Sunday, 13 April 2008

Would You Give Heroin to Addicts ... Why Not?

1/    Ask yourself why you think addicts should not just be given the drug they crave. 

2/   Ask yourself why do you feel this way.

Some of you will think "I'm not subsidising their habit" or "they should be trying to get clean". Some will just laugh it off as ridiculous while thinking that "junkies are scum" and just piss weak. Lock them up, that will clean the streets up. Where do these opinions come from? Why are some people so strongly opinionated against giving heroin to addicts? Why do some see it as perfect common sense? Those who want prescription heroin are either related to the issue or have spent the time to do some real research or have the facts. On the other hand, those opinions that reject the idea of prescription heroin are derived from common sources such as the MSM, religious groups or peer groups and family. Out of these sources, the MSM effects the largest group but are more open to change. Those who have formed their opinions because of religion or being part of a conservative community will most probably never change their minds. 

Anti heroin crusaders including the MSM often leave out facts or demonise heroin to a point where fear takes over rational debate. Heroin is a 100 year old medication that has had very little problems until it was declared evil by the US. There were very few heroin users before the 1920s and were mainly white, middle class doctors. Addicts were prescribed heroin or morphine and lived normal productive lives as there was almost no street level dealing, no crime and no violence. This changed when the US made all heroin illegal. New users have increased in the western world as the laws got tougher. The UK never had a problem until they stopped supplying most addicts with heroin in the 1960s and 1970s. Even if heroin was totally legalised, there is NO evidence that new users would increase or addiction levels would rise. In fact a survey in 6 publications showed that less than 1% would use heroin or cocaine if available legally. Funny enough, addiction levels in the US have never changed and has remained constant at 1.3% from the day this information was first recorded up until today. Heroin is still used medically in countries such as England, Belgium, Canada, Denmark, Iceland, Italy, the Netherlands, Norway  and Switzerland.   

For the average Joe, the idea of giving heroin to junkies must seem ludicrous at best. They know that junkies live in abandoned factories, have dark heavy set eyes and beg on the streets for money. They know how weak these junkies are and they made their own bed, so they have to sleep in it. If junkies were serious about getting clean they can do. Many have done it already so the junkies who continue to use drugs are doing it because they want to. No one is forcing the drugs into their bodies. Cracking down harder on the long term junky who can't even finish their detox, will send the message that the government is serious about being tough on drugs. When faced with court, give them the choice of rehab or jail. That will clean up the streets and allow those who made a mistake to redeem themselves. Simple really.

This is also the default government approach and it reflects in our drug policy. Here lies the problem. ... most experts and doctors in the field disagree with the current policies. You should really be asking yourself if  you trust your own opinion regardless of where you got it from or should you instead listen to doctors and scientists who have spent their lives studying addiction.

The case for prescription heroin has been highlighted constantly for over a decade and grows each year. If most of the experts agree that prescription heroin is working overseas why isn't it a priority in Australia instead of applying the same "tough on drugs" strategy that have been a complete failure for the last 40 years? Many countries now prescribe heroin after rigourous testing and research. 

These countries have completed a heroin trial or can prescribe legal heroin to addicts: England, Canada, The Netherlands, Spain, Switzerland and Germany.

The success of the heroin trials have been much documented by the medical industry with many other countries now looking into it as a solution to their own problems. The negative press is always biased and easily debunked with simple facts and figures. Similar criticisms from social conservatives are always without evidence and based on personal opinions only.

'The evidence is already in that such approaches are foolish, and have wider ramifications than are usually considered in "evidence based" trials - especially trials by researchers with a predisposition to distribute heroin rather than minimise its use.' 

-Andrew Bolt

The success of heroin trials is heavily documented and the approval of several major countries to make prescription heroin part of their drug policies, should be evidence enough for at least a trial in Australia. You will find so many cases for prescription heroin on the internet but rarely will you find a case against. Reports by experts, doctors, welfare groups, scientists, politicians, law enforcement officers, judges, senators etc. singing the success of prescription heroin can leave no doubt. For  years there has been constant brainwashing from governments, moralist and the media that total abstinence is the only path and if you disagree, you are "soft on drugs". Well now there is no excuse to fall for these fear tactics and it's time to be pragmatic. Get past the terminology and let facts speak for themselves.

At the same time, the addicts were receiving their daily fix, they were also enrolled in health, social and psychological services, Ms. Gurtner said. ''Heroin was the cookie to get them inside. Then we try to work with them in a comprehensive way.''

As a result, program officials said, crime decreased 90 percent among participants, who are mostly around 30. New H.I.V. and hepatitis infections dropped markedly, the number capable of working doubled, and individual heroin doses decreased. About 80 people -- including 5 in Thun -- chose to enter abstinence programs.

-New York Times

Heroin Myths & Misconceptions

Drugscope U.K.

Article

Instant addiction

That heroin is addictive is a fact. Heroin is not however, instantly or even nearly instantly addictive (neither is crack cocaine or any other substance). This idea is based upon a fundamental misunderstanding of addiction and the supposed power of the drug. Research consistently shows that becoming addicted to any drug takes time, usually at least 2-3 months (often much longer) where the user builds up to regular daily use. No drug has the power to instantly addict a user. This is a myth which often gets reinvented by the media (often due to authorities such as the police or politicians making such a statement) each time a `new' drug comes on the scene (witness 'crack', 'ice'). Usually the new drug is not a new drug at all.

Controlled heroin use

Heroin use in many cases leads to heroin addiction. However there are also many occasional or 'controlled' heroin (and other drug) users who are capable of using the drug with informal controls/constraints on their using behaviour e.g. using only at weekends, never on a working day, never alone, never with children around etc. In some cases such use can go on indefinitely with little physical harm accruing to the user. It is not uncommon for the drug use of such users to be unknown by those close to them.

Heroin is relatively non-toxic

Heroin itself is relatively non-toxic (it doesn't destroy skin tissue or other cells in the body as does alcohol and tobacco). Most of the health problems that stem from heroin use are life-style related or linked to the route of administration (injecting drug use for example - through sharing needles or improper use - often leads to various blood-borne diseases or viruses such as HIV or Hepatitis B/C and/or abscess or collapsed veins).

Heroin itself cannot give you spots, make you thin etc. as suggested by previous 'educational' campaigns. Those with the resources to buy their heroin without it impacting on money for food or personal welfare and who are careful about how they administer the drug, can live a generally healthy lifestyle.

Although overdose, (fatal and otherwise) can result from heroin use, it is rare that this is solely the result of heroin use alone.

Heroin is not cut with dangerous substances

Heroin is almost never purposely adulterated ('cut') with dangerous substances, despite popular belief that it is.

Addiction is not forever

Heroin addiction is not necessarily a 'life sentence'. Many heroin addicts 'mature out' of their addiction. The research literature reports extensive evidence of 'spontaneous remission' and 'maturing out' that demonstrates that even the most chronic of addicts may leave their addiction behind them when their circumstances change, (e.g. new partner/child/job/perspective on the world, fed up with lifestyle/being arrested/having no money/having no relationships with family/friends/children etc). This relates primarily to ideas around 'addiction pathways' and undermines simplistic ideas of addiction being primarily bio-chemical in nature.

References

Brecht, M.-L. & Anglin, M. D. (1993) Conditional factors of maturing out of narcotics addiction: Long term relationships. Proceedings of the Social Statistics Section, American Statistical Association. 209-214.

Edwards, G. and Lader, M. (eds.) (1991) The Nature of Drug Dependence, Oxford, Oxford University Press.

Pearson, G. (1987) The New Heroin Users, London, Blackwell.

Waldorf, D. & Biernacki, P. (1980) 'Natural recovery from heroin addiction: A review of the incidence literature', in, Norman E. Zinberg, M.D. and Wayne Harding, Ed.M. (eds.) Control Over Intoxicant Use:Pharmacological, Psychological and Social Considerations. Cambridge, Mass.

Waldorf, D., Reinarman, C., & Murphy, S. (1991). Cocaine changes: The experience of using and quitting. Philadelphia, Temple University Press.

Kaplan, J. (1985) The Hardest Drug: Heroin and Public Policy, Chicago, University of Chicago Press

Morgan, J. and Zimmer, L. 'The Social Pharmacology of Smokable Cocaine: Not All I'ts Cracked Up to be' in Reinarman, C. & Levine, H. (eds.) Crack in America, London, University of California Press

Newcombe, R. & Matthews, L. (1994) 'Crack in Liverpool: A Preliminary Study of a Group of Cocaine Smokers', in Coomber, R. (ed.), Drugs and Drug Use in Society: A Critical Reader, Dartford., Greenwich University Press.

WHO/UNICRI (1995). Cocaine Project. Geneva: World Health Organization

Harding, W. and Zinberg, N. E. (1977) 'The Effectiveness of the Subculture in Developing Rituals and Social Sanctions for Controlled Drug Use' in Brian M. DuToit, (ed). Drugs, Rituals and Altered States of Consciousness, A.A. Balkema, Rotterdam

Zinberg, N. (1994) Drug, Set, and Setting: The Basis for Controlled Intoxicant Use, New York, Yale University Press

Blackwell, J. S. (1982). Drifting, controlling and overcoming: opiate users who avoid becoming chronically dependent. Journal of Drug Issues, 13, 219-235

WHO/UNICRI (1995). Cocaine Project. Geneva: World Health Organization

8 comments:

phallacy said...

I'm curious as to why you are content/happy to be an addict. As an utter hedonist, I'm fully in favour of people getting off anyway they choose, though I'd prefer that speedfreaks & drunks do it elsewhere than my vicinity.
What I cannot understand is choosing such a boring drug as heroin.
Yes, I know the ole, "if God mnade anything better he kept it for himself" celebration but it's the 2nd & subsequent shots that flummox me. WHy do you want to be wrapped in cotton wool, why not smoke a joint and have a laugh or drop acid and watch the pretty world go by, and maybe discover the basis of your death-but-not-just-yet wish.
I remember the day the revocation of the British GPs' right to prescribe heroin (and meth & cocaine)became law. That night the first dealers sprouted in Dixon St in the 'Dilly like evil weeds.

Terry Wright said...

Thanks Phallacy.

Heroin is not my drug of choice at all. I find it boring as well and pray to Dawkins that I can be opiate free. I was never into sleepy drugs including grass. Drinking was my choice... and speed when I was younger. Acid and mushies were also fun and I did my fair share's worth. I have tried most drugs when I was younger but had started to settle down when I got mixed up with smack. I got into smack because I didn't give a fuck about my life anymore after my wife's death. I wanted to become a junkie and die.

Of course I was finally able to deal with the death but it was too late and I was addicted to heroin. I have constantly been on decreasing doses of methadone but when I got to a certain dose, I would use again. I have the full support of my family and my partner but I later discovered that depression can cause some seretonin deficient people to seek out opiates but don't know why. That is how my pharmacologist explained it to me anyway. He has told me that I will probably be on opiate treatment for the rest of my life. I would happily never touch heroin again if I could get off opiates all together.

BTW, I don't get high from heroin anymore ... just a feeling of being half normal again.

nathan harris said...

Have you tried going to a drug detox to get off the last of the methadone. a homeopathic doctor may be able to help you with the seretonin question. If you want to stop try looking into some nutritional aspects before you go to a detox. Be sure the detox has the seretonin and nutritional concepts in mind, a hospital detox is not going to be the best place. That being said ending methadone hasn't worked for many

JNBC said...

I think the time of use before becoming an addict is shorter than 2 months.
It is from my perspective the best drug available. Very euphoric. And it allows one to work while under effect. I am a user (smoker) since more than five years and it is another myth to say that the euphory wane off with time (it may happen but not in my case). It is still now as good as the first time. I just need a bit more ( say 5x ). My opinion is that heroin should be legal, but I think that a social taboo is a good thing to prevent the big crowds from abusing the drug. Also, I think that heroin should be controlled, in a way similar to gambling, that is, one should be able to restrict one's access to the substance as one could ask a casino to forbid oneself entrance.

Terry Wright said...

Thanks Nathan
I have tried everything.

I was only talking to someone(D&A worker) about this an hour ago and how he is seeing more and more of people like me. Some longer term addicts are now being told that they may very well be on opiate treatment forever. I have always worked on the assumption that my methadone would keeping reducing until zero and I would be free. After about 10 years, the thinking has changed 360º.

JNBC.
I'm glad you like your drugs :-)

The two months mentioned got me a bit as well. But I like to go on what the experts say because my opinion means jackshit really compared to facts. I suppose that's the whole point about the many myths on drugs.

I think the euphoria wears off when you're addicted and have to have it everyday. I can remember heroin being really great once ... a long time ago.

Thanks for dropping by.

albi said...

G'day Terry, nice to meet you, and thank for your interesting blog.

I currently support 2 people struggling with addiction (1 heroin and 1 speed) and have also supported other addicts in the past, though I mostly work in generally counselling.

I'm in total agreement with you that addictions should be treated within the medical/counselling model, and that heroin and other drugs should be decrimanalised.

The question I had for you relates to methadone. My current client has successfully avoided heroin for about 4 months, but finds that the biggest obstacle they face is the dealers and other addicts they come into contact with at the drug and alcohol clinic they receive their meth dose from. I've seen it myself - dealers literally waiting in the hospital carpark for potential clients.

What's you experience been?

albi said...

Sorry, I should have mentioned that I live in a smallish (40,000) pop rural qld town.

albi

Terry Wright said...

Thanks Albi
I have never come across dealers at the chemist waiting to sell gear. I could imagine that it happens at clinics though especially in rural cities. Yes, definitely keep your guy away from other users. Talk is a big trigger to go and score. It used to happen to me a lot. I used to get this advice all the time to remove myself from the drug scene and other users ... it is good advice. The closer I am to the dealers the easier it is to make that snap decision to score. A tip is to get away as much as possible. Weekends away, stay with friends on the other side of town etc.

I hope that helps.
Drop by again.