I up-voted you because it's a fair question, but the grand-parent is absolutely right: there are plenty of cases where opioids are marginally effective. The management of chronic pain in particular is problematic because opioid tolerance can develop in as little as two weeks. In addition, some people have paradoxical reactions to opioids, i.e. increased pain (http://www.ncbi.nlm.nih.gov/pubmed/21412369). Finally, the side effects of high-dose opioids are no joke.

Marginally effective because it creates a dependence that ceases to become as effective as the onset and you merely end up with an addiction.

Marijuana, on the other hand, produces consistent highs and its effects reach deeper than mere pain relief though it's good for that too. Pot does seem to dull intelligence because it slows people down. This is not a sign of loss of intelligence however. In fact, the real culprit behind dulling of intelligence is alcohol.

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In terms of marijuana and its effects on brain cells, or neurons, there is little evidence to suggest that any of the active ingredients in the marijuana plant administered at doses appropriate for human consumption have neurotoxic effects.

This is in direct contrast to alcohol, where the body’s digestive process creates metabolites such as acetaldehyde and other “reactive oxygen species” which are toxic to the brain and other cells in the body. This is why you have a hangover, after drinking large quantities of alcohol.

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- http://www.drugpolicy.org/blog/does-marijuana-kill-brain-cel...

Opiates get misused for a lot of pain when they're not really suitable for that particular type of pain.

For many people opiates are marginally effective because they were misprescribed.

I was in PT for 2 years. I had to function during that period.

I was given hydrocodone, which dulled things and made me nauseous. The stronger stuff worked better, but left me exhausted.

It was easier to deal with pain.

I have no idea about marijuana. It's illegal to study it, so there are few facts available. Personally, I've seen a few people get hooked on opiates without any intention of abuse. All my pothead friends from college seem to have suffered no ill effect.

I'm sorry you had that reaction. It really must suck to be one of those that can't handle opiates (sincerely; my mom can't either).

Due note that the side effects do release over time in some people. For instance one patient I'm familiar with had an adverse reaction to hydrocodone frequently (1:1 to 1:3). But within a year it was closer to 1:50 and years later is around 1:200. There are other options that are more powerful and have less side effect. Combining with an anti nausea med seems to work (dimenhydrinate (Dramamine)).

I've read at least one study that showed improved cognitive due to opiates (from the pain relief). Unfortunately I can't find it right now (but I now get the point of a bookmarking service).

Addiction itself isn't that big of a deal. If the user doesn't want to be addicted, there easy ways to slowly get off. Take time, there's no rush. It's only the legal and financial aspects that make it problematic. If a doctor gives someone half a gram of hydrocodone for pain, they should be legally obligated to provide significantly more over time in case the patient starts to suffer any withdrawal symptoms. But doing so now, even admitting you took an extra one some night, gets you listed as a bad person. That's what needs fixing.

Yes I know many people. I also know some that OD'd off of crap "heroin". I know users that got promotions and high personal praise after switching to full-time OxyContin use.

I've met successful CEOs, VPs, and scientists that are addicted to opiates (Confirmed.) In your next professional interactions, look at everyone's pupils. You'll find some incredibly pinned. That's a pretty good sign.

Truth is things like OxyContin are often given to middle-upper class users and they suffer little downside (sex drive and constipation being the main things.) After you have enough income and supply the popular perception of addiction being a problem just disappears.

This view is just absurd. Beyond comprehension.

You are aware of some people who function well with addiction so you assume that all addiction "isn't that big of a deal." BS. Go to a treatment facility and tell the patients (of all income levels) their opiate addiction "isn't that big of a deal."

I've meet many people (one an amputee, one great grandma in her 80) who have become addicted to their doctor prescribed medicine. All of which look like they have their lives together from the outside (and aren't having problems paying for their medicine) but their lives are being absolutely destroyed by opiates.

In the case of alcohol addiction there is even a word for this - "high-functioning alcoholic."

Just because you are able to function normally doesn't automatically make your addiction "not a problem" or doesn't mean it doesn't effect you in a negative way.

I'm not telling you that every addict is having their lives destroyed by addiction, but to assume that just because some don't means that all don't given enough income is preposterous.

"In your next professional interactions, look at everyone's pupils." No, thank you. I couldn't imagine wanting to do this.

The majority of people I know that use, and the ones I meet online seem content to be addicted. Outside of funding issues and the occasional "what's sex drive again?" they seem to love it (on apart from when they must make a BM). It enables them to handle things they otherwise couldn't. I've met young kids with bone diseases leaving them vulnerable to repeated bone breakage. A fent lollypop later and they're beyond happy, and also have left pain behind.

I know professionals, drowning in whatever their work is. On behind or in debt. Opiates give them the optimism to face another day.

I'm honestly curious to know who is being destroyed by opiates, as in, what does destroyed mean? Outside of finances, legality, quality control, and other non-intrinsic, imposed issues.

Edit: If you'd like, my email's in my profile

Opioids are said to work poorly on nerve pain.

Would love to learn more about how pot "seems to dull intelligence", do you have any sources?

Personal usage a long time ago, and firsthand experience. I don't mean long-term (maybe, maybe not; irrelevant). I mean at high enough doses to get high or seek pain relief, pot doesn't seem to leave the user with their full intelligence.