioids as abuse, and others believe that responsible recreational use of opioids is a reality (of which there is plenty of historical literature to back up). --Thoric 21:09, 30 Nov 2004 (UTC)
If I may interrupt, I am presently a clinical physician (secret: I want out), but my education began with two degrees in mathematics. The number of fallacies I read below this is greater than three, but I would appreciate if you folks would consider the following isuse: while we are sitting around trying to agree on a definition for the word abuse, the actual definition on which we should focus is medical versus non-medical. Abuse is too open to interpretation and bizarre rationalization to be made tangible even by a bunch of intellectuals such as yourselves; the medical versus non-medical discussion has some legal starting points and plenty of wiggle room for employment of the socratic method to find a reconcilable dividing line. Do you find this a reasonable approach? DrMorelos 00:57, 25 November 2006 (UTC)

There's POV and there's POV. From a legal AND medical view, opioid abuse is exactly that. Why do we need to lend credence to those who dispute those well-held opinions? Cool, their opinion deserves mention, but I'm not aware of a society/group that promotes decriminalisation of opioid abuse. UNTIL it has been decriminalised, the moniker "abuse" is not POV, pretty much as "speeding" is defined by the speed limit on the road you're driving on. JFW | T@lk 21:51, 30 Nov 2004 (UTC)

Laws are constantly in a state of flux, as are scientific and medical views. Opium has over 5000 years of recreational use. 80 years of anti-narcotics legislation is a small blip in comparison. Noted historical authors, philosophers, scientists and doctors have used and abused opioids. Certainly it is to the interest of prohibitionists to black out all research on the grey area of recreational use between drug addiction and medicine, but that doesn't erase it from history. As for groups that support it, there is a growing movement to legalize all drugs. I can provide links to several groups, political parties and organizations if you are interested. --Thoric 22:35, 30 Nov 2004 (UTC)

Under the present legislation, "abuse" is pretty well defined. Your attempt at NPOV is laudable, but a bit overdone. Do we also need to NPOV murder to allow for the thousands of years that killing for the sake of religion was considered a virtue? Again, I am not intent on suppressing the views of the political/users' groups, but I do not want you to suppress the perfectly reasonable use of the word "abuse" where this is utterly obvious. Wikipedia is not a vehicle to overthrow legislation. JFW | T@lk 08:44, 1 Dec 2004 (UTC)

How on Earth were you granted authority over the validity of using words like "abuse?" I would like to apply for some words, myself. DrMorelos 00:57, 25 November 2006 (UTC)

I would have to agree with JFW. In attempting to form NPOV, it forms an implied legitimisation of an activity that the vast weight of medical opinion deems to be detrimental. Medical professionals are not "prohibitionists" - we endorse the safe, efficacious and judicious use of medicines including opioids. We should not fall victim to the fallacy of appeal to tradition - just because something has been done for 5000 years does not legitimise it. By all means mention of recreational uses should be made, but Wikipedia should not be seen as endorsing abuse of opioids. -Techelf 09:23, 1 Dec 2004 (UTC)

First of all, please stick to the topic at hand -- opioids, not murder. There is, and always has been a distinction between abuse and ludibund use of opiates and all other drugs. Your political bias, and those who share it cannot change this. Documenting the ludibund use of opioids distinctively from drug abuse should not only exist subject to your opposing POV, and NPOV documentation should not be misconstrued as "endorsement" of said activity. A warning that ludibund use of opioids can often lead to addiction and hence abuse is perfectly fine, but to suppress the truth goes against NPOV policy. If you still deny the existance of ludibund use of opioids, I suggest checking out some books on the subject, such as The Heroin User's Handbook. --Thoric 17:27, 1 Dec 2004 (UTC)

I am not planning to read a book to understand your POV, especially because you have utterly failed to understand and address my two good metaphors (the speed limit and the murder example). "Recreational use" of opioids is dangerous enough for governments worldwide to forbit it, defining it as abuse. Most people using opioids for non-medical uses are using them because they are addicted, not because they want a carefully planned kick with naloxone on the side in case they get comatose, drop their respiratory rate or get so constipated they need phosphate enemas. You cannot for one moment claim that your activism is an act of NPOV. JFW | T@lk 20:32, 1 Dec 2004 (UTC)

Alas, if you insist to stray off topic. First of all, the fact that exceeding the posted speed limit on a public road or highway (or speeding) is against the law does not nullify the existence of legitimate car racing, and certainly shouldn't block the mere mention of street racing as if it legitimized or even advocated the activity. Murder, while illegal is justified by governments in the case of war, self defense, capital punishment (which, as you should note has supportive and opposing views despite the opposition being the majority view) or euthanasia. Most rational people do not consider drug use to be equatable with murder. The ludible use of opium has a huge history. Heroin has an a documented addiction rate of about 20% (many claim less). For those not mathematically inclined, 20% is not "most people". You cannot claim that a mere brief definition of recreational use is somehow my personal biased "activism". How about doing some research outside of the prohibitionist propaganda camp. --Thoric 21:02, 1 Dec 2004 (UTC)
Excuse me for not being a recreational drug user - but what is "ludibund" supposed to be exactly? At any rate, you ignored what I said earlier so I will repeat it for your benefit - anything that is not safe, efficacious and judicious constitutes inappropriate use. This includes recreational use of opioids - how can you argue that it is appropriate to cause self-harm? Even if the addiction rate is only 20%, opioid-use always produces a range of detrimental effects which JFW alluded to. Also, opioids produce a physical dependence-syndrome in all users - it has been proven that continuing misuse of addictive agents is almost-always to prevent the negative effects of withdrawal (negative reinforcement). Unlike those with right-wing political agendas to push, as health-professionals, we act in the best interests of our patients and using established best-practice. We do not judgmentally tell users that they are "wrong" - instead we explain the dangers and consequences associated with inappropriate use, and offer help if they want. That is NPOV. You clearly do not understand NPOV or indeed the term prohibition. Current established best-practice is harm minimisation - noone in their right mind is here to promote prohibition. So, rather than dismissing everyone else as a member fof the big prohibitionist conspiracy, perhaps you should consider that your activism is itself a biased POV. -Techelf 03:44, 2 Dec 2004 (UTC)

For the record, I'm not a recreational drug user, I am a drug researcher. Ludibund comes from the Latin ludibundus, meaning playful, sportive. Anyways, the safety of an activity does not detract from its recreational value, in fact for some, this adds to its appeal. Think mountain climbing, extreme sports, motorcycle racing, even downhill skiing is a dangerous activity. A common element between these activities, and drug use is that the danger factor is greatly increased by the lack of education and instruction with that activity. The detrimental effects of opioids stem primarily from their legal status. On a completely level playing field with alcohol, heroin turns out to be less detrimental. Scientifically alcohol is slightly more addictive compared to heroin (see Relative Addictiveness of Various Substances). Physically, alcohol causes far greater damage to the body -- cirrhosis of the liver, damage to other organs, shrinkage of the brain, etc. Opioids cause constipation. If a hard core alcoholic is suddenly deprived of alcohol, they can die from the resulting delirium tremens. Death from opioid withdrawl is virtually unheard of. Now, for the real topic at hand, the NPOV of this article: The ludible use of drugs POV is a known and long existing POV. Your opinion to label ludible use of drugs as "inappropriate", or even worse as "abuse" is an act of imposing your POV onto the article. According to the NPOV policy, articles are not supposed to have a POV -- only present a collection of known points of view. As for the uses of drugs, there are five different categories, ordered from most approved to least approved of:

  • Medicinal - used to treat an illness
  • Therapeutic - used as a tool in therapy
  • Experimental - used for experimental research to prove or disprove the above two uses
  • Recreational - used purely for pleasure and enjoyment
  • Abuse - where the user has lost self control over his or her usage of the drug, has developed a dependence on the drug, and where the use of the drug has a significantly detrimental impact on the user, and possibly also a negative impact on the user's friends and family

You say that you don't judgmentally tell users that they are "wrong", yet you advocate labeling recreational use as abuse. I am only advocating that you maintain the NPOV policy by not wording the article in an opinionated way. You are certainly free to point out that the current majority political and medical communities view all non-medical use as abuse (highlighting the opinion of those groups), but this opinion should not be held by the article itself.

I am in full accordance with wikipedia's NPOV policy to note the distinction between recreational drug use and abuse. For you to label recreational use as abuse is to impose your non-neutral point of view onto the article. --Thoric 14:53, 2 Dec 2004 (UTC)

Also, if you truly support harm minimisation as you state, then how about adding a section on it, and heroin maintenance? --Thoric 17:18, 2 Dec 2004 (UTC)

I do apologise for my implication that you're a recreational-user - I took the accusation of being a prohibitionist to heart too much given my left-leanings. However, I have not said that recreational-use is abuse, and if it was implied then I should clarify that it was not my intended meaning. I had only meant to express, above, that you can only "neutralise" an article to a certain point beyond which it becomes a POV itself (and this POV seemed to be suggested in some of your earlier comments on this page). There is also a fine-line between what constitutes recreational-use and misuse; and therein the danger lies. I agree that, all things considered, ethanol is probably more dangerous; and certainly the social-cost of ethanol misuse far exceeds that of opioid misuse; and that the danger is vastly underestimated by most. I have personally had the experience of being prevented from rendering first-aid to a collapsed casualty by a person too drunk to differentiate between a penlight and a camera; so I know this all-to-well. The reason I have not added a section on harm minimisation is that it is not my field of expertise. Certainly I am an advocate of harm minimisation, and have attempted to convince certain individuals in my field (pharmacy) of its value. Also, we do not to my knowledge have an established heroin-maintenance therapy in Australia - the standard approach used here for the management of opioid dependence is methadone-maintenance. Hope that clears things up a bit. (btw, I figured lundibund might've been Latin-derived, but I can't say I've heard it used anywhere...) -Techelf 12:56, 4 Dec 2004 (UTC)
I also apologize for the name calling, it gets us nowhere. I would certainly rather work together than argue :) --Thoric 21:30, 6 Dec 2004 (UTC)

Thoric, you've failed to convince me. Most opiate addiction starts as "recreational use". Alcohol, when had in moderation, is not very dangerous, while a large segment of recreational opioid users end up using a lot and getting all the complications, ranging from abcesses on injection sites to repeated emergency room attendance with coma. The best prevention of opiate addiction remains the ban on recreational use. I have never said that recreational use is impossible, but in the present paradigm of law and medicine it is a tautology. JFW | T@lk 10:39, 5 Dec 2004 (UTC)

It is well documented that addicts can and do switch their vices (i.e. from alcohol, to drugs, back to alcohol or even to gambling or other non-substance related addictions). Scapegoating the problem onto the drug takes the focus off of the real underlying problem. As a doctor you know that most normal healthy people can use opioids to manage acute pain without becoming addicted. I will agree that the people who most often come to use opioids "recreationally" make it their drug of choice because it fills a void in their life -- but these people have issues that existed long before the drug use. They could have just as easily became alcoholics, but just because alcohol is a socially accepted drug does not make being an alcoholic any "better" than being a junkie. I'm not proclaiming that patterns of responsible recreational use of opioids are comparable to that of alcohol in the western world, but historically opiate use has played a major part in the rest of the world. Islamic nations banned alcohol in favor of opium. Asian countries banned smoking of tobacco, and allowed smoking of opium. Favoring one drug while demonizing another has been a very common theme throughout history. The time approaches to get past this nearly superstitious tendency. --Thoric 03:24, 6 Dec 2004 (UTC)

I have little problems with the paragraph in its present form, although I've toned it down a little bit. There are various POVs, and I hope yours is now represented adequately. JFW | T@lk 08:17, 6 Dec 2004 (UTC)

It is good that we were able to find middle ground. I do respect the work and expertise of both Techelf and yourself even if I get a little heated in debate ;) --Thoric 21:30, 6 Dec 2004 (UTC)
Sometimes a nice heated debate keeps out the cold :-) JFW | T@lk 23:06, 6 Dec 2004 (UTC)

This may have been 'sorted out' here already, but I get the impression from the article that it wrongly assumes that use of the drug while physically dependant must always be 'abuse'. Peoplesunionpro June 29, 2005 02:44 (UTC)

Typically, physically dependant, non-medical use of opiates would be seen as abuse by most people... although if it had no negative impact on your life and loved ones, then it would be little different than caffeine addiction (social stigmatism aside). This is a really touchy subject in the current political climate, mainly because opiates are highly demonized, and anti-drug propaganda is standard fare. It's a very small percentage of the population who will avoid even drugs such as wine, chocolate, coffee, tea or an aspirin... but they are still all drugs. If you want to get really technical, our bodies and brains are constantly producing "drugs"... natural chemicals, which currently have medical names which are named after the drugs that affect the same receptors -- endorphins (endogenous morphine), endocannabinoids (endogenous cannabis alkaloids), nicotinic acetylcholine receptors (nicotine from tobacco), muscarinic acetylcholine receptors (amanita muscaria mushroom), etc, etc. --Thoric 29 June 2005 23:12 (UTC)
Folks, I would like to point out that this argument became specious paragraphs ago. Audience members who actually read the discussion pages are probably not judging you, but are probably recognizing that reading the whole argument is reading an argument and not a debate. You are all obviously intelligent, educated and sharp; the discussion here is laudable as philosophic waxing if the emotion were simply removed.
Also, what do you think of the fact that substances like cocaine have been designated "narcotics?" If you want philosophy, discuss the differences between legal and medical definitions of, oh, anything. DrMorelos 01:03, 25 November 2006 (UTC)