Sunday, June 16, 2013

How One's Addiction to Drugs Affects the Whole World

*I would like to note that my labtop has recently broken and has resulted in me writing this post via my iPad and cell phone. Thus, the spelling, grammar, and format of this post is not the best. I apologize ahead of time for the way this post is constructed as of right now as my editing via my phone and iPad is extremely limited right now. I will hopefully have the issue fixed by the end of next week and will go back to this post to clean it up and make sure everything is as best as can be. Thank you for your understanding Guys and I hope this post can still be a good read despite some of the mentioned issues. I will do my best to respond to comments but please excuse any late or poorly constructed replies. Thanks again and enjoy.  -Seeingthelight*

Introduction
"Drugs never cure disease. They merely hush the voice of nature's protest, and pull down the danger signals she erects along the pathway of transgression. Any poison taken into the system has to be reckoned with later on even though it palliates present symptoms. Pain may disappear, but the patient is left in a worse condition, though unconscious of it at the time."
                                                                                                        -Daniel. H. Kress, M.D

The world of drugs and those who use them is one that everyone is aware of existing yet is something most know little about or fully grasp. Many get their facts and information through the media, anti-drug campaigns, politicians, and their parents when they are young children. Yet, there is world of valuable information out there that is far too often overlooked or ignored. Both current and former addicts, medical facilities, rehabilitation programs, and those who partake or once partook in the drug underworld often carry more information than what intially meets the eye when it comes to learning about the world of drugs. While it may seem strange to some, it is here where this information can prove most valuable and is thus where we must sometimes look to if we truly ever want to become a society with little to no illegal drug use or at the very least, one that has a firm understanding of the world of drugs.

Each kind of drug maintains its own process and techniques concerning how the drug makes it way into the hands of the people using the drug. There is the cultivation of the materials/ingredients needed to make the drug, the manufacturing and production processes to make them, the transportation of drugs from one country, region, person, or group to another, and finally the selling of these drugs to mid to low level drug dealers who then sell the drugs to the users themselves. It is often a long and complicated process between the time the drug is created to when it reaches the hands of the user. The cultivation, production, transportation, and selling of a single batch of drugs often involves hundreds, if not thousands of individuals with each person involved within the process getting their own share/cut of the profits or drugs.

Even before I became a user of drugs myself, I was always fascinated in this process and amazed just how complicated it is. See, the drug game is like any other business industry in that it revolves around one thing; money. Money is needed to pay the people involved in manufacturing, transporting, and selling these drugs as well as being needed to pay for the drugs by the users themselves. In between all of this, there are costs for things such as bribes, manufacturing equipment, means of transportation, security, weapons, and real estate property. Put it all together and you have a multi billion dollar industry that rivals in size and profitability the likes of corporations such as Wal-Mart, Apple, General Electric, and JP Morgan. In fact, the Mexican drug lord, Joaquin "El Chapo" Guzman was ranked the 55th richest (10th richest in Mexico) person in the world by Forbes, truly highlighting just how much money is involved in the world of drugs.

Drug use and the illegal drug trade that supports and feeds it has a tremendous impact on not only the users themselves, but on the rest of society as well. As you will see later in this post, the costs are enormous and can really make one think just how much of a problem this issue is. Take for example, the figure below, which demonstrate the costs (lost productivity, health care, rehablitions, death, etc.) that drug use has on society as a whole.

Drug  Health Care Overall
Tobacco$96 billion$193 billion
Alcohol$30 billion$235 billion
Illicit Drugs$11 billion$193 billion

As you can see, drugs and drug use affect society in a huge way. Not just financially, but in other ways as well. Drugs can literally ruin people's lives, destroy relationships, and cost society thousands of dollars. That's not even mentioning all the people who have lost their lives through drug overdoses and violence between gangs and cartels in addition to the thousands of individuals who each year lose their freedom due to drug related crimes and arrests. Therefore, I would like to dedicate this post to discuss and take a further look at how drug use affects not only the users themselves, but the rest of society as well.

Some Quick Information about Commonly Abused Drugs

I would first like to provide you guys with some quick information about some of the more commonly abused drugs. While there is a wide array of drugs to be covered, I will only focus on what I feel are some of the more common drugs and ones that I feel my readers would be most interested in. These drugs are Cocaine, Heroin, Marijuana, and prescription painkillers. While Methamphetamines could certainly fall under this category, I am leaving them off the list as I feel most of the readers of my blog are geared more towards opiates and downers than a drug such a Meth. I included Cocaine on the list as the drug has always been one of the first drugs that comes to mind for most when thinking of the illegal drug trade. This information, with the exception of the section about prescription painkillers, was gathered from a report by the U.S. Drug Enforcement Agency in May of 2004. The link to this report can be found by clicking HERE.

Cocaine

The U.S./Mexico border is the primary point of entry for cocaine shipments being smuggled into the United States. According to a recent interagency intelligence assessment, approximately 65 percent of the cocaine smuggled into the United States crosses the Southwest border. Cocaine is readily available in nearly all major cities in the United States. Organized crime groups operating in Colombia control the worldwide supply of cocaine. These organizations use a sophisticated infrastructure to move cocaine by land, sea, and air into the United States. In the United States, these Colombia-based groups operate cocaine distribution and drug money laundering networks comprising a vast infrastructure of multiple cells functioning in many major metropolitan areas. Each cell performs a specific function within the organization, e.g., transportation, local distribution, or money movement. Key managers in Colombia continue to oversee the overall operation.

Cocaine prices in 2001 remained low and stable, suggesting a steady supply to the United States. Nationwide, wholesale cocaine prices ranged from $12,000 to $35,000 per kilogram. In most major metropolitan areas, however, the price of a kilogram of cocaine ranged from $13,000 to $25,000. Average purity for cocaine at the gram, ounce, and kilogram levels remained stable at high levels. In 2001, the average purity of a kilogram of cocaine was 73 percent. Typically, cocaine HCl is converted into crack cocaine, or "rock," within the United States by the secondary wholesaler or retailer. Crack cocaine is often packaged in vials, glassine bags, and film canisters. The size of a crack rock can vary, but generally ranges from 1/10 to 1/2 gram. Rocks can sell for as low as $3 to as high as $50, but prices generally range from $10 to $20.

Following a significant increase over the period 2002-2005, global cocaine seizure totals have recently followed a stable trend, amounting to 712 tons in 2007 and 711 tons in 2008. Seizures continued to be concentrated in the Americas and Europe. However, the transition from 2007 to 2008 brought about a geographical shift in seizures towards the source countries for cocaine. Seizures in South America accounted for 59 per cent of the global total for 2008, compared with 45 per cent in 2007.

In 2007 and 2008, cocaine was used by some 16 to 17 million people worldwide, similar to the number of global opiate users. North America accounted for more than 40 per cent of global cocaine consumption (the total was estimated at around 470 tons), while the 27 European Union and four European Free Trade Association countries accounted for more than a quarter of total consumption. These two regions account for more than 80 per cent of the total value of the global cocaine market, which was estimated at $88 billion in 2008.

For the North American market, cocaine is typically transported from Colombia to Mexico or Central America by sea and then onwards by land to the United States and Canada. Cocaine is trafficked to Europe mostly by sea, often in container shipments. Colombia remains the main source of the cocaine found in Europe, but direct shipments from Peru and the State of Bolivia are far more common than in the United States market.

Heroin

Heroin is readily available in many U.S. cities as evidenced by the unprecedented high level of average retail, or street-level, purity. Criminals in four foreign source areas produce the heroin available in the United States: South America (Colombia), Southeast Asia (principally Burma), Mexico, and Southwest Asia/Middle East (principally Afghanistan). While virtually all heroin produced in Mexico and South America is destined for the U.S. market, each of the four source areas has dominated the U.S. market at some point over the past 30 years. Over the past decade, the United States has experienced a dramatic shift in the heroin market from the domination of Southeast Asian heroin to a dominance of the wholesale and retail markets by South American heroin, especially in the East. In the West, by contrast, "black tar" and, to a lesser extent, brown powdered heroin from Mexico have been, and continue to be, the predominant available form.

The availability of South American (SA) heroin, produced in Colombia, has increased dramatically in the United States since 1993. SA heroin is available in the metropolitan areas of the Northeast and along the East Coast. Independent traffickers typically smuggle SA heroin into the United States via couriers traveling aboard commercial airlines, with each courier usually carrying from 500 grams to 1 kilogram of heroin per trip. These traffickers increased their influence in the lucrative northeastern heroin market, which has the largest demand in the United States, by pursuing an aggressive marketing strategy. They distributed high-quality heroin (of purity frequently above 90 percent), undercut the price of their competition, and used their long-standing, effective drug distribution networks. Investigations also indicate the spread of SA heroin to smaller U.S. cities.

Mexican heroin has been a threat to the United States for decades. It is produced, smuggled, and distributed by poly-drug trafficking groups, many of which have been in operation for more than 20 years. Nearly all of the heroin produced in Mexico is destined for distribution in the United States. Organized crime groups operating from Mexico produce, smuggle, and distribute the black tar heroin sold in the western United States. Traditionally, trafficking groups operating from Mexico evaded interdiction efforts by smuggling heroin to the U.S. market as they received orders from customers. By keeping quantities small, traffickers hoped to minimize the risk of losing a significant quantity of heroin in a single seizure. Even large poly-drug Mexican organizations, which smuggle multi-ton quantities of cocaine and marijuana, generally limited smuggling of Mexican heroin into the United States to kilogram and smaller amounts. Nevertheless, trafficking organizations were capable of regularly smuggling significant quantities of heroin into the United States.

High-purity Southeast Asian (SEA) heroin dominated the market in the United States during the late 1980s and early 1990s. Over the past few years, however, all indicators point to a decrease in SEA heroin available domestically. Significant investigations led to the incarceration in Thailand and extradition to the United States of more than a dozen high-level violators who played key roles in moving SEA heroin shipments to the United States. SEA heroin trafficking links run from independent brokers and shippers in Asia through overseas Chinese criminal populations to ethnic Chinese criminal wholesale distributors in the United States. In the United States, ethnic Chinese criminals rely upon local criminal organizations for the distribution of SEA heroin. Despite the recent decline in the trafficking of SEA heroin in the United States, Chinese criminal groups remain the most sophisticated heroin trafficking organizations in the world.

On the street, heroin purity and price often reflect the drug's availability. High purities and low prices, for example, indicate that heroin supplies are readily available. DEA's Domestic Monitor Program (DMP), a retail heroin purchase program, tracks urban street-level heroin purity and price. The most recent data available show that, in 2000, the nationwide average purity for retail heroin from all sources was 36.8 percent. This number is significantly higher than the average of 7 percent reported two decades ago and higher than the 26 percent recorded in 1991. The significant rise in average purity corresponds to the increased availability of high-purity SA heroin, particularly in the northeastern United States. Moreover, the DMP indicated that the retail purity of SA heroin was the highest for any source, averaging 48.1 percent in 2000. SWA heroin followed with a 34.6 percent average and Mexican heroin averaged 20.8 percent. Heroin purity at the street level generally remained highest in the northeastern United States, where most of the nation's user population lives. In 2000, Philadelphia recorded the DMP's highest heroin purity average of 74.0 percent. Over the last several years, Philadelphia has ranked consistently at or near the top in DMP retail heroin purity levels. In addition, New York City continues to be one of the major importation and distribution centers for SA and SEA heroin.
In 2008, global heroin seizures reached a record level of 73.7 metric tons. Most of the heroin was seized in the Near and Middle East and South-West Asia (39 per cent of the global total), South-East Europe (24 per cent) and Western and Central Europe (10 per cent). The global increase in heroin seizures over the period 2006-2008 was driven mainly by continued burgeoning seizures in the Islamic Republic of Iran and Turkey. In 2008, those two countries accounted for more than half of global heroin seizures and registered, for the third consecutive year, the highest and second highest seizures worldwide, respectively.
Marijuana
Marijuana is the most widely abused and readily available illicit drug in the United States, with an estimated 11.5 million current users. At least one-third of the U.S. population has used marijuana sometime in their lives. The drug is considered a "gateway" to the world of illicit drug abuse. Relaxed public perception of harm, popularization by the media and by groups advocating legalization, along with the trend of smoking marijuana-filled cigars known as "blunts," contribute to the nationwide resurgence in marijuana's popularity.
Marijuana smuggled into the United States, whether grown in Mexico or transshipped from other Latin American source areas, accounts for most of the marijuana available in the United States. Marijuana produced in Mexico remains the most widely available. Moreover, high-potency marijuana enters the U.S. drug market from Canada. The availability of marijuana from Southeast Asia generally is limited to the West Coast. U.S. drug law enforcement reporting also suggests increased availability of domestically grown marijuana.
According to 2000 Domestic Cannabis Eradication/Suppression Program (DCE/SP) statistics, the five leading states for indoor growing activity were California, Florida, Oregon, Washington, and Wisconsin. DCE/SP statistics indicate that the major outdoor growing states in 2000 were California, Hawaii, Kentucky, and Tennessee; these states accounted for approximately three-quarters of the total of eradicated outdoor cultivated plants.
Organized crime groups operating from Mexico have smuggled marijuana into the United States since the early 1970s. These groups maintain extensive networks of associates, often related through familial or regional ties to associates living in the United States, where they control poly-drug smuggling and wholesale distribution from hub cities to retail markets throughout the United States.
Groups operating from Mexico employ a variety of transportation and concealment methods to smuggle marijuana into the United States. Most of the marijuana smuggled into the United States is concealed in vehicles - often in false compartments - or hidden in shipments of legitimate agricultural or industrial products. Marijuana also is smuggled across the border by rail, horse, raft, and backpack. Shipments of 20 kilograms or less are smuggled by pedestrians who enter the United States at border checkpoints and by backpackers who, alone or in groups ("mule trains"), cross the border at more remote locations. Jamaican organizations also appear to be involved in dispatching Mexican marijuana via parcel carriers.
Prices for commercial-grade marijuana have remained relatively stable over the past decade, ranging from approximately $400 to $1,000 per pound in U.S. Southwest border areas to between $700 to $2000 per pound in the Midwest and northeastern United States. The national price range for Sinsemilla, a higher quality marijuana usually grown domestically, is between $900 and $6,000 per pound. BC Bud sells for between $1,500 and $2,000 per pound in Vancouver; but when smuggled into the United States, it sells for between $5,000 and $8,000 per pound in major metropolitan areas.
During the past two decades, marijuana potency has increased. According to the University of Mississippi's 2000 Marijuana Potency Monitoring Project (MPMP), commercial-grade marijuana THC levels rose from under 2 percent in the late 1970s and early 1980s to 6.07 percent in 2000. The MPMP reports that Sinsemilla potency also increased, rising from 6 percent in the late 1970s and 1980s to 13.20 percent in 2000.
Prescription Painkillers
Prescription drug abuse in the United States has been growing at an alarming rate over the past decade, especially among younger users. The growing trend of prescription drug abuse among young people can later be seen below in figure 57. This form of drug abuse is unique in that its target market often includes upper class, white collar, and educated persons who don't necessary live in the city, instead living in the suburbs. In the past, drugs such as meth, cocaine, and crack were often seen to hit hardest lower class, improvised areas within the United States. However, this is not to say these drugs were not used by upper class, white collar individuals. Remember, any drug can take control of any person, not matter what race, gender, class, or background and prescription drugs are no different.

The costs that prescription drug abuse exerts on the United States is borderline insane. Take for example a report published in an article by CNN which noted the following in concern to the costs associated with prescription drug abuse: "One study puts the potential overall cost of painkiller abuse at more than $70 billion a year...Pill addicts who shop around for doctors to score prescriptions cost insurers $10,000 to $15,000 apiece. The toll in lost productivity: $42 billion. The criminal justice bill: $8.2 billion". In yet another article published by CNN, the costs of prescription drug abuse were seen to be greater than the costs of several chronic diseases and illnesses such as Diabetes. The article stated how the annual costs that the condition Diabetes had on society in 2008 was estimated to be roughly $174 billion while prescription drug abuse resulted in costing society roughly $193 billion in 2007. Figure 71 provides as similar comparison of this issue as well but with all drugs rather than just prescription drugs. These articles and figures my friends, truly illustrate what you call a problem that needs attention immediately.
Prescription drugs hold the stigma that because they are made and sold by doctors/pharmacies that they are safer and less likely to cause addiction, creating a sense of false security. The use of prescription opiates over time has led many users to switch over the more affordable and easily available drug, heroin. Fortunately, the government, medical profession, and police have took notice of the recent surge of prescription drug abuse and recent measures have been taken to help curb abuse. Only time will tell how effective these measures and actions are.

Infographic - see text below for description
The facts behind prescription drug abuse
Figure 72
The most likely cause behind the surge in prescription drug abuse is the overprescribing of these drugs. The United States is by far the largest consumer of prescription drugs and the number is borderline comical when the amount of Oxycodone (one of the most commonly abused prescription painkillers in the U.S.) consumed by Americans is taken into effect. Sometimes, doctors just simply make the mistake of overprescribing as they genuinely try to help patients dealing with pain. However, there are also doctors and pharmacists out there who seek to make money by writing prescriptions or stealing them for drug dealers in return for a cut of the profits these dealers make off selling the pills. There is also the problem of doctor shopping, where patients go from doctor to doctor in hopes of obtaining multiple prescriptions. These problem was brought to attention in a documentary produced by Vanguard titled Oxycontin Express. I highly recommend to anyone viewing this incredible piece of work by Vanguard. The documentary can be seen clicking HERE

As mentioned, emergency rooms have seen quite an increase in visits from young adults, teenagers, and even adolescents due to overdose of prescription drugs or from mixing them with other drugs or alcohol. While prescription drugs alone can be dangerous when misused or abused, they are even more dangerous when mixed with other drugs or alcohol. The results can sometimes be deadly yet this does not appear to act as a deterrent to users of prescription drugs. Figure 73 below highlights this growing problem among our youth and the need for it to be addressed immediately.

Infographic - see text below for description
Percentage of teens who mix prescription drugs with other drugs or alcohol
Figure 73
Every day in the US, 2,500 youth (12 to 17) abuse a prescription pain reliever for the first time.
Prescription drug abuse, while most prevalent in the US, is a problem in many areas around the world including Europe, Southern Africa and South Asia. In the US alone, more than 15 million people abuse prescription drugs, more than the combined number who reported abusing cocaine, hallucinogens, inhalants and heroin. Hospitals and rehabilitation programs have seen a dramatic increase in patients coming in to seek help for an addiction to prescription drugs. Due to the popularity of these drugs among young people such as adolescents and teenagers, it can at times be difficult for these people to admit they have a problem and ask for help. I know this was especially true in my case as I was ashamed of what I had gotten myself into and was afraid of what my family and friends would think of me. The figure below, which can also be accessed by clicking HERE, provides the most common reasons for not seeking treatment given by young users of prescription drugs. 

Reason Percentage Reporting
Not ready to stop using34
Did not want others to find out about their problem22
Did not want neighbors to have negative opinions22
Believed problem could be handled without treatment21
Had cost concerns (for example, insurance did not cover treatment)10
Did not know where to go to get treatment8
Did not think treatment would help8
Did not have time8
Could not afford it6
Treatment programs unavailable4
Treatment might have negative effect on job3
Lacked transportation3
Programs did not have openings2

*Wu, L.T., et al. Treatment use and barriers among adolescents with prescription opioid use disorders. Addictive Behaviors 36(12):1233–1239, 2011*
In 2006 in the United States, 2.6 million people abused prescription drugs for the first time.
A 2007 survey in the US found that 3.3% of 12- to 17-year-olds and 6% of 17- to 25-year-olds had abused prescription drugs in the past month. Prescription drug abuse causes the largest percentage of deaths from drug overdosing. Of the 22,400 drug overdose deaths in the US in 2005, opioid painkillers were the most commonly found drug, accounting for 38.2% of these deaths. Depressants, opioids and antidepressants are responsible for more overdose deaths (45%) than cocaine, heroin, methamphetamine and amphetamines (39%) combined.

CAUSE OF DEATHS

Prescription
Drugs
Street Drugs
Combined:
39%
45%(Amphetamine
+ Heroin
+ Methamphetamine
+ Cocaine)
In 2005, 4.4 million teenagers (aged 12 to 17) in the US admitted to taking prescription painkillers, and 2.3 million took a prescription stimulant such as Ritalin. 2.2 million abused over-the-counter drugs such as cough syrup. It is now not uncommon for first-time users to between the ages of 13 to 14 and the number of pills circulating schools in the U.S. is rather depressing. After all, this is our youth and future we are talking about.

Some Charts, Graphs, Tables, and Figures About Drug Use and The Illegal Drug Trade 

There is a lot of information and reading for this post so I thought I would give you guys a little bit of break by providing some illustrations that showcase the presence of drug abuse and its effects on society. If you are not already aware of it, I have recently created a reference page for all tables, figures, charts, pictures, and graphs which can be accessed by clicking HERE. Simply use the figure number (example: Figure 72) to reference or find whatever figure you wish to see at a later time.


Stimulant 1.1 million, Sedatives and Tranquilizers 2.6 million, Pain relievers 5.1 million
About 7 Million Americans Reported Past-Month Use of Prescription Drugs for Nonmedical Purposes in 2010
Figure 56

Past year use - MJ 34.8%, Vicodin 8%, DXM 6.6%, Addderal 6.5%, Tranqs 5.6%, Salvia 5.5%, Hallucinogens 5.5%, Oxy 5.1%, Sedatives 4.8%, MDMA 4.5%, Inhalants 3.6%, Cocaine 2.9%, Ritalin 2.7%
Prevalence of drug use among 12th Graders in the United States
Figure 57

Global heroin flows
Global heroin flows from Asian points of origin
Figure 58 
Global cocaine flows
Global Cocaine Flow
Figure 59
Figure 60
World Wide Drug Routes
Figure 61
Figure 62
The impact the war on drugs in Mexico has had on people living in Mexico
Figure 63
Figure 64
Worldwide Drug Use by Drug
Figure 65
Growing trend of drug use in the United States. Note the increase in "other drugs" most likely indicating the growing use of prescription drugs and heroin.
Figure 66

Drug Distribution Pyramid

Figure 67 


How residents of the U.S. feel about certain measures to control drug use and the illegal drug trade
Figure 68

So, Exactly How Does One's Addiction Affect Other People Besides the User Themselves?

Now that you guys have some information on just how large and complicated the illegal drug trade is, I would like to provide my analysis as to how it affects not only the users themselves, but the rest of society as well.

Let's start with the cultivation and manufacturing/production of the drugs themselves. In order to obtain the necessary ingredients and materials to produce drugs such as cocaine, heroin, marijuana, and the like, there needs to be people willing to do such a job. A majority of the ingredients and the cultivation of them occurs in 2nd and 3rd countries where often poor and desperate people see the illegal drug as a means of earning money and supporting themselves and their families. A scenario commonly seen in places such as this are when farmers are approached to grow and cultivate items such as coca leaves (cocaine), cannabis plant (marijuana), and opium poppy plants (heroin). In some cases, these farmers can earn far more money working within the drug trade than they would normally make from growing and cultivating things such as fruits and vegetables. Thus, resulting in the beginning of the ongoing cycle of drug production.

Once the materials that are needed to produce the drugs are obtained, the next step in the process to take these materials and make them into drugs. The people involved in this step can range from uneducated persons to someone with a knowledge of chemistry. This process can be especially dangerous when having to deal with toxic and flammable materials. After the drugs have been created they are then, more or less, packaged into large (in comparison to what you would see on the streets) units of the drugs to be transported across the world. Again, the people involved in both these steps are usually poor and desperate individuals that some would say are taken advantage of by the drug cartels. This is especially true in poor nations where a couple dollars in pay difference can mean the difference between having a meal, running water, or a place to live.

Once the drugs have been produced, the drug cartels must then find a way to get their product into various parts of the world without getting caught. Sometimes, the drugs are transported in shipping containers oversea, by aircraft, underground tunnels, or even people. The people who transport the cartel's products are often referred to as drug mules and once again, usually involve poor individuals desperate for a shot at a better life. These mules can simply carry the product in a suitcase, duffle bag, under their cloths, or in the trunk of their cars. However, there are also times when these mules will swallow large amounts of the drugs to excrete them at a later time (gross, I know). If the mules are caught by authorities, they risk not only punishment from the police, but from the cartels as well for the lost product and unwanted attention.

Finally, once the drugs are transported into the targeted country, the drugs are then sold to top to midlevel drug dealers who then sell the product to lower levels dealers that most of us (if we obtained our opiates or drug of choice) have probably dealt with before. A vast majority of these low levels dealers come from poverty stricken homes and areas, once again highlighting the trend that the poor and desperate are the ones targeted most by drug cartels. As most of us here already know, the final step in the process is the transaction between the low level dealers and the person buying the drugs.

The combination of all these steps results in a process consisting of hundreds, sometimes thousands of individuals when looking at the entire network as a whole. The poor and desperate are forced to decide between working a low paying job with little satisfaction or a job that pays more while exerting less effort. The competition between cartels and gangs results in hundreds of violent crimes and homicides each year, leaving parents without children, siblings without brothers and sisters, and friends without companions.

Then there are the addicts themselves, whose addiction to drugs often results in them doing things they would have never dreamed of to support their habits. Some steal from not only total strangers but from their friends and family to support their expensive habits. Others may look to selling drugs to support their habits, providing yet another outlet for others to obtain drugs and feed their addictions. Try to look at it like this. An addict is desperate for cash to score their bag of heroin (or any other drug) so they steal $50 from their parents while pawning their friends iPod after stealing it. The money they get from these actions goes towards buying drugs, which in return goes from the drug dealer to upper level dealers to obtain more drugs for selling. The upper levels the send the money to the cartels which then go towards paying the people who are involved in growing/cultivating, producing, or transporting the drugs. As you can see, it's all one big and complicated cycle involving numerous people. They weren't kidding when they said money makes the world go around.

Figure 70

In my opinion, the root causes for this vicious cycle are the demand for the drugs and monetary gain. Without demand, these drugs and the cartels, gangs, and people involved with them would cease to exist, or at the very least be of much lesser influence. Thus, we as humans must learn to cope with these problems and develop ways to reduce the demand for illegal drugs. It's a lot easier said than done and is something that has been tried for nearly the last 100 years. The demand for these drugs is what fuels this monster, which looks to target helpless or desperate individuals. The people making and selling these know exactly how addicting some of them can be and that there will always be a market for their products.

Think about how many times you may have been forced to do something you would have never done if not for an addiction to drugs. Would you have pawned something of sentimental value, stolen money that wasn't yours, or paid a crap load of cash to obtain your drug of choice during a drought? This is exactly what the people involved in the world drugs hopes for and is aware of as they know a great number of individuals would rather do something bad than face withdrawal. At the end of the day, the addicts, cultivators, producers, cartels, and dealers are all intertwined and connected with one another in some way, shape, or form.

Figure 71

There are also the cases of overdose deaths, a scenario that is far too common in the drug game. It's sad when someone loses their life to drugs, leaving those around with the question "how could this happen to my son, daughter, friend, brother, or sister?" A overdose doesn't only cause a world of pain and loss to the individual who loses their life, but to those closet to them as well. No one should have to attend to their child's funeral.

The need to support one's habit can often result in one committing crimes such as theft, burglary, scams, or even violent crimes. If these individuals get caught too many times or with a serious enough crime, they risk being sent to a prison, jail, or institution. These crimes and the punishments that can come along with them affect society through the costs that result from maintaining the prisons, jails, and institution along with the costs associated with theft, burglary, and scams. An addicts need to support their habit by committing various crimes can result in parent losing their son or daughter, a man or woman losing their spouse, or an employer losing an employee. Figure 69 below shows just expensive drug addiction can be on society with the total cost estimated to be around $559 billion each year. As you can see, one's addiction can have quite an impact on society as a whole.

Estimated Economic Cost to Society from Substance Abuse and Addiction
Drug addiction costs to society (global figures)
Figure 69

I want to make clear before I go any further that I am not speaking on behalf of all addicts and I am not saying that all addicts are bad people or people that commit devilish acts. Rather, I am trying to demonstrate the powerful hold drugs can have on people and how they can turn some people into entirely different individuals. I have lost friendships with good friends because drugs got too much of a hold on them, turning them into liars, cheaters, scammers, and thieves. I know I have done my fair share of things that I really regret and would have never done if I was sober and without an addiction to Oxycodone. Thankfully, I have managed to change (for the most part) and put these ugly experiences in my past, although I still remember what I once was and even cringe when I think of some of the stuff I once did for drugs.

I would like to end this section with some quick information and facts highlighting the costs that drug abuse and the illegal drug trade can have on society.

- It is estimated that in 2000, illegal drug use cost the United States alone close to $161 billion:
  • $110 billion in lost productivity
  • $12.9 billion in healthcare costs
  • $35 billion in other costs, such as efforts to stem the flow of drugs
- In addition to the costs in lost productivity, healthcare, and efforts to eliminate or contain the illegal drug trade, the following are also costs that are the results of drug use and market surrounding it.

  • Spread of diseases such as HIV/AIDS and hepatitis C  through the sharing of drug paraphernalia
  • Deaths due to overdose or other complications from drug use
  • Effects on unborn children of pregnant drug users
  • Crime and homelessness.

- Analysts estimate that the illicit drug trade has annual earnings between $13.6 to $49.4 billion.

- By October 31 2012, 18,061 individuals, including cartel members, citizens, and police have been killed as a result of Mexico's war against drugs and drug cartels, which have been fueled by the worldwide demand for illegal drugs.

- With more than 33,000 people dying in 2005 of drug related overdoses in the United States alone, drug overdose is now the second leading cause of accidental death, behind only motor vehicle accidents (43,667).

- On Dec. 31, 2011, there were 197,050 sentenced prisoners under federal jurisdiction. Of these, 94,600 were serving time for drug offenses. Meanwhile, on Dec. 31, 2010, there were 1,362,028 sentenced prisoners under state jurisdiction. Of these, 237,000 were serving time for drug offenses.-courtesy of drugwarfacts.org.

-Each year, state and federal governments spend more than $15 billion, and insurers at least $20 billion, on substance-abuse treatment services for over four million people.

-Throughout the 1990s, drug-related homicides accounted for between 25.7% to 44.6% of all homicides within the United States.

Conclusion

Without a demand for drugs, there would be no inter-drug cartel violence, a war on drugs, drug dealers, helpless individuals so very dependent on a substance, and the large financial burdens related to drug addiction. With no demand, the cartels would struggle to exist, the incentives to produce and cultivate drugs would drop, and parents wouldn't have to worry each night wondering if their child will simply survive one more day.

We must get to the root of the problem if we are to ever win this, thus far, unsuccessful campaign against drug use. For every drug dealer or cartel you take down, another one simply steps in allowing little disturbance. So, why instead focus on the addicts themselves and create ways to help them. Even better, if we provide child while they are young and learning the dangers of drugs and they can truly destroy not only the addicts life but the lives of those him or her. I am aware that there are programs that offer such education and training but can say from experience, they need a lot of work, attention, and aid. If we can better teach children just how serious drug use can be and the path that it can lead one down, maybe then they will be less inclined to use drugs later in life. After all, if a business doesn't have customers, it will not be able to survive. This is how we must treat the problem of drug use and addiction.

If you are interested in learning more about the illegal drug trade, drug abuse, and the effects both these things can have on society, feel free to check out a few of the links below.

National Institute of Drug Abuse

U.S. Department of Justice Report: The Economic Impact of Illicit Drug Use on Society

New York Times: Study Says Drug Abuse Costs Hit $468 Billion

Study Shows Illicit Drug Use Costs U.S. Economy More Than $193 Billion

Substance Abuse Prevention Dollars and Cents: A Cost Benefit Analysis

CNN: How Prescription Drug Abuse Costs You Money

CNN: Drug Abuse Costs Rival Those of Chronic Diseases

Thanks a lot Guys for reading and as always, please feel free to drop a comment in the comment section. I always enjoy hearing from my readers. Until next time my friends, take care and keep seeing the light!

Warm regards,

Seeingthelight


Friday, June 7, 2013

Heroin Assisted Treatment

Introduction

Hi Guys and welcome to my blog about opiate addiction. Summer is right around the corner and I must say, it feels good. The warm weather is certainly a plus and the combination of free time and nice weather has allowed me, and I'm sure many others, the opportunity to partake in some of our favorite activities, sports, and enjoyments that tend to disappear during the cold winter months. I always thought of summertime as the best time to get off opiates with the warm weather (I absolutely despise the chills associated with withdrawal), time off from school or work (vacation?), and the general sense of mellowness most associate with the summer. I hope my blog can help anyone who is thinking about or currently partaking in a life without opiates.

I also want to alert you guys about a new section of my blog that I have recently created and published. This new section will provide readers with various graphs, photos, charts, figures, and the like that can be used as a reference page for the related post that you are reading. For example, if the post you are reading is about the effectiveness of Suboxone treatment programs, you may read a sentence that says "Suboxone has had various levels of success in relation to specific age groups, which can be seen in Figure 25". You can then check out the new section to view this table, chart, graph, or photo. I will still include these illustrations within the posts themselves as well with the idea of this new section being that users can view these items at later times. The section is simply a normal post created in the usual fashion of my other posts and is labeled as "Tables, Charts, Photos, Figures, and Graphs Reference Page". The section can be found by simply clicking HERE. It can also be found on the homepage of my blog which can be accessed by clicking HERE. This section will be updated constantly and will be effective for any posts published after June 6, 2013.

On that note, I would like to use this post to discuss a topic that I recently came upon that has been meet with much criticism and debate; heroin assisted treatment.

Heroin assisted treatment is a method of treatment that is used to help treat opiate addicts (heroin addicts) by using the drug diamorphine/diacetylmorphine, commonly referred to as heroin. The drug is given to addicts under supervision with dosages being gradually lowered over time to help minimize withdrawal from the drug. I must say, I was really shocked when I first heard of this method and was pretty curious as to how effective this method of treatment really is. A doctor giving heroin to an heroin addict to help combat addiction seemed almost surreal and bizarre when I first came upon this treatment option.


Pharmaceutical Heroin Today
Figure 36

After doing some research on the issue, I began to gain a better understanding of the procedure and started to see the concept behind it. Some within the addiction community see heroin assisted treatment as a means of treating addicts with a drug that is "cleaner" than what they would normally be getting on the street while also having the drug administered in a safer fashion and dosage than what they would otherwise normally be practicing. This method of treatment is somewhat similar to what doctors sometimes do to aid patients who have been prescribed opiates over an extended period of time get off opiates by tapering the patient's dosage over a period of time with the eventual goal of coming off opiates altogether.

Obviously there is a major difference between tapering prescription painkillers with tapering heroin but the overall concept remains, for the most part, quite similar. This method of treatment is without a doubt one of the more lesser preferred methods of treatments but is still nonetheless actively used in some countries. With the methods, beliefs, concepts, medications, and technology constantly changing within the addiction community, it is not that unrealistic to think that this kind of approach (or one similar) of treating those who struggle with opiate addiction reaching other countries or facilities over time. Thus, I would like to go into further detail about this matter by talking about the exact nature of heroin assisted treatment, its history, where it is used, its effectiveness, the risks and benefits, and finally, my opinion on the matter. To make things a little easier on myself and your eyes, I will be using the acronym HAT at times to refer to heroin assisted treatment.
 
What is Heroin Assisted Treatment and How Does It Work?

Heroin assisted treatment (HAT) is the "prescribing of a synthetic heroin, in an injectable or capsule form, to opiate addicts that do not benefit from or cannot tolerate treatment with one of the established drugs used in opiate replacement therapy such as Methadone or Buprenorphine (Suboxone)". Under this method of treatment, heroin is administered under the supervision of a doctor with the dose being gradually lowered over time. Similar to how doctors taper patients off of prescription painkillers, the goal of heroin assisted treatment is to eventually wean the patient off of the drug in an effort to minimize withdrawal. After gradually tapering down to a fairly low dose of heroin, patients will sometimes then be switched over from the heroin to a low dose of Suboxone or Methadone for a brief period of time before jumping off opiates altogether.

The method of treatment allows addicts to identify and learn about their addictions with the hope that these addicts can learn to cope with their addictions and eventually achieve sobriety. By having the heroin administered under medical supervision, the risk of overdose, disease, criminal activity, and costs are lowered or minimized. Heroin assisted treatment is available and practiced in Denmark, Germany, the Netherlands, Switzerland, and the United Kingdom while experimental trials are currently being conducted in Canada and Belgium. Meanwhile, the policy has been heavily criticized and opposed by many within the United States with Methadone, Buprenorphine, and total abstinence being the more preferred and favored methods of treatments for opiate addiction.

The history of heroin assisted treatment began in the United Kingdom during the early 1920s and was commonly referred to as heroin maintenance. The method of treatment was available to a select group of patients, with many ironically being doctors themselves. Due to the close relationship between the United States and the United Kingdom along with the United State's strong anti-drug stance in what would eventually be labeled as the War on Drugs, the use of HAT experienced a sharp decline beginning in the 1960s. However, the method of treatment begun to see somewhat of a resurgence beginning in the mid 1980s and has since found a niche within the addiction community today with the United Kingdom, Netherlands, and Switzerland notably maintaining an active role and voice in the policy today. Germany and the Netherlands actually include the treatment option as a component of their national health care systems.

Bayer Prescription Heroin in 1910
Figure 51

The way in which the heroin is prescribed and administered varies from not only country to country but from clinic to clinic as well. For most patients who are partaking within a treatment program offering heroin assisted therapy, the patients are usually given their dose of heroin under the supervision of a doctor or medical professional. This course of action is preferred as it can help reduce the chance of the heroin being abused or sold on the streets. However, the United Kingdom is unique in that it sometimes allows patients who have demonstrated a sense of trust and responsibility to take home their heroin prescription or to have to only show up to the clinic once a day rather than several times throughout the day due to heroin's short acting half life. It is important to note that while this may seem rather extreme as well as the fact that the United Kingdom is one of just a few countries where HAT is legal, less than 1% of all opiate replacement treatments for heroin in the United Kingdom are heroin assisted treatments.

Clinics in the Netherlands meanwhile often require patients to make at least two visits per day to obtain their doses of the heroin with the option of being able to take home a single dose of methadone each day. Switzerland handles their treatment programs by at first requiring patients to make daily (sometime multiple times per day) visits to obtain their doses with the possibility of patients being able to take home a pill form of heroin after the patient has demonstrated a sense of trust as well as being able to obtain employment.

Patients are sometimes prescribed Methadone in addition to the heroin to help provide relief for withdrawal if the heroin wears off before the patient is able to obtain their next dose. The use of heroin in treating addicts is seen as a way in combating what has been viewed by many as an epidemic that is growing in size and severity each day. Still, there is much fear that this method of treatment can be dangerous, contradicting, and ineffective with many fearing the possibility that the drug can make its way to the streets. Similar to the way in which concerns surrounding Suboxone and Methadone affected programs, this has resulted in tight regulation and supervision of the clinics and doctors who offer this option of treatment.

The Pros and Cons of Heroin Assisted Treatment

As you can probably already gather, there are several pros and cons of heroin assisted treatment. The method has been met with its fair share of intense criticism with many feeling that it is simply a means of providing addicts with their drug of choice, holding little to no value in actually treating their addictions. There is also the issue of the prescription heroin possibly getting out onto the streets. We have already seen just how easy it can be for prescription painkillers to make their way onto the streets and into the hands of addicts each and every day with little disturbance or interruption. With the heroin used for HAT programs most likely purer and with little to no additives (cuts) than most heroin found on the streets, there runs the possibility that drug dealers and addicts may see this as a means of making profits or getting high. Think about how often you hear about a corrupt doctor or pharmacist who wrongfully prescribes, steals, or sells prescription drugs for profits. Well, what would stop these same kinds of people from doing the same exact thing with heroin?

Another cause of concern involves the safety of the patients themselves who are partaking within an heroin assisted treatment. Heroin is a dangerous drug and is certainly one of the more common opiate culprits behind overdoses and opiate-related deaths. Doctors will have to use extreme caution in not only determining how much heroin is safe enough to administer but that there is enough administered to help provide relief from withdrawal. I ask myself, what happens when a patient with an extremely high tolerance to heroin enters treatment? The patient will most likely require a dose of heroin that could be considered dangerous in order to minimize withdrawal. Is the risk really worth it or would the patient be better served with a drug such as Methadone or Suboxone? I'm sure programs offering this type of treatment have thoroughly thought these concerns over but it begs to ask the question, how safe, supervised or not, can administering heroin really be?

The Success of Switzerland's Harm Reduction Programs
Figure 53

The benefits of heroin assisted treatment are a little more difficult to identify and support. A good comparison of HAT would be to the harm reduction programs that several cities across the world run. These programs are created and implemented with the hope that they can reduce and minimize the various risks and negative consequences so often associated with drug use. An example of a harm reduction program would be a needle exchange clinic in which IV users of heroin can drop off dirty or used needles in addition to being able to obtain new and clean needles. The program helps prevent needles from being carelessly tossed on the ground where they could be picked up by an innocent child or accidentally poking someone who unintentionally comes into contact with the  carelessly disregarded needle. Needle exchange programs also discourage needle sharing which can result in the spreading of diseases such as hepatitis or HIV/AIDS. This is critical as diseases such as these are very present within the world of drug and its inhabitants.

I mention the comparison of the needle exchange programs in relation to the heroin assisted treatment option because both concepts are meant to reduce the risks and harm that often come along with using a street drug such as heroin. Supporters of programs such as these see heroin use as a problem that is difficult to stop or even prevent and look to ways to help deal with the problem at hand through harm reduction rather than the difficult and, unfortunately, often unrealistic attempt to eliminate heroin use totally. To sum it up, supporters of these programs feel as through quitting heroin cold turkey or with drugs such as Methadone or Suboxone is too ineffective for some select addicts such that using heroin under a supervised tapering regimen is the next best option. A good saying for this particular scenario is that heroin assisted treatment is the lesser of two evil when compared to heroin use on the streets.

Sign for a Needle Exchange Program
Figure 54

Another benefit that is used to support HAT is that the method of treatment can reduce criminal behavior and costs. Addicts partaking in one of these programs would be obtaining their heroin legally (man that sounds crazy, doesn’t it?) through a doctor’s prescription rather than buying it off the streets from a drug dealer. Addicts will also not have to pay anywhere near as much as it would cost to maintain a habit of buying heroin off of the streets. This would, in theory, reduce the need to commit criminal acts such as theft, drug dealing, prostitution, and violent crimes to support one’s habit. Ultimately, this combination would result in fewer arrests and incarnations. Who would have ever thought that giving heroin to heroin addicts could reduce criminal behavior?

A final benefit that one could associate with HAT is that the method of treatment would be much safer for the addict than if they were purchasing and using heroin from the street. Because individuals within the program would have their doses overseen and administered by a medical professional rather than the addicts themselves, the risk of overdose is greatly decreased. More often than not, heroin is rarely pure, often containing a variety of additives. Occasionally these additives can result in serous illness or death due to the presence of harmful additives, allergic reaction, or the inclusion of more potent drugs (such as Fentanyl). Another factor to consider is the overall nature of the heroin underworld and drug game, which is often filled with dangerous places, acts, scenarios, and people. No one is going to get harmed or killed in a medical facility or treatment program over bag that was shorted or because someone didn’t pay back some money or drugs that they were loaned.

So, Just How Effective is Heroin Assisted Treatment?

Trying to determine the overall effectiveness of heroin assisted treatment in comparison to more traditional methods such as opiate replacement therapy, AA/NA, or total abstinence is, for the most part, quite difficult to determine.

In North America and Europe alone, there are an estimated 2-4 million heroin users with 1-2% of this population prematurely dying each year. The social, economic, and medical costs attributed to heroin use is believed to be in the billions of dollars in addition to the thousands of individuals serving sentences in prisons, jails, hospitals, and institutions each year. In other words, heroin has had a major impact on society and this holds true to not only the addicts themselves, but to everyday people as well. Every day, family members and friends lose loved ones to heroin addiction, be it from incarnation, destroyed relationships, or death. Heroin use is unfortunately a growing problem that looks like it is here to stay. This is all without mentioning the enormous impact prescription painkillers such as Oxycodone, Oxycontin, Dilaudid, and Fentanyl have had on society as well. 
There are a few studies out there that have been conducted over the last 25 years in regards to the effectiveness of heroin assisted treatment. It is a lot of information to digest in these studies to the point that it wouldn't really be appropriate to include all this information in this post. Rather than copying and pasting all this information into this post, I thought it might be a better idea to include the links to these studies below. I will also touch upon some of these findings in my own words below as well as providing you guys with some of the more important results of these studies. The following links below this paragraph will bring you to these studies. The first link is a detailed study conducted by the European Monitoring Centre for Drug and Drug Addiction (EMCDDA) that provides a great insight on the matter. I defiantly recommend checking it out if you have the time even through it unfortunately requires you to download the document after you click on the link (it is, however, free and on a secure site). The articles are as follows:
Between 1994-1996 , a study involving the effectiveness of heroin assisted treatment was conducted by an independent research team consisting of members from the Addiction Research Institute and the Institute of Social and Preventive Medicine at the Swiss university, Zurich University. The study demonstrated several positive results in regards to the effectiveness of HAT. The link to the study is the 4th link above this paragraph and can also be accessed by clicking HERE. Some of the findings include (in blue font): 
"The safety of patients and staff could be evidenced (no fatal overdose from prescribed substances, no successful thefts or deviation to the illegal market, few cases of violent behavior). In contrast to expectations, the daily dosages of Diamorphine could not only be stabilized, but were slightly reduced over time. Many patients preferred to combine injectable Diamorphine with oral methadone, in order to have more freedom to resume school attendance or employment"
"The consumption of illegal / non-prescribed substances while being on the program was reduced significantly (especially the daily use of heroin and cocaine, to a lesser degree the regular use of Benzodiazepines). Cannabis use on the other hand remained essentially unchanged, but without noticeable effect on treatment outcome."
"Regarding social integration, it may be mentioned that homelessness was significantly reduced, while reintegration into the regular labor market proved to be more difficult. Most spectacular was the reduction of criminal activities according to self-report and police data (Killias & Rabasa 1998)."
"Retention in treatment was superior to what is observed in other forms of treatment (76% over a 12-month period). 60% of discharged patients could be transferred to a regular treatment program within 18 months (about half of those to drug-free programs)."
In 2000, a second systematic follow-up study was made (Güttinger, Gschwend et al, submitted). The study included 244 patients covering a period of 6 years. At that time in 2000, 46% of patients in the previous study were still in treatment while 48% of discharged patients had entered a regular program. The study also provided a comparison of those still in treatment with those who were discharged showing the following information (again, in blue font):  

 

- a significant reduction in illegal heroin, cocaine and Benzodiazepine use in both groups
- no reduction in cannabis use in both groups
- a significant reduction of homelessness in both groups
- no reduction in unemployment in both groups
- a highly significant reduction in living from illegal income and in new court cases.

The results of the Swiss study clearly illustrated mostly positive outcomes for patients involved in the heroin assisted treatment trials. Despite these results, the study stresses that it is not recommending heroin assisted treatment as a first line of defense in the battle against opiate addiction. Rather, the method of treatment should be reserved for a select few individuals, focusing on those who are 1) using heroin and 2) have been unsuccessful with other lines of treatment in the past such as Methadone or Suboxone. In other words, someone with an addiction to prescription painkillers shouldn't attempt to go this route as it geared more towards heroin addicts as a last resort. Using heroin, whether in a program or not, can at times be like playing a game of Russian roulette as the potential risks, addictive nature, and reputation of the drug are all well documented. Heroin assisted treatment should thus be reserved for those heroin addicts who have exhausted nearly all other possible options (with little to no success) such as abstinence, Methadone, or Suboxone before looking into a HAT program.
 
Now lets take a look at a study conducted in the Netherlands in which injectable Diamorphine (heroin) was administered to patients. The group receiving the injectable heroin was compared with a group receiving Methadone. The Dutch study showed that after twelve months, client retention rates were higher for the Methadone group compared to the heroin assisted treatment group. However, patients in the heroin assisted treatment group responded better than those in the Methadone group in regards to aspects such as comfort level, side effects/reactions, and overall cost effectiveness of program. The overall findings of this study demonstrated that the group receiving the heroin assisted treatment was usually nearly equal to or greater than (although not by substantial margins) in most factors of the study than the group in which members were administered Methadone.  
A quick summary, conveniently in the form of a table, of a few of the studies conducted that focused on the effectiveness of heroin assisted treatment can be found by clicking HERE.
 
A final aspect to look at when determining the effectiveness of heroin assisted treatment is the availability of the program. As I mentioned earlier in my post, HAT is quite limited in that it is only legal and available in a select few (five to be exact) countries and even in those countries, the number of heroin assisted treatment programs is small. I bring this issue up because what good is a treatment option when it is close to impossible to find or partake in. To demonstrate to you guys just how few HAT programs there are worldwide, take a look at the number of HAT programs in each of the five countries where the method of treatment is legally available.
Country                                   Number of HAT Programs
Denmark                                             3
Germany                                             7
Netherlands                                        17
Switzerland                                        23
United Kingdom                                3
 

 

My Final Thoughts and Opinion on Heroin Assisted Treatment

Over the past decade, the world (especially the United States) has seen what appears to be an epidemic in regards to the abuse of prescription painkillers and opiates. Thus, we must learn new ways to deal with this growing and demanding problem. Is heroin assisted treatment the perfect solution to this problem? Of course not, but neither are drugs such as Suboxone or Methadone. For some, these methods of treatment work wonders while for others they are ineffective. Rather than praise one method while bashing another, we should give each method a fair and efficient evaluation determining what works and what doesn’t. Would I consider HAT a solid solution to opiate abuse or something I would try myself? My answer is probably not, but I believe that if it truly works for some people, then it has its place within the addiction community.

What I’m trying to say is that if it works for some people, is proven to be relatively safe and effective, and is used the right way, then who am I to say it does or doesn’t have its place within the addiction community. For example, I am currently on less than 1 mg of Suboxone a day after being addicted to over 200 mg Oxycodone for roughly two years. I have been on the Suboxone for a little over a year and through a supervised taper regimen, have found the drug to be a total godsend. However, there are some people who feel Suboxone just doesn’t work well enough for them and would prefer other means such as Methadone maintenance, AA/NA meetings, or total abstinence to treat their addictions. If those routes work for you, than all the power to you with the most important thing at the end of the day being whether or not you are clean off of opiates or are, at the very least, heading into that direction through your method of treatment.
Typical Outpatient Clinic
Figure 55

I look at heroin assisted treatment as a more untraditional means of tapering just like how someone would be tapered off of a prescription painkiller. I think a lot of criticism surrounding HAT programs is due to the stigma that revolves around heroin. Most people, rightfully so at times, see heroin as an evil, dangerous drug that has no place in the medical community. Yet when you get down to the main ingredients in most prescription painkillers, they are almost the same ones usually found in heroin, often coming from the same kind of plant. Because these prescription painkillers are made in a factory or lab, there is often a sense of false security that comes with them. Well guess what, at the end of the day both heroin and prescription painkillers can cause addiction and both result in similar withdrawal. To provide you guys with a metaphorical example, think about marijuana. There is a difference between some high grade marijuana and some low grade mids. Yet, at the end of the day, they are both kinds of marijuana.

The best way that I can describe how I feel about HAT is to tell someone to try to look at the relationship and similarities between heroin and prescription painkillers in the big picture. By big picture, I am referring to looking at where both come from, the similarities in the highs between the two, the withdrawals that can accompany both, and the devastating consequences that both can have on people and those around them. Is it really that insane to think and see the similar nature between both beasts? Sadly, I think it is not that crazy to think and see such as thing.

To reiterate and summarize my final thoughts on heroin assisted treatment, I say that while it is something I would never consider partaking in myself (if it were legal in the U.S.), I think that the method of treatment is deserving of further attention. As of right now, I feel this method of treating addicts leaves far too much opportunity for it to be misused or abused. I admit that I could certainly use more information or firsthand accounts of the process that one undergoes when getting into one of these programs as well as more information as to how they usually operate.

Under the proper supervision and environment, I feel there is potential and promise for this concept. However, the idea of giving someone with an addiction to heroin the opportunity to take home doses of the drug seems a little absurd to me in that I feel the potential for abuse or misuse is too great to allow someone to take home and administer the drug themselves without the supervision of a medical professional. I have met and seen firsthand several addicts with prescriptions to Suboxone and Methadone who do not take their medications as prescribed or even sell them as a means of supporting their habits. Thus, I don’t believe it is too farfetched to see something like this occurring in a program that offers heroin assisted treatment.

Conclusion

Well, I think this post might take the icing on the cake for the longest post that I have written thus far. If you read it all, especially in one sitting, I would like to thank you for taking the time to do so. I hope you found this post interesting and if you are someone in a country where heroin assisted treatment is legal and are considering this method of treatment, that you found this post was helpful. I would love to hear what you guys think of this topic under the comment section so please don’t hesitate to drop a comment. If you have any firsthand experience with HAT, I would greatly appreciate your input on the matter.

As always, thanks for reading Guys. Don’t forget about the new section in my blog that allows readers the opportunity to view the various pictures, graphs, charts, figures, and tables used throughout my blog. I think this section will be especially helpful for referencing items as well as allowing readers the opportunity to look something up that they may have read in one of my previous posts. I can only hope that my next post is as exciting and interesting as this one as I must admit, it is at times getting more and more challenging to find and write about fresh and interesting topics. I guess that's part of the fun as well. I have certainly learned a lot since I wrote my first post roughly a year ago.

Well, my time is now up and I thank you for yours. Take care my friends and remember…in even the darkest places and times, there is always light so don't hesitate look around a little bit to keep seeing that light! It’s there somewhere, I promise.

Be safe, be healthy, and most importantly, be happy.

-Seeingthelight