This article was inspired by the second funeral that a family member attended for a former schoolmate. The second death occurred after the person successfully completed rehabilitation, but then relapsed and died of a drug overdose after completing the rehabilitation period. This article does not address rehabilitation. It provides information on things to avoid if you are using drugs and want to stay alive.
Before we look at how to avoid overdosing (OD), we should consider some of the conditions that define the addiction to a drug.
Here are some of the traits of an addictive drug.
- The user establishes a psychological attachment to the drug
- This is partially due to a response of the brain to the drug by producing or mimicking endorphin (pleasure) chemicals.
- The psychological attachment is often increased because of social interactions of other users of the same or other drugs.
- There is a physiological attachment to the drug
- The body integrates the drug effects and reacts when that drug is withdrawn. This is called drug dependency.
- This withdrawal reaction indicates a physical dependence on the drug.
- The amount of the drug must be increased to get the same physiological response for the user. This is called increasing tolerance.
- The lethal dose of the drug will vary based upon the metabolism of the drug by the individual user and interactions of drugs with each other.
- For a given individual, quantities of the drug that were tolerated before rehabilitation may kill the person after rehabilitation because the body has readjusted when the drug was withdrawn for a period of time. Reduced tolerance for the drug is established when the body adapts to the elimination of the drug during rehabilitation.
- Under steady usage of the drug, the lethal dose is fixed based upon the individual’s metabolism, but the amount required to get the desired mental and physical response increases over time (tolerance). If you stop using the drug and start using it again, your tolerance may be much lower, e.g. you went through rehab and then started using again.
Mixtures of drugs can be lethal, especially when central nervous system depressants (CNS) are combined with alcohol. The deadly combinations include the following:
Tranquilizers and alcohol together can be lethal.
“Benzodiazepines are a type of medication known as tranquilizers. Familiar names include Valium and Xanax.” Tranquilizers and alcohol are capable of depressing the functions of the central nervous system, which can lead to stopping breathing, stopping the heart, or putting the brain into a coma. This is a link to a discussion of the characteristics of the benzodiazepines with regard to speed of response, addiction potential, and length of activity.
Tranquilizers and opioids are also potentially lethal when used together.
Both are CNS depressants. Tranquilizers are generally cheaper and more readily available than opioids so they are combined to produce more effects than either drug alone.
The combination of cocaine and heroin has a special street name called speedball. It combines a strong stimulant with a strong CNS depressant. Cocaine in excess can cause heart attacks, aneurysms, and strokes. Heroin in excess can depress breathing to cause coma or death. Since cocaine processes faster than heroin, depressed breathing from heroin can occur after the stimulant effects from cocaine have worn off.
Alcohol and opioids work very similarly to the combination of tranquilizers and opioids. The addition of fentanyl to heroin has made any combination of other drugs, e.g. tranquilizers or alcohol, especially deadly.
It has been estimated that alcohol increases the effects of other CNS depressants by factors of 3 to 5 times. Notable victims of alcohol and sleeping pills have included rock stars, writers, and gossip columnists. Drinking and drugging are at least as dangerous as drinking and driving. Don’t do it.
Before we talk about improving your chances of surviving any kind of addiction, it is important to realize that estimates are as high as 80% of people addicted to opiates started with a prescription written by a physician. Xanax, the tranquilizer, is the most widely prescribed drug in the US. Alcohol causes more deaths than any other addictive drug each year. Tobacco will kill you, but it is generally slower and often much more painful than the other lethal drugs.
There is a major psychological survival boundary that has been crossed when a user switches from smoking, snorting, or ingesting a drug to injecting the drug. In addition to the direct risks of putting the drug into your bloodstream, the risks of sharing needles lead to HIV, hepatitis B, and hepatitis C, abscesses, and collapsed veins. If you are using needles you have exposed yourself to some or all of the above risks.
This article can help you identify the risks, but one of the attributes of addiction is that users continue to use their drugs despite knowing it can kill them. Given those facts, try to get control of your choices to allow you to get help. There are some drugs that provide pleasure when used in moderation. There are some drugs that are always dangerous no matter how you approach them at the beginning of your use. Choose wisely and stay alive. When you regain your will to live, you will be assisted in continuing to heal and regain your life.
The poem below was written after a friendship with a heroin addict was established. It is called Smoke Ring. My friend told me it was the best description of the relationship of an addict to heroin he had seen from someone that wasn’t an addict. I told him that was close enough for me.
The candlelight dances
on the silver spoon
borne in no mouth,
but cherished by many
as the candle of tranquility
and the substance of life.
There is no need
for other things or for You.
The sharp, happy pain
winks as the needle slides home;
big breath in, now wait…
slow sigh out.
Warm, wet, floating easy
into the arms of a lazy lover,
and The Lover smiles with you
like she is your very best friend.
But then you look closely and find
her teeth are all needles,
her tongue is a rubber tube,
and she screams feed me, fuck me, fill me.
You sweat, you smile, you ache, you cry,
and then you hit the street
looking for the Candyman and hoping
that he won’t mind that you are a dollar short.
But he does mind, and you only have the deposit
on six Coke bottles; you’d kill for a dime.
“Friend, spare change? Thank you.”
The candlelight dances on the silver spoon.
© Copyright 1972
If you are already addicted to drugs, consider getting help. If you have decided you are going to continue using drugs, consider the information in this article as a warning.