What Does Prescription Heroin Really Mean for Junkies?

Switzerland has just become the first country to include prescription heroin as part of official government policy after a referendum voted 2 to 1 in favour of it. Although the 1300 patients who already receive prescription heroin in Switzerland are breathing a sigh of relief, what does it mean to addicts worldwide? Will other countries follow suit and if so, what will be the criteria to be accepted into the program? 


Also heroin trials to date have focussed on one or maybe two cities in each country so that leaves the vast majority of addicts not able to participate until the trial is either extended to cover other locations or it becomes government policy like Switzerland.

Swiss Approve Prescription Heroin BBC 

 

(mmmmm . . . look at all that heroin!)

Swiss voters have backed a change in health policy that would provide prescription heroin to addicts. 

Final results from the national referendum showed 68% of voters supported the plan. The scheme, where addicts inject the drug under medical supervision at a clinic, began in Zurich 14 years ago before spreading across the country. But in another referendum, the Swiss appear to have rejected the decriminalisation of cannabis. 

The heroin vote was one of a series of referendums held to decide policy on illegal drugs. The policy is described as one of last resort - prescribing addicts with the very drug that caused their problems in the first place - but supporters say it works, and Swiss voters appear to have agreed, the BBC's Imogen Foulkes in Berne says. Switzerland would be the first country to include it in government policy. 

Supporters say it has had positive results - getting long-term addicts out of Switzerland's once notorious "needle parks" and reducing drug-related crime. 

Opponents say heroin prescription sends the wrong message to young people and harms the addicts themselves.

Firstly though, congratulations to the Swiss for leading the world in common sense and pragmatic health policies. The world owes a lot to the Swiss (and the Dutch) for having the courage to care more for their people than pleasing the United States or hysterical religious groups. 


Secondly, we shouldn’t forget that this is the second attempt at trying something new. The first project, dubbed Needle Park was a failed experiment but it was still recognition that treating addiction with strict law enforcement wasn’t working. 


There have been several heroin trials now and all with very positive results. Even though they have all been successful, only 2 trials have developed into more permanent programs. One in Switzerland and the other in The Netherlands. Spain, Germany, Belgium and recently Canada have all held heroin trials with the UK’s trial finishing shortly. Also Denmark has announced they will be commencing a 2 year trial with a few other countries toying with the idea. 


Whilst many heroin addicts must be relieved to hear the good news of an ever expanding prescription heroin trend, the reality is not as rosy as it seems. Geographically, it is impossible to include everyone in a trial which is not the objective anyway. Most trials last about 2-3 years and for a program to be approved and operated in other cities, it may be 4 or more years away. Then you have to qualify them. At the moment, trials are for hard core, long term addicts who have failed other treatments and continue to participate in risky behaviour. I think the general consensus is that only the homeless or really desperate addicts will get in on the trials but established heroin assisted treatment (HAT) programs encompass other long term users more readily. But what about those functioning heroin addicts with jobs who appear to live a relatively stable life? Are they eligible? 


This site has shown many functioning addicts who remain outside the law by using and/or selling an illegal substance and are kept in a world of shame by hiding profound issues from their families. The binding thread is that they have all failed repeated attempts at treatment. Will they ever be included in a program for prescription heroin or are they not considered ‘desperate’ enough. A cynic could argue that these addicts might be excluded because they won’t contribute to the success statistics of such a program when there’s no room for improving key issues like homelessness, employment and health. A slap in the face really for those addicts who have been strong enough to stay employed or healthy whilst living with the nightmare of addiction.

As an addict in Vancouver for 38 years I was certain I would have no problem attending the program. It seems they only took Downtown addicts which gave them a very limited demographic and my calls went from wait to forget it. You could contact the NAOMI people if you want info but you'll be searching through an unpublished project.I hope you discuss parameters as most trials make getting off of heroin a prerequisite, which kills the project as you may well imagine. Harm reduction and working and happy clients should be the goal.Don't let them set you up to fail. [...] In my case I offered to move to the moon if transport was available. They seemed to have some issue with my actually having a roof over my head. They seemed to think that if you had it together enough to actually pay rent you didn't need a maintenance program. 
-Terry McKinney. Vancouver BC

I imagine some addicts would consider changing their lives dramatically if prescription heroin was available but not where they live. The opportunity to receive clinical grade heroin as part of their treatment is a huge temptation which I can testify to. Although prescription heroin may have been perfect for myself a few years ago, I am happy on my current treatment. The idea of injecting daily again or having to visit a clinic twice a day doesn’t appeal to me currently and it’s bound to be the same for other recovering addicts on substitution treatment. That’s if we were eligible at all.

HAT will expand over the next decade as it’s success becomes more accepted by governments frustrated over current drug policies and so will the requirements for entry into the programs.

Heroin is basically non toxic and users are able to lead relatively normal lives if they don’t have to deal with the consequences of it’s illegality. Most of the problems associated with heroin addiction are purely because of man made laws and not the drug itself. Issues like the spread of blood borne disease (Hep C, HIV/AIDS etc.), crime, health, employment and social exclusion are recent problems caused solely by treating this medical condition as a law and order issue.

Before the 1960s, some countries already treated opiate addiction with either morphine or heroin and there were very few problems. Back then, a great proportion of addicts eventually weaned themselves off opiates and went back to their normal lives, often over a 5-7 year period which is sometimes called the natural addiction cycle. It’s ironic that in this age of advanced technology and medicine, we are starting to revert to treatments from over 50 years ago.

On a sad note, there are many who criticise HAT for all sorts of reasons except those that count. There’s the “sending the wrong message” argument and the “we should be getting them off drugs” excuse. These are all just philosophical opinions that have no bearing in the real world and are just placing the morals of drug use above the health and well being of someone with a medical issue. Associated Press reported that one opponent of the Swiss decision, Sabine Geissbuhler from Parents against Drugs was so adamantly opposed to the program that she publicly stated:

I would never, never, put my children into a heroin prescription programme. What kind of freedom is that? I'd rather they were dead -Sabine Geissbuhler - Parents against Drugs

Releated Links: 
Swiss vote on radical heroin rules 
Swiss likely to approve prescription heroin