Gone, baby, gone

It appears that opium harvests greatly exceed demand for heroin and no one seems to know where the excess heroin is.

Plan to vaccinate babies against drugs

The U.K.'s Daily Mail recently ran a story on a plan to vaccinate children for cocaine, heroin and tobacco. The vaccine would prevent any effects from the drugs and therefore prevent any addiction.

A group called the Transform Drug Policy Foundation has written a response on their blog. They argue that: Drug vaccines don’t really work; Giving drug vaccines to children is profoundly unethical; Even if vaccines worked it wouldn’t prevent problematic drug use, or offending.

I find it pretty unlikely that there would be any significant steps in this direction in the near future. I think it's far more likely that drugs like this will be tried with people who have developed problems before their used in preventative strategies.

Activists Plan 'Safe Site' for Drug Smokers

Another article on calls for a "safe inhalation site" in Vancouver:

Addicts who smoke hard drugs will have an indoor place to get their fix if a Vancouver drug users group is able to open North America's first safe inhalation site later this year....

Such an unsanctioned facility would provide a supervised location for addicts to smoke crack cocaine and heroin, in much the same way that Insite -- Vancouver's legally sanctioned three-year-old safe injection site -- provides services to addicts who inject the same drugs.

Ending an Opium War: Poppies and Afghan Recovery Can Both Bloom

Washington Post columnist Anne Applebaum argues for the U.S. to start purchasing opium poppies from Afghanistan. She frames it through a lens of Afghan national stability and U.S. foreign policy interests. Her arguments are persuasive, unfortunately a couple toss away lines suggest a bias:

Of course it isn't fashionable right now to argue for any legal form of opiate cultivation.

...

The only good arguments against doing so -- as opposed to the silly, politically correct "just say no" arguments --...

What are the "just say no" arguments anyway? Am I silly for feeling queasy about the idea of further institutionalizing poppy farming and wondering if has the potential to increase international production?

I'd also challenge the "politically correct" and "unfashionable" feels spurious., she's hardly in the wilderness. Certainly, the White House is staunchly pro-war-on-drugs, but the media, academics, public health activists, and growing numbers of politicians and political thinkers on both ends of the spectrum are increasingly calling for radical changes in drug policy--including legalization

The needle and the damage done

This 2 year old article about the disciplinary of some British methadone maintenance physicians has been making the rounds today. It has a pretty clear bias for maintenance, but it offers quite a bit of history about the British opiate addiction treatment. It also illustrates how committed the British system has been to methadone. The whole debate is between methadone detox and methadone maintenance.

As the story of these doctors progresses, it includes drugs (obviously), Madonna, Hollywood and martial arts--what more could you want?

Three of the doctors involved were found guilty of misconduct and one was stripped of his license.

Afghan heroin surge

The LA Times reports that the DEA is denying a surge in heroin from Afghanistan in spite of an internal memo released by Senator Feinstein:

Heroin-related deaths in Los Angeles County soared from 137 in 2002 to 239 in 2005, a jump of nearly 75% in three years, a period when other factors contributing to overdose deaths remained unchanged, experts said. The jump in deaths was especially prevalent among users older than 40, who lack the resilience to recover from an overdose of unexpectedly strong heroin, according to a study by the county's Office of Health Assessment and Epidemiology.

...

According to a Drug Enforcement Administration report obtained by The Times, Afghanistan's poppy fields have become the fastest-growing source of heroin in the United States. Its share of the U.S. market doubled from 7% in 2001, the year U.S. forces overthrew the Taliban, to 14% in 2004, the latest year studied. Another DEA report, released in October, said the 14% actually could be significantly higher.

Poppy production in Afghanistan jumped significantly after the 2001 U.S. invasion destabilized an already shaky economy, leading farmers to turn to the opium market to survive.

Not only is more heroin being produced from Afghan poppies coming into the United States, it is also the purest in the world, according to the DEA's National Drug Intelligence Center.

Despite the agency's own reports, a DEA spokesman denied that more heroin was reaching the United States from Afghanistan. "We are NOT seeing a nationwide spike in Afghanistan-based heroin," Garrison K. Courtney wrote in an e-mail to The Times.

He said in an interview that the report that showed the growth of Afghanistan's U.S. market share was one of many sources the agency used to evaluate drug trends. He refused to provide a copy of DEA reports that could provide an explanation.

The agency declined to give The Times the report on the doubling of Afghan heroin into the U.S. A copy was provided by the office of U.S. Sen. Dianne Feinstein (D-Calif.), a member of the Senate Caucus on International Narcotics Control.

This potent heroin, which the DEA says sells for about $90 a gram in Southern California, has prompted warnings from some officials who deal with addicts that they reduce the amount of the drug they use. Many addicts seeking the most euphoric high employ a dangerous calculation to gauge how much of the drug they can consume without overdosing. An unexpectedly powerful bundle of heroin, therefore, can be deadly.

"I tell people, 'If you're using it, only use half or three-quarters of what you used to,' because of the higher potency," said Orlando Ward, director of public affairs at the Midnight Mission on Los Angeles' skid row.

[via: New Recovery]

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.

Drugs: why we should medicalise, not criminalise

This sounds so rational. When you read the whole column, it's also wrapped in the language of social justice. However, her arguments are so flawed that it's difficult to know where to begin.

Of course we should try to get drug addicts off their drugs. It is good that waiting times are now shorter for rehabilitation. But treatment doesn’t work unless users really, really want to give up. And even then, they often relapse because the cravings are so strong. So it is not surprising that enforced treatment and rehabilitation is so unsuccessful. A National Audit Office report on the Government’s Drug Treatment and Testing Order, a court-administered mandatory programme for addicts, found that 80 per cent of offenders were reconvicted within two years.

It is much more sensible to prescribe a maintenance dose for addicts, which they must take under supervision so they cannot sell it on, until they are ready to try to give up. That way, they can attempt to lead a normal life, to refrain from crime, to stay off the streets, even to hold down a job, until they can wean themselves off the drugs.

Among the flawed assumptions are that:

• addicts don't want help;
  
• treatment is only helpful if they're in the "action" or "preparation" stage of change;
  
• the failure of their lousy treatment system means treatment doesn't work;
  
• legalization would be a panacea for consuming countries and producing countries;
  
• crime should be the measuring stick for the effectiveness of drug policy;
  
• abstinence focused treatment is ineffective;
  
• doing more would be too expensive;
• we have to choose between legalization and maintenance

I'm struggling to find the words, but I also find it troubling that among some HR advocates there is something resembling a fetishizing of heroin addiction or vicarious derivation of street credibility. While speaking to some harms, they fail to grasp the pain and demoralization that addicts experience when they call it an illness but treat it like a lifestyle choice. Why such half-measures when addiction is concerned? Why is the case for treatment on demand framed as a symptom of some kind of moral panic? I suppose I am guilty of moral alarm at the "suble bigotry of low expectations." (Now, now, principles before personalities.)