Addicted to methadone?
Old habits die hard. The latest figures on drug treatment in England [876KB PDF] show that despite calls for services to be "more ambitious", despite a new drugs strategy stressing the importance of helping users get clean, the proportion of addicts getting into rehab is stuck at just 2%.
Out of 207,000 problem drug users who were in treatment last year, the official data show that just 4,600 managed to access a residential rehab bed. Meanwhile, the number of heroin users in England prescribed methadone and other substitute drugs has gone up to a record 147,500.
Let me remind you what the National Treatment' Agency's Paul Hayes wrote last November:
"The problem with methadone (the standard treatment for opiate addiction) is not that it doesn't work, but that it works too well. Stability, improved health and reduced crime are necessary steps on the road to recovery and a drug-free life, but not the destination. We need to balance the risk of relapse if people attempt abstinence, against the risk of inappropriately thwarting their ambition to become drug-free."
In arguing that "too often the system is not ambitious enough", Mr Hayes was signalling a change of direction in drugs policy. A philosophy of harm-reduction had seen tens of thousands of heroin addicts effectively parked on methadone for years.
Government ministers, embarrassed by my revelations that only a handful of addicts leave treatment drug-free each year, demanded a shift from "maintenance" to "recovery".
So today's statistics will be a real disappointment. The agency wrote to me earlier this week to say that the latest figures "have given us cause for concern as they still show residential rehab not growing at the rate we would expect it to". Now I know why.
The NTA estimates that the treatment system currently has the capacity to provide residential treatment for around 17,300 people a year and, even accepting that the 4,600 users identified today is an under-estimate, it is clear that there are far too many empty beds.
Earlier this week I went to one reputable rehab centre in South London where managers told me they were operating at around 50% capacity. Half the rooms were unoccupied even though there were hundreds of people locally trying to get into the unit.
Manager Dave Heywood was particularly incensed that drug teams were not referring addicts because the National Treatment Agency had just spent thousands refurbishing the centre and equipping a new fitness room. He asks:
"Would you spend £10,000 redecorating your house and then walk away and leave it empty for six months?"
Nearby I met Mark Dennison, a 44-year-old homeless man who has used heroin for 25 years. He was caught shop-lifting at the beginning of this year and the court gave him a Drug Rehabilitation Requirement Order - basically he had to get treatment or he could be sent to jail.
So, Mark spent 12 weeks straightening himself out on methadone, he then went through six weeks of detox. The next step should have been rehab but he didn't get the funding. The consequence was entirely predictable.
"I ended up going back onto heroin. I didn't have anywhere to live and they expected me to go back onto the street, homeless and not take drugs. I'd done all that work and it just seemed ridiculous. It's obvious what's going to happen. And you don't even see the people it goes up in front of, a board which you have no contact with. We appealed it three times. They refused me three times."
Faced with a heroin user like Mark, drug workers have to make a calculation. Residential rehab typically costs between £500 and £1500 a week. Methadone, in contrast, costs virtually pennies. Many addicts won't manage intensive rehabilitation and end up using again.
But methadone is an addictive drug itself and there are real risks. Last year 378 people died from an overdose of methadone. One person every single day. The death toll was 16% higher than the year before and 73% more than in 2004 (Deaths related to drug poisoning in England and Wales [310KB PDF]).
When it comes to making the choice, drug workers tend to go for the cheaper option, as today's figures show.
The consequence is that only a small proportion of people using treatment services end up clean.
The phrase "no drug use" in the top line means that clients are free from substitute drugs as well as their "drug of dependency" so, while numbers are increasing, this chart is hardly a cue for celebration. Just under 9,000 people out of a total of 207,500 in treatment emerged drug free last year. That is 4.3%.
Quite rightly, the National Treatment Agency will argue that drug addiction is a chronic condition and users are likely to need a few goes at giving up. Just as smokers may quit many times, so might a heroin addict.
And there is some cause for optimism in today's statistics - fewer young people are coming into treatment for heroin and Paul Hayes feels confident enough to claim that "we may have passed the high-water mark for heroin addiction in this country".
But, but, but. More mature heroin and crack addicts are entering the system than ever - 24,000 last year - and if we want to help them get off drugs completely can we be satisfied with a half-a-billion pounds a year system that only managed to get 9,000 people clean?
PS The NTA has suggested I clarify the meaning of "no drug use" in the table I reproduced. To be clear - these are people who have been through treatment and are discharged free of their drug of dependency and, in the judgment of their clinician, of all other illegal drugs. Obviously, no-one who is discharged from treatment can still be on methadone.
Worth adding too that few believe the only value in treatment is getting people off all drugs. Clearly, there are social benefits in dealing with the destructive chaos that can often go with drug misuse. Yes, there is some good news in today's statistics but there is still some way to go to ensure that people like Mark (see above) are given every chance to get off drugs, to stop committing crime to fund his habit and to start contributing to wider society.
I'm 
~RS~q~RS~~RS~z~RS~00~RS~)
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I am confused - is the conclusion that capital has been spent on rehab accommodation and staffing too but there appears to be a funding issue that prevents greater utilisation of these facilities? If this is correct who is responsible for making the decisions and when will they account for this situation?
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The only answer to the drug problem is de-criminalise it then regulate it. Politicians know this but like all tough decisions dare not say it.....
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This seems to be a common problem in this country.
I've heard of similar cases with things like millions being spent on a new hospital wing which remained shut because they couldn't aford the doctors & nurses to staff it, schools refurbishing classrooms but not using them as they couldn't afford teachers and from the private sector train companies having to cancle trains because they don't have enough drivers (despite having the stations, tracks and trains).
I think it must be a problem with the accountants / accounting methodoligies that can pass one-off capital expenses but can't authorise ongoing expenses (wages) and the budgets are so inflexible they can't re-allocate money from capital to revenue budgets.
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The thing that Mark misses here is the news behind the story. Residential rehab is costly and most rehabs are private businesses. Each council only has a limited finate amount of finances to spend on treatment for people in their local area. It is costly and doesn't always work. Clients often take 3 or 4 times to get completely clean. The fact is methadone does save lives and removes the need to committ crimes in order to fund a habit. Also there is a lot more work done now on reducing client's methadone towards abstience. However the fact remains some clients will never suceed without methadone and will not live beyond their 40's. So things are not as simple as they seem.
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How about financing the voluntary sector?
I work as an unpaid volunteer along with many others in a Christian community which specializes in taking people in and rehabilitating them. We don't have a waiting list or long interviews and referrals (mark could have come to us the same day) we don't require funding (we are self funding) we have an open door policy because addicts need residential help the same day. What we need is a property in the country where we can take people in for the first part of their rehabilitation but we need upwards of £500,000 for that. Being a small Charity (reg:1010448) that is a huge amount of money for us but apparently the Government throws that away regularly in ineffective projects. We have a good success rate so give us funding and send all the addicts/alcoholics to us!
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Realistically there is no complete answer
All we can do is offer rehabilitation to those who want it by having an open door policy and continue to crack down on drug imports and dealers. Please don't de criminalize or regulate it, stop giving methadone out...have you ever nursed someone through methadone withdrawal? I have and I've been through it myself and it's beyond words the suffering compared to heroin withdrawal, as is coming off Subutex.Total abstinence is the only way and that has to come from wanting to give up, the only thing methadone does is set you free to use other drugs except in very rare cases(the voice of 27 years of experience)
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This comment was removed because the moderators found it broke the House Rules.
I work in the drugs field and have for a decade.
This idea that getting "clean" is everything is very dangerous. And it was the way things were up until the 90's. Why did we change to the harm reduction approach? - because more people could be helped! Now hundreds of thousands. Yes we could detox more people more quickly - but they would be back very soon for another detox. And remember there are real dangers with detoxing. The point you are most at risk of overdose is straight after a detox when your tolerance is reduced. So extrapolated over thousands of detox's - this means more deaths. Here is a future Mark Easton bog - Overdose deaths soar due to hasty detox's!
This is a difficult area with enormous need. I am aware of Mark's repeated focus on the NTA and I it has a real right-wing feel to it. Sorry Mark. The are issues with the NTA - how about the huge amount of data and paperwork they require of us. Perhaps if that were removed we could do a bit more "treating".
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Rapping people up in cotton wool in rehab away from any real temptations of drug use? is rehab really the answer? is their any evidence post rehab that people stay clean for the long term?
The fact of the matter is rehab is like living in a bubble. The real test in staying drug free is the post rehab experience. More discussion should be given to this?
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I am currently on Methadone and I have many problems with my treatment.
I have not been able to see my keyworker for nearly 3 months now! She is always ill or unavailable, A few months ago I was very low and feeling suicidal I contacted my Keyworker, who has always said she will be available for me to talk to, and explained just how low I was feeling. The response I was met with was 'What do you expect me to do about it?'
I explained that I was unhappy with my treatment, especially the way my medication has been messed around with without my consent or knowledge.
I used to collect my methadone 3 times a week then suddenly and without warning this went to 2 times a week and 2 weeks later this went to once a week all without asking me first. I explained that this is unsettling for me and I was told it was because I have given negative drug tests.
I havent had a drug test since January this year. My meetings with my keyworker take about 2 minutes every 4 weeks (That is when Im able to see her) I am asked if I have used heroin or crack and when I reply yes, my keyworker says 'I wont test you this time then'
I have had enough of the way i am being treated by them.
It makes me feel that im not a person in their eyes I am simply a statistic and am being manipulated by them for their own benefit.
I have complained several times about this and have written to the PCT and BAIS (The drugs agency that is responsible for my treatment) and I get no-where.
It appears I do not have a voice and any complaint I try to make is pushed from pillar to post.
Whenever I contact them to find out how my complaint is progressing they claim continually they have no record of it, even though I have sent the complaint by recorded delivery and have even travelled to their offices and handed it to the appropriate department personally!
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Note that when "Mark" says he was off heroin while he was on methadone, he's almost certainly lying. Methadone is used in addition to heroin, not instead of it. Might as well give them heroin and be done with it.
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I was employed within the substance misuse field in one form or another for over ten years, Tiers one to four. In my last post I worked at Tier 3 for a national organisation (Corporation) which will remain nameless.
I decided to opt out this year after becoming increasingly concerned with where monitoring drug treatment was heading. Countless times I and my team were reminded that TOPS form monitoring and funding was intrinsically linked.
Targets-funding-targets!!!!! Commisioners and managers ego's were more the focus than the client and their physical and mental health.
We were constantly hounded by management to massage figures and data (TOPS). No longer was the client the focus of treatment, but the data that could be manipulated. This I am afraid, was endemic of the organisations I was employed with throughout the last decade.
Access to rehab for clients is in the hands of local CDAT who of course hold the funding for Tier four treatment. Drug treatment for clients is available to those who wish to jump through hoops to receive it.
The last organisation I worked for, one of the biggest service providers in the UK, employed ex service users after finishing 16 week structured day care programmes, all of which relapsed consistently.
If you want to see drug treatment a success in the UK, then CLEAN it up from the TOP first.
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Fifteen years ago, I was working as a community support (for a voluntary organisation) with a number of homeless people who were on a methodone 'scrip'. All of them ended up back on heroin eventually, because of the very issues you raise, they were back on the streets, on methodone, with no long term efforts to get them off their drug dependence or to address the issues that put them there in the first place. They also told me that methodone messed with their digestive systems, made them feel very ill, and unable to eat properly, and that in may ways it was worse than heroin. What all of them would have preferred, was a clean supply of heroin (short-term) with support (long-term) to get them off drugs altogether and to get their lives back together. That support just wasn't available. Fropm what you say, it sounds like things have not improved at all.
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Methadone maintenance is a bit akin to "helping" a drunk stay off whiskey by feeding him beer. Maybe ok for a detox (although there are better ways), but this shouldn't go on for more than a couple days.
It might "reduce harm", but calling it treatment is a lie. Even when it achieves its goal, it leaves an addict active in his addiction. I also don't necessarily believe it requires expensive rehabs. Narcotics Anonymous is free, as are numerous church-sponsored programs based on largely the same principles. If an addict is inclined to get free, NA will work; if he's not, I don't care how good your facility is.
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The problem with treatment of any kind is it must be structured around the current laws on drug use. which in turn is the inherent flaw in all treatment programs.
We need a public referendum on drugs and drug policy should be set in law by experts no One person should ever have the last say as the result will always be based on personal belief.
The issues of funding are common and will only improve if the drug treatment programs have a steady source of income. IE an economy based on soft drugs that will fund those that are now at harm from both the dealers and the government in turn to get their lives back on track. In turn by having a legal platform to base drug use and consumption on will free up resources and slow the human trafficking issues that we have in the UK. There are so many problems that while they wont be totally fixed they will be greatly reduced and easy to manage.
Then maybe we can start closing prisons the way they are in the Netherlands. which in turn puts more money into the public purse for public spending.
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What do these people expect? That we pay for them to have houses and jobs and pay for them to have great lifestyles just to stop them doing something that they shouldn't be doing in the first place? Why can't we just bang them up and use drugs confiscated from drugs busts to wean them off the stuff if they want to get off it? Then it'll cost less! Personally I'd let them take as much of the gear as they want. That's what they want isn't it? At least it'll keep them quiet and relatively safe whilst the rest of us are struggling to get on with our lives.
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Methadone is technically an even stronger class A drug than heroin. It's more dangerous and is even harder to get off than heroin. Most addicts just use methadone as a safety net for when they've got no heroin. Trouble is, it doesn't give them the same fix asheroin. So why don't the government just let doctors prescribe addicts heroin like the Swiss do? Crime would plummett. Consider that addicts make up 2% of the population and committ 70& of the crimes, our current drugs strategy is pathetic and immoral.
For rehab to work addicts need to want to get off heroin. Cutting back methadone and increasing rehab treatment will just result in more heroin being bought and more crimes committed. It's not brain surgery, yet this seems to be the new cosy consesus that will no doubt be shattered ten years down the line as we hit another brick wall. I wonder what the new strategy will be then?
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@11 Rogerborg
"Might as well give them heroin and be done with it."
Actually, there's truth in that. Heroin itself is pretty cheap, not all that harmful when given in clean, controlled doses and as part of a rehab/detox program and it turns out from a study I read a few weeks back that using a steadily decreasing dose of the real thing is MORE effective than methadone treatment.
We, and by we I mean politicians and a portion of the move conservative (small c) end of society, are just hung up on this "Heroin is a drug! Methadone is a medicine!" thing that's not really true.
In the end I'm of the view that the criminalisation of heroin and other drugs just doesn't help here. Clearly it's not something we just want to make available to people, but at the same time the more we make heroin addiction a medical rather than a legal issue the better.
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@10 supadannydee
"I am currently on Methadone and I have many problems with my treatment. I have not been able to see my keyworker for nearly 3 months now!"
Supadannydee, We are concerned to hear of the problems you have been experiencing and we would like to talk to you. Please contact the National Treatment Agency on [Personal details removed by Moderator]
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The drug experience: Heroin
http://wiredin.org.uk/all/articles/entry/2077/the-drug-experience-heroin-part-1/
Well worth a read.
"There are nearly half a million war veterans in Scotland and at least 100,000 have mental health problems as a direct result of their war experiences...
More than 5000 veterans are homeless (in Scotland alone) and many find it difficult to find any real structure after being institutionalised by the forces."
Source: http://www.dailyrecord.co.uk/news/real-life/2009/09/02/ex-paras-reveal-how-armed-forces-fail-scots-war-veterans-as-they-are-dumped-back-in-society-86908-21642170/
I wonder how many of them end up as addicts ?
"55-year-old Martin Riley, the son of a regimental sergeant major in the Royal Engineers. He worked in bomb disposal and mine clearance; dangerous and exacting work. 'I don't know why - I'm certainly not a hero,' he reflects. 'It seemed exciting at the time, though.'
Drugs proved to be Riley's undoing and the start of a spiral into addiction. Today he is off heroin and although he hated the hostel at first, he now describes it as 'an absolute bloody life-saver'."
Source: http://www.veterans-aid.net/news-soldierspfmisfortune.html
The story behind addiction is never as straight forward as some people would like to make out. It's easy to make statements like:
"What do these people expect? That we pay for them to have houses and jobs and pay for them to have great lifestyles just to stop them doing something that they shouldn't be doing in the first place?"
The reality is often very different, for many addicts Heroin appears to be an escape from the misery, monotony & danger of their daily lives at first but can quickly overwhelm them and leave them unable to do anything about their problems.
It really is about time people came down from their ivory towers and accepted that "There but for the grace of God go I" next time they see an addict. Many very successful people have had their lives fall apart through no fault of their own; none of us knows how we would cope with such an event occurring in our lives or how long it would be till we reached out for the needle.
Personally, I'd make it a government policy to buy Heroin directly from the Afghan farmers and then provide it free of charge to all addicts in a safe and medically supervised environment where the addicts would be able to access help with kicking their habit.
I don't really see the point of Methadone, why replace on addiction with another that is just as hard (if not harder) to kick while having no health benefits to the users ?
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I know this sounds callous to suggest, but in a world where we're about to start cutting NHS frontline services (and I know, I'm committing blasphamy by suggesting that our politicians are lying to us, but stay with me), is attempting to get everyone to the "golden standard" of a drug-free life a high priority?
Obviously methadone has many social benefits over heroin - reduced crime blah, blah, blah - and at very little cost. The NHS decides how much a QOLY (quality of life year) is worth when it comes to life and death. Is the same calculation made with drug rehabilitation?
Obviously here I'm only considering the optimum allocation of Government resources. I think drugs are disgusting things that destroy lives and should be tackled as such.
Given the storys we're reading here, and the knowledge that the Government is incapible of treating people as human beings, I'd say:
@ 5 david... - I would love to see the government buy your charity a house to work in, rent free. The voluntary sector is almost by definition a preferable choice for providing drug treatment and there is no reason they shouldn't do it. The costs are minimal and the social returns are great.
Given what I'm learning about methadone reading here, it does sound preferable to prescribe heroin.
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There are three points which Mark's piece doesn't cover, and which are rarely ever mentioned when discussing heroin use - one: there are a lot of 'functioning' addicts out there. they can control their heroin intake and hold down steady jobs. and two: many addicts do not inject heroin, they smoke it.
and thirdly; people take drugs because _they like how it makes them feel_
so we if we ever going to get a realistic picture of heroin use, we need to think beyond the stereotypical imagine of a homeless heroin addict with a needle in their arm, robbing to pay for their habit. because there are many many instances where this just isn't the case.
heroin makes the people who take feel good when they first take it. what we should be spending all this money on, isn't 'rehab', but finding out why people get high in the first place. what we should be examining are the social reasons behind people taking drugs. and improving our social structure so people can feel emotionally supported, instead of relying on a drug to make them feel good.
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In patient units tend to be reserved for people with alcohol, not heroin, addiction. Detoxing from alcohol is dangerous, potentially fatal, while detoxing from heroin is unpleasant but can be done safely in the community. Whether this policy is useful or not -it seems to ignore societal influences on drug use- can be debated.
Also, sending people to local drug rehab clinics poses problems of keeping them near the drug users and sellers they know. But sending people to far away clinics has problems of funding.
Really, this blog shows again how disjointed the treatment for mental health problems can be. Services are created without the supporting structure to feed patients in one end, or care for them when they leave. There's not enough funding to staff these services properly. There's not enough funding to fill the beds.
And yet the need is *clearly* there.
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Why do we look down on those who take drugs because they Govenment is a party of hypocrites the media talks about drug taking as if it is only the lower classes that take it when this is far from the truth and what is drugs used for like blood diamonds for currancy the Govenment does not care how many us just as long as the media does not talk about them and their kids using it more people die from booze and ciggies all of these should have on the bottle and pack what it has in in it and what it does then take the stigma away from it and let people make a chose its the money that is the problem and those who make millions out off it like Curtis Warren and the Govenment.
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I've been reading all the comments - I find this subject very interesting indeed because I used to be addicted to crack and heroin. I managed to escape my addiction in 2006. It was a miracle or something like it, and I am very lucky to be alive.
My drug use was very intertwined with my ex-boyfriend. The two things didn't go without each other. I began using crack in 2003 and used heroin to help me sleep after smoking crack. It is strange to think back on it now. I knew I needed to stop about 3 months after I started taking the drugs and it took me nearly 4 years of going to a branch of the Cranstoun Drug Agency (of and on) and lots of time at 12-step meetings (AA, NA and CA) It took a lot of effort. I remember actually resigning myself to the fact that I would have to go and get drugs and do things I didn't want to do, for the rest of my life.
It was only in March 2006, when I tried to die and was taken to the emergency department that I could see some kind of way out. I at least became "unaddicted" to heroin.
I stayed at my mum's and didn't sleep for about 5 days. I thought I was going crazy. I asked my mum to call the doctor in the middle of the night one night because I couldn't sleep. The docotr said I should be doing what I was doing in a detox. I said ok then put me in a detox and of course she couldn't. There was a 6-week waiting list. I asked her if she thought I should go and buy some more drugs to put myself out of my misery until the waiting period of 6 weeks was up or if I should continue detoxing on my own. She didn't reply.
After two weeks, I didn't have a habit anymore and I went back to work. It helped me take my mind off things,but even after that, I used again, until June 2006 when I made another effort at meetings (I'd tried and failed so many times, at times I thought it pointless) but I made a really good friend there and we hung out all the time. She helped me when I wanted to use and eventually I stopped wanting to.
I stopped using crack and heroin because of my sheer determination not to have a wasted life and thanks to the people I met at meetings, who I put my faith in. They steered me in the right direction until I could do it myself. I do not go to meetings anymore. Sometimes I wonder if I should, but I am teetotal. I have a good life now. If I can get of class A drugs without a treatment centre in sight, with determination and a lot of support, anyone can do it.
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@ ScottishgirlNZ Well done to you a very brave choice I hope you continue to find the strength and friends to keep you clear.
You were very lucky in the fact that you have family that care you probably fall into a 5% bracket there though. The other 100's of thousand's of addicts in the UK are not so lucky.
It is time we stopped with Criminal action and treat people who have fallen into the trap of addiction like sick people people that have a life threatening illness like cancer or a failing heart(the failing heart is probably the most fitting example both emotionally and physically)
Again good luck in staying clean ScottishgirlNZ You'll meet a lot of people along the way that will try and drag you back but stay strong and keep your resolve even in the darkest of days.
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As the parent of a heroin addict I can't help but observe the general lack of compassion for a group people who are as vulnerable as many of the other sufferers from self inflicted conditions who are not regarded as almost sub-human. Heroin addicts along with alcoholics have been effectively abandoned by the state and are generally regarded with fear and loathing that in other circumstances would be considered a disgrace to civilisation. Despite the fact that thousands of former military personnel were succesfully treated with maintenance doses of "morphine" to manage addiction resulting from their service to the nation there is no great humane effort to solve the majority of criminal and social conditions resulting from heroin addiction by providing the addicts with the heroin they need. Instead they must live in abject squalor and experience each day in a permanent state of chaos because politicians decided to use them as vote winners. Heroin addicts apparently do not merit the care they need and have become political footballs for those in power who do not have the backbone to treat them for what they are -human beings with an illness. The many pat and frankly brutish remarks on this comment board serve to underscore the dehumanisation that has taken place in the UK where addicts are concerned. In almost all cases the reason they are addicts is not just that at one point they enjoyed their drug experience and made a collection of misguided judgement, it is that there exists no real society to care for them and to pursue their rights to a civilised existence. The country needs to look to the Swiss model where heroin addicts are provided with safe areas and prescription heroin as part of a dependency reduction program that eliminates almost all of the social issues that criminalised addicts find themselves in and commits them to a supervised and cost effective pathway to a more purposeful existence.
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@27
In wholehearted agreement with everything you've said.
@25
Keep up the good work, remember, you are worth it :)
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Boris couldn't agree more I hope all goes well for yourself and family, your right we teach hate of addicts with the same enthusiasm that the Hate towards blacks was in the USA and south Africa during the slavery years and later civil movements that finally gave equal rights to all humans regardless of race colour and sexual orientation, but they left addicts out and continue to enslave persecute and destroy lives with out dated policy.
World goverments are responcable for so much suffering when it comes to drug policy. People who say they want to keep drugs illegal should be made to live with addicts for a while live in communities for a while that is blighted by Class A drugs and see how well the Ivory tower policy stands up.
I urge all members of the public to ask why the goverment funds drug dealers with policys that are ment to protect us and our children and communitys. Why they make policy that creates a good market for class A drugs while making soft drugs expensive and unavalable to people leaving only addictive drugs at the cheap end of the market. Time to ask to see the policys work in the favour of the Crown of the public and of the tax payer sod the goverment they dont have to live with the consiquences of their ill thought out policy.
The blind truly will lead the blind in the UK.
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One of the most harmful aspects of drug taking is the rubbish that is mixed into drugs to maximise the profits of the criminals that sell them. These chemicals are often more harmful than heroin. The rich can afford to buy the more expensive 'cleaner' drugs whilst the poor have to put up with the poisoned variety. It was ever thus - '10 Ace' will always kill you quicker than a bottle of 'Bolly'.
But, now we have troops in Afganistan, why don't we kill two birds with one stone? We move into the Talibans poppy fields and offer protection and a better, safer market for the growers. We then market the drug as either morphiates or as pure heroin at knock down prices - selling only the purest strain we can achieve.
In the stoke of a fantatists keyboard we will have
1. Removed a huge source of income from the Islamo-fascists.
2. Stolen the market from the drug barons.
3. Provided a better quality drug to users who, if the want it, have to agree to a programme of 'weaning' off it.
Considering the millions wasted on the ineffective fantasy solutions of the cuddly-bunny brigade surely it's worth a try?
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Oh hooray, yet another self-appointed 'expert' who's read a few statistics and a few reports and thinks he's qualified to comment on myself and how I do my job. I have been a front-line drug and alcohol worker for many years and seen and heard many bright new ideas and strategies come and go, and consistently fought for better services for my client group in the face of politicians who only jump on the drug and alcohol bandwagon when they think it might win them a few votes. The latest simplistic ill-informed idea is the conservative 'rehab good, substitute prescribing bad' which Mr Easton seems to be advocating. It's no coincidence that rehabs are privately run businesses. Who else would they run to but the tories? Maybe they should consider being better businesses, take a look at the NTA rehab directory and see how much some of them are charging for example, before blindly accepting the premise that every client should be sent off to them so they can trouser public money.
That being said, I have always found my clients the appropriate treatment package, and I find it hugely insulting that Mr Easton can casually toss out comments like 'drug workers tend to go for the cheaper option' as if we do a cost analysis on every client who walks through the door. My clients get the right treatment for them, I leave the penny pinching to politicians. I cordially invite Mr Easton to come along to my project and see what we actually do, rather than tell me what I should be doing, as virtually every sentence in his article above proves he knows absolutely nothing about the realities of drug treatment.
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Whilst my life journey through working with addicts has now been over thirty years.I must say it has come down to two choices ,
1.Do we punish people with addictions
2.Do we treat people with addictions
The cost to the community, health implications and crime related addiction runs into billions of pounds.It is clear from the results that new methods are required to tackle a problem that is costing billions of pounds and effecting thousands of lives.Referral,treatment and support should be a matter of fact and planned from first intervention and most of all funded, and after all that process , the client still has to make the choice and always has that choice.We will always have people with an addiction, an with the ever increasing alcohol consumption that we see today with our youth , what is laying in store for later years, we are scratching at the surface once again.
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This is good
President Obama Issues New Medical Marijuana Guidelines
http://networkedblogs.com/p15006975
maybe we will see cannabis used to treat addiction to meth become more widly spread with this anouncement
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another interesting article.
High society: Britain's drug-taking clubbers
Almost all Britain’s thousands of clubbers routinely take drugs, in particular cocaine , cannabis and ecstasy
http://women.timesonline.co.uk/tol/life_and_style/women/the_way_we_live/article6879862.ece
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Responsible Use of Narcotics
These points to an interesting article in findrxonline where they talk about this subject it is necessary to inform the community.
It is ultimately the patient's responsibility to use narcotics responsibly.
A few years ago, narcotics were only prescribed after surgery, severe trauma, or for terminal cancer because of a concern over the possibility of addiction. Recently, they have been cautiously prescribed to treat moderate to severe non-malignant chronic pain in conjunction with other modalities such as physical therapy, cortisone and trigger point injections, muscle stretching, meditation, or aqua therapy. Unfortunately, the upsurge of narcotics as medical treatment also increased associated cases of abuse and addiction.
Derived from either opium (made from poppy plants) or similar synthetic compounds, narcotics not only block pain signals and reduce pain, but they affect other neurotransmitters, which can cause addiction. When taken for short periods, only minor side effects such as nausea, constipation, sedation and unclear thinking are noted.
However, when narcotics are taken for several weeks to months, these side effects can become more challenging: loss of effectiveness due to built-up tolerance, possible addiction, or overuse for a temporary "high," not for pain. Because of the potential for addiction, whether physical (anxiety, irritability, nausea, vomiting, abdominal cramps and insomnia) or psychological (compulsive use, craving the drug and needing it to "feel good," narcotics are considered controlled substances findrxonline indicated in their medical articles, which means that the FDA and DEA govern their distribution, prescription, and use and classify them into different schedules as per the Controlled Substances Act of 1970.
While weak narcotics such as Tramadol (Ultram) and Schedule IV opioids analgesics such as Darvon or Darvocet N 100 have a low risk for physical dependency and addiction with mild side effects such as dizziness, sedation, headache, nausea and constipation, Schedule III opioids analgesics such as Lortab, Tylenol #3, Vicodin and Vicoprofen have a low to moderate potential of physical or psychological dependence. Demerol, Dilaudid, Duragesic, Oxycontin and Percocet, which cannot be automatically refilled, fall under Schedule II because of their high abuse potential, and possible severe physical or psychological dependency.
In view of the fact that narcotics can be addictive, they should only be prescribed when no other alternative is available and should only be taken as directed by your doctor. Most often, patients are required to consent to adhere to certain rules regarding the use of their prescription listed in a "Narcotic Agreement" between the patient and physician. Often, violation of this contract, especially selling, sharing, or trading the medication, attempting to obtain duplicate pain medication prescriptions from different physicians, and attempting to have the medication refilled early, at night, or on the weekend, to mention a few, would result in the patient's discharge from the practice.
So, take responsibility for your actions and know all your treatment options. Narcotics are rarely your sole savior.
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In the main the power sits with the commissioners and community care budget holders in local authorities. They have finite budgets generally derived from the Pooled Treatment Budget and make decisions based upon need. However, the people making assessments and deciding how money should be allocated are generally not practitioners and often do not know the difference between modalities of treatment, let alone the difference between rehabs and their particular therapuetic approaches. This often results in clients being poorly matched with the right treatment, having to meet rigorous criteria for entry and residential treatment being viewed by professionals as the Holy Grail. 'Only when all else fails will we financially support rehab' is an all too familiar cry.
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Why not register addicts, provide them with appropriate doses of their drug of choice and throw the book very hard at anyone caught in possession who is not registered? Perhaps it would be too radical to suggest that perhaps the ingredients for herion be bought from Afghanistan? (Thus depriving the Taliban from a source of income?)
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My brother is a heroin addict and is currently on a methodone program. I live abroad and have no idea how to get him the help he needs. He has been taking methodone for at least 7 years, which frankly, seems like a case of passing the buck.
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I was on heroin for years and eventually got help from my local drugs team. Methadone stabilised my life, i'm now half way through a degree at uni. Words cannot explain how desperate i am to quit methadone, i long to feel normal again, to be me. My drug worker is no help at all, she rarely remembers my name or that i'm even on methadone. Everytime i see her i tell her i want to go to rehab; i've made so much progress now i just need rehab to help me through that final step. Unfortunately i'm not worth it, rehab costs to much despite me turning everything around. Being a student means i can't afford rehab, i want the help but its all down to money. If anyone can help me with my predicament please get in touch. Thanks.
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I think something should be said firstly for the processes in which heroin substitutes are issued. There is an increasing problem with addiction to heroin substitutes such as subutex, methodone. Subutex is taken and blocks the affect of heroin therfore giving you a free high rather than desperatly do anything just to get a score. Nothing has been said about mental health assistance. When will somebody ask the question 'why are people staying on this drug even after attempts of rehab have been made?' I believe there is a mentality in England where we just like to hand out medications to anybody we feel needs them. This is simply not enough. The thought of pyschological help is a taboo in Britain, where in many other countries worldwide, the method of psychologists is used on a daily occurence and actually viewed as normal. Lets stop labelling people as 'this' or 'that' and actually employ empathic and professional sociologits/psychologists to assist in the rehabillitation of users and programs need to be revised and stuck to nationally.
I have used most drugs but those that i have never touched, were mainly because i have never been in the presense of them. That is not to say that i would not have used them. I come from a wealthy area in the South East of England where heroin has become a 'buzz word'. Instead of a 16 year old wanting to experiment with marijuana, i have personally witnessed this age group scoring heroin. Times have changed to the point where the availability of this particular drug will determine how many users it attracts. I think a question also needs to be asked as to what measures are being taken to prevent smuggling and more importantly, are those in charge actually aware of the rapidly growing problem. There seems to be a relationship between this increase in availability and Britains activities overseas in The Middle East where most of the poppy needed to produce heroin, is actually harvested?
I have a 10 year old brother and i dont want him growing up thinking its ok, to speak of this drug in such a blahzay, naiive fashion. Would a generation seek something that they were not aware of?
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This prohibited drugs are called the "untouchables". There are many cases came from this prohibited drugs and still rising. How we could help as ordinary citizen? I'm working in a residential treatment centers and we cater those person who are addicted to drugs. At first it is difficult to handle but we need to focus on it to eliminate their addictions.
Consider helping them to have a second chance in life and let them be guided by us. This is one of the best option that I could consider for you to know.
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well its almost the same methdone methadrone
what have you done Mr Johnson
http://www.thesun.co.uk/sol/homepage/news/2883607/Meow-Meow-kids-go-off-sick.html
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How many More Mr Johnson
http://news.bbc.co.uk/1/hi/england/humber/8570582.stm
Time for Mr Johnson to go policy with his backing has brought about more death from drugs, the parents should hold the government personally responsible for providing the wrong message about drugs.
how long has this drug been around 9-12 months and it's all sounding very lethal.
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soon to be a big florishing of heroin in the UK......
going to see some tonage over the next few months....
http://www.nytimes.com/2010/03/21/world/asia/21marja.html
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