| Lets look at heroin a little more carefully. Incredibly toxic? Hardly--it actually has a quite good safety profile when used as intended. Highly and immediately addictive? About 5 weeks ago I had a close chemical cousin of heroin. 3 times in fact. Addicted? I never felt the slightest desire for it once the cause of the pain was gone and I certainly didn't like what it did to my digestive system. (Morphine, given by a doctor for a kidney stone. Heroin is basically two morphine molecules stuck together.) Easy to overdose? The extremely limited medical use of heroin means we don't have good data, so lets look at morphine instead as it should be similar. The therapeutic index is 70. (This is the ratio between the proper dose and the dose that might kill, the higher the number the better.) For comparison, the therapeutic index for acetaminophen is 3--and yet it's over the counter! Heroin overdoses are common because of two issues: 1) Unknown purity. Users deliberately go close to the limits to get the biggest high, if they get heroin with a higher purity than they expect they can go over the edge. In a world where you bought your heroin from a pharmacy rather than the street such deaths would pretty much not happen. 2) Jail. Someone has been in jail for a while and not using, they get out, they take what they're used to taking--but now they aren't habituated. Now the dose is lethal. This one could certainly be reduced by having a required class for all druggies about to be released from jail--explain the problem and warn them that their usual dose is probably now a lethal dose. |
There are some other combinations that can cause similar trouble too (alcohol plus benzos, alcohol plus opiods).
Accidental overdose can also happen after relapse, most easily if avoiding the substance rather than receiving medical addiction treatment. Or if taking combinations of drugs that combine to impair judgement.