Talk:Hard and soft drugs

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Contents 1 Consolidation into Hard and soft drugs 2 Proposed Merge 3 Nicotine harder than crack? 4 MDMA 5 Empathogens, Hallucinogens and SSRIs 6 Reference Removed 7 Hardness of hallucinogens 8 "Misunderstanding" the terms 9 segment removed 10 moving nicotine and alcohol section 11 cite sources for potentially dangerous claims 12 definition for hard drugs 13 MDMA as reletively safe compared to Alcohol/Tobacco? 14 NPOV 15 Rewrite

[edit] Consolidation into Hard and soft drugs

I have been bold, and consolidated two articles that had already pretty much converged. I have left the talk pages from the old hard and soft articles. I have dropped the interwiki links until I see what the right thing to do is, though the inbound links should simply come here.

I left out a paragraph on another distinction made, which I quote here. I am still thinking how it might fit (I think it may need more context, as it is the only pharmaceutical usage discussed).

Recently, a new definition for soft drug has come into use. This definition refers to a drug which undergoes predictable metabolism to inactive metabolites after exerting its therapeutic effect. The ophthalmic drug loteprednol (Alrex, Lotemax) is one example of this kind of 'soft drug', as it undergoes hydrolysis into inactive carboxylic acid metabolites.

-SM 23:30, 11 November 2005 (UTC)

Definitely include this. To a pharmacologist or medicinal chemist, this is the first definition that comes to mind upon mention of the term "soft drug". Perhaps include a tidbit on important metabolic enzymes. 70.106.137.28 00:14, 7 November 2006 (UTC)

[edit] Proposed Merge

Propose and Support: I feel this article should be merged to recreational drug use as this article is only a stub that goes over recreational drugs and a distinction between them. Please comment. Thaagenson 16:08, 22 November 2005 (UTC)

I think that a little more work should be done on this article before it is merged, but I would support merging . Basically the hard/soft drug label is both a legal one of the Dutch drug policy, as well as a scientific one based upon the relative addictiveness of different drugs. I propose that we separate these into two separate sections, or make the Dutch drug policy a subsection to reduce confusion.

Scientifically the hard drugs are (in order of descending hardness): nicotine, ice (meth smoked), crack (cocaine smoked), crystal (meth injected), valium, qualuudes, barbituates, alcohol, heroin, crank (meth insufflated), cocaine (insufflated), caffeine, PCP

Scientifically the soft drugs are (in order of descending hardness): marijuana, MDMA, psilocybin, LSD, mescaline. --Thoric 16:40, 22 November 2005 (UTC)

Strongly opposed to proposed merge, the assumption that this article is only a stub that goes over recreational drugs and a distinction between them assumes a greater validity of the term Recreational drug use than warranted.

Please see further discussion. -SM 08:19, 1 December 2005 (UTC)

Strong oppose. I don't think the articles should be merged. Serious addiction to hard drugs, especially herion, is not a recreational activity, and I would argue the same for hard core meth (that I have only read about) and crack addicts. While I am not keen on the term recreational for describing marijuana use, as it implies that it is taken in one's leisure time whereas my perception (and I am know I am not alone) is that it's more like coffee, ie a good drug to use while working, and whereas alcohol is considered a recreational drug coffee is not. But while I can live with cannabis described as a recreational drug I oppose casting hard, highly addictive drugs like crack and heroin as recreational drugs, SqueakBox 19:20, 5 December 2005 (UTC)

Removed template per notice at Talk:Recreational drug use#Bifurcation of issues (merges and scope)

[edit] Nicotine harder than crack?

It would also be good to get some evidence that nicotine is harder than meth or crack. I simply don't believe it. You can't smoke 60 rocks a day for 50 years and still be aslive and the deleterious effects of meth are ntorious. So whatever criteria you are using to claim nicotine is harder than meth and crack is likely seriously flawed, and may have been written by people who didn't have a clue what they were on about (it sounds like that to me). Personally as an ex tobacco addict (larst on 11 and a half years ago) I am not pro tobacco but it is not in the same class (though in many ways tobacco is similar to crack, especially the short lasting affect), SqueakBox 19:31, 5 December 2005 (UTC)

Meth may be notorious, but how much of that notoriety is based on facts? How many methamphetamine users actually get into trouble?

Crack is a bad example simply because the primary harmful effect has nothing to do with cocaine - it is simply that crack produces exeptionally hot smoke. You could easily use cocaine at regular intervals daily for decades. It is arguable who'd be in worse shape, the 60 a day cigarette smoker or cocaine user.

Not true, crack burns at a low temperature, much more so than cannabis. That is why people snmoke it using plastic syringes, if you smoked cannabis through one of them the pipe would melt. Years ago an ENT surgeon said the problem with cannabis is it burns so hot. I disagree about about the harmful effects of cocaine, it is a drug that destroys people's peace of mind and kills far more rapidly than tobacco. You may be right about meth, it is not a drug used here in Honduras or that I have come across in others, SqueakBox 13:52, 20 May 2006 (UTC)

First of all, the hardness rating isn't based on intoxication, it is based on ability to stop using a drug. How hard it is to stop. Not necessarily how hard the drug is on your body. The drugs interference with your ability to function can actual reduce its ability to addict you. Studies show that if 100 people use cocaine, about 10 people will get hooked. The same studies show that if 100 people smoke cigarettes, that 20 of them will get hooked. Which is the harder drug to stop using? --Thoric 22:14, 5 December 2005 (UTC)

The scale cited which puts nicotine ahead of crack is for addiction only.

The idea of drug hardness is actually a subjective assessment of the magnitude of consequences of use, which has solidified into common usage, the primary component of which is the likelihood of addiction (in practice), but also includes deterioration of health (in practice) likelihood of antisocial behaviour (in practice), and likelihood of injury to self and other during use (in practice). The line between hard and soft is most aptly described as acceptable and non-acceptable in either a personal or a societal sense.

Even here, there is a cultural bias for users of naturally occuring drugs such as mescaline, peyote, psylocybe and cannabis to classify as soft drugs those synthetic hallucinogens similar in effect such as LSD (acid) and MDMA (ecstasy). Although all are powerful, I would observe that, in contrast to alcohol, meth, coke and heroin, these drug seldom lead to degradation.

-SM 23:20, 5 December 2005 (UTC)

I agree but I would say the same about nicotine which, if you don't count getting cancer or some long term health problem, clearly doesn't lead to long term degradation. I can believe it is very addictive but I seriously doubt if it has anything on crack in terms of short term addiction (we are talking minutes and hours here) which addicts have to keep smoking in order to avoid the extremely unpleaseant comedown which can extend over several hours if one has smoked enough. I don't find it credible that heroin is less addictive than alcohol as it takes a long time to get addicted to alcohol at least for most people whereas a degeneration into heroin addiction can be very fast. Again while valium is very addictive in the long run again you have to have used a lot of it to get addicted, which is why doctors still do pescribe it short term. I wonder how many of the 100 would get addicted to crack? I bet a lot more than would get addicted to cocaine, and anecdotal evidence would certainly back me up (I live in a city and a country and a region full of crack). There are clearly people like marijuana anonymous who consider cannabis to be highly addictive but one could argue lots of things are addictive (recorded music, work etc). I am amused that the blackberry mini portable computer has been nicknamed the crackberry and personally doubt whether I have come across anything as addictive as a computer hooked into the internet. If it is taken away from me (power and internet cuts) I quickly develop sym toms of depression, SqueakBox 23:51, 5 December 2005 (UTC)

It takes quite some time to get addicted to heroin. It is not, contrary to popular myth, fast. I also wonder how many recreational users of heroin actually become abusers. We appear to have no reliable information on this. All the heroin users I know are long-term recreational users, i.e. they use it on Friday and Saturday nights, and have done so for many years. They may or may not be typical of the majority of heroin users (note we only hear about the degenerate abusers in the news; we don't even hear about the addicts who use it daily, but otherwise live normal lives).

Again, I must make clear that the term "hard" applies to how hard it is to quit. I realize that on this scale, your old drug of choice seems to be the supreme evil, but if you look at mortality statistics, you will see that cigarette smoking is still the number one killer, second only to obesity. The short term effect on your health is secondary to life-long addiction. By your measure, the hardest drugs would be real poisons such as strychnine and arsenic. There is little concern by the DEA of people abusing those substances, and in fact the more toxic a substance, the less the DEA has to worry about it. This is partly why alcohol and nicotine are legal — because they are both quite toxic. Nicotine is a deadly poison. Two average strength cigarettes contain enough nicotine to kill an adult if the nicotine was extracted and injected. Alcohol poisoning is also very real. Alcohol and tobacco use kill over half a million Americans per year. --Thoric 00:06, 6 December 2005 (UTC)

The term hard applies to how hard it is to quit in part. My description above reflects actual usage. I hasten to point out that degradation was my own observation. That said, I also note two dear older friends of mine- smokers for decades- at home sadly on respirators. -SM 03:00, 6 December 2005 (UTC)

I don't believe that the common use of the word hard as in hard drug relates to the level of addiction but to the level of impact. Drugs like Meth and Crack and Heroin have a high-level impact on the lives of many users within the short term, while alcohol has an equally high impact on a minority of users in a mid to long range but can also inflame tragedy in the short run (drink driving or violence). The UK government does consider psilocybin and I believe ecstasy as class A ie hard drugs, and this indicatesd that many people clearly believe these are hard drugs, and with hallucinogens (LSD shrooms etc) it is understandable that people do classify these as hard drugs, IMO. Marijuana is the de rigeur soft drug, some would argue uniquely so and others would argue not so, SqueakBox 03:12, 6 December 2005 (UTC)

This is called meaning drift. People hear the term "hard drug" applied to meth, crack and heroin, and assume that it must be because of all the nasty stuff they hear about in the anti-drug propaganda. In actuality, it primarily refers to addictiveness. With all drugs on a level playing field, this would be the primary factor of harmfulness. Impact on health would be secondary, and level of intoxication tertiary. On a completely level playing field, opiates are less of a problem than alcohol. The true problem with drugs comes from lack of experience and knowledge in their use. --Thoric 03:55, 6 December 2005 (UTC)

[edit] MDMA

The article lists MDMA under the hallucinogens, however it is not hallucinogenic. Although it is possible to hallucinate after taking an Ecstacy pill, this is because pills are rarely pure, and sometimes contain no MDMA at all. The hallucinations are caused by other drugs used in the pill. I have edited the article to add a section devoted to empathogens, as I feel they should be considered seperately from hallucinogens.

Incorrect. It's primary effect is not hallucinogenic, but it does alter perception in a way that is reminiscent of low doses of true hallucinogens. I and others who have participated in research with pure MDMA can verify this.

[edit] Empathogens, Hallucinogens and SSRIs

Note these drugs are not dangerous when mixed with SSRIs. I have no idea why this myth persists. Quite the contrary SSRIs dramatically reduce the effects of hallucinogens such as LSD and empathogens such as MDMA. Drugs such as MDMA could produce dangerous stimulant effects when combined with non-reversible type A MAOIs, but that is an entirely different type of antidepressant. Note the caution does not strongly apply to the reversible type A moclobemide nor the non-reversible type B selegiline. Users should still exercise caution when combining the latter MAOIs with hallucinogens and empathogens, but the chances of life-threatening interactions is small.

Do not be too quick to dismiss the potential for MAOI-MDMA interactions. A quick google turns up "Addiction, Volume 98, Number 3, March 2003, pp. 365-368(4)" as documenting four deaths following the use of moclobemide to potentiate MDMA. Presumably, the dose was the usual 75-150mg employed to orally "activate" DMT, which is an insignificant fraction of the dose used therapeutically (300-600mg in primary care, 450-1200mg being more common with specialists).

The combination of any MAOI with MDMA will significantly potentiate the effects of MDMA. I would imagine the extent is similar to the 2-8x potentiation for CNS stimulants or the 4-8x potentiation for sympathomimetics.

More significantly, it will very significantly increase the likelyhood of serotonin-related adverse effects. Not only is the amount of 5HT and DA dumped into the synapse by MDMA-induced reversal of the reuptake pump increased a lot (due to greater quantities of monoamines stored in the vesicles), but there is no other metabolic pathway for 5HT than MAO inactivation. When you dump a lot of 5HT into the synapse, prevent its reuptake by reversing the pump, and prevent its degradation entirely, you get a further increase on the order of 5-100x (depending on the source you want to cite, and the dosage studied) in postsynaptic stimulation, cumulative with the increase in available 5HT.

The increase in phasic and tonic serotonergic activity, central and peripheral, is a serious problem, and this is not lower for moclobemide than any other MAOI, provided the dose is such that an equivalent level of MAO inhibition is achieved.

That said, like any combination of serotonergic drugs and MAOIs, an expert with access to lots of equipment and resources to allot a patient can probably find a safe way to combine them in an in-patient setting, given lots of time, serum level determination, genotype testing, and so forth. They know who they are, and they usually do this with tricyclics.

No-one else should attempt such combinations, even with moclobemide, unless they are doing so for a reason that justifies a clinically significant risk of serotonin syndrome, seizures/convulsions, rigidity, rhabdomylosis, hypertension, hyperthermia, coma and death, IMO.

Zuiram 05:55, 12 February 2007 (UTC)

[edit] Reference Removed

I have removed this reference at the end:

^ Ball KL., Alcohol is a hard drug. Part 1., Lamp. 1984 Oct; 41(9):34-40.

because the link is dead. 203.217.4.119 03:55, 28 March 2006 (UTC)

References involving a link to a website should not be removed due to the fact the page is no longer available any more than a reference to a book no longer in print should be removed. The reference only needs to contain the date when that webpage was available. If, and only if that page was not available on the date specified should it be removed. --Thoric 19:47, 5 June 2006 (UTC)

[edit] Hardness of hallucinogens

AFAIK, hallucinogens have always been considered to be "soft" drugs due to the fact that while they may have a perceived "high potential for abuse", in actuality a very small percentage of the population uses hallucinogens (excluding cannabis), and most hallucinogens (with the mentioned exceptions of the dissociatives) are non-addictive. Any claim of hallucinogens to be "harder" than cannabis is due to a misunderstanding of the term "hard" (or soft as the case may be). --Thoric 22:13, 15 June 2006 (UTC)

I agree.KroneMeltzer 21:38, 2 July 2006 (UTC)

[edit] "Misunderstanding" the terms

It seems to me, especially from the comments directly above, that there is a good deal of misunderstanding of the terms -- even by people who are otherwise knowledgeable in the subject.

The terms apply only to illegal drugs. This is stated in the article, but it could be clearer. Tobacco kills about 400,000 people per year. Alcohol kills about 100,000 people per year. For addictive qualities, they both rank right up there with the best. Heroin treatment programs often won't even try to get their patients to give up tobacco because they know it is hopeless. Heroin addicts have often reported that it is harder to kick tobacco than it is to kick heroin. Alcohol withdrawal is so severe that it results in death far more often than heroin withdrawal.

Just to put things in proper perspective - heroin typically kills fewer than 5,000 people every year, about the same number as Tylenol. That is pretty remarkable considering most of it is injected directly into the vein. If people were injecting alcohol or tobacco they would be dying like flies in the Raid factory.

So there ought to be a little more explanation that this is really a BS term like "bogeyman". It is something meant to sound scary that really doesn't make any sense at all. Everyone picks and chooses their own list of "hard" and "soft" drugs to suit their own particular prejudices, often accompanied by complete ignorance of the subject.

Wolfman97 17:42, 27 August 2006 (UTC)

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"Alcohol withdrawal is so severe that it results in death far more often than heroin withdrawal."

Part of this is incorrect. Opiates withdrawals will make you feel indescribably awful, but they can NOT kill you. Alcohol withdrawals and benzodiazepene withdrawals can most certainly kill you though.

- LazyNoAccountYet

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[edit] segment removed

I figure it's rude to remove something without saying why, so: I removed a bit saying that long-term use of aspirin and indeed all over-the-counter painkillers causes severe liver toxicity. This is untrue. Certainly there are many circumstances under which widely available, uncontrolled painkillers (most famously acetaminophen) can cause liver damage in most people, but long-term use at recommended doses is not one of them. If anything, this will probably cause kidney damage, and that's still not something that will happen in "most cases".

The suggestion that heroin use over a period of years causes no damage to the body is also somewhat misleading, as even experienced, cautious IV drug users (and- correct me if I'm wrong here- I don't think anyone's eating heroin) have a rather high risk of peripheral circulatory problems. It's a small thing, though, and I don't find it quite as offensive as the suggestion that an aspirin a day causes liver toxicity. Also, I can't think of a way to rephrase it. 128.113.228.16 03:49, 21 October 2006 (UTC)

I agree that the statements were overly bold, but from a strict substance vs. substance on equal ground point of view, opiates do little to no actual damage to the body(or brain), as they are nearly identical to natural chemicals produced by the brain and control the perception of pain at the source of where pain is perceived -- in the brain. NSAIDs (such as aspirin) on the other hand actually have a full-body effect on the platelets in your blood. Acetaminophen does damage the liver, both from high doses, and from long term use of low doses. --Thoric 04:14, 21 October 2006 (UTC)

I agree that opiate use, itself, is basically considered to have negligible harmful effects in the long term (at reasonable dosage levels, obviously). I feel it is important to note, however, that this is not actually because they are very similar to naturally occuring chemicals. Epinephrine naturally occurs in the body, but it is still associated with provocation of nasty arrhythmias at normal doses. It just so happens that the mind and body suffer no ill effects from prolonged high (but acceptable) levels of opioids. Lucky thing, too, since so many people are dependent on these compounds on a long-term basis.

Anyway, the reason I objected to that specific point is that it used heroin as an example. Certainly, heroin is a perfectly innocuous opioid. I actually think it's supposed to be associated with a lower incidence of side effects than morphine. Problem is, in many countries (including my own, the US), heroin is illegal, which means that "heroin use" can only mean IV heroin use for people there/here (in countries where it is legal, oral preparations are available, like with other opioids). Long-term intravenous use of anything, whether it is heroin or isotonic saline solution, is associated with all sorts of nasty circulatory problems when not performed by medical professionals; even then, there's a reason mainlines are installed in patients who get regular injections. I'm just saying that I'd like to see it with a better qualifier, or maybe with something that won't usually get interpreted to mean IV use (hydromorphone and morphine are definitely up there, right?).

Acetaminophen is pretty nasty, but it does not damage the liver in long-term use of low doses in alcohol-abstinent patients (i.e. "patients who follow directions"), only in high doses. It causes KIDNEY damage over the long term, not liver damage (and bear in mind that we're talking upwards of five years, here). In any case, the article claimed that aspirin and indeed all' OTC painkillers caused liver damage when taken over the long term. 128.113.229.81 19:25, 24 October 2006 (UTC) (ooh, dynamic ip)

[edit] moving nicotine and alcohol section

I am moving the nicotine and alcohol sentence to the "soft" section. LIke the soft drugs, it is veryharder to overdose on either alcohol or nicotine. --ProdigySportsman 02:11, 11 December 2006 (UTC)

Overdosing isn't the main criteria for determining whether a drug is hard or soft. Both drugs are quite addictive, especially nicotine. And the health risks are undeniable. Alcohol screws up your liver, kidneys, and kills brain cells. Nicotine is very addictive and usually leads to an early death. How can these drugs be considered soft? And ODing on alcohol isn't as hard as you think. Just do a google search of you are confused. Zachorious 22:29, 13 December 2006 (UTC)

Not only that, but nicotine is the most addictive drug known to man. --Thoric 17:32, 14 December 2006 (UTC)

Really? More than Heroin and Cocaine? I must have a special ability not to get addicted I guess. Many years ago I started experimenting with tobacco and smoked for a couple weeks everyday. Because the effects where so mild, I figured it wasn't worth it and quit right away quite easily. Maybe I'm different, I dunno. But I wouldn't doubt nicotine being as addictive as the hardest drugs, I've certainly seen people who get manic depressed if they didn't have their 12 pack that they usually have a day. Zachorious 23:20, 15 December 2006 (UTC)

if you injected nicotine (possible but unheard of) you would be addicted immediatly and if its purity was questionable like heroin you could quite easily overdose, nobody has ever died of smoked heroin over dose The Right Honourable 09:11, 27 March 2007 (UTC)

[edit] cite sources for potentially dangerous claims

• "There are also few physical health risks associated with soft drugs."
• "and are not known for causing any deaths"
• "many of which are closely related to amphetamines"
• "synthetic hallucinogens such as LSD (acid) and MDMA (ecstasy) as hard drugs, although they have very similar action to naturally occurring drugs such as mescaline"

These statements are completely false. Please cite the sources you have for these claims.

[edit] definition for hard drugs

is there any definition for hard drugs? or it's just a group of drugs? —The preceding unsigned comment was added by 85.250.232.251 (talk) 05:29, 7 March 2007 (UTC).

[edit] MDMA as reletively safe compared to Alcohol/Tobacco?

I think this isn't an appropriate claim to make at all. You can't just take the stats listing the number of deaths for each and then conclude that X substance is safer than X substance. Fewer people die every year from eating cyanide than from drinking alcohol, is cyanide safer than drinking? People who drink alcohol often consume it every day in varying amounts. People who use ecstacy don't take it every day.

I think such a claim isn't appropriate to make. It may be true or not, I don't know, but more statistics and information would have to be cited. There's more to the safety of a substance than just how many people die from using it, as that is attributable to so many other thing such as dosage, adulterants, pre-existing health issues, other issues such as water intake etc. etc.

I won't make any changes myself as I don't have information to cite either discounting or supporting such a claim, but I think, as simple common sense would dictate, the manner in which the statement is framed hardly constitutes a valid, factual claim.

Also, as I may add having just thought of it. PCP and DXM are listed as a hallucinogenic drug when they are not. They are classified as dissociative substances along with other such as Ketamine, Nitrous Oxide, Salvia and others.

On the whole I think this article is filled with factual errors.

You are absoulutely right about MDMA. As to DXM and PCP, they are indeed hallucinogens; They are not psychedelics, if that what you meant, they are dissociatives, but both are hallucinogens. Let The Sunshine In 17:06, 17 March 2007 (UTC)

who eats cyanide? and medical grade MDMA is probably safer than alcohol or tabacco, but street MDMA isnt medical gradeThe Right Honourable 09:15, 27 March 2007 (UTC)

[edit] NPOV

One thing this article is not. It needs fixing Crested Penguin 07:17, 21 March 2007 (UTC)

[edit] Rewrite

I'm going to rewrite a few things in this article. There is no need for a hallucinogen section, because hallucinogens can be discussed in the either the hard or soft drug section (most of them of course go in the soft drug section). I am also going to add a "Medium drug" section......since there are middle ground drugs. Zachorious 18:53, 22 March 2007 (UTC)

You realise it's all oringinal research and point of view, don't you? Let The Sunshine In 19:55, 22 March 2007 (UTC)

This is original research......none of the info I wrote is false. Do the research yourself ;-). Zachorious 10:46, 1 April 2007 (UTC)

Maybe it isn't (don't get me wrong, I'm all in favour of responsible drug use..), but it's still original research. There is no term in use such as "medium drugs". You can't rate by yourself the harmfulness of drugs based on fatality rates (although you could use the new study that was published in the Lancet). Put in the article whatever you can source, using NPOV language. Let The Sunshine In 14:43, 1 April 2007 (UTC)