Regarding the potential to become addicted to an opiate itself, I would point out, first, that an opiate is a derivative of opium. It's the poppy seed originally and then it was obviously chemically produced, and they have different derivatives, the most famous probably being morphine. They're very efficacious and I hope that this committee doesn't look at opiates themselves as bad because, unfortunately, they're fantastic for pain management and in my own practice I'm an advocate of responsible opiate use, whether it be fentanyl or all of them.
The opiates themselves activate or attach to the opiate receptors, so really whether it be heroine, OxyContin, hydromorphone, or morphine, they all attach to the same receptor.
Certain chemicals have a higher affinity for the receptor than others, and certainly have a little more potential for some of the nasty effects of them, which is what we hear about, the overdoses, and the respiratory suppression, and the bradycardia, and the different things that make me nervous when dispensing them. But certainly from our standpoint, they are essentially opiates and so they all have the same class effects to different extents, and if diverted at the highest dose they certainly are dangerous, equally.