Friday, 20 February 2009

Heroin Assisted Treatment Winning Approval in Europe

As heroin assisted treatment (HAT) continues to grow in Europe, the issue is starting to be raised again in Australia. Will Kevin Rudd adhere to his statement that Australia needs new ideas and fresh thinking when it comes to drugs and will his response will be evidence based? Or will he follow the worn out and tired, old rhetoric of John Howard and argue it sends the wrong message?

Australia needs new ideas and fresh thinking when it comes to dealing with critical and continuing problems such as drugs and crime.  But our response must be tough, targeted and evidence-based -Kevin Rudd. Then Federal Opposition Leader
When the ACT heroin trials were sunk by Howard about 11 years ago, he had the US pressuring him in their manic drive for Zero Tolerance drug strategies and also very strong personal views echoed by the then influential religious right and MSM. Are these overwhelming factors for Rudd or will he take the advice of experts and prioritise the well being of addicts and the benefits to society? We can only hope that the Rudd government will base these important health decisions on the continuing success overseas and pragmatic, evidence based results.

Dose Of Reality Fuels New Initiatives To Help Addicts
By Gwladys Fouché
The Guardian
February 2009

State-funded heroin is becoming a reality in Denmark, the latest in a small, but growing, number of European countries – including the UK – concerned with improving drug users' quality of life and reducing criminality.

Since 1 January, hundreds of drug addicts in the Nordic country have the right to receive two free doses of heroin a day, paid for by their health system. The offer is only for adult, long-term users for whom substitutes such as methadone and subutex have not worked.

"The aim is to improve their state of health, help them avoid committing crimes and stabilise their lives," explains Dr Anne Mette Doms at the Danish Board of Health, which supervises the project.

"Quitting altogether is not a realistic option for most of these patients. For them, this will be a chronic treatment, as if you were treating a chronic disease."

Addicts will need to attend one of five specialist drug clinics across the country, where they will inject diamorphine – pharmaceutical-grade heroin – under doctors' supervision. The drug will not be available on prescription so as to avoid resale on the street.

Danish authorities are in the process of setting up the clinics, registering the doctors who will work there, and finding out which drug companies they will source the heroin from.

The £7.2m project is expected to be up and running by March. The initiative was adopted by overwhelming consensus in February 2008, after all but one of the parties represented at the Danish parliament voted in favour of the policy – the only one against it was a tiny far-left party that did not oppose the project per se, but the way it was funded.

Among those in favour was the far-right Danish People's Party, a movement not usually known for its progressive views: at the last general election in 2007, it described some Danish Muslims as benefit-scroungers and fifth columnists who threatened Danish democracy.

Some might think this initiative is not surprising in a country with a historical tradition of progressive, social democratic policies. But, just as in the UK, the drug debate has been bruising in Denmark. And unlike in Britain, where heroin is available on the NHS for some cancer patients, heroin as a palliative is completely forbidden in the Nordic country.

"Five years ago I decided I would not participate in yet another debate on drugs," recalls Preben Brandt, the chairman of the Council for Socially Marginalised People and an advocate of the policy.

"It was too emotional, with different groups being very aggressive."

"The counter-argument was always 'you kill people by giving heroin' or 'with this initiative, you are telling people that taking heroin is OK'," he says.

"It is very difficult to have a rational debate when you are arguing against beliefs."

The turning point came when results became available from experiments trialling the policy in other European countries, including Switzerland and the Netherlands.

"The politicians became convinced that it could help those with the most severe drug problems," says Mads Uffe Pedersen, the head of the Centre for Alcohol and Drug Research at the University of Aarhus.

"You could not argue against the (positive) findings."

"The debate became more practical," agrees Brandt.

"It was about what policies worked and which ones did not. It was no longer about morality."

Attitudes towards drugs addicts improved too.

"Drug addicts in Denmark are less stigmatised," says Brandt.

"They are no longer perceived as criminals who are a danger to society. They're seen as patients who have a disease they need help with. The new scapegoats in Denmark are the foreigners."

Could a similar initiative be possible in the UK? It's actually happening already, with three schemes taking place in Brighton, Darlington and south London, where long-term heroin users can inject drugs under medical supervision at specialised clinics.

Early results indicate that the scheme has cut crimes and stopped street sales. Crimes committed by the addicts involved in the scheme dropped from about 40 to six a month after six months of treatment, Professor John Strang, the head of the National Addiction Centre at the Maudsley hospital, told the Independent newspaper.

A third of addicts stopped using street heroin and the number of occasions when the rest used it dropped from every day to four or five times a month, on average. It remains to be seen whether UK politicians will expand the policy nationwide, especially if they fear a possible backlash from voters. But if British voters are similar to their European cousins, this would not be an issue. Last November, Swiss voters approved the scheme overwhelmingly, with 68% supporting the plan. And there has been no popular backlash in Denmark, following the adoption of the policy by parliament.


Gledwood said...

I used to know someone who WAS on an old heroin script. I would not have believed this had I not viewed the dry amps on several occasions. His were 30mg "IV/IM/SC" though you can get 100mg ones. From what I could work out, 30mg is probably less than £5 worth of street gear here. 100mg about £12 worth.
There ARE schemes in operation and they DO give it at my local drugs service.
An Aussie nurse admi

Gledwood said...

~sorry I got cut off by my dealer ringing there! I was saying:
An Aussie nurse admitted they DO give injectable diamorphine to one patient but only because this person is in physical pain from another condition and has had longstanding heroin addiction for over 30 years. So there is "hope", I just don't know whether "hope" is for me...

Hey you must find since switching to morphine pills you feel a far better "hold"... isn't it more like being on heroin between hits?

Methadone just feels "different"~ to me like comparing Pritt Stick to superglue. Yeah it holds you, just nowhere near as nicely...

Terry Wright said...

Thanks G.

I suppose I am sort of in the same position. I am given morphine for pain and being an addict, the morphine is best suited for me. There is also the depression brought on by methadone that figures into it.

Slow Release Oral Morphine (SROM) is definitely a better "hold" than methadone (for me anyway). It's like that feeling a few hours after a hit of heroin where everything is just normal. No high but a feeling of relative calmness. The advantage is that it lasts all day and most of the night unlike heroin. There is still an initial high for an hour or two but that disappears quickly like methadone.

Maybe it's my strange reaction to opiates but heroin is a much better high than morphine or methadone. There's no comparison for me. Prescription drugs like morphine, OCs etc. are becoming very popular because of the known quality and dosage but they still lack the high of heroin. Incidentally, even though I am on a massive amount of morphine, I still get headaches and need to take a couple of painkillers with codeine in them. Work that one out.

sayv said...

hy.... visit night..... happy weekend...

Terry Wright said...

Selamat pagi Sayv.