Treatment for Heroin Users

#1 · 11-03-2013 02:51AM #1

Hi, I can't find a recent thread on this issue.

I'd like to know what people think about what the best or most effective treatment for users of heroin should be.

I know the subject of drugs can be pretty emotive issue for many people, but I think an objective or rational view is necessary if society ever hopes to help people who find themselves addicted to this or other drugs, but I'd like to just keep it with Heroin.

My own belief is that nobody wants to be addicted to heroin. Anyone I know who is or was on it says it's the worst stuff to be on.

I'm open to correction on this, but I think it's in or around 11'000 people who are on the drug at any given time in this country, and the main avenue of treatment is through the prescribing of a set dose of methadone, or physeptone or whatever one wants to call it.

Now, as far as I can see, this treatment is designed to wean a user off the heroin, but the rate of backsliding by those who are prescribed heroin-substitutes to the real thing is very high.

I'm told that this is because methadone doesn't give the high but keeps all the lows of heroin. I've seen men and women on methadone treatment and if they don't get their prescription for whatever reason they just completely cave, they get serious uncontrollable tremors, basically becoming a human wreck.

If I were an addict I know I'd find it hard to keep up a treatment which was so harsh. But my question is: Why not just give the users all the heroin they want? Customs seize a shedload of it each year. So give the user the stuff which keeps them "well". Such a policy could entail whatever restrictions you want, even making them take the stuff under observation and holding down some sort of job or course or whatever, just to make sure they don't go off and sell the stuff.

Now, I'm not saying legalise the stuff. Far from it. We don't need this stuff to be as available as drink. But the point of giving the hopelessly addicted user a supply of what he/she needs would be to enable them to exist without having to depend on robbery and other crime to feed their addiction and ergo it would take a lot of money from the black market.

I know there a good few posters on here who would have an experience of these people who need help. I think we're not doing enough to get them out of the hole they're in. But I think the current methadone system is a badly conceived idea. I could be totally wrong, just looking for an opinion on it.

J_E · 11-03-2013 02:57AM

Really think it's a bad idea to post this on AH...not going to be taken seriously by a lot of posters.

catallus wrote: »

If I were an addict I know I'd find it hard to keep up a treatment which was so harsh. But my question is: Why not just give the users all the heroin they want? Customs seize a shedload of it each year. So give the user the stuff which keeps them "well". Such a policy could entail whatever restrictions you want, even making them take the stuff under observation and holding down some sort of job or course or whatever, just to make sure they don't go off and sell the stuff.

Now, I'm not saying legalise the stuff. Far from it. We don't need this stuff to be as available as drink. But the point of giving the hopelessly addicted user a supply of what he/she needs would be to enable them to exist without having to depend on robbery and other crime to feed their addiction and ergo it would take a lot of money from the black market.

I'm not going to pretend I'm an expert on addiction treatment but I think this is a bad idea despite seeing your logic. If you were to give a heroin user as much supply as they want they will easily top themselves and die from an overdose. It's a little different from decriminalising the likes of cannabis.

You could argue that some heroin addicts are past saving and will never stop taking it but I think this sort of action would result in a lot of needless deaths. I don't know the statistics on the effectiveness of methadone treatments but at least it wards off users from the likes of needle sharing and criminal activity. Limiting use will only encourage a user to find more elsewhere.

An alternative to your solution would be to have needle banks and designated buildings where users can be supplied with sterile equipment and counselling should they look for it. I believe there are places like this out there in the world, and they don't aim to encourage use but provide a means to an end until a user is ready to take the first step to recovery.

catallus · 11-03-2013 03:31AM

I get your point about not encouraging use but from what I can see of heroin users, they need no encouragement at all, they are hopelessly addicted, forcing them to turn to crime to pay the suppliers.

It's not about saving anybody, it's about minimising the negative effect they have on society by providing them with what they need. Heroin will mess you up, everyone knows this, but sadly there's no shortage of people willing to dope themselves up, get themselves into a hole and then rob and thieve their way to the next hit.

Look, I'm not a bleeding heart, by any definition; another alternative would be to surreptitiously intercept the supply and put strychnine into the supply. Problem solved in a week. But only until next week.

I'm just throwing the idea of state-supplied heroin out there. Like I said, there's about 11'000 users out there. There are about 200'000 people being prescribed anti-depressants. So it's not a logistical problem.

My reasoning is: What addict wouldn't avail of it? Free State-sanctioned gear vs €25 a bag of dealer-cut stuff? It'd stop criminal activity and needle sharing immediately. I know what you're talking about with the needle centres but that was a last ditch effort to prevent the further spread of hepatitis etc..

J_E · 11-03-2013 03:42AM

catallus wrote: »

I get your point about not encouraging use but from what I can see of heroin users, they need no encouragement at all, they are hopelessly addicted, forcing them to turn to crime to pay the suppliers.

You're essentially slapping the face of every user who has successfully come clean. Your post insinutates that all addicts are a waste and will never make a change in their life. By making it 'State-supplied' you're basically nulling any chance of a user to possibly get off it when it's on tap. We should be supporting people who want to get off it, not trying to throw them into a pit with one another. Now I'm getting the impression you're one of these 'burn the junkies' types and I think that attitude does nothing but wrong. Have you experience or interaction with addicts?

catallus · 11-03-2013 03:50AM

No no no, I'm certainly not a "burn the junkies" type. You may be taking my strychnine suggestion a bit too seriously.

I have spoken to users who tell me it's a "demon-drug" "bad ****", basically the worst thing ever. They don't want to be addicted, but they are.

I'm not insinuating they are all a waste; quite the opposite. But the reason they seem to be such a drain on society is because the law gets them at every turn they try to take out of the hell they are in.

They can make a change in their life, but not through the current system of methadone: some of the users who have taken that have told me it's worse than the heroin.

I don't know what pit you are speaking of. But you're right, we should support those who wish to get off it, and I'm not an expert in addiction either, but it seems to me to be a bit more complicated than waking up one morning and saying, right! I'm off the gear!

.Henry Sellers. · 11-03-2013 03:53AM

When's the wedding?

Cereal Number · 11-03-2013 03:55AM

Big hairy mickey

scudzilla · 11-03-2013 03:56AM

Great Idea, and have every bag head in the EU descending on Dublin.

Fcuk 'em, if they wanna stick that **** in there veins then let them have to crawl on their knees in the gutter to get it

certifiedcrepe · 11-03-2013 03:58AM

Thinly veiled "I'm not on heroin" thread

J_E · 11-03-2013 04:02AM

scudzilla wrote: »

Great Idea, and have every bag head in the EU descending on Dublin.

Fcuk 'em, if they wanna stick that **** in there veins then let them have to crawl on their knees in the gutter to get it

Looks like the AH mob have arrived...

OP, if you want a serious discussion on the thread I suggest you take it elsewhere because you won't find it here.

catallus · 11-03-2013 04:12AM

By elsewhere you must mean off-line

I know it's an echo chamber but I would hope it is possible to have some open-minded people just give their opinion in a readable format.

I know there's a good few posters who would have an opinion one way or the other.

"Discussion" is a heavy term to use for what happens on the internet, but I really do think this is an important issue, it affects lots of people, the families and friends of those who find themselves in such a hole not least.

If we can help the small number of people who need it through a progressive policy then why not throw it out there for online debate, such as it is.

Ruudi_Mentari · 11-03-2013 04:36AM

If it's not that much a debilitating factor, for them and indeed has become their major motivation then it's gonna be hard.

and I guess that's how it goes I mean I had a pal stay over often and whilst he'd sip his meth in front of me taking a half hour to come out of the toilet was a bit of a suspicious. And that was over as number of yrs...... and that's how I left him but I know an uncle came off it, eventually.

Cavehill Red · 11-03-2013 04:48AM

Here's my radical solution: GIVE THEM SOME HEROIN.
Let me break that one down for you - give, as in, for free. Some heroin, as in, actual pharma-grade, unpolluted heroin.
That would achieve the following results:
1. An immediate collapse in crime as junkies no longer need to steal or burgle to make 300 quid a day to buy their junk.
2. An immediate and massive collapse in the income of drug dealers, drug importers and other associated ne'er-do-wells.
3. The liberation of a large number of police to pursue other crime prevention and detection duties.
4. A massive saving to the health service in terms of the costs of dealing with overdoses.
5. A massive saving in terms of money spent on pointless methadone schemes.
6. A massive saving in justice costs, especially prison habitation.

So, I reckon we should just open up a few places where we give junkies free heroin and let them sit there on the nod, nice and safe and monitored and get their highs, and I reckon the taxpayer should pay for it all, because let's face it, it would still be only a tiny fraction of the cost of what we're paying now, in health, maintenance schemes, justice, prison and social costs. Don't believe me? Go google Portugal and get back to me. It works, and it's the only sensible answer: don't treat them. Just give them the heroin.

orestes · 11-03-2013 04:49AM

Methadone doesn't treat heroin addiction, it just stops the body going ape-**** from withdrawl symptoms. It's not supposed to get you high on it, it's to stabalise your body while you wean yourself off a highly addictive substance, the same way people are weaned off high doses of painkillers. So methadone isn't really a treatment, it's a chemical substitute for the body while the person is getting treatment.

While I can see where you're coming from, I don't think it would do anything for anybody who wants to get off heroin and would just sweep the problem under the carpet by getting addicts off the streets and meaning less petty crime. Good idea from a civic point of view I guess, but I don't think it would do anything to fight addiction or help anybody who wants to get clean unfortunately. Although if methadone were still available to addicts wanting to get clean aswell I think it might actually be a workable idea.

JonEBGud · 11-03-2013 04:50AM

Any person who is addicted is addicted.
It takes quite an effort to go back to
normal.
Ask smokers for a tip. . .

catallus · 11-03-2013 04:58AM

JonEBGud wrote: »

Any person who is addicted is addicted.
It takes quite an effort to go back to
normal.
Ask smokers for a tip. . .

Some would argue it takes a bit of effort to get addicted in the first place.

orestes wrote: »

Methadone doesn't treat heroin addiction, it just stops the body going ape-**** from withdrawl symptoms. It's not supposed to get you high on it, it's to stabalise your body while you wean yourself off a highly addictive substance, the same way people are weaned off high doses of painkillers. So methadone isn't really a treatment, it's a chemical substitute for the body while the person is getting treatment.

While I can see where you're coming from, I don't think it would do anything for anybody who wants to get off heroin and would just sweep the problem under the carpet by getting addicts off the streets and meaning less petty crime. Good idea from a civic point of view I guess, but I don't think it would do anything to fight addiction or help anybody who wants to get clean unfortunately. Although if methadone were still available to addicts wanting to get clean aswell I think it might actually be a workable idea.

Getting addicts off the streets is not "sweeping the problem under the carpet". It is a civic solution; that's what I'm talking about; this idea that if heroin was freely available under strict circumstances it would make it harder for addicts to give up is wrong; it's a slap in the face to every alcoholic who has given up the booze. And also that argument ignores the easy availability of the drug as the situation stands.

Cavehill Red wrote: »

Here's my radical solution: GIVE THEM SOME HEROIN.
Let me break that one down for you - give, as in, for free. Some heroin, as in, actual pharma-grade, unpolluted heroin.
That would achieve the following results:
1. An immediate collapse in crime as junkies no longer need to steal or burgle to make 300 quid a day to buy their junk.
2. An immediate and massive collapse in the income of drug dealers, drug importers and other associated ne'er-do-wells.
3. The liberation of a large number of police to pursue other crime prevention and detection duties.
4. A massive saving to the health service in terms of the costs of dealing with overdoses.
5. A massive saving in terms of money spent on pointless methadone schemes.
6. A massive saving in justice costs, especially prison habitation.

So, I reckon we should just open up a few places where we give junkies free heroin and let them sit there on the nod, nice and safe and monitored and get their highs, and I reckon the taxpayer should pay for it all, because let's face it, it would still be only a tiny fraction of the cost of what we're paying now, in health, maintenance schemes, justice, prison and social costs. Don't believe me? Go google Portugal and get back to me. It works, and it's the only sensible answer: don't treat them. Just give them the heroin.

My thinking exactly, thank you.

Smidge · 11-03-2013 05:04AM

Just my two cents.......

There was an excellent community(ie not private,montessori) playschool where I used to live in Dublin.
Great people and great with the kids but they never got a penny extra towards improvements ie a swing, slide(of which they had nothing of the sort even though there was a large "play-tarmac" area) etc.

It has since been demolished and a centre for Addicts and their families has replaced it.

NO EXPENSE HAS BEEN SPARED ON THIS NEW CENTRE

Maybe, just maybe, if they had invested more in pre-schools and early services for kids we would need less treatment facilities later on for the people who fall through the cracks.

catallus · 11-03-2013 05:15AM

Smidge, That's a good point but the fact is that it's not kids falling through the cracks, it's adults and young people deciding to take heroin and then finding themselves in the hole they can't get out of. They do it for their own reasons, however banal or ludicrous we deem them to be. That's not what this thread is about.

Ask yourself why no expense was spared... was it to fulfill a quango, to give jobs to the HSE? Why would anyone who had eyes continue the cycle of addict/patient/addict.

I don't think education or rehabilitation is the issue when it comes to heroin users.

orestes · 11-03-2013 05:21AM

catallus wrote: »

Getting addicts off the streets is not "sweeping the problem under the carpet". It is a civic solution; that's what I'm talking about;

I think you misunderstood what I meant by sweeping it under the carpet. Free heroin is all good for active addicts who want to keep using and keeping them off the streets, that's why I agreed that it's a good civic idea, but I meant treating addicts who want to get well. Methadone helps recovering addicts deal with the physical withdrawl, it's like a very specific prescription painkiller. What about addicts who are trying to quit and their only options are heroin or nothing?

catallus wrote: »

this idea that if heroin was freely available under strict circumstances it would make it harder for addicts to give up is wrong; it's a slap in the face to every alcoholic who has given up the booze. And also that argument ignores the easy availability of the drug as the situation stands.

I disagree. Unlimited free access to anything that a person is addicted to will make it harder for them to hit bottom and make it harder for them to quit.

catallus · 11-03-2013 05:28AM

If someone wants to quit then the option should be there, methadone etc, if they want, but this willful and tortuous procedure in place now is at odds with every progressive and helpful idea and ideal I can think of apart from the dreams of doctors and psychiatrists who are making a mint from the imprisonment of the weak in the labyrinth of the law.

Cavehill Red · 11-03-2013 05:29AM

The evidence suggests that making people hit rock bottom has major social consequences and costs. Recidivism among addicts is also so high as to make the utopia of an addict-free society unfeasible and unrealistic. The alternative is harm reduction and management. That's what Portugal has chosen to do, with astonishing success, for over a decade now.

Smidge · 11-03-2013 05:33AM

catallus wrote: »

Smidge, That's a good point but the fact is that it's not kids falling through the cracks, it's adults and young people deciding to take heroin and then finding themselves in the hole they can't get out of. They do it for their own reasons, however banal or ludicrous we deem them to be. That's not what this thread is about.

Ask yourself why no expense was spared... was it to fulfill a quango, to give jobs to the HSE? Why would anyone who had eyes continue the cycle of addict/patient/addict.

I don't think education or rehabilitation is the issue when it comes to heroin users.

All due respect Cat I think you have missed my point.
If there was an interest paid in kids in underprivileged areas(that was where the preschool was in my example)maybe these kids would have been made to feel like they were "worthwhile".

You don't just wake up at 16 or 18 or whatever and become a junkie, there have been maannnyyy long years of neglect(of whatever description)before this happens.

It only takes one person to intervene in a childs life to put them on the right path.

orestes · 11-03-2013 05:35AM

catallus wrote: »

If someone wants to quit then the option should be there, methadone etc, if they want, but this willful and tortuous procedure in place now is at odds with every progressive and helpful idea and ideal I can think of apart from the dreams of doctors and psychiatrists who are making a mint from the imprisonment of the weak in the labyrinth of the law.

I'm sorry, but I have no idea what you're talking about here or what this is supposed to mean. It sounds brilliant, lots of nice buzzwords and lofty phrases and all that, but what does it mean?

Hank Scorpio · 11-03-2013 05:41AM

Phew! I haven't felt that good since Archie Gemmill scored against Holland in 1978!

catallus · 11-03-2013 05:46AM

Smidge wrote: »

All due respect Cat I think you have missed my point.
If there was an interest paid in kids in underprivileged areas(that was where the preschool was in my example)maybe these kids would have been made to feel like they were "worthwhile".

You don't just wake up at 16 or 18 or whatever and become a junkie, there have been maannnyyy long years of neglect(of whatever description)before this happens.

It only takes one person to intervene in a childs life to put them on the right path.

No, you wake up when you're 24 or 36 and your circumstances ( a partner leaves you, or you decide you don't want to or can't carry on in this world) and somebody offers you an antidote in the form of a drug and you take it because you can't see any other way out.

I get what you're saying: it's hard work to become an addict, but the hard road is easily taken when the world is against you; which one of us here can say we are so intelligent that we never made the wrong decision; to throw away a person because they are chemically and clinically dependent on heroin is wrong.

It's not about the kids. The law protects them well enough.

Cavehill Red · 11-03-2013 05:46AM

orestes wrote: »

I'm sorry, but I have no idea what you're talking about here or what this is supposed to mean. It sounds brilliant, lots of nice buzzwords and lofty phrases and all that, but what does it mean?

It means our current response to the heroin problem serves doctors (and to an extent other professionals like the police and prison officers) rather than those addicted, and suggests that a more progressive solution that actually addresses the addicts rather than the bank accounts of non-addicts ought to be found.

Smidge · 11-03-2013 05:53AM

catallus wrote: »

No, you wake up when you're 24 or 36 and your circumstances ( a partner leaves you, or you decide you don't want to or can't carry on in this world) and somebody offers you an antidote in the form of a drug and you take it because you can't see any other way out.

I get what you're saying: it's hard work to become an addict, but the hard road is easily taken when the world is against you; which one of us here can say we are so intelligent that we never made the wrong decision; to throw away a person because they are chemically and clinically dependent on heroin is wrong.

It's not about the kids. The law protects them well enough.

Heroin addicts who become so later in life are in the minority.

I'm talking about the majority who become addicts not through adult problems(ie 24 or 36 years of age) but through years of psychological,emotional,physical and social neglect as a child as whose world view is totally skewed, so much so that they feel they are worthless from a very young age.

If a child feels like that, where else is there for them to go?

Also, if you think the law in this country protects kids, you are fooling yourself.
It doesn't.
I see kids on a regular basis who should NOT be in their parents care

catallus · 11-03-2013 06:01AM

Well Smidge, I'll disagree with you on this point. Abuse of the mind and body of young people might be a catalyst for them to venture into drugs, but the same could be said for any drug.

Anyway, my point in the OP is about how to help them, not how to prevent it (which we never can)

Czarcasm · 11-03-2013 07:11AM

catallus wrote: »

Well Smidge, I'll disagree with you on this point. Abuse of the mind and body of young people might be a catalyst for them to venture into drugs, but the same could be said for any drug.

Anyway, my point in the OP is about how to help them, not how to prevent it (which we never can)

You're wrong. You're even more wrong with your give heroin addicts free heroin policy. You stated in your OP they wanted to get off smack, heroin, whatever, then suggest giving it to them for free because they'll never get off it?

I have successfully gotten people off heroin in the past and in my voluntary work I'm practically surrounded by heroin addicts and other types of drug users. You want to know what the best way to get them off heroin is?

It's not methodone subs or giving them free heroin, etc, it's letting them go cold turkey, letting them get wrecked, let their body clean itself out, then be there to support them and motivate them and not just dismiss them as hopeless and lost causes.

Cavehill Red · 11-03-2013 07:20AM

Czarcasm wrote: »

It's not methodone subs or giving them free heroin, etc, it's letting them go cold turkey, letting them get wrecked, let their body clean itself out, then be there to support them and motivate them and not just dismiss them as hopeless and lost causes.

Nonsense. The relapse rate for going cold turkey is approx 80% of addicts - in the first month.

Czarcasm · 11-03-2013 07:29AM

Cavehill Red wrote: »

Nonsense. The relapse rate for going cold turkey is approx 80% of addicts - in the first month.

I must have dealt with the other 20% so.

No, please, don't go linking statistics, figures and surveys, I'll tell you straight out now I couldn't care less about figures on paper without any context of each individual human being behind them.

Treatment for Heroin Users

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