Wednesday, December 20, 2006

A Complicated Kindness: Vancouver’s Heroin Prescription Trial Raises Research Ethics Concerns

Silly me.

I thought that an op-ed exploring ethical concerns related to an experimental heroin maintenance program may raised questions about the lack of accessible abstinence-based treatment, the palliative approach to a treatable condition, the stigmatization of heroin addiction as untreatable, or, maybe even questions of informed consent for a study offer people with a brain disease their poison.

I was too optimistic. The concerns revolve about the high admission threshold and the time-limited nature of the study--which, actually sounds like a legitimate concern. If you're going to assume the role of supplier, there are some ethical concerns about cutting off the supply.

4 comments:

Anonymous said...

QUOTE JASON:Silly me.

I thought that an op-ed exploring ethical concerns related to an experimental heroin maintenance program may raised questions about the lack of accessible abstinence-based treatment, the palliative approach to a treatable condition, the stigmatization of heroin addiction as untreatable, or, maybe even questions of informed consent for a study offer people with a brain disease their poison./QUOTE

There is more abstinence based treatemnt available than palative, I guess you live in a world where inefective treatments should be promoted over patient choice or the trial of alternative's...pass the leaches please.

A treatable condition indeed, very easily managed with maintainence but you'd no doubt like to see methadone stooped as well and the subsequent increase in deaths and crime.

and as for informed consent and brain disease LOL prehaps you need to look into recent research into brain chemistry and addiction, the disease model is a little old testament, still your opening words were right on the mark...silly you!

Jason Schwartz said...

I don't know where you live or how much you know about accessing treatment, but I just admitted a heroin addict who waited 6 months for residential treatment. There was no funding for it--insurance won't pay, indigent funding systems are grossly underfunded. The only treatments immediately available are methadone or once a week outpatient. I don't have a problem will methadone under 3 conditions: first, that there is reasonable access to good abstinence-based care too; second, that the methadone is one part of a comprehensive bio-psycho-social treatment program; third, that patients be permitted to detox. (We see clients who were refused methadone detox and were treated as non-compliant.)

You've inspired a new rule for posting. I'll screen comments for flaming and spam.

Anonymous said...

Hi Jason!
I find your perspective very interesting. I'm a student journalist at SFU adn I recently wrote an article on the effect of Insite on the community. And although i agree wtih the philsophy of harm reduction, it seems rather futile if we have all the harm reduction in the world but a lack of addiction treatment. From your previous comment it seems that you from a first hand experience about this problem. Do you think you can give me more info on the difficulty of assesing treatment? I'm thinking of doing a story on this issue. Espeically in light of Sam Sullivan's suggestion of substitution treatment.

Jason Schwartz said...

I'm not sure what you mean by assessing treatment, but I'd be happy to speak with you. You can reach me at jschwartz(at)dawnfarm.org or 734-485-8725.