Readers Write: Opium and Xanax

Opium Kills -- Sure it Does!
Yes, I know "there's a war on." A war on drugs. A war on terror. And I know that truth is the first casualty in any war.

In Opium Cure Can Kill, we're being asked to believe that in a particularly harsh winter, when children are cold, hungry, sick, poor, isolated and given opium -- it is the opium which is to blame if they die.

Good story. Bad science.

Actually, opium in its raw state is remarkably easy to manage when taken orally. Until modern Europeans got the idea of smoking it, and then of refining it and injecting it through hollow needles, no one even seemed aware that the drug could be either toxic or addictive. The Lotus Eaters in The Odyssey might have been poppy addicts, but only if we can safely assume Homer and his audience didn't know the difference between the two plants.

In the classical world opium was one of the few safe and effective medications available. Greek physicians knew enough not to use it to ease mothers in childbirth, but did prescribe it rather freely for their children's colic, croup and teething. Alexander's armies mixed the stuff in their field rations to promote endurance and fearlessness when they faced a long forced march with a hard battle expected at the end of it. And when they showed up in Afghanistan, the locals were already cultivating and using poppy. You'd think they'd still know a little something about using it as a pediatric medicine.

So, when an Afghan health minister tells us that folk medicine is killing children and doesn't bother to cite autopsy or toxicology findings -- excuse me for noticing how convenient and self-serving that conclusion is.
Mitch Kessler

Xanax and Lies
Though I love the Drug Reporter section and usually agree with many of your picks, I was a bit distressed to see the Xanax "addiction" piece by the person with bipolar disorder (The Joy Of Six Milligrams).

That kind of reporting gives ammunition to those who believe that addiction to benzodiazepines and opioid painkillers is driven by easily fooled "overprescribing" doctors. What should a doctor do when faced with a patient who might be lying? Not prescribe, in a vain attempt to prevent someone like Alexis Luna from hurting herself?

Or prescribe in case she's one of the majority of honest patients who benefit from these drugs?

The problem in Alexis Luna's situation is not her doctor, nor her bipolar disorder, nor the Xanax, but her lying. By failing to be honest about her medical needs, not only does she hurt herself, but she hurts the cause of pain and anxiety patients who desperately need these medications and often cannot get them because they are mistaken for liars like her.

If she wants to get better, she might want to consider that "getting over" on doctors is nothing to boast about.
Maia Szalavitz

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