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Treat Addiction as a Disease


Big Guy

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Methinks in the Toronto Rob Ford thread, the issue of drug abuse was referred to. I thought it deserved a separate thread.

I believe that drug addiction should be treated as a disease. Unfortunately, too many people consider addiction to be the fault of the addict and that marijuana is the gateway drug. Neither is true.

Pain killers like Oxycodone have been prescribed to anyone and people are finding that heroin is cheaper than the prescribed drugs. Pharmaceuticals have become the gateway to heroin addiction.

https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2010/06/treating-addiction-disease-promise-medication-assisted-recove

To-day, the heroin addict is forced to deal illegally - this means that they aid the criminal elements and soon find themselves with a criminal record. That in turn makes it very difficult for them to find work, which sends them towards crime, which sends them to jail - and the circle continues. Addicts soon lose being an asset to society and their families and become a financial drain - either in jail @$100,000 a year or thieving and pawning other peoples valuables.

We accept the fact that some people will suffer from a disease (Diabetes, Epilepsy etc) for the rest of their lives so we provide drugs to keep them alive.

I believe that we should identify heroin addicts and guarantee a program that supplies them with their daily need. That would allow them to work, look after their families and become productive members of society.

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We accept the fact that some people will suffer from a disease (Diabetes, Epilepsy etc) for the rest of their lives so we provide drugs to keep them alive.

You don't treat addiction by supplying the addict with the addictive substance. Doing so simply dooms the addict to death. You treat an addict for addiction by providing the medical help to get through withdrawal and non-medical treatments so the addict can learn to live without drugs.

The point of the 'disease model' is to bring home the point that addicts have abnormal brain chemistries that lead to addictive behavoir and quitting is not simply a question of will power. The model is NOT intended to be an excuse for an addict to continue with their addition.

Edited by TimG
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Do people have to go through illegal channels to get addicted before they qualify as legal heroin addicts? What about other opiates like fentanyl? Should they be provided too? And hw productive can you be while addicted to heroin?

When you are addicted to any drug that forces you to become a criminal to stay alive then you are not only not productive, you are destructive, expensive and dangerous. If the addict if given and guaranteed a daily dose of his/her addiction then they are able to function, be productive and look after their families.

Methadone treatment costs about $4,000 per person per year and that individual is able to lead a normal life.

Incarceration costs about $100,000 per person per year. Include the costs of law enforcement and crimes due to an addiction then you are looking at ....

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You don't treat addiction by supplying the addict with the addictive substance. Doing so simply dooms the addict to death. You treat an addict for addiction by providing the medical help to get through withdrawal and non-medical treatments so the addict can learn to live without drugs.

The point of the 'disease model' is to bring home the point that addicts have abnormal brain chemistries that lead to addictive behavoir and quitting is not simply a question of will power. The model is NOT intended to be an excuse for an addict to continue with their addition.

That has been our approach for the last 100 years.

How's it working?

And "addicts have abnormal brain chemistries that lead to addictive behavoir"?? You have to be joking!

The "disease" model or approach accepts that it it not the "fault" of the addict for getting addicted but the addict has a disease which requires medication for him/her to function normally - just like a diabetic, a person with cancer or someone with any other disease that requires medication for the rest of the patients life.

There is still the misconception that a heroin addict is some black guy in the ghetto who started with pot and then got hooked for kicks and deserves to suffer and an early death. The reality is that the heroin addict is now a middle class previously normal individual who experimented or was over prescribed and is now a drain on our system.

No matter how that individual became a heroin addict, he/she can again become a normal functioning positive member of our society.

What we have been doing is not working.

Time to deal with reality.

Edited by Big Guy
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That has been our approach for the last 100 years.

How's it working?

And "addicts have abnormal brain chemistries that lead to addictive behavoir"?? You have to be joking!

Time to deal with reality.

The current model is incarceration, which isn't working, but treating people to overcome their addictions can be successfull and that doesn't mean giving it to them. We could try that first to see how it works.

But yeah, brain chemistry changes when you're addicted. It even changes for chronic marijuana users. I thought everybody knew that.

Edited by BubberMiley
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And "addicts have abnormal brain chemistries that lead to addictive behavoir"?? You have to be joking!

Yes: http://www.helpguide.org/harvard/how-addiction-hijacks-the-brain.htm

Today we recognize addiction as a chronic disease that changes both brain structure and function. Just as cardiovascular disease damages the heart and diabetes impairs the pancreas, addiction hijacks the brain. This happens as the brain goes through a series of changes, beginning with recognition of pleasure and ending with a drive toward compulsive behavior.

Treating addicts with the addictive substance is like treating diabetics with sugar. It only makes the condition worse and leads even worse medical outcomes.

BTW: treatment does work. There are millions of recovered addicts living clean lives today in Canada. Your statement is like saying that since people still get cancer that what we are doing to treat cancer is a failure. Nothing could be further from the truth. Addiction, like cancer, is a difficult disease to treat and not everyone benefits but from every treatment but the treatments we do have do work for some people.

Edited by TimG
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What I am suggesting does work. It is the last resort after treatment has proven to be ineffective.

http://www.independent.co.uk/news/science/heroin-to-be-prescribed-to-canadian-addicts-by-doctors-9878322.html

What is happening across Canada is not working:

http://www.cbc.ca/news/health/heroin-s-resurgence-as-problem-drug-in-canada-1.2525103

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What I am suggesting does work. It is the last resort after treatment has proven to be ineffective.

What is happening across Canada is not working:

Prescribing heroin can't work unless the addict is also working through the issues that lead to addiction in the first place. At best it will simply transfer the addition to another substance like alcohol where the effects are more muted. That said, this approach has merit if it leads to real treatment for the disease.

The second link does not provide any evidence for your claim that treatment does not work. What is says is new addicts are constantly being created because they have access to cheap heroin. If anything it suggests that the inability stop the drug trade is the problem.

Edited by TimG
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Prescribing heroin can't work unless the addict is also working through the issues that lead to addiction in the first place. At best it will simply transfer the addition to another substance like alcohol where the effects are more muted. That said, this approach has merit if it leads to real treatment for the disease.

The second link does not provide any evidence for your claim that treatment does not work. What is says is new addicts are constantly being created because they have access to cheap heroin. If anything it suggests that the inability stop the drug trade is the problem.

Just how would you stop the drug trade?

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Just how would you stop the drug trade?

Well that is the billion dollar question. The trouble for policy makers is legalization is no solution because legal prescribed drugs like Oxycontin are just as much a problem as heroine (i.e. even if heroine was a legal prescribed drug you will still have a huge illegal trade for people who do not wish to be limited by the quantities prescribed by a medical professional).

Whether we like it or not the illegal drug trade will be with us forever. What we can do is make sure that people are educated about addition before they get addicted (education - not scare mongering) and are able to access treatment after they get addicted.

Edited by TimG
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You don't treat addiction by supplying the addict with the addictive substance. Doing so simply dooms the addict to death. You treat an addict for addiction by providing the medical help to get through withdrawal and non-medical treatments so the addict can learn to live without drugs.

The point of the 'disease model' is to bring home the point that addicts have abnormal brain chemistries that lead to addictive behavoir and quitting is not simply a question of will power. The model is NOT intended to be an excuse for an addict to continue with their addition.

Agreed.

If an addict needs substances during treatment while they work on getting better that's fine, but mind-alerting drugs for a lifetime is a ridiculous idea. It's called a disease also because it will continue to get worse before it gets better unless treated.

I'd consider decriminalizing possession and use of small amount of substances though, you shouldn't go to jail for self-harm.

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Well that is the billion dollar question. The trouble for policy makers is legalization is no solution because legal prescribed drugs like Oxycontin are just as much a problem as heroine (i.e. even if heroine was a legal prescribed drug you will still have a huge illegal trade for people who do not wish to be limited by the quantities prescribed by a medical professional).

Whether we like it or not the illegal drug trade will be with us forever. What we can do is make sure that people are educated about addition before they get addicted (education - not scare mongering) and are able to access treatment after they get addicted.

The illegal drug trade would die if drugs were legal, like alcohol.

Alcohol accounts for the vast majority of substance abuse, and contributes to (drunk) crime, but not to organized crime in distribution and sales.

The illegal drug trade only exists because we allow it to exist.

It's foolish really, because the illegal drug trade does a lot more damage to our society than drugs themselves, and policing and punishing it costs a lot more than regulating it would.

Similarly for prostitution.

The best way to get rid of organized crime is to legalize and regulate personal choices - drugs and prostitution - like alcohol.

Save the policing and justice dollars for serious and violent crimes that victimize others, and for social and mental health support to prevent and treat addictions.

But that would make too much sense, I suppose.

.

Edited by jacee
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The illegal drug trade would die if drugs were legal, like alcohol.

Then why is there an illegal trade of Oxycontin? It *is* legal after all. Or are you suggesting that we should stop requiring prescriptions to access drugs and let people by as much as they want of any drug they want?
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People do not stop committing crime because of the penalties involved. Criminals do not have any intention of getting caught when they commit a crime.

Individuals have no intention of getting addicted when they are experimenting with illegal drugs. People have no intention of getting addicted when they take medicine that has been prescribed for them.

The consistent argument that I hear against treating addiction as a disease is that it is the addicts fault for getting addicted so they deserve a short life on the street. That just ain't so.

Treatment for Diabetes, Polio, Lupus, Aids, Asthma, Cancer et al is medication for the rest of the persons life. I believe that if a person has attempted treatment to cure an addiction and it has not worked then the only answer is to be prescribed medication (heroin, methadone) for the rest of their lives.

In this way that individual will be given the opportunity to lead a normal and productive life rather than be a scourge on society.

Edited by Big Guy
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The consistent argument that I hear against treating addiction as a disease is that it is the addicts fault for getting addicted so they deserve a short life on the street. That just ain't so.

Treatment for Diabetes, Polio, Lupus, Aids, Asthma, Cancer et al is medication for the rest of the persons life. I believe that if a person has attempted treatment to cure an addiction and it has not worked then the only answer is to be prescribed medication (heroin, methadone) for the rest of their lives.

In this way that individual will be given the opportunity to lead a normal and productive life rather than be a scourge on society.

No addict can 'live a productive life' if given access to whatever drug they want. There are some cases where an addict chooses to limit the consumption to an amount prescribed by a doctor but those cases depend on the addict being willing to live within those limits. If the addict decides they want more then they will be back where they were before. That is why the only real treatment for addiction is to address the reasons for desiring a high. Prescribing drugs to an addict is not a solution. It is euthanasia. Edited by TimG
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Then why is there an illegal trade of Oxycontin? It *is* legal after all.

Because of society's moral panic.

Or are you suggesting that we should stop requiring prescriptions to access drugs and let people by as much as they want of any drug they want?

We don't need a prescription for beer do we?

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Related to this topic is Obama's action today of commuting the sentencing (severe lengthy sentences) of 61 prisoners convicted of drug and firearm offences with most of them related to drug offences.

Mr. Obama has now commuted the sentences of 248 prisoners, more than the total commuted by the previous six presidents combined, administration officials said.

“Most of them are low-level drug offenders whose sentences would have been shorter if they were convicted under today’s laws,” Mr. Obama said on Wednesday in a post on his Facebook page. “I believe America is a nation of second chances, and with hard work, responsibility, and better choices, people can change their lives and contribute to our society.”

He is also working to put programs in place to ensure a more successful re-entry into society.

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You can't treat alcoholism by giving people booze. Giving people drugs isn't treating addiction, it is just an attempt to manage it. People have to be given the opportunity and resources to get clean, the rest is up to them.

Drugs can help with some addiction. Most alcoholics have a shortage of dopamine receptors, and drugs like naltrexone that reverse the effects of opioids can drastically reduce usage even in people that keep using. They might still habitually drink but now but they will no longer be chasing a dopamine reward state so they drink much less.

The key in any case is to stop wasting money on enforcement and reroute that funding to medical research and treatment.

Edited by dre
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No addict can 'live a productive life' if given access to whatever drug they want...

I totally disagree with the concept. All addicts can live a productive life if they are given access to drugs they need to be productive.

I apologize for picking just one statement out of your opinion. That is generally not fair and I try not to do it often.

There is an assumption that if a person is an addict then they are "impaired" or generally unable to function. That is not the case. There are a number of people in our area who are in the Methadone program. They submit their urine tests and then get their prescribed cup of Methadone - and then go to their 9 to 5 jobs in manufacturing, finance, education, private enterprise et al.

They have attempted withdrawal programs that just did not work got them. Their systems now require the drug (medication) to just get them to a physical point where they are able to function normally.

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You can't treat alcoholism by giving people booze. Giving people drugs isn't treating addiction, it is just an attempt to manage it. People have to be given the opportunity and resources to get clean, the rest is up to them.

When people have been given the opportunity to "get clean" and have not been successful then what?

Alcoholics have difficulty functioning because their addiction impairs their ability to function normally. That is why giving an alcoholic booze is never a solution. A heroin addict who requires his/her heroin or Methadone to function is a very different case.

Many heroin addicts are still very functional if they are in a position where they can afford to purchase the drug illegally. Because there is no supervision of dose, the requirement to stay "normal" increases with time.

I believe that it is in the best interests of Canadians if those heroin addicts who have attempted withdrawal and have not been successful be given free and supervised quantities of the drug to allow them to function in our society and to use the marketable skills that they have. It would also allow those addicts with family responsibilities to fulfill those responsibilities rather than have our government take over the raising of their children.

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You can't treat alcoholism by giving people booze. Giving people drugs isn't treating addiction, it is just an attempt to manage it. People have to be given the opportunity and resources to get clean, the rest is up to them.

Managing addiction is part of the recovery process. Injection sites offer both safe injection as well as resources for detox, housing, employment and recovery. If offering drugs in a controlled environment helps, which it clearly does given the numerous studies by experts, who are we to argue against that.

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That is why the only real treatment for addiction is to address the reasons for desiring a high. Prescribing drugs to an addict is not a solution. It is euthanasia.

The reasons for desiring a high can't possibly be addressed until the individual gets sober. It is the path to sobriety that needs to be addressed and that includes safe injection sites. As far as labels, addicts is too derogatory a term.

Edited by WestCoastRunner
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