Just a Box in the Street… But it Tells an Important Story

It was just a grubby, flattened box that had obviously been driven over a hundred times as it lay in the street. But it brought home to me that the neighborhood I was walking through is frequented by many heroin addicts. What had it contained? At one time, it sat on a pharmacy shelf offering a remedy for constipation. Anyone could have dropped it and they could have been constipated for many different reasons. But in this neighborhood—opioid addiction came to mind.

A box for a constipation remedy could be a sign that there are heroin users around.
The box that caught my eye and got me thinking.


  • Just a half a block away, there’s a house where an addiction support group has meetings from 9 a.m. to 9 p.m. I used to see an old friend, addicted to heroin for decades but now sober, lounging on the porch with other members. 
  • I often see people who look like they might be homeless sitting at nearby bus stops or headed for the free meal served next to the police station a few blocks away. 
  • Two blocks in the other direction, there’s a doctor who doles out buprenorphine to his addicted patients. 

Of course, since buprenorphine is an opioid, constipation is a common side effect.

This point came to broad public awareness during the 2016 SuperBowl when AstraZeneca ran an ad for constipation remedies, referring viewers to a website to learn more about “opioid induced constipation.” Naturally, AstraZeneca manufactures a constipation remedy named Movantik specifically designed for a person taking opioids.

Other Over-the-Counter Remedies Drug Users Might Need

There are other painful or uncomfortable symptoms caused by drugs that many people either take as directed or misuse. For whichever reason they’re used, the increasing number of people suffering these side effects has created a booming business for the remedies.

A man who has been misusing benzodiazepines or opiates has dry eyes.

Dry Eyes

Those addicted to opioids often add benzodiazepines like Xanax, Valium, Klonopin and many others to their polydrug mix. These drugs and others cause dry eyes. There’s a vast array of choices of over-the-counter lubricating drops or prescription drops that increase tear production. WebMD lists more than 140 of these products.

Dry Mouth

More than 400 drugs cause dry mouth including pain medications, marijuana and cannabis extracts, muscle relaxants and the kind of stimulants often sought by college students. Anti-anxiety drugs Valium, Ativan and Xanax and muscle relaxant Soma are also commonly abused (again, often mixed with opioids) and cause dry mouth. To remedy this problem, one company makes discs that melt slowly in the mouth, keeping it moisturized. Other companies make moisturizing mouthwashes.

Of course, there are illnesses and health conditions that cause dry eyes, constipation or dry mouth that have nothing to do with illicit drug use or prescription drug misuse. These side effects also result from medications taken exactly as directed.

But one has to guess that misuse of and addiction to anxiety medications, painkillers, cannabis products and other drugs over the last decade has helped boom the market for these remedies. It’s a sad aspect of the pharmaceutical industry that it has another way to profit from the addiction of millions of Americans.


Karen Hadley

For more than a decade, Karen has been researching and writing about drug trafficking, drug abuse, addiction and recovery. She has also studied and written about policy issues related to drug treatment.