The History of Opioids

[@hgbugalou]

Addiction is certainly an issue, but a lot of the negative side effects of opioid addiction are artificial and a result from how we as a society deal with drug use. The war on drugs turns someone who is simply and addict into a criminal. Once labeled a criminal it becomes harder to thrive in life, so the addict returns to drugs. Perhaps if we didn't completely ruin addicts lives after they are caught with drugs, like we do, and instead focused on treatment, the problem would not be as bad and there would be less addicts out there.

[@chronicallyfabulous88]

I absolutely agree!

[@cminmd0041]

+Michael O Absolutely true, but also we have to be honest about the part racism plays in all of this. The two writers of Broad Street joke on WTF podcast about doing pot at work and on the street, while 86% of the people arrested for marijuana possession were blacks and Latinos, 10% were whites, and 4%were all others. ▪ The NYPD continues to arrests blacks at 7 times the rate of whites and Latinos at nearly 4 times the rate of whites. But young whites use marijuana at higher rates than young blacks and Latinos.

[@rochelle123ist]

Michael O when I was recovering from stage 3 cancer OxyContin and Morphine were the only medications that gave me enough pain relief to make a complete recovery without complications.

[@kevinwhiting8391]

Michael O to A T

[@BgirlsFinest]

beloved Ortiz WOW

[@chronicallyfabulous88]

The single most important thing that chronic pain patients like myself need is an equally/more effective alternative to opioids. But in the meantime, we also need doctors to stop telling us to "just learn to deal with it" and help us to manage our pain with the resources available, including opioids. People are killing themselves because they simply cannot live with under-treated chronic pain. And it's not like our pain isn't a big deal. For me, local anaesthetic doesn't work because of my Ehlers-Danlos Syndrome (which is also the cause of most of my pain), so I've had four minor surgeries (difficult Implanon removal due to scarring, which took 4 attempts, each lasting 30-45min) and more than a dozen dental procedures, all without any anaesthesia or pain relief. People like me make Rambo look like a delicate flower =P So if we're saying our pain is too severe and constant for us to tolerate it, then that's some seriously intense and unrelenting pain. The kind that prevents you from sleeping until you're finally just too exhausted to stay conscious after 3-4 days of constant agony -- and even then, your heart rate doesn't drop low enough for you to sleep deeply because of the pain your body is in, so it barely counts, anyway. The kind of pain that makes you wail and sob and scream in your sleep (which scared the hell out of my parents, throughout my childhood). The kind of pain most people will never understand (thankfully). Humans have an astounding ability to adapt to extreme circumstances. But there comes a point at which we simply have no quality of life -- and a life with zero quality is not worth living.

[@terell-tdawg-stewart661]

💓💪🏽😎💪🏽😉

[@DANTEANDOLINI]

I have a degenerative head injury and am in constant pain. my brain doesn't work properly and have constant fatigue but can't sleep because half my skull is missing. They can't operate because of covid. I thought a constant prescription of oramorph would be ideal as I have no quality of life. and no ability to plan for the future. You're post. wow. Impressive. I respect what you have bravely endured/ embraced. Written without a leaning toward sympathy, but you wouldn't be able to fight your pain with that attitude. You have chosen your name wisely. Respectfully, Dan

[@ryanboldt7751]

I am so sorry you’re dealing with that pain 😞. It’s real and my prayers and hope are that you can manage it somehow.

[@JustCallMeAnonymous]

I appreciate your balanced point of view on this issue. I feel this war on drugs rhetoric often casts aside the fact that pain is still a serious health concern that needs to be adressed.

[@rochelle123ist]

Recovery Rage especially pain from cancer and life threatening injuries.

[@DeltaDrifter2201]

Yea, I have been through some surgeries throughout my life and I am 17. I have been prescribed Opiods for the past 2 to 3 years of my life. The surgeries I had were pretty darn painful so Opiods were needed for the most part. A lot of the time people or doctors, in most cases, often use more caution to giving these medicines to "younger people" because apparently we are at risk of misusing and becoming addicted to these drugs more so than older people. This is bullshit. I have never had a problem with addiction or misusing opiods because I control when and how many I take. As long as you constantly don't rely on these drugs than you should be fine. Even if you are using the drugs mainly for the euphoria effect, as long as you keep control and don't constantly use them then you won't become addicted to them. I admit sometimes I take one solely for the euphoria which shouldn't be thought of as a bad thing. Nowadays the most amount I take are 2 or 3 a week. I can completely control the usage of the drugs even after being on them for so long.

[@superacer1]

@@DeltaDrifter2201 I agree, I was the same way broken bones after a wreck at 16 spent months on opioids.. generally used them as prescribed but would sometimes take an extra for the euphoria.. after I healed and stopped getting them prescribed I had no problems quitting and putting it behind me.. never became a heroine junkie and I’d of been far worse off if they hadn’t given me them for the excruciating pain..

[@mikethomas6120]

I find it highly ironic the countries like Great Britain massive empire and wealth today was built on the back of selling highly addictive narcotic drugs to the Chinese. But yet today they outlaw these drugs in their own country by basically using the same war on drugs mentality that most western countries use today. All drugs should be legal! The people who want to take drugs are going to take them weather they are legal or not. So why not just legalize them all so they can be regulated for the safety of those who do choose to use them?

[@EDD519]

THEY DON`T BELIEVE YOU OR ME ! @@DeltaDrifter2201

[@CCRLH85]

I'm 31, and I've had back pain since I was a teenager. I thought that I'd gotten used to it but, as I age it gets worse. My doctor and I are trying just about everything we can to avoid narcotic pain relievers but, the only time in the last decade I remember being completely pain-free was when I was on Vicodin after oral surgery for a week in my twenties. Of course, I don't remember much else from that week since I was almost completely debilitated mentally thus the avoidance.

[@SlimThrull]

Say what you will about opioids. When I had a kidney stone I was VERY glad to have them for a couple days.

[@DMrRaa]

I feel you on that, when I have mine start running, the only thing I can think about at that time is how to cope with this excruciating pain and thank god oxycodone exists.

[@Anonarchist]

whe i had my kidney stone, i was certain some horrible defect had occurred an i was actually working a stray mutant tooth through my urinary tract. it was like sand, *sand*! i don't want to know what an actual solid craggy stone feels like.

[@umarsubhan7035]

i currently have a perianal hematoma and i gotta say, tramadol has taken some of the edge off

[@ryanboldt7751]

That is a great use of opioids. Managing pain for a few days, what a gift. I had the same experience when I needed them for a few days after major back surgery.

[@Greg-yu4ij]

I felt like I’m dying the past 4 days due to an ulcer. I don’t even bother going to a doctor about the pain because I’d be asking him to expose his neck for me. It’s a shame we have to lose 100,000 Americans every year to chinese fentanyl because we don’t trust our doctors to manage pain anymore

[@TulipsToKiss]

due to a genetic mutation I have recurrent, acute pancreatitis. I was diagnosed at 13 and I used to spend a little under a month being hospitalized every year. When I was 16, my doctors (for reasons I still don't understand) stopped regulating my pain meds (I was on morphine at the time) and before I could realize what was going on I was addicted. I mistook my pancreatic pain with the pain of withdrawals. Once the Dr figured out what was going on I was tapered off until my symptoms went away. Withdrawal was crazy (literally feverishly hot then freezing cold every 7 seconds for 2 weeks.) It sucks because I'm 25 now and when my pancreas starts acting funky and I go to the ER for help they always give me the side eye thinking I'm a druggie. Instead of my record reflecting the Drs mistake it's taken as my own mistake. Idk what the answer to chronic pain is but it ain't this!! (side note, I'm given dilaudid now when I go to the hospital because morphine is no longer strong enough to manage my pain... can we maybe talk about tolerance in the future? I'd love some more info/your opinion on it in the opioid/pain management scope!!)

[@BrettsCorner92]

I have cerebral palsy and I take an opiate as needed for severe pain. I do not take it every day. And I've been doing this for years with no issues.

[@cmariern]

just wanted to say great topic. im glad you're addressing it. history specifically was interesting to me, lots of new info.

[@Kaalyn_HOW]

Ohhhh how I deeply hope you cover the parts of things like Subutex, Suboxone, Methadone for treatment, as well as Narcan and the other drugs that can intervene on an overdose. Those would be so so valuable to cover. Particularly if you have information on using any of them long term instead of just to come off a stronger substance as intended. As someone who's had to be on some of those wayyyyy longer than originally intended and now can't handle the withdrawal due to other health issues, I'd really love to see what all you'd have to say about those medications . I'd also love to see if you address the insanely crazy epidemic of adding the most fatal of cuts to heroin at a rate it's almost never been at. ....killing SO many people at rates that are like a 400% increase from just the previous _year_ in some suburban areas. Adding lethal cuts to heroin was _always_ going on but the strength, amount and frequency is on epidemic levels in my area and many others. (...while heroin usage in general - particularly in rural areas - is known by most everyone to being a national crisis.)

[@YusufSheth]

Great video, Mark. I work as a medical assistant and a scribe in a pain management clinic in an area with particularly high heroin addiction rates. We treat chronic pain as well as do addiction management. Opioids and their dangers have become a regular topic of my day-to-day life and I relish the opportunity to learn as much about them as I can. Really great channel. I look forward to this series just as much as I do to all the content you make. Please keep it up.

[@patriciasalber7085]

Great review of the history of opioids. It is particularly interesting to see the waxing and waning of the popularity of these drugs in medicine. I actually had to pass an online course in pain treatment in order to renew my California medical license - the focus was all on undertreatment. It would clearly have a different focus today. Thanks for this video.

[@chris73brown]

Thx for vid. Loved it. Opioids are great & very beneficial in every aspect for acute pain if used as prescribed & responsible

[@DorthLous]

Weren't there research showing addictions had more to do with the environment and well-being of the individual than just the drug itself? As in, it was an indicator that other things needed to be fixed and, if left alone, they would still self-destruct, but by tackling those weaknesses, the individual could often dump the addiction altogether?

[@SpySappingMyKeyboard]

+Dorth Lous If we are talking about the same thing, the research was done on rats, and has arguable application to humans.

[@cminmd0041]

+SpySappingMyKeyboard I think what he was talking about was the original "Rat Park" studies done in the 70s that showed how addictive properties of drugs. But when the studies were recreated they found that the drugs were addictive in an inverse proportion to the environment being poor. The rats with nice environments were quick to stop using the drug tinted water.

[@SpySappingMyKeyboard]

cminmd0041 Yea, that's the study I was thinking about. I also think there is some controversy about that study, in both its ability to be repeated and applicability to humans, but I may be wrong.

[@Eldorado1239]

As far as I know, one of the respected studies trying to prove the opposite - that opioids are extremely addictive - was also based on rat experiments. Rat in a cage preferred heroin water over normal water. From all the info I've gathered, we simply don't know enough and more serious research needs to be done. With humans. And not funded by people who want to buy a specific result... as in "find me a correlation".

[@jakesoulvie4397]

That makes sense. Depressed people will love the dopamine-driven euphoria made by heroin much more than a healthy, life-loving adult would.

[@mcspazotron]

This channel needs more subs man!

[@InorganicVegan]

More of the subs need to watch at all.

[@kyleroddy6817]

Watching this while getting prescribed Hydrocodone due to my wisdom teeth getting removed. Feeling 1000 times better though

[@monkeyaround92]

I'm excited for this miniseries! We just learned about overwhelming opioid use in suburban America today. A lot of my peers felt that the perspective of lower income and underserved communities was largely absent from this discussion.

[@madeleinegerlach4854]

Thank you for making this! I have many chronic pain conditions and I'm only 23. I've been on many opioids over the years and am currently on Methadone. I'm currently 20mg lower than I was one month ago. I'm proud of myself, because I've been on opioids since January 2013. I know my body is dependent and withdrawal really, really sucks, but it's worth it to get off as much as possible.

[@Ilovemygoat4good]

This episode was beautifully conducted as a Public health student I really love it.

[@P1taJ]

OOOOO, a new intro

[@nolanthiessen1073]

Excited for the miniseries!

[@InorganicVegan]

+Nolan Thiessen Sup, Nolan?

[@nolanthiessen1073]

Oh, you know... catching up on the day's videos.

[@InorganicVegan]

Nolan Thiessen Cool. Something I wrote got published! www.geneticliteracyproject.org/2016/04/20/vegan-manifesto-support-gmo-foods-biotechnology-research/

[@nolanthiessen1073]

Exciting!

[@InorganicVegan]

Yes

[@repker]

Man, talking about opioids always hits close to home :/

[@rochelle123ist]

Obviously this narrator never had stage 3 cancer. Cancer is the worst pain I've ever experienced. Opiates need to be freely available to cancer and terminally ill patients.

[@Cugelclever]

I agree 100 percent.

[@dead_kennedys7870]

Really not weed, with few negative effects?

[@rochelle123ist]

A Pedo In a Speedo if you had terminal cancer cancer or life threatening injuries you would scream for morphine! Would you let a surgeon operate on you without anesthesia? Weed won’t do shit for cancer and life threatening injuries!

[@dakarai47]

@@rochelle123ist inaccurate bud weed helps plenty of cancer patients strains are beyond powerful now a days

[@graywatson1255]

Thank you for the video it was very informative

[@jyrinx]

He stopped the hug shipments!! That bastard! :-)

[@jyrinx]

Er, one hug shipment. Still! A whole shipment of hugs, destroyed! 2:42

[@mitchellbrown5846]

+Luke Maurer XD That's hilarious!

[@MrRishik123]

+Luke Maurer wow

[@cmousers]

Hmm I wonder if this will segway into an episode or two talking about pain and how it works

[@rosalindearp6923]

I wish Bayer would bring back laudnum.

[@elliemccarthy5672]

IV toradol (An NSAID) worked pretty great for me when I was in the hospital for intestinal blockages.

[@Kyrator88]

+Ellie McCarthy Problem with Ketorolac is that after a couple days of administration the chances of a gastrointestinal hemorrhage increase dramatically making it dangerous to used over a long period of time.

[@elliemccarthy5672]

Kyrator88 true, true. There is definitely a place for opioids, there is no doubt, and Ketorolac is not the perfect drug either. I am just saying that, when I was in the ER they were about to give me morphine like it was nothing but I wanted to try something else before rushing to opioids. And it worked! I was only on it for about 10 hours before the blockage passed (I have crohn's so blockages are sort of common during a bad flare) and I was able to manage the pain with heat packs and Hyoscyamine (along with months of steroids to treat the inflammation).

[@swe_nurse1497]

+Ellie McCarthy As Kyrator points out Toradol (Ketorolac) is a short term solution but as you say it is usually quite effective. I work in orthopedics and we use both IM and IV Ketorolac regularly after surgeries including amputations and often it is quite effective in treating pain. Especially combined with Oxycodone (Oxycontin). The downside is the side effects Kyrator is talking about, especially for older patients.

[@rochelle123ist]

Ellie McCarthy not if you have cancer pain like I did. I have no regrets taking OxyContin and Morphine when I truly needed them.

[@elliemccarthy5672]

rochelle123ist yeah i totally get that (see comment above in reply to Kyrator88

[@Jake-kn3xg]

Why must drugs that make us feel amazing be bad for us physiologically and psychologically/ It's such a bummer.

[@Cugelclever]

The only bad part is withdrawal, as long as you are careful. Long-term opiate use doesn't cause any real harm to the body or brain.

[@10aDowningStreet]

The reality isn't that simple, long term opiate users are increasingly likely to come in harms way because of fake pills and heroin both deliberately contaminated by dealers with extremely potent fentanyl and its analogues, even ones who are 'careful'. Even people buying cocaine or black market benzos have overdosed from products cut with fentanyl. Unfortunately taking any illicit drug carries great risk, which is why they ALL need to be legalised and regulated.

[@chillsahoy2640]

One would think that a well-researched series of episodes on opioids and their suitability for long-term pain management would be sufficient grounds to bring into question current drug legislation, and finally put in place laws and regulations that are based on evidence rather than fear, manipulation or rabble-rousing. Unfortunately, that's far too sensible to be considered in Parliament or Congress.

[@cminmd0041]

+Mr Schrödinger - I am the one who reviews. Actually, the medical community needs to admit their is no effective treatment for long term pain! Turning people into drug addicts will move their chronic pain down on their list of problems, but that is hardly a solution. Be honest and admit we don't have any treatment so new ideas can get funding!

[@den264]

After ten years of cold water extraction three times per day I finally qualified for government treatment as a senior citizen. I have been taking 2mg of Suboxone daily for three years now. I was a walking skeleton, pale as a sheet and shaking all over on the day I first got on this miracle medication. My weight is now normal, suntaned and calm as a serene lake. What a transition. If only I had quit my job and gone on welfare like most junkies and single moms in town, I could have been given free treatment ten years earlier. Oh well such is life in socialist Canada.

[@Kyrator88]

Please cover Benzodiapenes. I think they're actually worse than Opioids and seem to be prescribed more widely. Also Amphetamine use amongst students for study? I've never heard of that happening in the UK but allegedly it happens widely in the USA?

[@guitarguidetv4792]

People take adderall in the US and the U.K..

[@Kyrator88]

Spencer Miller Except they don't take it in the UK

[@guitarguidetv4792]

+Kyrator88 that sucks dude, adderall feels great, like steroids for your brain.

[@Drag0ncl0ud]

I'm sure students have their own crazy study habits on every county. Chinese students in well funded schools can get amino acid IV drips when studying for their college entrance exams. Most people seem to have a dependency on caffeine to study. It all leads to the same end goal of having more concentration and less fatigue.

[@Kyrator88]

Drag0ncl0ud Amino Acid IV and drinking coffee are hardly comparable to abusing Amphetamines to study.

[@MattCantu76]

I have chronic pain for the rest of my life. Oxycodone is the only thing that dulls the pain enough for me to live with a quality of life. You can't throw out the baby with the bathwater, just because some people are abusing it.

[@thecommiehunter1149]

Government makes things harder if they can't get paid for it

[@ryanboldt7751]

I think a real tension that we don’t want to talk about is that pain is a part of life and it’s coming to everyone at some level as we age. Our culture will do anything to do pain “avoidance” when really we need to work on pain management. I have had chronic back pain for years due to surgery with nerve damage and there’s likely no fixing it 100%. Managing weight, exercise, physical therapy, and the use of pain killers (usually Ibuprofen or Aleve, but including the occasional opiate) make it much more manageable. But there’s no magic bullet and I’m going to be dealing with some pain forever and I need to accept that. I think it’s easy to get the expectation that we’re gonna be 100% pain-free but as we age that’s just not going to be possible. So I’m grateful for technology and the development of painkilling medicine which has been super amazing!

[@ehart624]

Thanks, interesting video. I always learn something from your videos. I didn't know the maker of OxyContin pled guilty and paid such a huge amount. And I'm curious to learn more about the research involving opioids and chronic pain.

[@ashleyoasis7948]

The guy who invented Fentnyal got arrested

[@vwa9832]

Great video guys. Good job

[@charlietuba]

I was gettin' pretty tired and they smelled so good, and I Figured, well, I'll just stretch out in this little field of POPPIES! POPPIES! POPPIES! poppies! (Cough) Hey, what a strange dream, man! The little flowers, they smell awfully good, and I was pretty tired. The old wizard's just gonna have to wait, man, because I'm just gonna Stretch out again in the little field of POPPIES! POPPIES! POPPIES! OH GOD! OH GOD! OH GOD! Dorothy! Dorothy! Dorothy! (SNIFFFFFFF) DOROTHY! DOROTHY! DOROTHY!

[@marygeorge96]

As someone who suffers from severe chronic pain due to Ehlers-Danlos Syndrome (hypermobile type) it's really frustrating that opioids are the only drugs that can even touch my pain. They make me constipated and drowsy, and you have to keep increasing doses due to tolerance. But it's so much better than nothing. I also have Borderline Personality Disorder along with severe depression, and every time I get my prescription they're wary of giving these drugs to someone who is at risk of suicide. But I'd never even want to abuse them because I NEED them to get through my day. I'm still unable to work, and spend much of my time asleep or lying down, but if I didn't have my painkillers to numb the pain a little I'd kill myself through other means. They may not be perfect but people NEED TO STOP demonising patients who need opioids to get anywhere close to functioning. I am not addicted, I am dependent. I'm not unable to work because of them, they enable me to get out of bed most days.

[@chronicallymeee]

I also have EDS (well it's not confirmed yet, but there is strong suspicions.) The time I was on morphine was the best time, and it wasn't even like about experiencing a high or anything, it was the fact that I had the ability to just go to the mall and buy socks without having to plan it, or call a cab to get me home from the train station. It was the only time I could make a plan for a date and actually be fairly sure I can make it. But because of this war on drugs fear of opioids I'm on disability instead of finishing school. I'm constantly suicidal because I can rarely leave my house, and I can't have friends because they expect me to get places consistently. The problem with oxycontin was that the half-life was misrepresented. If there were better altnernatives I would be more comfortable with limiting opiod use, but the fact is there really isn't. Also please don't tell me it's killing people I know, one of my best friends died from an overdose, my province has declared a state of emergency over opiod overdoses. But most of that is because the only people can treat their pain is with street drugs which don't have regulated strengths, and are therefor much easier to overdose on.

[@marygeorge96]

+Chronically Me I'm on mobile but if I could give you a thumbs up I would. It's probably me being over sensitive and cranky but I felt like this series of videos (and the "war on drugs") and the comments were a needless attack on opioids when many people need them to function. It's a shame people who don't experience chronic pain don't understand what it's like but there's nothing we can really do about that. I hope you are able to return to school some day! I also had to drop out this year and am in the process of applying for benefits. Good luck with everything xxxx

[@briankane8950]

Please tell us about "Pain measurement" ?? (I wish I had an emoticon for shock here) because my neurologist said it was not possible twenty years ago and that my "10" is different then most peoples.

[@sdmugabe]

Excellent video sir!

[@samuli787]

Thank you for this episode Aaron. I have been wondering if the same is true about ''mild opioids''? In Europe the use of opiates like codeine, tramadol and dihydrocodone is far more common than the use of ''hard opioids'' like Oxycodone. US and to a lesser extent Canada seems to be some of the only countries where the use of the very potent opioids seems to be very common. What is your opinion on the ''mild(er) opioids''.; can they be used safely? Ps. I'm a Finnish medical student.

[@Iruparazzo]

+samuli787 I'm sure I'm wrong, but isn't codeine more related to cocaine than opium?

[@samuli787]

+Iruparazzo No. Codeine is one of the alkaloids present in opium poppy's latex. Codeine is around 1/10 of morphine's potency.

[@Iruparazzo]

samuli787 Aha, ty so much for the info =D

[@airtightpuppy1]

Well, you're right about codeine and tramadol being "mild" opioids. But dihydrocodeine (I'm assuming you meant that) would certainly be considered a "hard opioid" and it actually is in America. We just don't just it much at all. We use semi-synthetic ones like hydrocodone and oxycodone instead.

[@jaimie00]

I suffer from chronic pain due to extensive abdominal adhesions. I can't stand for more than a few minutes, and I can't sit up straight for more than 2 hours, and that's with my pain meds. Without them, I can only stand for 2 minutes and sit up for 30. The details are below for anyone who wants to discuss it, but the main thing I want to say is that it took me 3 years to get *any* help with my chronic pain, and that was with proof that I was in a lot of pain. Nothing they tried helped me, and they were unwilling to give me actual pain medication. I couldn't see how I could keep going like that. I had very low quality of life. I moved across the country (my family paid for it), so I could try medical marijuana. It did nothing for my pain. I couldn't believe it. The doctor who certified me for medical marijuana made some calls to my former doctors, did research, and then came to the conclusion that I needed opioids. Now, I'm weird with meds. I don't get high, at least not at the doses most people do. The only way I know I've taken my meds is that the pain is reduced to a manageable level. I have to go off it when I start to develop a tolerance, and I don't have all the withdrawal symptoms people talk about. I'm in a lot of pain, I sweat more, things move through my GI system faster, but that's it. Then I go back on the regular meds and I'm good again. I realize I'm not a typical patient, but when people start talking about how it's prescribed too much (where are these magical doctors?), or when they believe that a large percentage of those who take it get addicted (just not true), I remember what my life was like before, and I just can't go back to that. There's no point in it. Background: They went in to try to cut the adhesions during my hysterectomy. The surgery took twice as long as it should have, and the doctor estimated that he only got about a third of them. He described them as cobwebs of thick scar tissue that were so bad that they couldn't even find my right ovary, which they were also supposed to remove. The doctor said he'd never heard of a case so severe. The pain was better for a little while after that, but several months later, the pain had returned worse than ever before. I couldn't do the simplest of tasks. I was completely disabled. And since surgery just made them grow back worse than before, I'm not a good candidate for further surgery.

[@winterwolf9969]

Your so right, pain is real and we need those medicines to alleviate it. All this talk is scaring the hell otta the folks who need them and making them wonder if they, without releif, would even wanna go on living. People who abuse have ruined it for the honest pain paient whom works with their doctors and should be out in jail.

[@patriciaapodaca253]

People take opioids to help with chronic pain and without it they could be bedridden, suicidal or have no Avenue to a somewhat productive life. Those that abuse it cause those that need it to control pain fear that it will be taken away due to the negative issues that really don’t affect them.

[@FatherDraven]

You should talk about kratom in this series. It saved my life from heroin addiction.

[@ashleyoasis7948]

Kratom is good if you have a more serious addiction to go down a level but if you have no experience with opioids kratom will be you’re new herion becuse I could not get such drugs but could get kratom and that pretty much got me hooked sure the consequences are not dire but it does cause addiction if that’s the straight up source I support control kratom being given out like how methadone is given out as an alternative heck even getting rid of those alternatives it should not be up there for any randomer to buy

[@marvymarier8988]

@@ashleyoasis7948 Says who ?

[@ashleyoasis7948]

@@marvymarier8988 I think Kratom should only be legal once ppl respect to treat it like its coffee because who cares if you get addicted it’s legal abundant every where and international that you get things like a KratomBucks becuse trust me I used to make my Kratom delicious and thought having a little Kratom bar be revolutionary and make me lots of money but it’s now illegal so my life ain’t worth jail time and you can argue all you want they will never ever make Kratom or weed legal just saying to ppl don’t do it becuse it is addictive and it will eventually will turn illegal.so best stay away from it I was hooked on K for 2 years then the Covid lockdown happened and I ran out of a bag could not order and becuse my brain chemistry was in tune with this drug and my habit got interrupted I went insane and nuts.so I’m just saying to ppl to cut of the Kratom as you can becuse you’re country no matter where you are will eventually ban it and you want to end up like how I did.there even banning Kratom in the countries they grow in like SE Asia so how on Earth is it gonna get harvested here,sure dark web but that requires things like bitcoin and all this other complicated BS.

[@marvymarier8988]

@@ashleyoasis7948 It helps people with pain. When you have enough pain you don't care if it's addicting .We use much more dangerous legal drugs Now , yet they are ok.

[@MelodyRaindo]

Outro music is way too loud, and at 2:40 it says "hug" instead of "huge" (I assume). Otherwise good job, and keep it coming!!

[@celestial-death]

Also at 0:25 diarrhea was misspelled xD they put a random "o" in it!? lol

[@Floccini]

I am a non-drug using Christian, do not even drink alcohol, but I can make no sense of our drugs laws. Legalize it all. People like you and me need to convince people to not use. Government does not have the right tools to address the problem

[@rochelle123ist]

J Oliver I totally agree with you!

[@Parker8752]

Just so you know, the thumbnail says "the history of opiods"...

[@markolsen9060]

And I'm without a computer to fix it until the morning...I WILL FIX IT I PROMISE!

[@avalean]

+Mark Olsen Transparency jitters on some of the early transitions (2:03) and outro volume is lower than expected. Love the videos though, keep it up.

[@r3v3rbs0ul]

+Parker8752 Probably not fixable, but at 2:47 the Commissioner destroyed a "huge" shipment of opium, not "hug"- First time visitor over to this channel and really enjoying it. Thank you!

[@GeterPoldstein]

Fancy intro!

[@geminixnet]

I am a chronic pain patient. I take methadone. I've been on Opana(oxymorphon), the hydromorphone extended release and every other opiate and other drugs such as Soma, gabapentin, preglabin, amitriptyline. You get the idea. I think too often we conflate addiction with dependency. The medical community also confuses "drug seeking behavior" with someone whose pain is not adequately controlled. The opiate crisis is not black and white. When used properly opiates can be some of the safest analgesics. No liver damage with opiates, no stomach bleeding, no seizures (well except for tramadol which is a synthetic opioid.)

[@OboeFiles]

Can you do one on ocular health??

[@girlstalk9653]

A couple months ago I was in the ER for an exposed nerve in my tooth. I was given 10mg oxy (which I was very grateful for at the time) and sent home with a script for THIRTY 5mg PERCS. 30!!!!! When I explained my mother is an addict and I would like something nonnarcotic I was told, "don't worry about it these aren't that addictive" My mom's active addiction started in 2010 by being prescribed oxy for her chronic pain. that being said all opioids should be taken/prescribed with care.

[@kamerystka]

As I understand it opioids are good for a quick but short pain like for a surgery but are addictive and dangerous for a long-time pain. Am I right? Plus I am very interested in the doctor's opinion on use of marihuana to manage pain ;)

[@tristragyopsie5464]

this is me giving another 100 thumbs up. (they would only let me click once :( )

[@darthtrump4428]

i'm gonna click thumbs down just to bring balance to the galaxy

[@Urspo]

well done!

[@lcarthel]

+healthcare triage Now that you've covered opiates, you guys should do a series on endogenous cannabinoids (anandamide), psychedelics (DMT, etc), and stimulants (adrenaline, etc) to really round this thing out! :D

[@steveh46]

Around 7:30 you say Opioids cause more deaths than any other drugs (in the USA). But in the US alcohol causes far more deaths than all opioids put together. NIAAA says, "Nearly 88,0009 people (approximately 62,000 men and 26,000 women) die from alcohol-related causes annually, making it the fourth leading preventable cause of death in the United States." The figures for opioid related deaths seem to be about 1/4 to 1/3 of that number, in the range of 20,000 to 30,000 deaths each year.

[@Klice82]

I have a question, I'm from Russia, and some doctors here don't prescribe opioids for cancer patients because they afraid of addiction, but other sources say that opioids don't work this way if pain is real, and your video says that opioids COUSE the addiction, no matter how pain is real, so, basically, my question is, is it makes sense to deny cancer patients of opioid pain killers.

[@mcgeufer]

They are addictive no matter if you take them for fun or against pain. However, in case of cancer, I´d say the addiction is just the smaller risk. The same with chronic pain. Does it matter to you if you are adictetd or not while you need to take a pill everday against your pain?

[@dsf8497]

This is why we need legalized marijuana.

[@AlthenaLuna]

+Dylan Forest That doesn't address and won't help people who have to manage severe and/or chronic pain while working, and would get most of them fired even if they weren't smoking it before or during work hours.

[@iltopop]

+AlthenaLuna laws can fix that

[@jamesl1332]

+AlthenaLuna I've taken opioids twice ever, and there is no way I could work with those in my system. Oxycodone, especially, made me so drowsy I spent a whole weekend asleep. When I thought I had caught up enough, I took one before work on my first day back, and my head could not stay up by 9:30a. With a written prescription, edible marijuana treats of certain cultivars could keep you working (probably not heavy machinery), pain free, and doing so legally should a drug test come up.

[@johnharvey5412]

+AlthenaLuna I suspect that it's better than being on heroin at work.

[@AlthenaLuna]

I don't know why you're assuming I'm for using opioids at work, my point is that we need options that both work for pain management with lower risks AND allow people to be functional outside the home, so weed isn't an improvement in the direction we need.

[@AlanmanAaron]

Nice new intro

[@Puppy_Puppington]

i been a responsible IV user for 6 years straight now! if anyone needs help with withdrawing lemme know asap!!!!

[@coffeeis1up436]

The Inquisition stopped opioids? Wasn't expecting that.

[@guyincognito1985]

The pharmaceutical companies seem to parallel the banking industry in terms of business practices: do whatever you can get away with and just pay a nominal fine that is subtracted from the vastly superior amount of profit you just made. Meanwhile hundreds of thousands of drug addicts are put behind bars and have their lives ruined.

[@ProjectCreativityGuy96]

The top solution? **Sees a gun/starts thinking thoughts that should not be thought of!**

[@dersitzpinkler2027]

If only there another plant that when ingested greatly reduces chronic pain and digestive issues, but didn't have strong side effects or potential for addiction and overdose. OH WAIT!

[@Memento_Mori_Morals]

Doesn't work for everyone/thing.

[@jamesricker3029]

if only... people might be able to be functional and clear headed while pain free... too bad nothing like that exists.

[@dakarai47]

@@jamesricker3029 cbd exist bud

[@ajmarr5671]

Cognition and Opioids As an adjunct to this video on opioids, it is important to understand that increasing opioid levels in the brain can be achieved through simple cognitive protocols. This by no means is a ‘cure’ for addiction, but it can help ameliorate cravings when opioid levels are low. The proof is in the pudding or in the procedure of course, and I ask the readers forbearance with this observation, explanation, and the more detailed procedure presented here and linked below. An Observation and Modest Proposal Individuals who engage in tasks that have a consistent and high degree of ‘meaning’ (e.g. sporting events, creative activity) commonly report a feeling of high alertness and arousal (but not pleasure) that may be construed to be due to the activation of mid-brain dopamine systems as a result of moment to moment perception of positive act/outcome discrepancy. However, a significant subset of these individuals also report a feeling of pleasure or bliss, but these reports are characteristic only in non-stressed situations when the musculature is relaxed. Since relaxation engages opioid systems in the brain (and covert neuro-muscular activity inhibits them), and because opioid and dopamine systems can co-stimulate each other (with dopaminergic activity scaling with the salience of the outcome, as well as attendant pleasure), blissful states require the simultaneous engagement of resting protocols and meaningful cognitive states, behaviors that can be very easily replicated in day to day life. A more detailed explanation (pp.47-52 and 82-86) of this position in the following open source book on the neuro-psychology of resting states. It is based on the work of the distinguished affective neuro-scientist Kent Berridge of the University of Michigan, who was kind to vet the work for accuracy. www.scribd.com/doc/284056765/The-Book-of-Rest-The-Odd-Psychology-of-Doing-Nothing

[@happycathy101]

Could you talk about Trigeminal Neuralgia?

[@spartycool]

+Kim Hill When I read this I thought you were talking about a brain freeze but I now realize that it's much more serious than that.

[@benbarker8154]

I have always been baffled by pain meds. Which pain meds work "best" for what? Which pain meds will damage which organ systems?

[@GregTom2]

Acetaminophen: Used to be thought of as an anti-inflammatory, but now understood to have a sepearate and elusive mechanism of action. Safest. Mildly effective. Overuse (expecially with chronic alcohol) slightly increases the risk for liver failure. Anti-inflammatory drugs: (Ibuprofen, celecoxib, naproxen, etc.) : Effective for muscular / articular / inflamatory pains. They downregulate the source signal from the wounded area. Zero effectiveness if the pain doesn't have a source other then the nervous system. Can cause stomach ulcers and acute kidney failure. To be avoided in elderly patients. Opioids (codeine, morphine, hydromorphone, fentanyl, etc): Downregulate the nervous system amplification of pain signal. Think of it as your laptop's speaker playing music instead of the microphones it's been plugged in. Overdose causes respiratory failure. Constipation frequent, including intestinal damage and infection following the constipation, also cause psychological and physical dependance. Huge withdrawal effects. Anti-epileptics (pregabalin, gabapentin, etc): Mildly effective for nerve-related pains (e.g. if a nerve is getting crushed in your spine). Rarelly super effective but they tend to be what the doctor prescribes to avoid starting opioids. Also used for fibromyalgia and other idiopathic self-reported-chronic-pain. Antidepressants: Moslty serotonin-norepinephrine reuptake inhibitors like venlafaxin. Part of a multi-dirrection approach to pain management. They have been shown to be more effective than placebo in combination with other pain management drugs for several conditions. Generally considered to be effective against the psychological elements of pain (expecially effective for depressive and anxious patient, whose psychological state can significantly increase the perception of burden from pain). Hope that helps

[@DaedricSheep]

last time i was this early I helped set out the snacks

[@EDD519]

it works !

[@anthonyyates9003]

So the lease on Hong Kong was only for a hundred years not indefinitely please correct

[@zetaprime133]

2:48 Wow, how did he destroy a HUG shipment of drugs? Did he hate it out of existence?

[@untwerf]

I would be grateful for someone to explain why this opiod crisis is apprently fairly unique to the united states among countries in the western world.. for example i live in the uk and to the best of my knowledge we do not have an opiod crisis here..

[@lehannaallen]

Typo (in case you want to fix): In your 1839 history section, you have Commissioner Lin Zexu "destroying a HUG shipment".

[@blinkfuhrer]

Wait you cant state state pain relive is often undertreated and then state that pain drugs should not be used... this is not logical.

[@mrtalos]

Do opioids really kill more people than any other drug? I know misuse definitely can kill, but I find that statement a surprise if true. and I know Aaron usually doesn't state incorrect information.

[@mrmoth26]

Alcohol and tobacco kill more. So that claim is false.

[@peterattia8135]

Yeah, and we should "protect" against addiction people dying anyway i.e. from cancers.

[@doubleplusgoodful]

I was not expecting the Spanish Inquisition

[@bretharley7480]

Damn he destroyed a 'hug' shipment?!

[@bakslashr]

With so many chiropractors and alternative medicine specialist using "Dr." wouldn't including MD such as "Dr. Aaron Carroll, MD" be better so that we can at least get people to figure out why this is important?

[@Pierrot110194]

+bakslashr People are doing that? Isn't that extremely illegal?

[@bakslashr]

+Peter Pepper No, it isn't illegal. Non physicians can be, and are, called doctor assuming they have a doctoral degree which my or may not be medical related, and may or may not be from an accredited school.

[@vtheaquarius7085]

Rip Prince.

[@Eatmorepaper]

what are you talking about? they absolutely work for chronic pain and are literally the only reliable medication to treat chronic pain symptoms. it doesn't treat chronic pain as in stop the source of the pain from being injured or whatever the reason is that its painful. you have to continue use, but as long as you are responsible and stick to an effective dose you wont have to increase your dose.

[@ProjectCreativityGuy96]

The most deadliest curse that i would do anything to take it back!!!!!!

[@mrhyperbolic7455]

I had a rather large and deep cyst surgically removed from my neck. Afterwards the surgeon would not prescribe the 10 Hydrocodones I requested. He said to take Tylenol. I was in intense pain and luckily a friend of mine gave me 2 Hydrocodone that night and 2 more for the next day/night. Then strong Advil worked. I told the Doctor on the follow up what happened and blamed him for my discomfort which was totally unnecessary and he said nothing. Just looked at me. The Doctors are running scared and the patients suffer needlessly because of abuse. Just another point of view. GET THE MEDS WHEN NEEDED...

[@thecommiehunter1149]

I wanted Oxycodone because it's good and help with jaw pain and all the doctors care about it addiction? Thats all not the care of the patient just that

[@den264]

You and thousands of others are being punished for the reckless missuse of painkillers over the decades. My neighbor in Hamilton Ontario was on single mothers allowance and used to Doctor hop around town geaning scrips for painkillers from each of them. She then sold the pills to get money for stronger drugs. This activity was not unusual in my town. When the authorities got wind of this the doctors were instructed to stop prescribing painkillers to all but the most serious cases. So the lowlife scum are responsible for thousands of genuine cases being left to suffer.

[@Sssavage27]

2:41 a hug shipment

[@kentkarlsson8277]

Thank you for explaining the history and maybe the next one will bring in our war machine guarding the poppy fields in Afghanistan

[@truckstractorswildlifeguns6648]

there is NO alternative for the treatment of pain .effective treatments anyway, if there was an alternative a problem would not exist in the first place .

[@malterwitty5433]

Is codeine an opioid ?

[@jamesl1332]

Aww. The end would have been a great segue to the previous HCT about marijuana being good for health, and it's possible use as a long term pain management supplement, without the addiction aspects. If only we had lots of scientific studies to support such a notion. I don't even use marijuana, but I find its prohibition is problematic. Which leads me to my observation/question: a common thread we hear about marijuana now is that the government shouldn't interfere with what a healthcare professional prescribes. As in, the doctor knows best, who is the government to say marijuana isn't the best medicine. But it seems like that was also the way opioid use got out of control in previous "outbreaks." Is that a function of unscrupulous medical professionals, or not understanding the addicting aspects of the opioids at the time? Or even this time? Is it akin to doctors prescribing antibiotics for everything under the sun? I want my doctor to be able to prescribe whatever plant, or pharmaceutical, or eye of newt, is necessary for whatever my condition may be. But it seems that the professional as a whole has made mistakes on certain pharmaceuticals in the past. Heroin, LSD, MDMA, cocaine all started as prescription drugs. Is it wrong that they can no longer be prescribed? And what does that say about the coming marijuana prescriptions? Is it safe to take that train in reverse? Will we get back to prescription LSD? And is that okay if we do?

[@TheBillymybob]

There are deffinately issues with Heroin and stronger drugs due to their addictive properties, exactly what they are and how they work is mostly understood but hard to study due to lack of funding and it being illegal for people to volunteer for human trials. As far as marijuana goes, scientists have extracted various Canabaliods from canabis and found the active ingredient that causes all the good side effects, such as lower blood pressure and anti anxiety/depressant, isn't the work of THC but CDC which actually inhibits the effects of and causes non of the recreational side effects.

[@den264]

Been taking bdh marijuana for migraines and it works a peach. Highly recommend it.

[@sinsaiyang]

My professor made me watch this...

[@americangooeyduck5743]

It is becoming a big problem but I don’t think it really is with people of chronic pain or terminally ill like myself I do use pain medicine and so I guess I have a dog in the fight a lot of the overdoses that you hear of its illicit drug use a lot of it synthetic coming over from Mexico etc. but that being said this is 2018 and I know with my doctor and my medical facility they monitor me pretty well constantly doing lab tests making sure my body is processing it safely also monitoring the concentration in my system and I just know nowadays they really watch it on the pharmaceutical and the pharmacies monitoring people and I think that’s all that really needs to be done it’s just gonna take time to clean up the aftermath from the early 2000‘s and I honestly think about that has to do with when it start becoming a major problem a lot of people that were abusing them they just cut off they did not wean down or did not put them through treatment they just cut them off which force them into withdrawals which in turn made them go out to the streets it should’ve been handled differently but that’s what we’re dealing with right now. It is a great pain management medication if it’s used properly and if it’s managed properly.

[@sammasek5891]

dont let this distract u from the fact that the avengers blew a 5 to 1 infinity stone lead to thanos:(((

[@sammasek5891]

fr and england blew a 13 colony lead to the US

[@sammasek5891]

they choked

[@ricearoni06]

"... destroyed a hug shipment" There's a typo on one of the early slides about the opium issues in China.

[@TheBrothersBlue]

Kratom. It really does save lives, why do you think pharmacutical companies want to Schedule it?

[@Cugelclever]

I have seen little other than anecdotal evidence regarding kratom's efficacy. Till some research has been done, I would advise caution to anyone interested in trying it.

[@marvymarier8988]

@@Cugelclever It works ; my friend has chronic headaches and swears by it .

[@chengyanboon]

Paracelsus! Hippocrates! Old friends for Sawbones fans

[@kevinjenkins6986]

Problem: there are no alternatives for opioids

[@smartzeusy]

Opiates are the class of drugs originally derived from opium poppies, opioids are something else entirely and include endogenous substances (produced by the body) as well as opioid antagonists such as naloxone, substances which act on kappa opioid receptors are also often included in that category nowadays. Including hydrocodone with drugs like hydromorphone or oxycodone is highly misleading, hydrocodone isn't nearly on the same level as the latter two and is highly unlikely to be the drug of choice for regular users. It's also very much debatable that the limited access and general demonization of heroin in the public's eyes are responsible for the epidemic more than anything else. It's simply much easier to sell pharmaceuticals than it is to sell heroin nowadays, there isn't really an epidemic just a shift in which substances are used, a few years ago heroin use went down dramatically but then abuse of pharmaceuticals increased. If you're going to talk about healthcare and posit yourself as an authority on the subject you best get your facts straight, particularly when it comes to alarmist subjects like this one. (EDIT: I don't know where you got your 'heroin most deadly drug' stat from but it's highly unlikely to be correct, and if it is then you're missing a big part of the picture. Most heroin overdoses aren't caused by heroin itself, they are usually caused either by the use of heroin with other substances or heroin being cut with other drugs. You'll also have to distinguish between incidental overdoses which are sometimes fatal and voluntary overdoses. Even when it is heroin alone and nothing else, it's often when addicts stop for a period of time and then restart that they then overdose, due to tolerance being lower and quantities not adjusted properly partly due to the variability in concentrations of the illicit substance.)

[@dennis8445]

Too much of any one thing isn't good for you and that applies to everything. Don't be a fool live by the rule.

[@kaylahood5081]

I hate opioids. They constipate me so terribly that I can't eat anything due to the awful bloating.

[@rochelle123ist]

Kayla Hood I also hate opiates but if you had cancer like I did you would be begging for OxyContin or Morphine.

[@Shizomis]

I find this enjoyable to watch while snorting oxycodone

[@DANTEANDOLINI]

Just give people with serious pain a lifetime prescription. It's cheap. It works and is safer than sugar and most of that other stuff they prescribe

[@Abraxis86]

History is about detailing past events, if you're going to tell us what to do in the future, you're not a history video, you're an opinion piece using history as justification. Which isn't a problem at all. But don't use a title like "The history of...", implying objectivity.