How Prescribing Heroin Could Actually Save Lives

[xchrom]

http://www.alternet.org/drugs/how-prescribing-heroin-could-actually-save-lives



Another International Overdose Awareness Day (Aug. 31) approaches and many people are still focused on prescription opioid drugs and their role in overdose fatalities. Those do indeed play a big role. But another threat is snaking through the country and we need to plan for its impact.

Here comes the heroin.

Reports are coming in across the country, from places like Montgomery, Maryland,Ellensberg, Washington, Concord, New Hampshire, throughout Kentucky and in the Twin Cities, Minnesota. Heroin use and heroin overdoses are growing. According to recent research by SAMHSA (Substance Abuse and Mental Health Services Administration), the number of first-time heroin users has nearly doubled lately, from around 90,000 “first-timers” in 2006 to a whopping 178,000 in 2011. Our normal approaches (crackdown, get tough, prohibit, arrest) have never done much good long-term. Will anything be different this time?

Some people, including members of law enforcement, link the rise in heroin use to crackdowns on prescription drug abuse. We have been raiding pain clinics, thwarting ‘doctor shoppers,’ sentencing non-violent people, including elderly people, to long stretches in prison for low-level drug prescription drug sales. 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.

[Spider Jerusalem]

1. Reform of prescribing guidelines would probably be a better start

the USA uses 80% of the opiates produced in the world, with less than 5% of the population. Opiate drugs are vastly, vastly OVERprescribed in the USA. The lax prescribing guidelines, the fact that some really quite addictive drugs are schedule III, and the horribly broken and over-expensive US healthcare system (which means that consultant pain specialists aren't called in when they should be to see if, say, oxycodone is even appropriate) are all part of the problem. (That and American hyper-capitalism, which has seen an increase in opiate prescriptions thanks in part to aggressive drug company marketing.)

Treating addiction issues as medical and not criminal would also help.

[RiffRandell]

2. I don't if prescribing heroin is the best answer.

It is a huge problem. People go to pill mills that get shut down and turn to heroin for the withdrawals and it's cheap.

I have a friend in Seattle that I was discussing this with a few weeks ago as heroin overdoses have increased there for this reason.

Heroin withdrawals are horrid....if the people were medically detoxed that would be great, but if they still want to get high they will.

People get addicted to methadone. It's just so sad.