Opiate rant

It boggles my mind how much time, effort and resources the medical industrial complex puts into pain relief research when we got it right with opium and morphine a hundred goddamn years ago. Are they desirable for everyone? No. But instead of trying to meet the needs of people with complex or difficult to treat pain conditions, the pharmaceutical industry is desperately trying to create alternatives for people that wouldn’t need alternatives with decriminalization, education and home synthesis rights.

The average relationship to opiates in the so-called US is not what it could be. It’s extremely hard to manage physical dependency when your supply is inconsistent and you have to spend half a batch trying to get a handle on how strong your shit is and then have to start over with a completely different batch a week or two or three later–to say nothing of how impossible it can feel to schedule tolerance breaks or plan ahead to manage how fast your tolerance builds when you don’t know where your next fix (or the money for it) is going to come from. Black market pressure (especially how drug penalties are calculated) prioritizes the most potent possible substances in the smallest physical quantity, meaning lots of people are forced to take doses much higher than what they would otherwise need or find desirable, causing tolerance to build very rapidly and be difficult to control. AVOIDABLE gastrointestinal problems, malnourishment, and infection run rampant because our culture teaches drug users that these are punishments for immorality, not simple side effects and risk factors that can be dealt with through drug-user-specific health education and care.

How many people would live happy, desirable lives–fuck it, how many people would STILL BE ALIVE RIGHT NOW if they had the option to use safely produced, content-guaranteed, consistently-dosable opiates? How many people are suffering on non-indicated ineffective gabapentin prescriptions when their pain could be easily, safely managed with opiates? How many people lose years of their life to antipsychotics and SSRIs when a week or two of opium tea could’ve been all they needed to get through that rough patch, cope with that death, keep that awful event from becoming a life-long trauma?

What would happen if instead of choosing between pain and fentanyl-cut who-knows-what, you could plant some poppies in your back garden and have next-to-free access to effective relief? If instead of shelling out for pharmaceutical pills that could just as easily be cut you could make your own or get them from a farmers market stall or your friend in the corner house with the big lot and know exactly what was in them and how they were made? If you could go to any doctor or community healer or medic or harm reductionist or WHOEVER and get customized, experienced, well-thought out advice on a dosage and tolerance management plan, on food habits and options to help with suppressed appetite and potential GI problems, recommendations for supplements or medications to limit or eliminate GI distress, fresh needles and rigs or glassware and injection training and wound-care supplies and instructions, supplements and medications and exercises/habits to limit lung damage from smoking…

No more ruinous addictions. No more ulcers from tainted supplies or trying to disinfect wounds with hand sanitizer and mouthwash. No more avoidable pain and emotional distress. No more emotional and physical damage from using intense substances without knowing how strong they are or what effects they might have. NO. MORE. FUCKING. DEATHS.

Opium is exceptionally easy to produce–morphine and heroin are more complicated, but we’ve been making them for a long time prior to modern industrial labs and the basic chemistry knowledge and equipment needed for safe production could be 100% achievable to just about anyone. The harm reduction and side effect management are THERE, they’re just obfuscated by drug war politics and general health illiteracy. Opiates are not ontologically dangerous, they are made dangerous by the state. Because the state is not invested in healthcare, it only cares about control. Opiate deaths are a punishment. Addiction (as opposed to managed dependence) is a punishment. For daring to be poor, for daring to be Black or Indigenous, for daring to be disabled, for daring to try to be OK in a system that dangles health and happiness as a reward for participating and being the right kind of person— and to get the right kind of people to do the right kind of thing, to live between the lines and reproduce civilization, to retain homeostasis in the social macroorganism, there has to be a threat. There has to be a scapegoat. There has to be the wrong people who do the wrong things.

The opiate crisis was engineered through overprescription and under-education. The problem wasn’t just availability of these substances: It was and continues to be pushing opiates without harm reduction, without health literacy, without unconditional safe supply and user-tailored healthcare.

I don’t have any grand synthesis to wrap this up in a nice bow. I’m just tired, and angry, and scared, and screaming into the internet in the hopes someone reads and understands. I don’t have an answer. I don’t have a call to action. If this inspires you to do anything, please do it. I don’t want people I love to die anymore.