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Author: Shernide Delva
Canada has taken a controversial approach to fighting heroin addiction. The Canadian government has just quietly approved a new drug regulation that will permit doctors to prescribe pharmaceutical-grade heroin to severe addicts. Essentially, Canada’s strategy for treating addicts resistant to other forms of treatment is simple: let them have heroin.
While this is a first for Canada, other countries have similar programs. The approved regulation ensures that Canada’s trail-blazing clinic, Crosstown, in Vancouver, will be able to expand their special heroin-maintenance programs. These programs allow addicts to come and go as many as three times a day to receive prescription heroin from a nurse for free.
Back in May 2016, Canada was in the beginning stages of legalizing prescription heroin. Health Canada explained in a news release:
“A significant body of scientific evidence supports the medical use of diacetylmorphine, also known as pharmaceutical-grade heroin, for the treatment of chronic relapsing opioid dependence,”
Health Canada continued stating they were considering the idea of legalizing prescription heroin since several other countries have used it and found it effective.
“Diacetylmorphine is permitted in a number of other jurisdictions, such as Germany, the Netherlands, Denmark, and Switzerland, to support a small percentage of patients who have not responded to other treatment options, such as methadone and buprenorphine.”
Lowering the Cost of Addiction?
Furthermore, Dr. Scott Macdonald, a physician with Crosstown Clinic, explained that heroin maintenance programs are much cheaper for taxpayers than paying for the cost of drug addiction. A person battling drug addiction can cost the tax base $45,000 Canadian Dollars (around $35,000 in U.S. dollars) per year in crime costs, health care costs and more. On the other hand, prescription heroin in a Vancouver clinic costs around $27,000 or $21,000 in American Dollars.
The government ensures that this type of treatment is for a small minority of users “in cases where traditional options have been tried and proven ineffective.” The purpose is to give health-care providers access to a wide variety of life-saving treatments options.
In 2005, Crosstown Clinic conducted their first clinical trial of prescription heroin and has operated ever since. The clinic provided diacetylmorphine to 52 addicts under a special court-ordered exemption. They expect that number to double over the next year if supplies can be obtained.
The Case for Prescription Heroin
A regulation like this will raise controversy. However, studies in the past argue the benefits of using prescription heroin over harm-reduction treatments such as methadone. The studies found that patients stayed in treatment longer and relapsed less in comparison to those who received methadone.
Furthermore, researchers found that those receiving diacetylmorphine had a longer life expectancy compared to those receiving methadone. When it breaks down to costs, prescription heroin costs society less.
Researchers also found that those receiving diacetylmorphine had a longer life expectancy than who received methadone. Crime costs reductions occur with both options. When it breaks down to costs, methadone therapy costs society $1.14 million, compared with $1.09 million for prescription heroin.
“The question I get most about heroin-assisted therapy is whether we can afford the increased direct costs of the treatment,” co-author Dr. Martin Schechter of the University of British Columbia said in a news release. “What this study shows is that the more appropriate question is whether we can afford not to.”
A Two-Sided Argument
Still, many remain solidly against the option. Collin Carrie, a Conservative member of Parliament, stated that his party adamantly opposes the use of prescription heroin.
“Our policy is to take heroin out of the hands of addicts and not put it in their arms,” he stated.
However, Scott Macdonald reiterated that the patients considered for these treatments are long term users. Typically, they have been on heroin for decades and have tried treatments like methadone with repeated failed attempts.
“Our goal is to get people into care,” he said.
When it comes to addiction, the entire world is seeing an outstanding amount of deaths related to drug overdoses. Treatment options like these are controversial, but unfortunately, they need to be a topic of discussion. Still, the best option remains learning to live a clean, sober life in recovery. Do not let your addiction go on for too long. There is time and hope for you. Do not wait. Call today.
CALL NOW 1-800-951-6135
Author: Shernide Delva
In an effort to curb what many consider to be the worst public health drug crisis in decades, the CDC has issued a series of guidelines and restrictions intended to reduce the abuse of prescription painkillers. On Tuesday, the federal government released these CDC standards, ending months and months of disagreements with pain doctors, and drug industry groups. However, many are still asking the same vital question: will these guidelines even work?
The CDC guidelines will be the first national standard for prescription painkillers. The guidelines are intended to provide a more sensible approach to prescribing highly addictive medicines. In the past, drugs like OxyContin and Vicodin were easily prescribed to patients. Although efforts have been made to reduce the amount of prescriptions prescribed in the medical community, these guidelines will further limit how opioid medications are distributed.
“This is the first time the federal government is communicating clearly to the medical community that the risks outweigh the potential benefits of these drugs,” said Dr. Andrew Kolodny, head of Physicians for Responsible Opioid Prescribing, which supports the guidelines. “It’s one of the most significant interventions by the federal government.”
These guidelines recommend what many addiction experts have long called for which is pushing doctors to recommend other pain management options. The CDC guidelines also limit the amount of prescriptions a doctor can prescribed at one time.While these new guidelines are non-binding, they are likely to have a huge influence in the medical community.
New CDC Painkiller Prescription Guidelines
Just to give a brief overview, here are some of the main specific guidelines that will be implemented in the next coming months.
- Doctors should first try ibuprofen and aspirin to treat pain prior to prescribing more high-risk drugs such as opioid medications.
- Opioid treatment for short-term pain should last only three days, at the longest seven days. This will be a significant change. Currently, doctors prescribe for anywhere from two weeks to a month of opioid medications for short-term pain management.
- Doctors should have patients undergo urine tests prior to getting prescriptions.
- Doctors are to participate in a drug tracking system to ensure patients are not getting medicine from somewhere else. Currently, 49 states have these systems yet only 16 are required to use them.
- These guidelines will not apply to patients receiving cancer treatment or end-of life treatment.
The new guidelines are a dramatic shift from the ideology of the 1990s. Back then, an initiative to fight for pain management resulted in opioid prescription painkillers soaring in popularity in the medical field. Pharmaceutical companies and medical experts pushed to have these drugs readily available because at the time, they were thought to be effective solutions to treat back pain and arthritis without the fear of addiction. Boy, were they wrong back then.
Now, as overdoses continue to mount, and addiction claims more and more lives each year, the country is desperate for an answer. While these guidelines may have good intentions, other professionals argue that more rules can cause more harm than good. Recent tighter restrictions on painkillers have resulted in the drugs soaring in cost on the black market. As a result, a significant number of addicts turn to heroin to satisfy cravings.
For nearly two years, these standards have been bitterly opposed by Big Pharma and pain doctors who feel that these guidelines will only post unfair hurdles for patients who really do suffer from chronic pain. They argue that drug addicts will simply find another way to get their fix, like heroin. Opponents of the new guidelines also believe that these rules are an incursion into the role of doctors.
Dr. Thomas R. Frieden, director of the disease centers, responded,
“It’s become increasingly clear that opioids carry substantial risk but only uncertain benefits — especially compared with other treatments for chronic pain.”
He continues to support the guidelines, stating they are meant to be “a tool for doctors and for patients to chart a safer course,” describing them as a benchmark for medical practice, not an unbending dictate. The idea, he said, is to balance the risks of addiction with the needs of patients.
“For the vast majority of patients with chronic pain,” Frieden said, “the known, serious and far too often fatal risks far outweigh the transient benefits. We lose sight of the fact that the prescription opioids are just as addictive as heroin. Prescribing opioids really is a momentous decision, and I think that has been lost.”
Essentially, Frieden is saying these new guidelines are meant to help with the addiction crisis and certainly are not meant to prevent those with chronic pain from receiving medications they need. Furthermore, it is uncertain the effects opioid medications have on chronic pain in the long run, so we can not assume that restricting these drugs cause any harm to those patients.
Considering how urgent the addiction epidemic is, something has to be done, and at least these new guidelines encourage conversation. Education and prevention is the key. Each year, the data is increasingly more frightening. There clearly is not a one-stop solution to all of this. Do you think these guidelines will be effective? If your or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.
Author: Shernide Delva
A new HBO documentary focuses on Cape Cod’s heroin epidemic. In a recent interview, director and Oscar winner Steven Okazaki elaborated on the documentary which premiered on Monday.
Cape Cod, a town known more for its seafood, beaches and lighthouses than drug addiction, now has a huge heroin problem. Those affected most are middle-class white locals in their early twenties. If you were to follow the stigma of addiction, you never would have guessed a town like this would have such a major heroin problem.
As we know, the drug epidemic is affecting people in every part of the country, and an emphasis is being placed on the middle class. In the documentary Heroin: Cape Cod, USA, it explores the latest heroin epidemic in a wracking yet necessary way. At times gruesome, the documentary gives a two-way mirror perspective of how addicts are managing to live with their habit on a daily basis.
This is not the director’s first film magnifying heroin use. His 1999 HBO documentary Black Tar Heroin: The Dark End of the Street followed drug use in San Francisco’s Tenderloin neighborhood. These users were mostly off the streets, scourging for drug just to maintain a normal state of being.
Furthermore, the document exemplifies how the greatest shift in drug addiction is the change of scenery. Heroin is not just a drug seen on the streets anymore. Recent data suggests the fastest growing group of heroin use is mostly middle-class white kids, 18 to 25 years old.
The Modern Day Heroin User
The main change in heroin users in this generation compared to previous ones is the shift in technology. Now, heroin users do not have to go to sketchy neighborhoods to get their fix. With the invention of smart phones, users can text their dealer and have the drugs dropped off right at their doorstep.
“The iPhone is also good for texting your dealer and getting the drugs delivered to you. You don’t have to go to the sketchy part of town,” Okazaki said.
However, other than the changes in technology, the kids in Cape Cod are the same as addicts anywhere. They steal, lie and cheat for cash to fuel their addiction.
“They do the same hustle for money—steal their mother’s jewelry, tell their father they need new tires for their car, steal stuff from Home Depot and return it for cash, work at strip clubs, go into prostitution, deal, whatever they have to do. The desperation is the same,” Okazaki continued.
The Lost Voices: Parents of Drug Addiction
One of the important areas this documentary tries to focus on is the parents who are affected by their children’s drug use. Okazaki stated that parents who have lost a child to an overdose have some of the strongest voices in activism.
In the documentary, the parents have a group, Parents Supporting Parents, that meets every Monday on the Cape. When Okazaki came to film the documentary, there were no meeting schedules so he asked the mothers if they would be willing to have one for him to film. Over 20 people came eager to talk.
Many of the children featured are very connected to their parents. Some live at home and others talk to their parents every day. The parents featured in the film either enabled their kids or work endlessly to find ways to keep their child sober.
“I was totally taken aback,” Okazaki said in an article. “These parents, they’ve been through it and they’re seeking support from each other and they’re tired of feeling uncomfortable around their neighbors. They were really welcoming and incredibly open.”
During the course of filming, little was done to interfere with what was happening. Staff carried the overdose antidote Nurcan in case of an overdose. In the end, two out of eight of the documentary participants overdosed and died which exemplifies how serious heroin drug use is right now. Many are not surviving. Okazaki says it was difficult at times to deal with this reality while filming and editing the documentary.
“It’s really painful. They were once alive and smiling and laughing. It’s heartbreaking. The two young women who overdosed and died were smart, caring, lovely young people. You never know who’s going to survive and get clean, or go on forever using or die.”
Overall, the overall message of the film is how easily obtainable heroin is and how something desperately needs to be done to prevent these tragedies from occurring again.
There is so much sadness and loss over drug use and as of late, the numbers continue to climb. Watch Heroin: Cape Cod, USA on HBO. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.