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Wednesday, May 18, 2016

Canadian doctors may soon have prescription heroin as an addiction treatment option

Dr. Eugenia Oviedo-Joekes, examined whether hydromorphone, a licensed pain medication, is as effective in treating a chronic heroin addiction as diacetylmorphine.(Rafal Gerszak For The Globe and Mail)
Vice has an article out that reports pharmaceutical heroin may be an option for doctors treating heroin addiction.

Canada's federal health agency intends to open up legal access to heroin as a treatment for chronic opioid abuse, a move that is already being heralded by doctors who have fought to make the drug a legitimate option.

The announcement comes as the country struggles with a rise in illicit drug overdoses and an especially dramatic spike in those involving fentanyl, which is roughly 100 times more potent than heroin. The province of British Columbia declared a public health emergency in April after fentanyl overdoses killed 200 people in just three months and neighboring Alberta last week made naloxone, an opiate overdose antidote, available without a prescription.

"There are people across this country who are suffering from severe opiate use disorder that need access to this," said Dr. Scott McDonald, who has been fighting for years in British Columbia to make heroin a legitimate treatment option for those with severe opiate addictions. "A small number, but a significant one."

The new proposed a regulatory amendment by Health Canada would allow diacetylmorphine, or pharmaceutical grade heroin, to be considered under its Special Access Program (SAP).

Under the SAP, clinical experts assess requests for emergency access to drugs for people who have serious or life-threatening conditions, where traditional treatment methods haven't worked, are unsuitable or unavailable.

Prescribing heroin to tackle opiate abuse is already legal in a number of other countries, like Germany, the Netherlands, Denmark, and Switzerland, for those patients who haven't responded to conventional treatment options, like methadone and buprenorphine.  Read full article here….

The article below is from  TheGlobe and Mail.  The article has some interesting findings of double blind studies, primarily asking if hydromorphone, a pain reliever, is more effective in treating heroin addiction, as pharmaceutical grade heroin…..

People with chronic heroin addiction may soon have another treatment option after the conclusion of a groundbreaking study in Vancouver’s Downtown Eastside.

The four-year Study to Assess Longer-term Opioid Medication Effectiveness (SALOME), led by principal investigator Dr. Eugenia Oviedo-Joekes, examined whether hydromorphone, a licensed pain medication, is as effective in treating a chronic heroin addiction as diacetylmorphine, also known as pharmaceutical-grade heroin.

The results, which will appear in Wednesday’s edition of the Journal of the American Medical Association Psychiatry, show it is: Participants on both medications reported three to five days a month of illicit drug use, compared with almost daily illicit drug use prior to the study. As well, illegal activities dropped to an average of less than four a month, compared with an average of more than 14 a month before the study.

Participants in the double-blind study could not determine which drug they were receiving, researchers found.

It’s the first time hydromorphone, commonly used in palliative and acute care, has ever been evaluated as a substitution treatment for opioid dependence.

“Chronic addiction has huge consequences for individuals and society,” said Dr. Scott MacDonald, who oversaw trials at Providence Health Care’s Crosstown Clinic from late 2011 to late 2015. “We now have an additional treatment option – one that does not have the political and regulatory obstacles and stigma that prescription heroin has to it.”

Hydromorphone is also readily available in Canada, whereas prescription heroin is manufactured by a pharmaceutical company in Europe and must be imported through an onerous process.

This new option builds on heroin-assisted treatment, a secondary treatment targeted at entrenched addicts who have failed repeatedly with traditional options such as methadone or buprenorphine. For them, receiving prescription-grade heroin in a supervised, medical setting has been shown to improve physical- and mental-health outcomes and reduce illicit drug use and related criminal activity.

SALOME’s 202 participants averaged more than 15 years injecting street heroin and had attempted methadone several times in the five years prior to beginning the study.

Dr. Oviedo-Joekes, SALOME’s lead researcher, noted that 80 per cent of participants stuck with the study – an important finding, because injection drug users are at high risk for HIV and other blood-borne illnesses and may not frequently engage with the health-care system. During the study, participants saw doctors three times a day.

“We see them every day. We have an opportunity to provide comprehensive care,” she said. “This is a very small group of patients – not more than 10 per cent of everybody on substitution treatment – but they are the ones that are the most vulnerable. They are the ones we have failed over and over with every other treatment.”

No one from the College of Physicians and Surgeons of B.C. was available to comment on the research on Tuesday. In an e-mailed statement, the college said its Prescription Review Program staff “will be interested in reading the full study to understand the implications going forward.”

SALOME is the next chapter of the North American Opiate Medication Initiative (NAOMI), North America’s first clinical trial of prescription heroin, which took place from 2005 to 2008. That study confirmed the effectiveness of heroin-assisted treatment – currently offered in countries including Switzerland, Denmark, Germany, the Netherlands and the U.K. – but produced the unexpected finding that a small group of participants that had received hydromorphone seemed to yield the same benefits.

SALOME was then launched to investigate whether hydromorphone is as effective as prescription heroin in heroin-assisted treatment.

The trials drew the ire of Conservative former federal health minister Rona Ambrose, who objected to Health Canada’s approval of special applications allowing people cycling out of the study to continue receiving prescription heroin. In October, 2013, Ms. Ambrose introduced regulations to make prescribing the drug outside of a clinical trial illegal.

Providence and five plaintiffs launched a constitutional challenge and sought an injunction while the case was before the courts; the B.C. Supreme Court sided with them the following May, saying the risks associated with severe heroin addiction “will be reduced if [the addicts] receive injectable diacetylmorphine treatment from Providence physicians.”

Crosstown Clinic currently treats upward of 140 people per day. Currently, 110 are on prescription heroin, about 25 are on injectable hydromorphone and a “small number” are on oral hydromorphone, Dr. MacDonald said.

44 comments:

  1. this kinda stuff saves lifes. End the war on drugs! treatment is x7 cheaper.

    ReplyDelete
  2. ...actually most Canadian provinces have approved naloxone without a prescription for the emergency treatment of Fentanyl overdose, including British Columbia....not just Alberta

    recreational drug use is a personal lifestyle choice, as in even smoking or the use of marijuana.. nobody makes you 'do drugs' and eventually, you and your family have to pay a terrible price of that irresponsible choice.

    Legalize drugs, the war on drugs is lost anyway with Mexico paying the highest price with a body count in the thousands every year ...just because drugs are legal doesn't mean you would have to use them.

    ReplyDelete
    Replies
    1. Recreational? Give your head a shake. No one used hydromorph or fentanyl for kicks. Weed is the only recreational drug I have ever known. Educate Yourself son, opiate addiction plagues the most marginalized people in society. They make easy targets for ridicule and shaming by people such as yourself

      It takes balls and tenacity to recover, and recovery is possible with former addicts becoming valuable members of society, albeit in far too many cases. It is a disease listed in the dsm V. Yes, thankfully, it can be arrested and regress over time.

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  3. Canada is fucken smart!

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    1. If canadians were real smart, they would punish the pushers, all the way to the banksters and money launderers, expropriate ALL THEIR MONEY, and supply all the addicts for free, whatever they fancy, heroin, cacaine, meth, naloxone, hiv, whoppers, big macs, whatever...along with rehab programs for free.
      --The queen would die real quick...

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  4. Now the question is, who is going to grow it for them? They going to ask MEXICO to grow it for them like the fucken gringos did in Vietnam? Then they gonna hate on Mexico and put pressure on the Mexican gov to start a war on drugs? For shit they started? Please grow your own shit Canada, let Mexico be.

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    1. 10:15 the Canadian weather only lends itself to growing trees, and white haired white polar bears, but canadians are burning their forests to be able to see their trees and experiment with cold resistant strains of heroin poppies, grifa, cacaine...
      --But china, India, afghanistan, turkey, all them Arab countries make more than enuff stuff to snuff, mexico is not needed but for two things, staging area, and fall guys...

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    2. Canada can easily grow their own.

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    3. The brittish empire has successfully grown their own for about 400 years, and chinese teas on top of it, needs no help unless there is a need for mexican or south american fall guys aka "narcos"...
      See: The Opium Wars

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  5. Where is Canadiana when you need her?

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  6. Pharmaceutical heroin already exists. It's called Oxycontin and it is the first step in a lot of junkie's heroin addiction process.

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    Replies
    1. you are missing the point...and no oxy is not pharm H, what the story is about is legalization...allowing docs to prescribe the drug to addicts.

      oxy is only the first step when a person becomes addicted, by using it as a recreational drug or legit RX for pain. going to Heroin is a financial decision.

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    2. That last sentence Chivis was 'BINGO'!Going to heroin is a financial decision.How true that rings.

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    3. Thanks Chivis for bringing your common sense to the equation

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  7. Great Please Let Mexico grow it. That would take the crime out of it. I have family menbers on Herion

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  8. I know someone personally that was addicted to percocets.She has now been on methadone for many many years.[yeah you will never get off the stuff].She doesn't do percs any more but will do cocaine when she can.I don't know if the US has the methadone program or not.She has to go for regular visits with a doctor to get her cocktail or she will get cut off.Her 'cocktail' costs like $13 a week or so but it's not as much in volume as it was years ago.I don't know how this herion or this other drug will help fentynal people.Some just take it as a 1 or 2 time thing so would that mean anyone can get free herion if they want.I doubt it.Maybe will help the chronic users until Mexicans learn to keep the fentynal out of it but that might be the retail drug seller doing that bit with adding the fentynal to the herion.This would make a huge dent on the Mexican cartels Canadian market as most of the herion users are in Vancouver,British Columbia and with the crash in oil prices Alberta doesn't have the money it used to but it was mostly cocaine so that would be a double whammy for the cartels.

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    1. I'm in Atlanta and have started a Suboxone treatment program. Suboxone is nice because it blocks other opiates from latching on to the receptors in your brain so you can't get high while on it.

      You can still get high on heroin when taking Methadone, lol.

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    2. 5:01 She got on methadone to get off Percocet ? Damn ! Sounds like she is going backwards . I haven't kept up with drug much in the last 25 years but I am familiar with these 2 . To me Percocet always seemed pretty light weight compared to methadone . I will promise you that if she thought Percocet was a problem wait until her bones start hurting trying to kick that methadone shit. I think she just wanted to get high and went to methadone

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    3. trust me people get high on suboxone. it is afterall an opioid. If you use it as prescribed ....no high...but addicts soon discovered By crushing the sublingual tablets and either snorting or injecting the extract, it gives an effect similar to equivalent doses of morphine or heroin.

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    4. A question, what makes your stomach churn until it hurts because it needs another dose?
      --It has been added to cigarettes, along with the death warning labels and i'm sure lobbyists paid millions of dollars to select congressmen to approve it...

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    5. Chivis . Really seems like she was on easier stuff to kick before the methadone . I think she still just wants to get high . Back in the day Percocet seemed pretty light weight to me . Been clean so long now adults that have known me their entire life don't know what I was . Sometimes I realize what I thought I knew turns out to be wrong . Had a big tolerance back then so maybe I'm wrong .
      Bottom line is if she wanted bad enough she would clean up . Its not easy but so many just are just not willing to do what it takes . I lost my desire to mess with them anymore a long time ago.

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    6. 11:47-You might be right but hey didn't Prince die of Percs and he was a Johovah Witness and was ready to go to rehab that week.Apparently though this woman's husband is totally afraid of her[and he's no slouch]if she doesn't get her 'cocktail' he says she can't even function and is the biggest bitch of the bitches but last week docs found out she is riddled with cancer and her husband says she's doing tons of cocaine.Isn't an opiate with cocaine called a speedball or is that only if you inject it?

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    7. @ 10:31 you confused me for a minute, I think you meant canadiana to receive your message..

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    8. 9:46 . That stomach churning is wanting more dope . Withdrawal. Meth heads get the stomach churn when they are getting ready to do one .
      Ok opiates tend to settle the stomach and if your not used to them constipate . I know you may barf when you shoot up but they still have a calming effect . Heroin is a super pain killer . The withdrawal of most if not all drugs is opposite of the drug effect . Upset stomach , the shits and severe pain . Many get past that over and over but still get back on it because that urge just don't go away for a long time . I quit smoking years ago but for the first year I kept catching myself reaching for my shit pocket to get a cigarette .
      After getting past the severe physical withdrawal you still have that mental addiction that pretty tough to deal with . Most that have been doing drugs so long it seems impossible . That's only an illusion . But it causes so many to go back .
      It is tough but very possible for ANYBODY to stay clean and live a productive life .

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    9. canadiana . I apologize to you and chavis on the Percocet thing . It has been so many years since I messed with anything . Percodan is a II drug . I used to say I was a walking PDR. God I bet yall thought there was a real idiot posting on here . I was truly thinking of Darvocet . The red long shaped pill . Pretty light weight but still a abused drug .Percocet is a much abused drug . Was reading these older post to see if chivis ever answered me and caught I. Been clean since 1987 and really don't consider all the pharms now .
      Sorry again

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  9. The only thing I see here is a new drug for people to get high. My cousin try many drugs to help him quit his heroine addiction but at the end he died because of his drug abuse.

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    Replies
    1. William hitt clinic
      You tube
      Tijuana

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  10. Junkie pigs...actually pigs are cute and innocent so let's just call junkies junkies. Unless a person has been molested as a child and turns to drugs and deserve help, I say let the loser junkies perish...how disgusting injecting heroin...junkies are a waste of human breath

    _Canadian girl

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    1. I am surprised that you are a hater and that you are so ignorant. The vast majority of addicts become addicted during adolescents or young adulthood. When heroin is awash in certain communities, many youth will become addicted. True it is a condition with the hallmark of selfishness which hurts families and society but most addicts would change their condition given proper treatment.

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    2. *(BB, just replied to @7:46am...would u be kind to add 'Canadian girl' to my reply?

      Thanks.)

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    3. Canadian Girl...you must have lived a sheltered existence. Self righteous to the core.

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    4. True that Chivis. And my condolences to you and your family, I read about your brothers story, powerful and sad. He was extremely talented, and working family man, as you said a functioning addict. I have a question, how long after the trial for his murder did the murderer kill the teen?

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    5. Deference to Chivis.

      _Canadian girl

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    6. Chivis . What is Canadian girl referring to ? I didn't know about this .

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    7. 8:57 The most bitter truth is that your best friends lead you to drug addiction just to pick your pocket, not even out of frienship, just out of personal greed...

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    8. @11:01 my personal story, one of millions. About my bro, murdered and who was a functioning addict....paz

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  11. Are you the same person as our Canadiana? I am from Calgary, eh. We have a lot of drug traffickers here who get their products from Mexico, esp. SINALOA. They are the ones putting Fentanyl in their Heroin. Dangerous. Canada has de criminalized drug possession eh. USA should do the same. My cousins live in BC which has bad HEROIN problem. This program will help. I spend my winters in Arizona eh. Bye for now.

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    1. Arizona mmmmm maybe you are the jump from USA to Canada.

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    2. I'll see you at STAMPEDE.

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    3. I'd like to be a drug trafficker and connect to all over the US and canada, maybe next year...
      --naaah, there is not enough money in the world.

      Delete
  12. This is a great idea for a few reasons.
    -Reduces crime
    -Reduces number of needles on streets (think of the children)
    -Reduces number of beggars on streets, good for adjacent businesses
    -Reduces spread of STD's and infections with clean needles.
    -Reduces emergency room visists (overdose, contaminated heroin shot.)
    -Important, addicts are seen by a health care professional. This means that unrelated diseases can be caught early on, rather than being left untreated and costing taxpayers a lot of money in the hospital later on.

    ReplyDelete
    Replies
    1. 8:57 your proposal dilutes the budget into into too many small pieces and little checks, nothing there in the form of Corporate Welfare Queen Contractzzz for us, Corporate Welfare Queens, and without us they ain't no democracy left, did you know that, mmh?

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  13. For those worried that giving a heroin addict heroin is counter-productive, please consider the following.

    Giving addicts what they want removes the street heroin aquisition cycle
    (get high, beg/prostutution/steal, run around look for dealer, get high, beg steal, run around look for dealer.)

    This gives the addict some time to establish longer term planning. Addicts are living on an hourly basis, not thinking about their future. Give them what they want, and they will be able to consider the personal consequences of their addiction.

    The stability that heroin treatment would provide the addict a choice to become a productive member of society. A choice to not be homeless.

    It would reduce the sense of hopelessness that is responsible for sustained depression and suicide.

    And it removes the incentive for doctor shopping, enabling people who are actually in pain not to be discriminated against because doctors fear narcotics will be diverted.

    This is good for everyone. Homelessness will go down, needle pollution will go down, STD rates will go down (if an addict bangs a hooker who bangs a businessman who you bang...you might get hiv so you should be interested).

    ReplyDelete
  14. Boo hoo cry me a fucking river the only way to fix addicts is by letting them overdose

    ReplyDelete

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