So, late last week, I was hit with both a kidney stone and a urinary tract infection. I found my hydrocodone ineffective against it. The nurse practitioner that treated me told me she wasn’t all that surprised, as hydrocodone isn’t all that good against kidney stones and it usually requires different pain relievers. Oddly, NSAIDs work best, but I can’t take NSAIDs orally. She gave me a toradol shot which did help. However, in two days, I went through 5 days worth of pain meds. At which point, I decided to detox myself…
I went in search of information. How many days did I need to not take meds to completely restore my intolerance of the medication? Surprisingly, everything agreed; if I was physically dependent on the pain medication, I’d know in 12 hours. The first 48 hours passed with no symptoms of withdrawal. So, I decided to do it slightly different and I broke the rest of my pain medication for the month. This means I’m taking half pills of 5/325 hydrocodone – 3 times a day, until I run out and I will be out about a week early. Which is fine, I can use that time to completely restore my intolerance. Because it takes just 5-10 days to detox from opiates. Shorter than most drugs, including alcohol, nicotine, and caffeine. However, that’s not the surprising part either.
The surprising part was while I was researching how long it would take to detox, I learned that about 35% of all opiate overdoses each year are because of this quick detox. Roughly 35% of all overdoses in the US are referred to as “post-release overdoses.” What the hell is a post release overdose?! If you are a heroin or Fentanyl user and go to jail, prison, get stuck in psychiatric care, or enter a treatment center for just two weeks, your risk of overdose upon release is around 80%!
This is because their tolerance has been built up significantly during their months/weeks/years of use and abuse of their preferred opiate. When they get out and return to the drug, they resume at the level they were using when they went in. But their body has detoxed and their tolerance is no longer high enough to handle that much of the drug at once, resulting in an overdose.
Okay, time for some numbers; in 2017 there were 47,000 opiate overdose deaths. If 35% of them were post release overdoses that means 16,000 of those overdoses were related to abuse of opiates after being released from an institution and the users tolerance having fallen off. According to NIDA (National Institute of Drug Abuse), nearly all opiate overdose deaths in 2017 involved heroin, fentanyl, or a combination of multiple opiates and other medications (Ie: oxycodone + gabapentin + benzodiazepines or alcohol + hydrocodone + sleeping pills). They also point out that overdoses have increased dramatically with the increase of fentanyl in the US. Fentanyl is cheap and easy to make, much like meth, and it’s 100 times stronger than morphine.
Fentanyl is so cheap and easy to make, that it is being used as filler and cutting material in many illegal drugs. This means your meth, cocaine, or X, might contain fentanyl. And without a high opiate tolerance, just two grains of fentanyl can cause a fatal overdose.
The point being; we never seem to have the full picture when it comes to the opiate crisis. There are factors beyond the legal use of opiates by pain patients like myself that are causing it. In comparison, in 2017 there were roughly 65,000 homeless veterans in the US that no one was really doing anything about.