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A massive heroin crisis is gripping the state of Vermont and the town of Rutland is Ground Zero. Many facilities are prescribing the drug Suboxone to mothers who are pregnant to wean them off Heroin given the addicting symptoms. However, it turns out that babies are getting horribly addicted to Suboxone as a result, like this one baby.
By her 20th birthday, Coleman was hooked on heroin, and she lived with the addiction for 10 years. She went into rehab five years ago and has been clean, but on Suboxone, ever since. Her firstborn, Cade, was born addicted to Suboxone and struggled with withdrawal. But nothing prepared her for Jax.Al Jazeera America has done documentaries on this crisis for the last two nights. What we are seeing is a warning that this sort of thing can strike anywhere, whether it is rural America or the inner cities. The problem is that too many legislators are not well versed enough in scientific literacy to understand that certain treatments are not simply a matter of the bottom line, but a matter of following best practices that have been tested and replicated by the scientific community. And too many states are following the punitive model of punishment, creating a stigma for drug use and a disincentive to seek medical treatment.
After the birth, Coleman and Jax were kept at Rutland’s hospital for four days, then sent home. But Jax continued to show severe withdrawal symptoms, and Coleman said she was uneasy. A few days after leaving the hospital, she was trying to settle her son, rocking him back and forth. She said she was exhausted taking care of her sick baby and didn’t know what to do. Then Jax went quiet. His lips turned blue.
Panicking, Coleman picked him up, shook him lightly and then blew in his face. Finally, he took a breath.
“It felt like forever,” she said. “It was probably a good 20, 25 seconds, you know, where he just was limp.”
Last night, Al-Jazeera focused on some of the policy mistakes made by the state. The governor has been on a well-meaning crusade against Heroin use in the past year. However, he cut funding for Heroin stays that would be paid for by Medicaid from 28 days to 14 days.
As of July 2013, the state slashed the number of days of in-patient rehab it would fund with Medicaid, from 28 days to 14, unless a patient gets prior authorization. The directors of two residential treatment centers told America Tonight that since then, the number of patients requiring readmission at their facilities has doubled.This makes perfect sense. Scientific evidence shows that it is frequently necessary to keep Heroin addicts in treatment for at least three months. In fact, the NIH says it is critical.
William Young, executive director of Maple Leaf Farm, said they looked at the number of people who called them for readmission since July 1 and compared the data to the same period in 2012. They found that the calls had more than doubled.
Remaining in treatment for an adequate period of time is critical. The appropriate duration for an individual depends on the type and degree of the patient’s problems and needs. Research indicates that most addicted individuals need at least 3 months in treatment to significantly reduce or stop their drug use and that the best outcomes occur with longer durations of treatment. Recovery from drug addiction is a long-term process and frequently requires multiple episodes of treatment. As with other chronic illnesses, relapses to drug abuse can occur and should signal a need for treatment to be reinstated or adjusted. Because individuals often leave treatment prematurely, programs should include strategies to engage and keep patients in treatment.This is borne out by a study from England.
Longer stays in treatment were predictive of better 1 year outcomes.Al-Jazeera interviewed a drug rehab specialist last night who had this to say:
Dr. Deborah Richter is a family physician and one of Vermont’s leading addiction specialists. Asked whether two weeks was sufficient in-patient care for a recovering addict, Richter said, “Absolutely not!”To its credit, Vermont does understand the need for a rehabilitation-based approach. They are one of only 13 states in the country which has a "Good Samaritan" law, which means that if you check yourself into treatment or check a friend into treatment, you will not be prosecuted. But the problem with its model is that it is an out-patient model; the problem with that is that it is a lot more difficult to get patients to take the medications they need to get off Heroin addiction.
“It takes much longer in my experience,” she explained. “You need about 90 days for people to be able to reset their thermostat, so that they can have more resistance.”
As early as 2006, the Bush Administration's NIH recognized the futility of a forced abstinence approach.
One old concept has been proven false, for we now know that "forced abstinence" from drug use during incarceration, if abstinence occurs, does NOT alleviate addiction. Research shows that effective treatment of addiction - a chronic, relapsing disease of the brain, characterized by compulsive behavior - requires addressing underlying issues and causes. Because drug addiction compromises the circuits involved in processing punishment and reward and in exerting control over one's actions, the addicted person will compulsively seek drugs despite the threat of severe punishment (e.g., incarceration, loss of child custody), at the expense of natural rewards, such as that from family and friends, and even when they consciously do not want to do it. Comprehensive drug abuse treatment therefore offers the best alternative for interrupting the vicious drug use - criminal justice cycle once a person gets caught up in it.This was taken from testimony by Nora D. Volkow, M.D., Director, National Institute on Drug Abuse in 2006 to the House Judiciary Subcommittee on Crime, Terrorism, and Homeland Security. Volkow also noted in her testimony that treatment-based approaches have been shown to significantly reduce both drug use and recidivism.
Why Treatment Should be Provided to Offenders with Drug Disorders:
For Public Health and Safety. We know that drug use increases the likelihood of criminal behavior. In fact, offender drug use is involved in more than half of all violent crimes, in 60-80 percent of child abuse and neglect cases, and, not surprising, in 75 percent of drug dealing and manufacturing cases. Moreover, illicit drug use costs this country about $180 billion a year in crime, productivity loss, health care, incarceration, and drug enforcement. Uninterrupted, the drug abuse-crime cycle jeopardizes public health and public safety and taxes an already over-burdened criminal justice system. It follows then that reducing drug use can reduce crime and improve not just the health, safety, and well-being of the individual, but of communities and society as a whole.
One possible solution to infant drug addiction is Buprenorphine instead of Suboxone.
A NIDA-supported clinical trial, the Maternal Opioid Treatment: Human Experimental Research (MOTHER) study, has found buprenorphine to be a safe and effective alternative to methadone for treating opioid dependence during pregnancy. Women who received either medication experienced similar rates of pregnancy complications and gave birth to infants who were comparable on key indicators of neonatal health and development. Moreover, the infants born to women who received buprenorphine had milder symptoms of neonatal opioid withdrawal than those born to women who received methadone.However, as the NIH notes, treatment of any kind of drug addiction is complex with a lot of variables involved. Every individual case is different; the mother whose son nearly died from Suboxone withdrawal had another son who did not experience symptoms that were quite as severe. It becomes even more complicated when factors such as mental illness are involved.
The death of Philip Seymour Hoffman has led Valerie Vande Panne in the Daily Beast to call for the legalization of Heroin.
In the days since, there’s been all kinds of chatter about the evils of heroin or the need for better drug education. But there hasn’t been much talk about the painful, obvious, cold, hard truth: Heroin should be regulated—and not only because science says so, but because, (and again, let’s be honest) look around.The problem of Heroin addiction is not limited to Vermont.
Drug prohibition didn’t keep us from this great cultural loss. In fact, drug prohibition causes thousands of unnamed human losses we suffer day after day, month after month, year after year in this country. Think of the person you know (or your friend who knows someone) who has died because of a heroin, or opiate, overdose. Say their name—because they deserve to be remembered, as much as Hoffman does. And because in a health-centered, rather than law enforcement-centered, world, they didn’t have to die.
According to the Center for Disease Control, “opioid analgesics, such as oxycodone, hydrocodone, and methadone, were involved in about 3 of every 4 pharmaceutical overdose deaths” and “38,329 people died from a drug overdose in the United States in 2010.” According to the Office of National Drug Control Policy, from 2006-2010, that was a 21% increase.Another reason to legalize -- in extreme hardcore cases, Heroin itself has been shown to work when conventional methods have failed. Time Magazine:
Death by heroin increased 45 percent during the same time frame.
What’s the best way to treat the most serious heroin addiction? Giving addicts therapeutic doses of heroin itself may be cheaper and more effective than methadone, according to a new Canadian study.The site debate.org has posters debate on this and other topics. 59% of their users that participated say that Heroin should be legalized. Opponents say that it would only make the problem worse.
Researchers divided a group of heroin addicts in two Canadian cities who had repeatedly not been helped by conventional treatment, into two therapy groups. One was provided heroin plus intensive social and medical support while the other received an equally enhanced methadone program as part of the clinical trial.
The new analysis showed that even though heroin treatment can be as much as ten times more expensive than methadone, lifetime social costs related to chronic addiction were cut by an average of $40,000 Canadian for each of these previously untreatable heroin patients. The research also suggested that addicted people given heroin under medical supervision would live a year longer on average than those in methadone treatment.
Comments from supporters of legalization:
The whole Heroine dilemma is the direct result of the drug being illegal and on the streets. Before Heroine was banned it was used as a remedy for countless of illnesses and discomforts.
Heroin itself is not toxic for the human Body. If Heroin could be used again as a remedy and NOT abused as a class A drug, we would all benefit from it. Police would concentrate on the REAL CRIMINALS, the prisons would be empty, street criminality would decrease, addicts could go their every day life and pursue a career without hustling for the drug the whole day. The drug would cost almost nothing and it would be 100 pure and could be taxed by the government ( like alcohol)
Its common sense in a free country we should be allowed to put what we want into our bodies. If we legalized drugs and taxed them it would save so much money and lives in the form of not incarcerating and breaking up families and inbound tax revenue a total win win. And those that need help because of a drug problem will have more access to addiction treatments and medicines without the stigma drug addiction has in this country today. In time there will be less drug users and youth in this country will no longer see it as the outlaw thing to do it would become uncool leading to less of the population doing drugs.Opponents:
No, it kills too many people already.
Legalizing Heroin will also legitimize it, and that will be deadly for our young people. Keeping it illegal will make keeping children away from it easier. Heroin is addictive after only one or two uses. It cannot be compared to alcohol which is addictive only to a small part of the population.
Legalizing heroin will lead to widespread usage.Jeff Deeney, himself a recovered Heroin addict, wrote last month in Atlantic that Heroin should be legalized.
Legalizing heroin will cause an epidemic of addiction and adequate resources do not exist to support such an increase in the number of hard drug users from a medical or rehabilitation standpoint. Once becoming quickly addicted to heroin, new users would become a burden on society as they would not be employable or reliable as family members.
Legal pot isn’t enough. For there to be an American version of Insite, Vancouver's celebrated, medically-supervised, legal injecting space, the U.S. would need to decriminalize entirely. If Philip Seymour Hoffman had taken his last bags to a legal injecting space, would he still be alive? Had he overdosed there, medical staff on call might have reversed it with Naloxone. Had he acquired an abscess or other skin infection, he could have sought nonjudgmental medical intervention. Perhaps injection site staff could have directed him back to treatment.
Safe injecting sites are an amazing, life saving, humanity restoring intervention we can’t have because our laws preclude them. Too frequently, heroin addicts instead utilize abandoned buildings and vacant lots to shoot up in order to evade arrest. The risk for assault, particularly sexual assault for women, in off-the-grid, hidden get-high places is incredible. Overdosed bodies are routinely pulled from such spaces in North Philadelphia.