Sunday, 18 April 2010

Giving Free Drugs to Addicts

What is more important? Stopping; violent crime, theft, robberies, drug overdoses, thousands being murdered in drug wars, the spread of HIV and HCV etc. or trying to stop drug addicts getting high? History has revealed 2 things - you can’t have both and trying to stop society from using drugs simply does not work. So, which would you choose? ... stopping associated crime and violence or stopping users getting high?

I’m sure most rational people would prefer to cut out nasty social ills like robberies, HIV, HCV, violence and murder but I am just as sure that some muffins would be so anti-drug that they would refuse to answer or try to change the question. 

Most informed people already know that prohibition causes crime and violence whilst not having much success at lowering drug use but how about the public? Do they know this or do they simply find it difficult to acknowledge due to decades of misinformation from the authorities? Is legalisation or handing out free drugs to addicts just too radical for the everyday citizen even if it cut crime rates by half and changes society dramatically for the better? According to a recent survey by McNair Ingenuity Research, 66% of Australians think people would be more likely to try or use drugs if legalised but only 5% confess that they would indulge. 

One of the survey’s most interesting results concerned what people thought would happen if illegal drugs were decriminalized. Although only 3% of people said they would personally use drugs more often, 62% said they thought other people would. The results were similar when we asked whether you’d be more likely to try drugs at all (only 5% said they would, but 66% thought others would).

It seems we define the people who can’t be trusted with drugs as everyone but ourselves.

-Kirsten Drysdale - Hungry Beast. ABC TV

Giving drugs to drug addicts is not new. Most western countries supply highly addictive opioids like methadone, buprenorphine and suboxone to heroin addicts. Other countries give out Slow Release Oral Morphine (SROM) and even free heroin. These programs are heavily regulated and restricted to opiate abuse like heroin because opioids are basically non toxic. The most success has come from supplying heroin to long term addicts who have failed repeatedly in other treatment programs. The success or prescription heroin has prompted a growing trend for drug experts to push this strategy. 

The main problem is that many addicts don’t qualify for the program because of the strict guidelines and heroin is the only targeted drug (a limited number of cocaine addicts were also given their drug of choice in the latest UK scientific trial). What about those who missed out on the trials or those who are just not “hard core” enough to make it to a permanent program? What about users of cocaine, methamphetamines and prescription medications? Once again it seems that politics and ideology are robbing addicts of valuable treatment options. 

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. 
-Comment by Terry McKinney. Vancouver BC (28/05/2008) - The Australian Heroin Diaries

How imbecilic can we be when we know that most established addicts will use street drugs everyday but the idea of government supplying safe and free drugs is simply out of the question. Up will come that old argument that dishing out illicit drugs is dangerous to their health and we should be trying to get people off drugs, not encouraging them. These reasons might be fine in prohibition utopia where drugs can be eliminated but not in the harsh realms of reality. And that’s the problem. The people who make these important decisions aspire to a “Drug-Free World” which has more chance of being a Disneyland theme park than materialising on planet earth.

I was in Canberra when the trial was set to happen. Now a decade later, failed relationships, failed uni attempt, lost employment and still raging habit, i often wonder where i'd be now if it had've gone ahead. damn howard! i wrote to chief minister stanhope last year at 3am, hanging out, begging for him to think about another try. 6 wks later he replied (shock horror) and said he was 100% behind it, but couldnt do anything til howard was gone. well hes gone.......Methinks its time i start emailing again :) 
-Comment by plzHoldSteady (22/01/2008) - The Australian Heroin Diaries

I always wonder how many lives we could have saved and how many addicts would now be clean if the proposed ACT heroin trials weren’t poo-pooed by Howard. Given the success from every heroin trial overseas, it must be quite a few. Imagine how many lives we could save or change for the better if skipped the strict criteria for candidates of prescription heroin. What if we simply opened it up to anyone who has been on methadone for more than a year or had attended a rehabilitation program and failed? And what if we supplied all dangerous drugs like ice, cocaine, heroin etc. and even ecstasy and other drugs that can be contaminated with filler products? What is the real downfall of this idea compared to the benefits? The same groups would continue to use the same drugs and those who don’t use drugs would continue to abstain. The sky would not fall in and societal chaos would not engulf mankind. Some dedicated users might increase their intake but many more will take advantage of extra treatment options and quit using drugs. 

I don’t think the public has correctly been told what would happen to their surroundings if illicit drugs were distributed by the government or legalised. The most obvious effect is that crime would drop by about half and several billion dollars would be saved every year. This are not just a slight decrease in costs or small improvements but massive, unparalleled changes to crime rates and government spending. Whole police departments used to fighting drug crimes would be relocated to other, understaffed divisions ... including more cops on the street. The back log in courts would eliminated. Huge percentage drops in overdoses and deaths. Organised crime losing their most profitable source of illegal income. Prison populations dropping so much that not only won’t new jails be required in the near future but some actually might shut down. Dangerous meth labs would almost cease to exist. You would be able to buy flu tablets with pseudoephedrine again without having to produce your passport, a personal reference from an astronaut or leaving your first born as collateral. Convenience store workers, pharmacy staff and train travellers  won’t have to worry about desperate junkies robbing them anymore as they will cease to exist. The CourierMail, Adelaide Advertiser, Daily Telegraph etc. will have to expand their subject matter or lose 8-10 pages. The quality of drug education will improve ten fold. Young adults will no longer be so susceptible to a permanent criminal record. Teen drug use will drop as the mystique of drugs will be gone as well as unscrupulous drug dealers who don’t ask for age ID. The problem of alcohol will be addressed more rigourously and classed as a dangerous drug. And so on...

Ironically, easier access to drugs will improve life for users and addicts. Their health will greatly improve and many of them will be able to work once again. They will be able to re-establish relationships with their families and no longer run the risk of being imprisoned. Many of the health issues for drug addicts are the result of prohibition, especially for heroin users. Opiates including heroin are basically non toxic and can taken for decades with very few physical problems. Haven’t you ever wondered why street junkies on heroin look sick but those on pain medication look normal? They are both taking the same sort of drug but the most visible heroin addicts in society often don’t eat very healthily, sleep where ever they can, have very few clean clothes and are more focussed on dodging the police and paying for their next hit. Take away the high cost and the stigma attached to drug addiction and they get to live much more productive lives. In the countries where heroin is prescribed to addicts, there has been substantial improvements in their health and personal lives. Most of them cease any criminal activities and many find work. 

The big question is - why are other countries looking into evidence based strategies like heroin assisted treatment and related programs while Australia keeps regurgitating tired, old drug policies that fail every year?

New Approach To Drugs Seeks Footing In Costa Rica
April 2010

The drug debate in Latin America has started to shift.

For decades, possession and addiction in the Americas have been treated with a zero tolerance policy. Efforts to slow drug use have largely centered on arresting and punishing users.

But packed jails, overburdened court systems, and a growing consensus that the war on drugs is failing are transforming the discussion.

In August, 2009, Argentina's Supreme Court ruled that it was unconstitutional to prosecute people for possession of drugs for personal use. One month later, Colombia's high court issued a similar ruling.

In Peru and Bolivia, there are now small clinics that give cocoa leaves to crack addicts in order to manage and lessen their addiction. Bolivia's President, Evo Morales, has asked the United Nations to eliminate the narcotics label on the coca plant.

Now, in Costa Rica, high-ranking officials are joining the tolerance dialogue.

In March, Costa Rica's Chief Prosecutor, Francisco Dall'Anese, proposed offering free drugs to addicts as a way to compete with dealers. Squeezing in between the addict and the supplier to offer a cheap alternative would “break” the finances of drug pushers and “reduce demand,” he told the Spanish–language daily La NaciĆ³n.

“Here, what we would do is preempt the business of drug dealing,” he said.

The reasoning behind the proposal is fairly simple. By stopping the flow of income to drug dealers and eradicating the addict's need to steal in order to buy another fix, crime rates should drop.

This idea is not revolutionary. Countries in North America and Europe have used harm reduction techniques such as methadone clinics for years to treat heroin addiction.

These efforts have been regarded as successful in reducing crime and curving addiction by medical journals.

Dall'Anese's proposal, though, does represent a fundamental shift in Costa Rican drug policy, as providing addicts with free, chemical substitutes would take the drug addiction problem out of the hands of law enforcement and place it at the doorstep of public health officials.

Related Articles


Ibogaine Detox said...

I'm all for harm reduction and I hope the government continues this mode of addiction treatment but, I think Australia might want to look into Ibogaine as a treatment methode for addicts like NZ is. It's not a very well knowen methode of detox but it works like nothing else I've seen.

Terry Wright said...

Thanks for your comment.

You hear a lot about Ibogaine for addiction but the chances of Australia ever considering it, are remote.

Gledwood said...

I think if I had been offered "drugs of the world" on a silver plate many years ago and then been left on my own to try them, I know which ones I would have gone for: heroin, LSD and cocaine in that order. I was fascinated to know what illicit drugs felt like. (Fascinated and repelled though ~ it took a very long time for me to get into heroin because I knew people who were addicted to it (these people were my way in) and saw how they lived and their lives were not pretty

Alex Tsesis said...

It's an approach that we probably won't ever be fully comfortable with here in the United States. Some folks at a group of suggested a test in the area several years ago and it never got past the local government. Still, there may be some merit to it yet...especially if we keep imprisoning our addicts.

Terry Wright said...

Thanks Gleds.
Of course, some of us were destined to use drugs but the population as a whole would not allow them to destroy their lives. Lucky us.

Thanks Alex.
Your clinic has what all clinics should offer ... options. I think this is the key to successful treatment.

Heroin Assisted Treatment (HAT) has proven very successful so far but is still only one of many options in the countries that provide it. Sadly, the US has spread so much misinformation and fear that perfectly viable programs like HAT are deemed too radical.

I'm sure if your local government was made up of doctors and didn't have to worry about being re-elected, then there may have been a different outcome.

Keep up the good work!