Vancouver, Canada, has a drug problem. The city is known for its heroin addicts, marijuana users, and methamphetamine addicts. Maybe more importantly, it is known for its ways of dealing with these drugs and their users. It has taken controversial steps that few other countries in the Western World have taken in an attempt to make a difference for its drug users.

Some people would call their approach a social experiment, or that the government is looking the other way or even encouraging drugs use. But for many, Vancouver’s handling of illegal drugs has been a life saver.

InSite

The city of Vancouver gives money every year to a community organization to operate a facility called InSite. This facility takes a very controversial approach to dealing with drug addicts. In fact, it is the only facility of its kind in North America. InSite is a building where drug addicts can go to shoot up “in safety”. Users must supply their own drugs, but are provided with clean needles and syringes, and are supervised by medical staff in case they overdose. InSite oversees an average of 491 injections per day, and many of its addicts come back repeatedly throughout the day to get their fix.

Supporters

The history of InSite has been plagued with conflict. Several legal challenges have threatened to close its doors, and parts of the Conservative federal government have worked to close InSite. But so far, the courts have ruled in favor of this facility. Supporters say that their primary goal is to reduce harm to addicts, by preventing the spread of disease and the risk of overdose. The British Columbia Ministry of Health Services provides money for InSite, and the police force in Vancouver says it helps them promote harm reduction. Supporters say because of InSite there are fewer crimes, fewer homicides, and fewer drug overdoses in Vancouver. InSite also offers counseling and treatment services to help the addicts that want to get clean.

Opponents

But the problem that most other people have with InSite is that it allows addicts to stay in their addiction. InSite helps addicts maintain a “functioning junkie” status. By taking away some of the dangers of substance abuse, InSite allows these people to continue using their drugs with few consequences. It encourages drug addicts to use drugs, and doesn’t seem to encourage often enough the benefits of detox and treatment. The benefit of facilities like InSite is that they prevent a number of overdoses. InSite staff intervened on 484 overdoses, lives that would have been lost had they not been at InSite. But these drug addicts, no matter how hard they try, cannot really function in society, and giving them the means to continue in their drug usage is not benefitting them in the long run. Last year, 411 people were admitted to detox at InSite. Maybe with more patients in a successful detox program, they would have fewer patients in their injection booths, and they would really save lives.

Sources

InSite

Vancouver’s ’safe house’ for drug addicts draws controversy

Near Olympics, Vancouver’s (mostly) legal drug zone

Linda Robertson: Vancouver’s ‘real world,’ outside Olympic bubble

When it comes to illicit drugs, heroin is about as bad as it gets. It is highly addictive, widespread, and ruins or even ends many lives every year. Heroin often is used by the hardest and most experienced of drug users, and many people’s mental picture of a heroin addict involves a homeless person, begging for money or stealing to support their habit, and so trashed that they can’t even talk.

But heroin addiction often happens to other, seemingly unlikely people as well, and it grips them just as hard as anyone. A new trend in high school students from the suburbs is to do heroin. Even with all the education and literature warning people about the risks of heroin use, an estimated 150,000 people began using heroin from the first time from 1995–2002. People start using heroin for a variety of reasons. Some people are looking for a stronger drug with more of an effect after using more moderate drugs for some time. Other people are pressured into trying heroin by friends or co-workers, and get hooked right away. Still other people are trying to escape from something difficult in their life, such as a bad relationship, loss of job, or money problems. Whatever the reason, individuals that experiment with heroin with the intent of stopping after a short time often find themselves months down the line, completely addicted.

Heroin, a derivative of morphine that comes from the poppy plant, is one of the most addicting illicit drugs. It is also one of the most contaminated drugs, with the dirtiest addiction practices. Users crave it so much that they will buy drugs off the street that are cut with all kinds of substances, even with strychnine or other poisons. The strength of heroin is rarely communicated to the user on the street, which puts heroin users at risk for overdose. Heroin addicts lose all concern for their body and physical health. The feeling of euphoria from doing their drug becomes the most important thing. Heroin addicts will use dirty needles to shoot up, or contaminated supplies to smoke or inject it. AIDS and hepatitis B and C are a result of unclean heroin practices.

Effects of Heroin

Chronic heroin users can rarely hide their addiction. While under the influence, heroin users will show slurred speech, droopy eyelids, and an overall slowness to their movements. Chronic users that shoot up will develop collapsed veins, clogged blood vessels, cellulites, and those that smoke or inhale it develop infections of the heart or lungs.

Treatment

There is treatment for heroin. The first step to recovery is detox, which can cause withdrawal symptoms such as nausea, body aches, insomnia, restlessness, and cold flashes. Detox medications can ease the symptoms and the cravings. A good treatment facility will have a long-term plan in place or heroin addicts trying to get clean. Counseling by trained professionals and support groups with others that are recovering will help an addict work toward staying sober.

Sources

http://www.treatmentsolutionsnetwork.com/heroin-rehab.html

http://www.drugabuse.gov/ResearchReports/heroin/heroin2.html#what

http://www.drugfree.org/portal/drug_guide/heroin

New York City’s health department is under serious criticism this week because of a brochure that has been dubbed “Heroin for Dummies”. The 16 page brochure, which has been in circulation since June of 2007, was recently brought to the public’s attention because of its alleged encouragement to try illegal drugs.

How to Do Drugs Safely

The brochure was most likely created with a lot of good intentions, but probably not with as much thought. It gives almost friendly advice on how to stay safe when doing illegal drugs. Tips like “jump up and down before injecting in order to find your vein more easily” and “only shoot up with a friend in case something goes wrong” are among the ones that have people outraged. The pamphlet cost the city $32,000 to create and distribute, money that many taxpayers are furious to hear about. The main argument about the pamphlet is that is seems to be encouraging people to do drugs, as long as they can do it in a safe way.

The city’s health department does not agree. They state that the brochure was made for drug addicts, in order to prevent overdose and things like HIV and AIDS. It has been distributed at homeless shelters, jails, and syringe exchange programs, and the city says it has saved lives. But critics argue that those that are addicted to heroin know most of these things already, and you can’t really make injecting a poison into your body safe. It is dangerous and risky, and a brochure isn’t going to make the addiction any safer.

Preventing Drug Use

City officials also say that they have recognized that it is impossible to stop every drug user, and this is designed to at least prevent overdose and death. But this kind of sounds like they’ve given up. Sure, we need to admit that there is a big drug problem out there and that we can’t reach everyone, but that doesn’t mean we should blow $32,000 on a pointless campaign. Instead, maybe they should have spent that money on getting some of those people into treatment. It would be interesting to know how many drug addicts actually read the pamphlet and stayed “safe” because of it.

The brochure does have a help number on it and encourages the addict to get treatment. But “Take charge. Take care” seems to otherwise be handling the drug problem all wrong. There is a big problem with drugs in New York City and drug overdoses kill over 600 people a year. However, there are other programs, other literature, and other ways of informing the public of certain dangers that are more effective. These drug addicts, and everyone, need to be taught about the dangers of drugs, as well as tools to avoid using them in the first place.

Sources

NY health department takes flak for heroin manual

City Pamphlet on Heroin Use Criticized as a How-To Guide

NYC’s top drug prosecutor blasts ‘how-to’ pamphlet for IV drug users

Addiction is such as harsh word, and it carries with it a number of negative implications. For example, some people categorize an addict as someone that doesn’t care about themselves, their family, or life in general. Or, an addict is the homeless person down the street. Or, addicts just don’t try hard enough at life. But addiction can happen to anyone –doctors, lawyers, pastors, housewives, college students – and people shouldn’t be too quick to categorize.

Perhaps you’re struggling with thoughts of addiction. Maybe you know deep down that you are addicted to something. These thoughts may be your first step toward recovery. No one likes to admit that they have an addiction problem, but until the issue is brought to light, the grip of the addiction will continue to grow stronger and stronger.

Physical Addiction

There are actually two ways a person can be addicted to a substance. First, and more clearly, a person can be physically addicted. This is when their body has built up such a tolerance and actual dependence on the substance that if it doesn’t get it, the body suffers withdrawal symptoms. Alcohol and heroin are examples of substances that cause great physical addiction and are hard to stop without great pain and suffering.

Psychological Addiction

The other way a person can be addicted is psychologically. This is often harder to manage. A person that is psychologically addicted has severe cravings and an uncontrollable desire to obtain the substance, and will often go to great lengths to get their hands on it. An example of this is cocaine. Cocaine does not produce very severe withdrawal symptoms, but a person that is addicted to it cannot seem to pull themselves away. The intense cravings that go along with withdrawal are hard for an addict to overcome. The drug becomes necessary in their life, and they will do anything to get it.

Symptoms of Addiction

So how can you tell if you are addicted? Where is that fine line between recreational use of alcohol and addiction, or between pain management and addiction to painkillers? While most addicts know they have an addiction problem, it might happen so gradually that they honestly don’t know they’ve gone so far. If an addict would take a step back and look at their life, they may find the following to be true:  They have built up a tolerance for the substance, so that more of it is needed to get high. They may have the desire to quit, but are unsuccessful. They will spend more and more time trying to get the substance, including illegal behavior. They will give up things that were once important to them if it stands in the way of using their substance. They will continue to use the substance even after being made aware of its impact on their life and their loved ones’ lives.

If addiction has become part of your life, remember that it can be treated. With proper help, addicts can get sober and start living a life free from their addiction.

Sources

http://www.ehow.com/about_5087236_signs-drug-addiction.html

http://www.nida.nih.gov/Published_Articles/Essence.html

http://www.mayoclinic.com/health/drug-addiction/DS00183/DSECTION=symptoms

The debate about the safety of Ibogaine has gone on for years.  Some people think it is the greatest drug ever found for addiction treatment and can’t imagine why anyone wouldn’t give it a second thought.  Other people believe that the drug is dangerous and the risks far outweigh the benefits.

History

Ibogaine comes from the roots of an African shrub, Tabernanthe iboga, and has been used by Shamanic tribes for centuries in rituals that connect humans with the spirit world.  The use of Ibogaine in the treatment of drug addiction was discovered by accident in the 1960’s, and the use of it for treatment has been argued about ever since.

Addiction Interrupter

Ibogaine at low doses is a mild stimulant.  At higher doses it causes hallucinations and an experience that interrupts a patient’s addiction to a variety of substances.  Ibogaine is known by scientists to have anti-addictive properties, and actually seems to alleviate withdrawal symptoms of substances such as heroin, cocaine, nicotine, and alcohol.  The problem is that the experience that comes with taking Ibogaine is severe and scary and dangerous to the patient.

Effects of Ibogaine

Someone that has taken a high dose of Ibogaine will experience two phases.  The first phase is the visual phase and it consists of hallucinations of objects moving around the room, colors flying, memory impairment, and dreamlike sequences.  This phase can last up to four hours before the second phase begins.  The introspective phase consists of a feeling of euphoria and thought clarity.  The patient will often reflect on their lives and the background behind their drug addiction.  This phase can last one hour, or it can last a few days, depending on the patient.

Risks

It is the experience that comes with taking Ibogaine that has many people concerned.  The patient is not in control of their body, and often is paralyzed by their altered mental state.  There have been a number of deaths from Ibogaine, possibly caused by interaction with other drugs, or pre-existing medical conditions.  But because of all these things, the U.S. government put Ibogaine on Schedule 1 in 1967, making it illegal in this country.  Other countries have banned Ibogaine as well, while there are as many as 12 countries that do allow its use.  Canada and Mexico both are among those that do allow the use of Ibogaine in clinics.

Future of Ibogaine

Boston’s Northeastern University recently held the Boston Ibogaine Forum, where those interested in the future of Ibogaine met for a conference filled with information about the drug.  Supporters want more research to be done on the drug in the hopes that it will soon be legal to use.  Perhaps, though, it is actually the study of the drug that both sides are waiting for, to determine whether or not it is as effective and safe to use as some say.

Sources

Greene, Doug Feature: The Boston Ibogaine Forum — from Shamanism to Cutting Edge Science 3/1/09

Sanchez, Carolina Banishing addiction forever? March 17, 2009

Why Choose Ibogaine for Drug Detox?

There are so many frightening stories out there of parents that have lost their teen to drug use.  Parents need to be aware of their teen’s friends and activities, as well as the potential risks for kids these days.  We have listed five of the most common substances that are abused by teens.

1. Marijuana:  Weed, pot, grass; it’s the same drug that many of the older generations used when they were young.  Perhaps that’s why marijuana is the most commonly used drug today.  “Everyone else is doing it, and our parents probably experimented with it.”  But the marijuana used today is more potent than the marijuana of the past, and the fact that many kids are trying it at a younger age means that these kids will be more likely to move on to a more powerful substance as they get older.  Plenty of lives have been wrecked by marijuana; it is not a drug to be taken lightly.
2. Prescription drugs: An estimated 20% of teens have used prescription drugs to get high.  This growing trend among teens and pre-teens is troubling because of how easy it is to obtain these drugs.  Most kids can open up their parents’ bathroom cabinet and have their choice of drugs.  Parents have been slow to catch on to this trend, and now the abuse of prescription drugs is a serious problem in schools.  Teens have begun having “pharming parties” where everyone brings a stash from their home and shares with the group.
3. Ecstasy: This drug is popular among the dance club scene and now is being marketed to kids.  With stamps of cartoon characters on them and their cheap selling price, this stimulant drug has become a popular past time among teens.
4. Inhalants:  Another danger in most homes is the presence of inhalants.  Teens and pre-teens have begun sniffing or huffing certain chemicals or household items in order to get high.  Often, teens don’t see this as being anything more than a game, and certainly don’t see it as being harmful.
5. Cocaine and heroin: These potent stimulants are causing growing concern for parents and law enforcement.  Often teens that start out with some of these other substances soon move on to more hard-core drugs, such as heroin.  Highly addictive, these stimulants cause such a high feeling that users are left looking for more.  The lives of many adults and teens have been ruined by these drugs.

A factor that is seen in many of these top substances is that teens don’t see the use of these them as being serious or harmful.  Teens are still learning and growing, there are many things they just don’t know.  Parents need to talk with their kids about drugs, and warn them about the severity of these substances.  Maybe with a little more time spent in education and prevention, these trends would not continue to surface among our teens.

Sources

Kowalski, Steve Cost, appearance of drugs appeal to teens January 25, 2009

Van Hollen, J.B. For teens, drug abuse genie is out of the prescription bottle 2/16/09

Ivers, Marianne Risky teen trends: Parents, don’t be in denial February 11, 2009

Drug Review A brief review of the most common drugs used by teens

There has been much talk in the past about the best way to help addicts come clean from heroin, with some people arguing for the use of drugs like methadone to treat patients, and other people holding firm to the idea that you can’t successfully treat a drug addiction with a drug.

Unfortunately, there is not enough evidence to conclude that either way is better.  Numbers do show that the use of methadone is successful in getting patients to give up heroin, but then the patient does not really end up being drug-free because they are addicted to the methadone.

History of Heroin
Heroin has been around for a long time, and is currently grown around the world, with large supplies in the Middle East, Asia, and Latin America.  The drug had been a problem in the United States for decades, but the Nixon administration actively tried to diminish supplies of heroin when he declared a war on drugs in the 1970’s.  It was during this time that methadone maintenance treatments came to light, and experiments were done to measure its effectiveness.  However, incomplete data recording, complex situations of treatment, and inconclusive evidence have all aided in the differing of opinions that we have today.

Heroin Withdrawal
What we do know is that heroin is a hard drug to beat.  The addict’s body quickly becomes so dependent on the substance that to go without it would mean a severe withdrawal.  Nausea, vomiting, pain, sweating, fatigue, depression and insomnia are what an addict goes through when trying to quit.  But, if a patient is put on methadone when stopping the heroin, the symptoms are not nearly as bad.  The patient will need to work to withdraw from the methadone, but that can often happen over weeks or months.

Another thing we know is that addicts that are required to quit heroin without the use of medication are less likely to stay in treatment than those that are assisted by drugs such as methadone.  Perhaps it gets to be too big of a task before them to be rid of drugs completely, but whatever the reason, more heroin users will stay in treatment if it involves using methadone or another medication.

Methadone Treatment Facilities
Many drug treatment facilities have built their programs around these pieces of information.  By using medications such as methadone, physicians are able to ease the withdrawal symptoms and to keep the addict in treatment.  Facilities may not be able to come up with statistics that say their patients have completed their program and are clean and drug-free, but that they are heroin-free.  According to many, this is a better alternative.  Many facilities work to help their patients become responsible members of society, by keeping a job or taking care of their family, something heroin addicts find almost impossible.  For those patients that require the use of methadone to achieve those goals, the benefit of living a normal life is worth it.

Schneider, Eric The War on Drugs Redux 1-12-09

Mooney, Bette From Yale to Jail

Mattick, RP Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence

http://wwwdasis.samhsa.gov/teds05/TEDSD2k5Hi.htm

If you or someone you love is considering treatment for a drug or alcohol addiction, there are many decisions you may need to make in order to find the right facility. Below are some things to consider when choosing a facility, as well as things to expect once you get there.

First of all, it might be necessary to call a hotline to get immediate help for an addiction. This would be used when a person doesn’t know where else to go for help, or possibly someone is in immediate danger. If this is the case, the individual on the other end of the phone can give you valuable information about immediate treatment options.

Types of Facilities and Programs

If the decision is something that is thought about for a while and discussed, there are many different types of programs that might be useful. The first questions might be whether the facility offers residential, in-patient, or out-patient treatment, or a recovery house or long-term care. Some facilities are gender or age-specific, which might be particularly helpful to adolescents or females who might feel more comfortable in a setting with their peers.

It may be necessary for the treatment facility to have a detoxification program for the individual to rid their body of harmful substances while being monitored by a staff of medical professionals. After the physical dependency of the substance is addressed, the patient can begin counseling and treatment to manage the psychological dependency. Many treatment facilities have different activities to aid in this part of the recovery process. Things such as group therapy and family involvement have proven successful in treatment, as well as the 12-Steps for recovery. Some specialized facilities also provide programs such as equine therapy, recreational activities, cooking opportunities, and other things geared toward giving the mind and body something positive to focus on.

Recovery is an Ongoing Process

It is important for patients to be directed to long-term care to assist them in staying sober in the future. By learning about the risks of relapse and the skills needed to cope with stress and addiction triggers, an individual will be more likely to stay substance-free. A facility should provide follow-up services to give the recovering patient a support base when they move back into their lives. Recovery is an ongoing process. The groundwork is laid when an individual goes through treatment, but recovery continues on as the person is put back into their lives and families and has to effectively put what they learned into practice.

Entering into a treatment facility is a scary thing for most people. The unknown is hard to face. But the right facility can ease discomfort with their caring staff and positive programs. It still won’t be easy, but the goal is for the treatment to be successful. By working with counselors and staff to learn about oneself and taking accountability for the addiction, an individual can actually aid in the recovery process. So while you can expect treatment to be a challenge, it will hopefully be the best thing you’ve ever done.

Sources

T., Buddy Components of Effective Treatment Programs What Makes Alcohol Treatment Programs Work? January 22, 2008

http://en.wikipedia.org/wiki/Drug_rehabilitation

A new study published November 5th in the Journal of the American Medical Association seems to show that addicted teens that are treated long-term with detoxification medications, including buprenorphine and naloxone, respond better than those treated for a short time. The drugs that were used in this study are two medications that were approved in 2002 by the FDA for the treatment of opioid addiction. Only about 7,000 physicians in the country are registered as potential providers of these drugs, and even less of that number will administer them to young people.

Opiate Detoxification Medications

Buprenorphine is a medication that significantly reduces the cravings of opioids. When combined with naloxone, an opioid antagonist, the results seem to be even better. Naloxone reduces or prevents the effects of drugs such as heroin or prescription painkillers, making them much less desirable to the addict. Naloxone also prevents the patient from misusing the buprenorphine combination because those that would try to inject the drug for a high (instead of taking it orally as prescribed) would suffer severe withdrawal symptoms.

While these medications have been used for adults in many instances, there has been little research on the effectiveness among young people addicted to opioids. The overall number of adolescents that abuse drugs has decreased since 2002, and while this is a very positive trend, the number of painkillers and opioids abused among teens has increased.

Study on Treating Adolescents

Dr. David A. Fiellin of the Yale University School of Medicine reports that as many as 10 percent of ninth graders have used opioids, and that 200,000 to 400,000 adolescents have abused some of these drugs. It seems that drugs are even more readily available to teens today than alcohol, as teens are able to order drugs online or steal them from their parents’ medicine cabinets. Often drug addiction starts as a fun thing that teens try, and ends up as a lifetime of dependence on the substance.

The study done by Dr. George Woody of the University of Pennsylvania’s Department of Psychiatry is one of the first of its kind. As was reported this week, researchers found that those teens that were put on a buprenorphine/naloxone combination (Suboxone) for an extended period of time (12 weeks or longer) were more likely to stay opioid free than those only given the medication for a short period of time. When taken off the medication, the drug use went up. Even with detoxification and counseling, the individuals that were taken off the Suboxone were back to using drugs in a short period of time.
While more research needs to be done on this topic, it seems that Dr. Woody and his team of researchers have shown that Suboxone is an effective treatment in the addiction of opioids when used for an extended period of time. There are those that disagree with the use of drugs to treat drug addiction, but if it means these adolescents have a chance to continue their life free of opioid addiction, many think these more drastic measures are worth taking.

Sources

Reinberg, Steven Extended Therapy Helps Drug-Addicted Teens November 4, 2008

Carver, Alice Extended Therapy for Young Opioid Addicts Better than Short Term Detox, Study November 5, 2008

Opiate Detox

How would you feel if your insurance provider told you that the doctors’ visits and treatment costs for your illness were not going to be covered, or that you would have to pay a high deductible? Many people in our country are being told just that, and the reason is that the illness they have is substance abuse. There has long been a view in the world that substance abuse is a choice, or a character flaw, not a mental illness. Things are changing, however, and more and more research is being done on the complexities of the brain and its reaction to substance abuse. People today are beginning to see that while substance use might start as a decision to try something new, it quickly becomes an addiction that can’t be controlled.

Congress approves Mental Health Parity Act

Congress approved legislation last week that would change the way insurance providers handle claims for mental illness and substance abuse. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 provides “equity in the coverage of mental health and substance use disorders by ensuring that group health care plans do not charge higher co-payments, coinsurance, deductibles, and impose maximum out-of-pocket limits and lower day and visit limits.” Supporters of this measure include many in the House and Senate, businesses, insurance companies, and physicians. However, a few questions remained and until last week, it was uncertain whether or not the bill would pass before Congress went into recess this year. By attaching it to the Wall Street bailout bill, however, Congress was able to pass it quickly.

Help is needed

Help can’t come soon enough for many Americans struggling with drug or alcohol addiction. According to the National Alliance on Mental Illness and the National Council for Community Behavioral Healthcare, mental illness is the leading cause, and substance use is the second leading cause, of disability among adults. Many of these adults are not getting the help they need to recover from their mental illness, and often it is because of the high cost of treatment. Another reason is fear of discrimination from their employer if they do seek treatment.

Equal Coverage for an epidemic

With legislation such as the Mental Health Parity Act, those with a substance abuse disorder can be reassured that their insurers will not be able to set a cap on healthcare coverage for mental illness or substance abuse that isn’t set for other illnesses.

In order to deal with the epidemic of substance abuse, we need more good addiction treatment facilities, more affordable health care to addicts, and more support behind families dealing with substance abuse. Through the passage of this bill, those with addiction should be encouraged to move forward and seek treatment, so that we can work toward decreasing the incidence of drug and alcohol abuse.

Sources

Congresswoman Shea-Porter Hails Passage of Mental Health Parity Act September 24, 2008

Many State Reform Initiatives Are Neglecting Mental Illness, Says Study July 08, 2008

Layton, Lyndsey Congress Approves Mental Health Bill Private Insurers Would Provide More Benefits Sept. 24, 2008

Ault, Alicia Equal Coverage For Mental Health?
Many States Require Parity, and Congress May Order It Nationwide November 6, 2007

Curley, Bob Congress, Bush Approve Addiction and Mental Health Parity Legislation October 3, 2008