Heroin injection rooms

[dudeness]

i have just been watching CNN and a short story on the introduction of a HIR in Vancouver..the first in Nth America..personally i believe they are a good idea and a solid health care initative..

[mmm]

1. agreed

good post

[Wonk]

2. A link for those not already familiar with this story

http://www.globeandmail.com/servlet/story/RTGAM.20030913.udrug0913ib/BNStory/National/

[WhoCountsTheVotes]

30. What good does this do? Any?

Well, it does keep the ugly junkies out of sight, but what does it do to help them? From the article:

"So far this year, 37 people have died of overdose deaths . . . this year in Vancouver," Mr. Campbell said in an interview. "What I hope is that it's going to prevent 37 people from dying."

How so? Shooting up in a little room is hardly different than shooting up in a doorway.

"It's saying, you the user are a human being and deserve to be treated like one, not just die in an alley."

Instead, they can die in a little room? I used to live right next door to an open air heroin market. I've been attacked by a junkie. I've seen people shoot up. The only solution is to arrest junkies and send them to involuntary detox and rehab programs. That is, if you actually want to save their lives, not just keep them out of public view.

The heroin market is *huge* of course, and seems to have high level people profiting from it, just remember as soon as the US outsted the Taliban from Afghanistan, the heroin started flowingly freely again.

(Needle exchange on the other hand is very good because it lessens transmissions of AIDS and Hep.)

[Cheswick2.0]

3. I have mixed feelings about this

Are they assuming because these people shoot up there that they will then be capable of making good choices at other times and places?

I am beleive you have to let people get sick, get arrested, sell their souls and their bodies so that they hit bottom and finally decide to get well. A cleaner, more comfortable place to shoot up might not be the answer.

[Wonk]

4. Did you read the article?

(snip)

Proponents argue that the clinic is needed to fight the epidemic of drug-related infections and disease raging though Vancouver's skid row.

Detractors Ñ and there are plenty Ñ say it condones drug use and will speed the downward spiral of addicts.

Still others say the clinic's ground rules are too tough and might scare away addicts.

(snip)

Researchers interviewed 458 addicts last spring in the Downtown Eastside and while 92 per cent said they would use a supervised injection site, support dropped to 32 per cent when told of the Health Canada guidelines.

more...



This isn't to make it easier for casual users to find a place to get high. It's targeted at already hardcore users, to keep them from dying on the street and to give them options. It also includes counciling and info about getting treatment to get off the drugs.

[Cheswick2.0]

26. yes Wonk I read the article

and unfortunately I know plenty about hardcore users.

I know you can't help them by making their lives easier. I'll bet a buck that all of these people have had tons of counciling and know all about how to get treatment for getting off drugs. In fact I will bet that once someone has reached that stage of progression, they have been in several treatment programs already.

You can provide them a place to get clean needles and counciling, that doesn't mean that later in the day or next week on a binge they aren't going to shoot up with some filthy needle shared at a flop house.

The reason I think Methadone is a better way to go is that the clients are drug tested every week to make sure they are not using any other substance. If they are they are out of the program and the time and money are spent on people who want to recover.

[MrPrax]

11. or the alternative

"I am beleive you have to let people get sick, get arrested, sell their souls and their bodies so that they hit bottom and finally decide to get well." or die, or get killed or end up in jail at a prohibitvely higher social cost with no treatment...

Just like sex...drugs...and People are still doing it
Tough love don't work...
liked the first part though,
"Are they assuming because these people shoot up there that they will then be capable of making good choices at other times and places?"

In a facility like this they are much more likely to be reached by user-counselling, health folks, recovery and treatment people than say in an alley somewhere...

But your right it is a stop-gap measure and I don't think anyone pushing this harm-redcution center is saying it's cure to a complicated social and economic problem

[Cheswick2.0]

27. tough love is the only thing that works

and frankly counseling and health information doesn't mean shit to an addict.

[bitchkitty]

25. If you had dead friends -

like I do, you would not make that statement. It is NOT better to let a heroin addict hit bottom, since bottom means dying of Hep C or AIDS.

That said, I'm not too happy about this article. I found the photograph of the women extremely disturbing.

[Ergotron]

28. Disturbing? Why?

She is an adult and responsible for her behavior. If she choses to us heroin and crack that should be her choice.

[WhoCountsTheVotes]

32. no, she's a junkie and NOT responsible, hence the problem

Does anyone remember why heroin was made illegal? HINT - it's not for the same reasons marijuana was - it's because it is a highly addictive and toxic substance - no matter what your libertarian fantasy utopia may be, society cannot allow unregulated heroin use, it's simply too dangerous.

I can understand why some businesses would like to be allowed to sell heroin again, like they did at the turn of this century - highly addictive drugs are quite profitable. Society as usual will have to pick up the tab for the crime, disease, and destroyed lives, while the investors get the profits. No thanks.

[pnb]

39. She is a junkie and thus is responsible

We all know it is an addictive drug. How do people develop these addictions? By starting to use the drug in the first place. I may have an addictive personality but I wouldn't know about it in regards to heroin because I've never used it.

With the exception of those born with addictions because of drug use of their mothers, ALL junkies are responsible for their 'problems.'

[DisgustipatedinCA]

42. About marijuana

Marijuana is most assuredly NOT highly addictive or toxic. It bears no resemblence to heroin.

Edited to add: marijuana was made illegal largely because of an Ashcroft-like zealot named Henry Anslinger. Marijuana was also demonized during the Great Depression in order to villify its constituency, Mexican railroad workers (so that white people could have the jobs previously thought too base). And of course, William Randolph Hurst had something to do with it as well. He owned paper pulp companies for his newspaper business. Hemp made better, whiter paper than wood. It was a competitor he didn't want around, hence its villification in his newspapers.

[bitchkitty]

33. Because she's

sitting there on the street, injecting herself in her neck with a needle. Because from reading the story I know that after this picture, she laid face down on the sidewalk. At one point in her life she was a little girl with little girl dreams and now she's face down in the gutter.

I never ended up face down on the street (to my recollection), but I was that girl, years ago, and I don't know why I'm alive now.

[Cheswick2.0]

31. don't make silly asumptions about what you think I know

What makes you think I don't know any dead people? What makes you think I haven't faced AIDS and Hep C and hundreds of other consequences and looked those things right in the face and been through hell because of them?
No I am not an addict. Never was.

[bitchkitty]

34. Apologies -

but your statement bothered me. Hitting bottom means dying in my experience.

I'm sorry that my post bothered you, but I don't think that "silly" describes my assumption. Your statement was kind of cold.

[Cheswick2.0]

36. yes you are right my statement was cold

So I apologize if I hurt you. However let me ask you this; Isn't facing the reality that hitting bottom could mean death part of what scared you into recovering?

[bitchkitty]

38. I honestly

do not know why I stopped. I guess I woke up, you could say. I saw myself and what I saw was hideous. It took far longer to recover self esteem than it did to recover my health or my life in general. This entire subject just bothers the shit out of me, but this is my fault, I should have stayed out of this thread! In that light, bub-bye! ;)

[Wonk]

5. CBC's The National on this (RealPlayer)

http://media.cbc.ca:8080/ramgen/cbc.ca/national/real/thenational.rm

Fast forward to about 8:30

[Dr Fate]

6. The current U.S. war on drugs is failing...

...I'd like to see how these clinics do in Canada...perhaps we can borrow some of their measures if they work???

A lot of Americans would have to see it work before they embrace it...

[Ergotron]

29. And failing miserably...

The WoD started with good intentions but has become simply another government jobs program kept alive to provide jobs to otherwise unemployable prison guards, DEA agents, and all manner of administrators and managers.

Just as the prohibition of alcohol before it, the prohibition of drugs only serves to keep the prices high which gives great incentive for profits to the gangs and drug cartels.

[SOS]

7. In Switzerland

this has been a success. The crime rate dropped 70% overnight.
Addicts are safe from dirty needles, they no longer need money for drugs and are offered detox anytime they choose.
Even the police chief in Zurich, who was opposed to the idea, now has praise for the harm reduction strategy. But the US prefers to cling to the failed war on drug users.

[Dr Fate]

8. Canada is closer to our own culture though...

...Switzerland is a really a homogenous culture...I'm not sure aits a model that fits the U.S. on every aspect..

[aneerkoinos]

19. Homogenous culture?

Switzerland has four OFFICIAL languages, French, Italian, German and Retoroman. Also loads of immigrants.

[FDRrocks]

9. I do not agree with this.

It sounds like a good idea, to help people get clean injections that do not threaten life or perpetuate disease and all, but I am for the current Methadone method.

You do not give people more cigarettes to wean them off. They need to hit a point where they realize the stuff is killing them, then wean themselves off using patches or other systems that introduce gradually-less amounts of nicatine into thier systems.

If people like the woman in Wonk's link perpetuate thier illness, thier life is basically meaningless. Methadone clinics may not be the ultimate solution, but it is a step in the right direction. I do not feel giving drugs in a sanitized environment (to people who have brainwashed themselves into believe they cannot live without that drug, which is utterly false), is a step in the right direction.

edit: My ultimate goal would be to reduce hard drug use, not crime or any of its offsprings. Attack-the-roots, type method.

[Sufi Marmot]

12. What if it kept people alive long enough....

...and they eventually got themselves into a treatment program? Or it kept them from getting HIV, which bought them some extra years to get clean? And who's to say their lives are meaningless, even if they are addicted? Was Charlie Parker's life meaningless?

I do not feel giving drugs in a sanitized environment (to people who have brainwashed themselves into believe they cannot live without that drug, which is utterly false), is a step in the right direction.

You may want to do some investigation into the neurochemical underpinnings of drug addiction.

-SM, Vancouverite who supports the safe injection program

[FDRrocks]

13. It is an odd issue

You raise a good question. I didn't consider that. I would support such a program if the membership was not infinite.

AA and NA taught me that people truely need to hit rock bottom to overcome thier sickness fully. And I, for one, do not think someone can live a full life under the control of hard drugs.

I don't want this to be a point of contention, I assume we are both for the betterment of society, just by different means (maybe not, for all I know)

edit: Will do the investigation on the issue of drugs and the mentality.

[Sufi Marmot]

16. Fair enough...

And I, for one, do not think someone can live a full life under the control of hard drugs. I don't disagree with this statement. My hope is that safe injection sites will keep drug users alive (and disease-free) long enough to come to the decision to clean themselves up - if they're going to use drugs anyway until they make that decision, I'm all for reducing the harm until they do. And I'd even be willing to have the government pay for the heroin (not indefinitely, but for at least a reasonable length of time so that people could stabilize their lives) if it meant: 1) a significant reduction in crime, especially property crime, and 2) lower judicial system/prison costs because the judicial system isn't clogged with drug offenders and those who committed crimes only to support their drug habits. I bet it would be much cheaper in the long run...

Peace... - SM

[prolesunited]

17. Hit rock bottom

or DIE, whichever comes first.

I agree that you can't live a full live under the control of hard drugs, but if people are using dirty needles, turning to crime or prostitution, they run a great risk of not being alive to get the treatment they need. Social darwinism at it's finest I guess. :shrug:

[Cheswick2.0]

35. Not social darwinism Prol

just acceptance of reality. These people have probably had plenty of treatment. Most people don't get to this level of progression in their desease without having been in and out of treatment.

If you have addicts in your life you know how the deceive themselves and you a million times if you let them. Provide them the drugs, clean needles and they will use forever. Maybe we can give them a free place to live too. Then they may never have to face the consequences of their use. Then their mothers, spouses and children can watch them sleep away the next 30 years, never having a lucid or meaningful converstation again, until the addict finally just stops breathing.

[Wonk]

18. Being from Vancouver maybe you could give us some more history on this?

I vaguely remember hearing that it was actually one of the major campaign issues during the last (mayor/provincial?) election, or something like that. Tons of public debate, iirc.

Sorry, I don't feel like googling around for all the details myself right now. Maybe you have them close at hand?

[aneerkoinos]

21. There are better stuff than Methadone

like buprenorfin products, that unlike Methadon don't give high for addicts but keep the detox effects away. For some addicts heroin seems to be the only possibility, so after trying everything else, better give them clean safe stuff and keep them away from crime. Out of crime circles many of them might, know what, get a job despite their addiction! Every addict is a different person, and what treatment works for one does not for other. There is no one fit-for-all solution, NA works for some people, some need heroin for the rest of their life, what is needed is multiple variety of treatments and social programs.

Even more importantly, the way heroin epidemias spread is through addicts becoming low level dealers. The system works exponentially untill markets are satisfied and is ideal for traffickers. Offering other options to financing addiction by dealing is very effective way to limit the spreading of the epidemy.

You are also wrong that to be addicted means that life is meaningless. That would be like saying that if anyone is dependent on any drug, his life is meaningless. Also, you are not the judge on how meaningfull other people consider their lives.

Last, attack the roots is the best (but not only) method, but first one must identify the roots. Practically all looser addicts have a background of mental problems, poverty, social exclusion etc. The real answer is to build more inclusive, more humane society.

[Wonk]

22. Hit the roots.

http://www.democraticunderground.com/duforum/DCForumID43/5936.html

[dsc]

10. This is a tough issue

Frankly liberal values can inform either side here. If you are the type of liberal who values individual rights then these rooms are a good thing. If though, you are the type of liberal who thinks government should make people's lives better then maybe not. I tend to think that the greater public good (presuming that they aren't released high) is to let the rooms exist. But it is a very close call.

[Wonk]

14. From the CBC link

it showed the "chill room" where they have to go afterwards so they aren't just released back on to the street high.

Also, there seems to be a misconception among some posters on this thread (not you) that the clinic will be giving out heroin to addicts. It won't. Addicts will have to bring their own drugs with them.

[dsc]

24. that seems to me to be the worst of both worlds

The only justification I can see for having these places is that people wouldn't be robbing people to get the heroin. Giving out clean needles would end the disease issue. I would vastly prefer that the give the drug or sell the drug at a reasonable price.

[dudeness]

15. perhaps I should add a little bit

as to why I support this concept..from as professional point of view ..as a a firefighter these rooms would significantly reduce needle stick injuries and other hazards I would face when responding to an OD..I think they are more humane and acceptable in a modern society than ignoring a problem and hope it goes away..

[sandnsea]

20. I agree with it

Methadone does not have a high success rate anyway. This seems to be working in Europe and I just see no reason to continue this sham of a 'war on drugs'. We need to do whatever it takes to help people get back into a 'normal' life and that's the most appealing part of these needle rooms to me. We need a total overhaul on this drug war crap.

[AntiBushRepub]

23. Not to mention...

In alot of cases, Methadone is a life sentence..

It is, in reality, much harder to get off methadone than it is almost anything else...

Buprenex is the way to go.

With methadone, you get just as sick as you do from other opiates when you don't have it, except for possibly 3 full weeks!.. instead of the 5 days or so from other opiates, before you start to feel better.

I am highly suspicious of why they push methadone so much...

Especially now that BUprenex is available, which can pretty much painless detox anyone in a few days with no withdrawal.
-An

[Cheswick2.0]

37. Is this really working or

do they simply have healthier addicts? Or perhaps it is just too soon to know if it works at all?

[barbaraann]

40. I have a question.

Doesn't a drug addiction require increasing doses of the drug for an addict to achieve a high, which eventually results in a fatal overdose?

Isn't death inevitable unless a heroin addict stops using?

[AntiBushRepub]

41. No.

Because tolerance works both ways...

At the same time that you require more and more to get the desired effect, you can also tolerate more and more without overdosing. These are directly proportional. One increases, so does the other.

However, people have died by taking some time off and getting straight... then when they relapse they go right back to the dose they were normally taking during the peak of their habit, but their tolerance has decreased, they can no longer tolerate as much, and they O.D.

-An