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The larks, still bravely singing, fly / Scarce heard amid the guns below.
November 11, 2007 9:57 PM   Subscribe

The poppy is bitterly ironic this Remembrance Day. Borrowed from John McRae's classic In Flanders' Fields, the poppy has shifted from a symbolic meaning to the central subject of an ongoing conflict. As international intervention in Afghanistan continues, opium production has reached record-breaking heights, with this single country now producing 90% of the world's total supply (utterly dwarfing global licit supply). Meanwhile, the world suffers a global opiate shortage(pdf), Canada's heroin maintenance project is threatened by politics, and the National Review of Medicine suggests that prescription opiates are far more dangerous than the "usual suspects".
posted by mek (26 comments total) 5 users marked this as a favorite

 
OP: the National Review of Medicine suggests that prescription opiates are far more dangerous than the "usual suspects"

Where does it suggest that? In fact, this is the last paragraph:
Dr Fischer says we're very far from an optimal approach to this issue, but he sees a surprising (and controversial) public health silver lining in prescription opioids overtaking illegals drugs like heroin: "They're not injected, so there's less risk for infectious disease, and they're controlled, so there's less risk of overdose."
--

As far as opioid shortage goes, it isn't really a supply shortage (yet). There are political & social factors in many countries that limit the consumption of opioids for otherwise accepted uses. Diverting Afghan output, by itself, won't do much. The primary barrier to engaging the issue of opium is attitudes & mindsets, especially those of the key enforcers of current drug policy.
posted by daksya at 10:13 PM on November 11, 2007


My favorite end of the world scenario is McDonalds-branded Opium Dens.
posted by b1tr0t at 10:21 PM on November 11, 2007 [1 favorite]


Sorry, I meant to say that they are posing an escalating public health problem, (while the drugs on an individual basis are less dangerous), as their potential for abuse is exploding: Oxycodone prescriptions increased a shocking 277% from 2001 to 2003, according to the final report of the OxyContin Task Force the government launched in 2003 to investigate the problem.
posted by mek at 10:23 PM on November 11, 2007


`*
posted by Artw at 10:42 PM on November 11, 2007


Sorry, I meant to say that they are posing an escalating public health problem ... as their potential for abuse is exploding: Oxycodone prescriptions increased a shocking 277% from 2001 to 2003,

Never thought people getting high was too much of a problem.
posted by spaltavian at 10:56 PM on November 11, 2007 [1 favorite]


Very well reasoned contribution, spaltavian. I am sure there will be a ton of people reading this thread who will now see why oxycodone abuse isn't a big deal.

b1tr0t: We already have McOpium! It's called tv!
posted by blacklite at 11:45 PM on November 11, 2007


Drugs Banned, Many of World’s Poor Suffer in Pain
posted by homunculus at 12:06 AM on November 12, 2007 [1 favorite]


Pain Management: A Fundamental Human Right
posted by homunculus at 12:08 AM on November 12, 2007 [2 favorites]


Maybe oxycodone abuse isn't such a big deal. If Rush Limbaugh can do it, it must be pretty cool.
posted by stavrogin at 12:26 AM on November 12, 2007


My favourite poppy of yore: the frieze on Palazzo Bartolini-Salimbeni in Florence.
The tale goes that the 16th century merchant Bartolini invited all his competitors to a grand feast and laced their vino with opium, so that he was the only one awake early the next morning to clinch a massive spice deal with the eastern traders who'd arrived in Pisa. To add insult to injury, he decorated the palazzo built with the earnings from the deal with a bas-relief of his new chosen emblem: three poppy-pods - and rubbed it all in with a reminder written in each window's cross-bar: "per non dormire". (D'Annunzio is likely to have appropriated the phrase during a stay at the hotel that still occupies the back of the building.)
posted by progosk at 12:34 AM on November 12, 2007 [3 favorites]


[errata corrige: spice silk deal.]
posted by progosk at 12:36 AM on November 12, 2007


Maybe oxycodone abuse isn't such a big deal. If Rush Limbaugh can do it, it must be pretty cool.

Or alternatively, if even a big shot conservative media personality like Rush Limbaugh stands so little chance of getting adequate pain medication without going to the black market, what hope is there for the rest of us?
posted by PeterMcDermott at 3:17 AM on November 12, 2007 [1 favorite]


As far as opioid shortage goes, it isn't really a supply shortage (yet).

Actually it is. British pharmacies have been reporting critical shortages in legal diamorphine supplies for the last two years or so now. Many people who were originally on diamorphine prescriptions have been moved over to synthetics.

The impact of the national shortage of diamorphine.
posted by PeterMcDermott at 3:25 AM on November 12, 2007 [1 favorite]


PeterMcDermott, the diamorphine shortage doesn't seem to have much to do with lack of raw material. More like problems at Chiron, and low capacity at Wockhardt.
posted by daksya at 3:57 AM on November 12, 2007


Should have added: the Swiss (& Dutch) don't seem to have had a lack of heroin. Apparently, the NHS can't tap that supply because of the specific formulation they desire i.e. freeze-dried ampoules. Afghans can't do much about that.
posted by daksya at 4:00 AM on November 12, 2007


Thanks for stealing the topic of my one liner in the rememberance day flamewar thread, you bastard.
posted by [expletive deleted] at 4:16 AM on November 12, 2007


That's John McCrae.
posted by oaf at 4:21 AM on November 12, 2007 [1 favorite]


The Brits should just swallow their fucking pride and buy some black tar from the Afghans. It's only just deserts for the Opium Wars.
posted by [expletive deleted] at 4:22 AM on November 12, 2007


There's been an initiative to legalise production in Afghanistan for some time, and use the product to alleviate the shortage of medicinal morphiates (as I understand it, at the moment there's demand in third world countries, it's just that the costs are far higher than the suppliers are willing to meet). There is some discussion on whether it will work. The Brits have recommended that instead of legalising opium, you subsidise other crops. Subsidies are necessary because Pakistan and Iran can kick Afghanistan's ass in any crop you care to name, which is why the alternative livelihoods drive is now viewed as problematic or a failure. The Afghans, taking their own delightfully esoteric approach to alternative livelihoods, are growing cannabis instead (in fact, in some areas you can double-crop, opium over Nov-June, cannabis July-October). The UN Office of Drugs and Crime has also given up on it, and is focusing on interdiction and cooperation, which may have been taken on board by the Brits, who are for the first time sending special forces to do the same.
posted by YouRebelScum at 5:04 AM on November 12, 2007 [1 favorite]


I should say, some of these are fairly fat documents... Apologies.
posted by YouRebelScum at 5:05 AM on November 12, 2007


And woops again, duplicate some of the initial posters posts. Must read more carefully in future...
posted by YouRebelScum at 5:19 AM on November 12, 2007


blacklite Very well reasoned contribution, spaltavian. I am sure there will be a ton of people reading this thread who will now see why oxycodone abuse isn't a big deal.

You have yet to demonstrate that it is. Also, you can't abuse an inanimate object.
posted by spaltavian at 9:55 AM on November 12, 2007 [1 favorite]


Related, the Geopolitics of Opium 2007.
posted by nickyskye at 10:57 AM on November 12, 2007



I have been writing about this problem for many years now: New York Times op-ed suggesting selling Afghan opium for third-world pain relief.

Feature in Reason about why doctors are afraid to prescribe.

More interesting fake sex for drugs story than the one in the FPP-- involving a woman named Riggle and her lies about a doctor.

The bottom line is this: no one can "make" someone into an opioid addict by giving them painkillers. Until we realize that becoming an addict involves at least initial acts of willfully ignoring doctors advice (no matter how much genetics may predispose some people to doing so), we will never understand how to deal with this problem.

Once we understand that pain relief cannot *cause* addiction-- and that preventing access by pain patients to opioids will neither prevent nor cure addiction, we will allow people in pain to have the treatment they need and provide addicts either opioids or abstinence-focused treatment, depending on *their own* needs and desires.

That way, you are not punishing pain patients for the addiction of others, you are not attempting to "treat" addiction by simply cutting off patients who are addicted but faking pain and making it worse by having them rely on street drugs rather than known-quantity pharmaceuticals and you can more effectively move them towards abstinence or stable maintenance by keeping them in the system.
posted by Maias at 12:01 PM on November 12, 2007 [1 favorite]


The poppy is bitterly ironic this Remembrance Day.
And, ironically, bitter.
posted by oats at 1:12 PM on November 12, 2007


Robert Young Pelton talks about Afghan narco state.
posted by hortense at 4:34 PM on November 12, 2007


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