Addressing reality with a health-oriented approach

nihilism by Brett Jordan
nihilism by Brett Jordan

We know how to crackdown — but we seem ignorant when it comes to what to do with all those addicted people we’ve “cracked down” on. You may thwart them with your database at the pharmacy, but they’re still addicted. Now what?

Abuse-deterrent formulations of drugs and prescription drug take-back days are well and good, but they don’t reverse an overdose, they don’t educate about drug safety and they don’t provide ready access to treatment. They don’t address the factors that cause people to turn to drugs for relief and they don’t acknowledge the uncomfortable fact that despite our best efforts, for some portion of the population, rehabs won’t work, methadone won’t work, and neither will cold turkey, tough love, prison, prayer or 12-Step.

Knowing that is true, we should take positive steps to address that reality with a health-oriented approach. We should bring the most marginalized populations back into the fold, increasing their interactions with physicians, counselors and other supportive service providers, without fear of arrest or incarceration, and without demanding abstinence.

We should consider the benefits of physician-supervised, prescription pharmaceutical heroin maintenance programs.


“despite our best efforts”?

Who’s “reality” and who’s “health”?

Have we ever really given these people our best efforts?

When “helpers” this pessimistic, it’s no wonder nothing’s worked.

This feels a lot like under-treating tuberculosis until it becomes treatment resistant and then claiming that the realistic and “health-oriented approach” is to ship them off to Arizona. How about trying to treat them in a manner we know works? We’ve never tried that, have we? And, it’s not too expensive.

Gateway Theory Revisited


A small but elegant gate to a meadow path.
(Photo credit: Wikipedia)


Keith Humphreys on findings that link marijuana, tobacco and alcohol use with opiate use:


The researchers used data from 2006 to 2008 from the National Survey on Drug Use and Health, an annual study representative of the U.S. population, to study 18- to 25-year-olds’ drug use behavior. They found that 12 percent of the survey population reported misusing prescription opioids around the time the survey was conducted.

They also found that both men and women who had smoked marijuana between the ages of 12 and 17 were more than two times more likely to later abuse prescription drugs than those who had not. Young men who drank or smoked cigarettes as teens were 25 percent more likely to abuse prescription drugs — though this link was not found in women surveyed. Fiellin said there was no clear-cut reason why the results differed for men and women.

Keith Humphreys, professor of psychiatry at the Stanford Medical Center, said that this association between “gateway drugs” and prescription pain medication was significant regardless of the exact mechanism behind the link.

“Some people believe the ‘gateway effect’ exists because early drug use primes the human brain for more drug-seeking, others argue that the friends you make using drugs as a youth are a ready source for other drugs later, and still others argue that there are factors, like impulsivity, that causes both early and later drug use,” Humphreys said. “Which camp is correct? Probably, all of them.”




Two stories on methadone

English: Methadone structure, animation


DEATHS among drug users have hit a record high in Scotland, increasing by a fifth in 2011, the latest government figures reveal.

Last year 584 people died from drug use, which means that drugs now account for one in every 100 deaths in Scotland.

The heroin substitute, methadone, was at the heart of the increase, with almost half of the drugs-related deaths involving the prescription drug.


How I Learned to Stop Worrying and Love Methadone

Just like ex-junkie Russell Brand, I used to believe that “maintenance” was as bad—if not worse—than active addiction. Here’s how I came to understand how fatally wrong I was.

I have no quarrel with any addict receiving methadone maintenance, IF they’ve been provided with accurate information and quality drug-free treatment.

I wish that, rather than describing methadone as, “the most effective treatment for opioid addiction,” they would be more specific about what they mean by effective:

…study after study shows that when methadone prescribing increases, addict deaths drop. It is superior to abstinence-only treatment in terms of fighting HIV and overdoses, and many studies find it superior in cutting crime.

Those things are important, but methadone is not the only way to achieve those goals and they’re not the only things that are important.

Of course, as we’ve pointed out many times, there is one group of opiate addicts that are not treated with opiate maintenance. Doctors are not treated with opiate maintenance and they have terrific outcomes.

Are we really denying addicted doctors “the most effective treatment for opioid addiction”?

Of course not. We’ve decided that, for them, we’re going to aim a little higher than reducing overdose risk, crime and HIV.