[Truth To Power]

Stupid wall of text yet again.

Translation: you can't refute a single sentence again.

You should know by now TTP that I do not bother to respond to your trolling. Move along now.

<yawn> You should know by now, Doc, that I don't let ignorami get away with false and absurd bull$#!+. You're in a discussion forum, not a pulpit or lectern, sorry. People here can answer you back. So put up or shut up.

The paper you posted included this:

Drug Free Australia has asserted that in 2003 the cost of running the Sydney MSIC equated to 400 NSW government-funded rehabilitation places[79] while the Health Minister for the Canadian Government, Tony Clements, has stated that the money for Insite would be better spent on treatment for clients.

His name is actually Tony Clement, no s, and he was the health minister in the most reactionary, fascist, anti-science, anti-poor, anti-equality, anti-liberty, anti-justice, anti-truth government in Canadian history. His evil, despicable government relentlessly tried to shut down Insite, even in the face of overwhielming scientific evidence that it was saving lives, saving public funds, preventing the spread of HIV, hepatitis, and other deadly diseases, and improving health conditions in the community.

Nice company you keep....

Now while we have one troll comparing heroin addiction to "video game addiction" and who we have consequently rejected out of hand,

People have died of video game addiction, sunshine. Didn't you know?

others seem to have cast my argument to believe that I support and either/or approach. That is not true. As you can see from your own source, my beliefs are closely in line with those who have tried the solution under consideration and are wary of it as a stand alone piece.

I.e., evil, lying scum who would prefer to exterminate addicts outright, but recognize the legal barriers to that final solution.

The public would be well advised to understand that "studies" are meant to be used by those who know how. They are not to be cited by the untrained out of context.

"Pay no attention to the man behind the curtain!"

I am approaching the wall of text I dislike so I will stop here. I refuse to engage in any idiots attempt to enter into a "drugs are not that dangerous" argument because such an argument IS idiotic. Nor is the comparing of one bad thing to another in an attempt to justify bad things smart or worth of argument.

So, no facts, no arguments, no logic.

Check.

[Truth To Power]

deleted <sigh>

[Pants-of-dog]

Drlee,

Harm reduction programs such as legal injection sites are just that: harm reduction. They are not going to cure heroin addiction or even address (let alone solve) any of the root problems that lead to heroin addiction.

So if the goal is to get rid of heroin addiction, harm reduction programs are only part of a comprehensive package, as you said.

But if the goal is simply to reduce harm and make the world a less dangerous place without curing anyone, legal injection sites are a decent step towards that.

[Drlee]

TTP.

Just more bullshit. Come back when you have an argument.

TTP.

But if the goal is simply to reduce harm and make the world a less dangerous place without curing anyone, legal injection sites are a decent step towards that.

This is not conclusively proved as your article basically says. It these days of limited resources, the money could be much better spent elsewhere. There is no reason not to insist on rehab along with these kinds of programs. Other than the money.

[AFAIK]

I am approaching the wall of text I dislike so I will stop here. I refuse to engage in any idiots attempt to enter into a "drugs are not that dangerous" argument because such an argument IS idiotic. Nor is the comparing of one bad thing to another in an attempt to justify bad things smart or worth of argument.

Thank you for the on topic reply. It is much more informative and helpful than insulting those of us who don't have decades of medical training and experience.

The reason I didn't google your sources is because I didn't want to risk reading the wrong thing, misinterpreting it and getting insulted again, which would be a waste of everyone's time.

[Drlee]

The reason I didn't google your sources is because I didn't want to risk reading the wrong thing, misinterpreting it and getting insulted again, which would be a waste of everyone's time.

Here is the thing. It is easy to reject decades of research and institutional knowledge on the chance that some newer idea is somehow the silver bullet that will cure what is annoying us. On the issues of homelessness, drug abuse, poverty and the like it is really easy to do that. We are all frustrated by these problems and they just don't seem to go away. You would think that we would have solved them a long time ago. Well guess what. We did solve them long ago. We know how to deal with these problems. We just are not willing to do it. Why? A number of reasons.

The solutions are expensive.

The solutions are not popular.

The solutions require that we forces some people to do things they do not at the moment want to do.

The solutions require that we deal with people who we do not care about and who are not generally popular.

The problem with drug addicts is that we just want them to go away. We want to be rid of them. As long as they are not ripping off our cars or hooking in public were are just fine with that. Programs like clean needle, methadone clinics etc., are designed to do just that. Offer the least amount of help consistent with preventing the public from being annoyed.

Then we have the issue of a significant number of people in the US (and I am sure elsewhere as well) who believe that the problems of homelessness and poverty distill to that of the sins of sloth and laziness. "They should "just" quit and get a job." But this is pretty hard to do if some physician is giving them maintenance doses of some drug that is killing whatever ambitions they ever had by keeping them in a perpetual state of listlessness, apathy and dependence.

None of us like the drug war. But the opposite of criminalizing drug use IS NOT legalizing drug use. It is preventing and treating drug use. To the addict the problem is not that drugs are illegal or readily available. It is that they are addicted and need help not to be addicted. There is no doubt in anyone's mind that the heroin dealer is selling death on the installment plan. There is also not doubt that making heroin illegal does contribute to ancillary problems such as crime, impure drugs and infection. But is NOT true that legalizing these drugs will necessarily make them any devastating to the user. We have had needle exchange programs in Arizona for decades and addicts still share needles, get HIV and other blood borne diseases. Why? Because you are asking someone who is fucked up to make good decisions. And they don't. Does this surprise you? We have had free-ride programs for decades and people still drive drunk. Why? Because they are drunk and not making good decisions. Imagine a life where there is never a time when you are not hammered. That is the life of a junkie. So why do junkies seek treatment? Usually it is because there is some event that allows/causes them to come up for air and in that interlude they are allowed into a program or otherwise get help.

And then add to this problem that of homelessness and poverty. For that is frequently the world of the heroin addict. Nope. If you want to fight drug abuse you will fail if you simply treat the symptoms and ignore the causes. We can do a really good job one addict at a time. But we have to be ready when they are and willing to do what is necessary to help them. That means a comprehensive program of treatment and community support. They need to get clean, stay clean, get a home and get a job. All of that. Anything less and we are just deluding ourselves.

[Pants-of-dog]

This may seem like an odd question but, why do we need to cure drug addiction?

If the answer is because of the health issues involved with drug addiction, then we should cure obesity and other such behaviours.

If the answer is because of the impact on others, then these programs that simply get addicts out of our sight and negate their impact on our lives seem like a simpler solution.

[Rancid]

I see POD has thrown a drug addicted relative to the streets....

[Drlee]

This may seem like an odd question but, why do we need to cure drug addiction?

Because it ruins lives. Millions of them.

If the answer is because of the health issues involved with drug addiction, then we should cure obesity and other such behaviours.

Are you kidding me? We should also cure cancer, AIDS, heart disease, malaria and bovine spongiform encephalopathy. What is your point. Do you want medical science to line up at some imaginary point and shout ready, set, go? Do you want to start with the worst problems and solve them in order leaving all of the others until the first one is done? Come on POD. This is not like you. Or are you referring to the behavior related aspects of obesity? Have you fallen for the right-wing trap of seeing some health diseases as legitimately "caught" such as cancer and other sin related like obesity?

If the answer is because of the impact on others, then these programs that simply get addicts out of our sight and negate their impact on our lives seem like a simpler solution

.

Do you have a box called "all of the above? Because unless you do you will attract a very simple crowd of those willing to answer your questions.

[Pants-of-dog]

Because it ruins lives. Millions of them.

Not all drug addictions do that.

And for those that do, how exactly do they do that?

....Or are you referring to the behavior related aspects of obesity? Have you fallen for the right-wing trap of seeing some health diseases as legitimately "caught" such as cancer and other sin related like obesity?

I am not sure what you are saying here.

Drug addiction, like obesity, has health issues that are caused by the behaviour of the person.

Do you have a box called "all of the above? Because unless you do you will attract a very simple crowd of those willing to answer your questions.

Well, I think that rather than focusing on drug addiction, we can focus on the negative impacts of drug addiction, as well as the negative factors that lead to drug addiction.

[Kaiserschmarrn]

This may seem like an odd question but, why do we need to cure drug addiction?

I don't think it's an odd question. Rather the question whether we should view addiction as an illness (which would imply that a cure/treatment is necessary or at least desirable) or not is interesting.

I've seen an argument that asserts addiction is not an illness but more like maladaptive learning of the brain. The person's main justification was that, contrary to an illness, addicts can decide to stop their addictive behaviour and most actually do so at one stage in their lives. Illness is usually independent of willpower, i.e. we can't decide to stop having cancer.

[Drlee]

Not all drug addictions do that.

And for those that do, how exactly do they do that?

Nonsense. Name an addictive drug that does not ruin lives.

And for those that do, how exactly do they do that?

Read my posts. I have answered this question several times. Besides. I am not going to explain how the world is round. If you wish to challenge a couple of centuries of research please feel free to do so.

Drug addiction, like obesity, has health issues that are caused by the behaviour of the person.

Not necessarily. There are time when neither are initially driven by behavior. But even if I grant this point, then you must also grant that so are strokes, cancer, COPD, AIDS, and diabetes. In such company we single out drug addiction but almost universally refer to those with the others as victims.

Well, I think that rather than focusing on drug addiction, we can focus on the negative impacts of drug addiction,

You are seeking a distinction without a difference.

as well as the negative factors that lead to drug addiction.

So you want to ignore treatment? Why?

I am all for dealing with the factors leading to drug addiction, obesity, cancer, COPD diabetes, etc. They are legion. But once someone is addicted I utterly reject any solution that does not incorporate treatment as an easily accessible option. Free treatment. Ready when the addict is.

There is no doubt that needle exchanges, methadone clinics and the like save lives. As I have said from the beginning I support all of these and I frequently teach addicts how to access them, how to more safely use their drugs and where to go for treatment in those sadly rare occasions when treatment is available.

I've seen an argument that asserts addiction is not an illness but more like maladaptive learning of the brain. The person's main justification was that, contrary to an illness, addicts can decide to stop their addictive behaviour and most actually do so at one stage in their lives.

Many addicts do kick the habit. The success rate for TREATMENT (successful treatment without the patient failing treatment) is about the same as it is for the control of diabetes, asthma, and high blood pressure.

Illness is usually independent of willpower, i.e. we can't decide to stop having cancer

.

Really? What gave you this idea? Can one seek early treatment? Can one avoid lifestyle choices that lead to cancer? What is a colonoscopy other than someone deciding not to get colon cancer. Can one decide not to get diabetes? In a great many cases, yes. Again. We insist on seeing addiction as naughty but a colon cancer patient who has never had a colonoscopy or a breast cancer patient who has eaten a high saturated fat diet as victims.

[Kaiserschmarrn]

Many addicts do kick the habit. The success rate for TREATMENT (successful treatment without the patient failing treatment) is about the same as it is for the control of diabetes, asthma, and high blood pressure.

I'm going to take your word for it, but the number would only be for people who seek treatment. For the rest, which is probably the majority, we don't have that data. But if you look at the percentage of people who are dependent on substances in their 20s versus 20 years later, you'll not that it drops dramatically. Most people just quit, although they may often need several attempts.

Really? What gave you this idea? Can one seek early treatment? Can one avoid lifestyle choices that lead to cancer? What is a colonoscopy other than someone deciding not to get colon cancer. Can one decide not to get diabetes? In a great many cases, yes. Again. We insist on seeing addiction as naughty but a colon cancer patient who has never had a colonoscopy or a breast cancer patient who has eaten a high saturated fat diet as victims.

So if I have cancer I can decide to stop having it? I'm sure all cancer patients around the world would be interested in your method of "quitting cancer".

More seriously though, I'm sure you realise I wasn't talking about prevention or early diagnosis (after all, you have read the rest of my post as well). I'm not necessarily agreeing that this distinction alone should be used to classify something as an illness or not, but there obviously is a difference. This is not about blaming or not caring about a certain group. We should care regardless of whether something is regarded as an illness or not.

[Drlee]

This is not about blaming or not caring about a certain group. We should care regardless of whether something is regarded as an illness or not.

Then there is no difference between this illness and any of the myriad diseases that proceed from lifestyle choices.

So I am glad that you want to care and not consider addicted individuals as weak-willed or sinners.

I'm going to take your word for it, but the number would only be for people who seek treatment. For the rest, which is probably the majority, we don't have that data.

Actually few things have been as carefully studied as addiction. It is a huge problem. We actually have a government agency specifically dedicated to the subject.

But if you look at the percentage of people who are dependent on substances in their 20s versus 20 years later, you'll not that it drops dramatically.

Not really. In the populations with which I deal many if not most of the addicts are older than their 20's. The use of heroin among younger people is dramatically increasing. That is scary. So is the fact (and I have posted this three times already so that it can be ignored) that the increased use of prescription opiates is directly causing seeking behaviors leading to heroin once the source of these pain releivers is gone.

One more point. This thread discusses physician administered heroin. I want to reiterate that it is not necessary and certainly not preferable to do this. We have drug treatments that are quite effective:

Scientific research has established that pharmacological treatment of opioid addiction increases retention in treatment programs and decreases drug use, infectious disease transmission, and criminal activity.

When people addicted to opioids first quit, they undergo withdrawal symptoms (pain, diarrhea, nausea, and vomiting), which may be severe. Medications can be helpful in this detoxification stage to ease craving and other physical symptoms, which often prompt a person to relapse. While not a treatment for addiction itself, detoxification is a useful first step when it is followed by some form of evidence-based treatment.

Medications developed to treat opioid addiction work through the same opioid receptors as the addictive drug, but are safer and less likely to produce the harmful behaviors that characterize addiction. Three types of medications include: (1) agonists, which activate opioid receptors; (2) partial agonists, which also activate opioid receptors but produce a smaller response; and (3) antagonists, which block the receptor and interfere with the rewarding effects of opioids. A particular medication is used based on a patient’s specific medical needs and other factors. Effective medications include:
Methadone (Dolophine® or Methadose®) is a slow-acting opioid agonist. Methadone is taken orally so that it reaches the brain slowly, dampening the “high” that occurs with other routes of administration while preventing withdrawal symptoms. Methadone has been used since the 1960s to treat heroin addiction and is still an excellent treatment option, particularly for patients who do not respond well to other medications. Methadone is only available through approved outpatient treatment programs, where it is dispensed to patients on a daily basis.
Buprenorphine (Subutex®) is a partial opioid agonist. Buprenorphine relieves drug cravings without producing the “high” or dangerous side effects of other opioids. Suboxone® is a novel formulation of buprenorphine that is taken orally or sublingually and contains naloxone (an opioid antagonist) to prevent attempts to get high by injecting the medication. If an addicted patient were to inject Suboxone, the naloxone would induce withdrawal symptoms, which are averted when taken orally as prescribed. FDA approved buprenorphine in 2002, making it the first medication eligible to be prescribed by certified physicians through the Drug Addiction Treatment Act. This approval eliminates the need to visit specialized treatment clinics, thereby expanding access to treatment for many who need it. In February 2013, FDA approved two generic forms of Suboxone, making this treatment option more affordable.
Naltrexone (Depade® or Revia®) is an opioid antagonist. Naltrexone blocks the action of opioids, is not addictive or sedating, and does not result in physical dependence; however, patients often have trouble complying with the treatment, and this has limited its effectiveness. An injectable long-acting formulation of naltrexone (Vivitrol®) recently received FDA approval for treating opioid addiction. Administered once a month, Vivitrol® may improve compliance by eliminating the need for daily dosing.

[Kaiserschmarrn]

Then there is no difference between this illness and any of the myriad diseases that proceed from lifestyle choices.

Of course there is a difference, but it doesn't lie in how we acquire an illness or addiction (making this distinction now for clarity).

So I am glad that you want to care and not consider addicted individuals as weak-willed or sinners.

I don't consider them weak willed or sinners, and I don't know why you would automatically assume that.

Not really. In the populations with which I deal many if not most of the addicts are older than their 20's.

If you are not talking about the sub-group that seeks or is in treatment, I'd like to see evidence for this. If you are talking about those in treatment, then this point is irrelevant to what I said.

The use of heroin among younger people is dramatically increasing. That is scary. So is the fact (and I have posted this three times already so that it can be ignored) that the increased use of prescription opiates is directly causing seeking behaviors leading to heroin once the source of these pain releivers is gone.

One more point. This thread discusses physician administered heroin. I want to reiterate that it is not necessary and certainly not preferable to do this. We have drug treatments that are quite effective:

I know that you were talking about specific drugs, but PoD's question seemed more general and that's the post I replied to.

[Pants-of-dog]

Nonsense. Name an addictive drug that does not ruin lives.

Marijuana and coffee are two obvious examples.

Cigarettes and alcohol seem to have negative impacts that are bad but are not considered as life ruining.

Read my posts. I have answered this question several times. Besides. I am not going to explain how the world is round. If you wish to challenge a couple of centuries of research please feel free to do so.

As far as I can tell, the main negative impact of drug addiction is helath problems.

Not necessarily. There are time when neither are initially driven by behavior. But even if I grant this point, then you must also grant that so are strokes, cancer, COPD, AIDS, and diabetes. In such company we single out drug addiction but almost universally refer to those with the others as victims.

And for these people who suffer illnesses due to their choices, we seek to minimise the harm and often do not try to "cure" the behaviour that leads to these problems.

You are seeking a distinction without a difference.

I think there is a difference. Much like we treat the health issues of obese people without treating the obesity.

So you want to ignore treatment? Why?

I am all for dealing with the factors leading to drug addiction, obesity, cancer, COPD diabetes, etc. They are legion. But once someone is addicted I utterly reject any solution that does not incorporate treatment as an easily accessible option. Free treatment. Ready when the addict is.

There is no doubt that needle exchanges, methadone clinics and the like save lives. As I have said from the beginning I support all of these and I frequently teach addicts how to access them, how to more safely use their drugs and where to go for treatment in those sadly rare occasions when treatment is available.

I am not ignoring treatment.

I am saying that we can legalise drugs, offer safe injection sites and other harm reduction programs, nd all without requiring treatment as part of the program.

Obviously, treatment programs for those who want to control their addiction are also beneficial.

[Drlee]

Drlee wrote:

Nonsense. Name an addictive drug that does not ruin lives.

Pants replied: Marijuana and coffee are two obvious examples.

Cigarettes and alcohol seem to have negative impacts that are bad but are not considered as life ruining.

Shall I et someone else dismantle this argument? None of this is true. Marijuana and coffee are not addicting by any reasonable definition. Cigarettes and alcohol are certainly considered life threatening. Stop fucking arguing just to troll this thread.

As far as I can tell, the main negative impact of drug addiction is helath problems.

You mean like death? Ask an addict. Almost all would disagree with you.

Quote:

And for these people who suffer illnesses due to their choices, we seek to minimise the harm and often do not try to "cure" the behaviour that leads to these problems

.

Not as a first choice. We try to end the harmful behavior as a first choice (quit smoking) or we seek to modify the harmful behavior.

I think there is a difference. Much like we treat the health issues of obese people without treating the obesity.

Actually this is not true either. OF course we treat diabetes with drugs but at the same time we try to get the diabetic to loose weight. This is an example that closely resembles the use of drugs to treat opioid addiction. We might fail several time and therefor continue the drug treatment but in the end we aim for a cure if at all possible. There are lots of diabetics however who will never be "cured" for a variety of reasons. Some could lose tons of weight and still require drug therapy. This is where my example fails. But even then, looking at the totality of obesity related diseases, like those of opioid addiction, most end when the patient is cured of the underlying cause.

I am not ignoring treatment.

I am saying that we can legalise drugs, offer safe injection sites and other harm reduction programs, nd all without requiring treatment as part of the program.

Regarding harm reduction.....We can. We do in most places. The form of these programs run a range of options. Almost everywhere including one of the drugs I mentioned above; all preferable to keeping the addict in constant danger.

As for legalizing drugs: Are you for legalizing Benzodiazepines? Amphetamines? Antibiotics? Is choice more important than preventing others from harming themselves and others through their ignorance? How about "One-a-Day Multiple Benzos. Fast acting... All Day Relief". Or over the counter Antibiotics. "Z-Pack for your child...at the first sign of a cold...because you just can't be certain".

We make the over the counter use of drugs illegal because, though safe when used properly, they are very dangerous for the patient and others when not used properly. "Education" is not the answer to legalizing drugs. We have education about drug abuse now. It is part of the solution but look how well it works? And it is hard enough to train doctors in the proper use of some drugs. The notion that we may throw the gates to the pharmacy open and train the public in their use is preposterous.

Decriminalization is another approach and one I support for some drugs. But decriminalization is decidedly not the same as legalization. And it can include in its penalties mandatory treatment. I favor mandatory treatment for addictive drug offenses anyway.

Obviously, treatment programs for those who want to control their addiction are also beneficial.

No. Ya' think?

[Pants-of-dog]

Shall I et someone else dismantle this argument? None of this is true. Marijuana and coffee are not addicting by any reasonable definition. Cigarettes and alcohol are certainly considered life threatening. Stop fucking arguing just to troll this thread.

Dismissing my argument without showing how it is wrong is not a rebuttal.

While many marijuana advocates claim that marijuana is not addictive, marijuana addiction is a reality, though the negative impacts are so slight that no one cares.

You mean like death? Ask an addict. Almost all would disagree with you.

If there are negative impacts other than health (I think death can be considered a health issue), and they are that obvious, it should be easy for you to mention them.

Not as a first choice. We try to end the harmful behavior as a first choice (quit smoking) or we seek to modify the harmful behavior.

And we can do this with drugs as well. None of this means we cannot legalise drugs and provide legal injection sites and other harm reduction programs.

Actually this is not true either. OF course we treat diabetes with drugs but at the same time we try to get the diabetic to loose weight. This is an example that closely resembles the use of drugs to treat opioid addiction. We might fail several time and therefor continue the drug treatment but in the end we aim for a cure if at all possible. There are lots of diabetics however who will never be "cured" for a variety of reasons. Some could lose tons of weight and still require drug therapy. This is where my example fails. But even then, looking at the totality of obesity related diseases, like those of opioid addiction, most end when the patient is cured of the underlying cause.

Regarding harm reduction.....We can. We do in most places. The form of these programs run a range of options. Almost everywhere including one of the drugs I mentioned above; all preferable to keeping the addict in constant danger.

Well, it seems we agree more than we dusagree about this.

As for legalizing drugs: Are you for legalizing Benzodiazepines? Amphetamines? Antibiotics? Is choice more important than preventing others from harming themselves and others through their ignorance? How about "One-a-Day Multiple Benzos. Fast acting... All Day Relief". Or over the counter Antibiotics. "Z-Pack for your child...at the first sign of a cold...because you just can't be certain".

We make the over the counter use of drugs illegal because, though safe when used properly, they are very dangerous for the patient and others when not used properly. "Education" is not the answer to legalizing drugs. We have education about drug abuse now. It is part of the solution but look how well it works? And it is hard enough to train doctors in the proper use of some drugs. The notion that we may throw the gates to the pharmacy open and train the public in their use is preposterous.

Decriminalization is another approach and one I support for some drugs. But decriminalization is decidedly not the same as legalization. And it can include in its penalties mandatory treatment. I favor mandatory treatment for addictive drug offenses anyway.

I am speaking of recreational drugs. If there are valid social concerns (such as there would be with improper use of antibiotics) that would be very different things. But bacteria and viruses will not evolve immunities becuase of someone's heroin addiction.

[Zamuel]

Nonsense. Name an addictive drug that does not ruin lives.

Water ... H(2)0 ... and before you start ranting about "it's not a drug" name a substance that has a more profound effect on the Human Body.

Zam

[Drlee]

Water ... H(2)0 ... and before you start ranting about "it's not a drug" name a substance that has a more profound effect on the Human Body.

Zam

It was time we had some humor in this thread. Where is rancid when you need him?