I've seen quite a few addicts who were downing 40 pills a day of percocet or vicodin, with no ill effects.
That right there tells me something is wrong. I'm a chronic pain patient, fortunate enough to be in Canada where all of our pain killing opiates are available without paracetamol (though you can still get say, Tylenol with codeine, but codeine is also available seperately). Mixing the paracetamol does have some theraputic value but not a heck of a lot. Certainly not enough to justify potentially destroying the livers of pain patients because their pain is not controlled by the maximum dose of compounded drugs available to them and thus forced to take more than the upper limit of APAP. Anecdotal evidence, sure, but in my own experience (taking morphine for shoulder pain) adding an extra strength tylenol to the mix whenever I take morphine doesn't help enough to be noticeable. It's not enough that I can reduce the dose of morphine I need, and so compounded drugs would not be useful in their intended purpose (at least for me, once again this is definitely not scientific).
It doesn't really dissuade drug users either. Sure, they are worth less on the street--but it is very easy to extract the APAP from them (see cold water extraction) and any addict that knows about this will do it (a friend of mine lived next to some casual opiate users in residence and they called upon him to do the cold water extraction). However, the majority of people who abuse these drugs aren't necessarily aware of the damage it will do to their liver. A lot of them are teens! It's absolutely wrong that this compounding is harming kids who don't know any better (about the APAP). Don't go taking this as "think of the children" though. But it's undeniable that a higher percentage of teens are using/abusing opiate painkillers without a prescription than before, probably on the grounds that "oh, because it's prescription its probably safer [than street drugs]" It's unfortunate that they don't know/care/understand the effects the APAP mixed in with the opiates they're using. Hell, even the media is contributing to this: look at House. Everyone who knows anything about Vicodin and what's inferred about House's use of it would know that he (a) would have switched to a lower APAP formulation, or a non-compounded drug (b) the level of APAP he's taking in would have completely destroyed his liver. And yet this is not talked about, probably because of widespread misconceptions about these compounded drugs
I really think that its unfortunate that the legitimate users of these opiate pain relieves are the ones that are probably at highest risk for liver problems, especially chronic pain patients who will take opiates for years on end. It's also unfortunate that although opiates and APAP have a synergistic effect, this is not really the reason for combining them [at least in the eyes of some] and it leads to more harm to those that abuse them than addiction and physical dependence would alone. Stop punishing the drug abusers. They need help, not to be punished by society because they "deserve" it.
And by the way, codeine sucks and is addictive. If you want to have something against dry cough, take pentoxyverine or theobromine.
Codeine can be "addictive", but one of the reasons its easily available is because it is far less so than stronger opiate painkillers. In the parent post, they were talking about using codeine for pain, not cough. While codeine is not nearly as potent as morphine or hydrocodone for pain relief, it is still effective in most people because some of it is metabolized into morphine by the liver. This doesn't happen in about 10% of people because they lack the necessary enzyme for this metabolism, but in the rest of the population it is quite effective. In regards to coughs, codeine is actually a very effective cough suppressant--not as potent as hydromorphone, brand name Dilaudid (most effective opiate for coughs) though still good enough for most coughs given that it is much easier to get (hydromorphone is Schedule II, codeine cough products are Schedule III [iirc, I'm Canadian so I only know our drug schedules really well] ).
By contrast, nuclear doesn't add any heat that isn't already in the system
I don't think you understand nuclear power very well. The whole *point* of energy generation is to add heat. If nuclear power didn't heat shit up it wouldn't be very damn useful. Nuclear energy turns the binding energy of the nucleus into heat--the energy was there, but it certainly wasn't in the form of heat. The total amount of energy on earth hasn't changed because of nuclear power plants--but the amount of heat has. If you hadn't fissioned that Uranium, you would not have the same amount of heat energy on earth. All of this nonsense about adding heat that wasn't already in the system shows a complete lack of understanding of what's going on. Almost all energy generation technology adds heat to earth that wasn't there before. That's the whole bloody point. The energy is not useful locked up in chemical or nuclear bonds/binding. But as heat we can turn it into electricity. Adding heat to the system isn't going to cause problems: the earth radiates away almost all of the heat we produce into space. That's why greenhouse gases are such a problem. Not because we're creating heat by burning carbon, but because that carbon traps heat in the atmosphere. But this technology doesn't need to burn carbon, so the earth can continue to radiate away all the waste heat. All this does is exploit the fact that in orbit you can get a lot better efficiency of solar panels, and beam it to earth using microwaves. Microwave rectennas are *a lot* more efficient than solar cells on earth.
In every non-trivial program there is at least one bug.