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Treating addiction with hydromorphone saves lives and money, experts say

thujone

thujone

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Aug 31, 2006
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A longtime heroin addict named Max winds a band of blue rubber around his bicep.

"So my veins will stick up," he explains before quickly sliding the needle beneath his skin and injecting a powerful drug called hydromorphone.

This isn't happening in a back alley. Instead, Max is inside a brightly lit room where injection drug users are taking part in a clinical trial where they are given their drugs and needles.

...

A new study says the drug used by Max, hydromorphone, is a powerful tool that could helps thousands of other Canadians battling opioid addiction.

Max is part of a subset of drug users that don't respond to methadone, the drug most widely used to treat addicts.

Researchers say about ten per cent of addicts don't find relief from methadone, so they often keep using street drugs.

...

When he was selected for the drug trial, things were looking grim.

"I was homeless, I was committing crimes to get my fix." He also didn't think he had long to live.

Since being enrolled in the trial, he has put on weight, works out every day and says he can function more or less normally after injecting hydromorphone.
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http://www.cbc.ca/news/canada/british-columbia/heroin-hydromorphone-addiction-1.3524118
 
Really? Dilaudid of all things? I mean for Christ's sake, even pharma grade Morphine would be better for this purpose. How is this supposed to work considering the extremely short half life of the drug? And the fact that it's taken IV, eventually leading to venous collapse? The whole not responding to methadone thing sounds like an honest crock of shit, not that methadone programs are honest in the first place. There's nobody on Earth that won't get relief from WD from done. They just still want to get high. We should be actively encouraging addicts to make lifestyle changes that lead to them ultimately quitting, not giving in to their every want all because an opioid already 10x stronger than morphine "didn't work" for them. I'm highly skeptical. Even having these methadone programs is a really "progressive" thing in terms of opioid addict stigma. Even more so when you consider the fact that it's a dead end and a money making scheme above all else. The concept here is even worse since the addict is still shooting up and really has zero incentive to quit. Jesus, this is not "treating addiction", it's simply making it even worse. At least with the 'done you're not shooting up and don't have to redose every 2 hours.

Pisses me the fuck off how this is just another government run dope enterprise and all the particularly far gone junkboxes are jizzing themselves thinking they're actually getting the better end of the deal. Wake up. You're giving these bureaucrat assholes power to rule over your urges and addictions while they laugh all the way to the bank.
 
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I'm guessing he's got a really strong needle fixation and that's what is really driving this. Opiate Replacement Therapy will crush the physical cravings for the drug, but not always the psychological ones for the ritual.
 
Methadone and or Suboxone doen't work for everyone, for most yes it does, but there is still a percent of people that continue to use while on either leading them to be kicked outta the program and back to what they were doing full time, this has been done in Switzerland I think with the heroin clinics for people that done respond to methadone or subs..also I have heard of Morphine Maintaince(which I think is a good option, while maintaining on pods I was better off than I have been on subs honestly...) BUT really odd they chose hydromorpone and not a longer acting opiate such as Morphine...Really odd. Dillys are all rush no legs, but if its working. I myself have thought about swithcing to done' because I have not responded well to subs(been on it 3 years, have periods of doing okay, but always end up relapsing on IV Morphine, Oxy, Dillie...anything thagt can be shot or even just a handfulll of Norco(like 150-200mg)... With Subs I find myself always trying to make it work, and the only way it does is with anothter drug added like benzos, lyrica,gabapentin, phenibut, then I find myself crave free and not having drug dreams constantly...subs by themself have not cut it for me. anyway

Edit: and for the needle fixation thing i found myself shooting my subs which SLIGHTLY helped, but I was mostly dong this to get a stockpile in case something happend to my doctor or I wasn't able to afford it anymore(insurance only covers it so long...guese your suppose to be all better in a year or two) or if I got kicked out for smoking weed, which is ridiculous that I would have to do that in fear of being kicked out for smoking weed. Fucked up I can get away with heavy benzo usage(well the shorter acting half life onces) all these others addicitive gabagerics and hell even weekly meth usage if I wanted to, but cant smoke a damn joint if I want to a couple times a week...bullshit.
 
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Yeah I don't see how this is any different from the heroin clinics in Europe - which isn't a bad thing necessarily, but IV hydromorphone is an odd choice, with the short half life and powerful euphoria.

I think that last one is the difference between subs/done and other opiates - subs and methadone simply don't make you feel nice and warm in the way most other opiates do. They stop the physical withdrawals, but they don't fill the hole in your soul ;)

Don't see how IV hydromorphone would be viable for long term treatment - they should at least use the XR pills, which give a steady buzz over 16 - 20 hours, you could possibly make daily dosing work, definitely twice daily. Of course you'd need patients who wouldn't go out and just shoot up even more opiates on the top, or take benzos/booze/etc, since there's no blockage effect like you get with subs or higher dose methadone.
 
Subs did not work for me. I ended up using IV cocaine. It is as screaming skull states, the bupe does nothing to help you with your addiction for it only controls the dependence. I actually had the means to go to rehab and take time off work to get my life together. Most people do not have that, or maintenance would probably be their last resort. No one wants to have a habit of any type, least of all one that does not satisfy you.

Hydromorphone is most definitely an odd choice. I think finances might have a lot to do with it.
 
I think if it lets the person live a productive life, then why not? I mean, as opposed to the person stealing shit and committing all kinds of crimes, and supporting organized crime. But then again that begs the question... why not just legalize and regulate drugs then? But anyway, hydromorphone indeed does sound like an odd choice all things considered. Heroin or morphine would make more sense to me personally.
 
manboychef said:
Subs did not work for me. I ended up using IV cocaine.
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I picked up a crack habit while on subs, like literally went from heroin daily to subs for a week then smoking crack on subs. There were strange factors in my life, largely my younger brother and g/f at the time were still multiple daily use heroin addicts so i was constantly around dope... so i started smoking crack claiming "i needed a thing that was mine" that lasted up until i relapsed and couldnt afford crack then got on methadone and because my g/f got on it too and my younger brother was in prison i wasnt going to be a solo drug addict so i didnt do anything other then smoke weed.

And I also met a lot of people on the program that shared that bit of the story on subs too. We would be in the waiting room and there was definitely a percentage of us that started doing cocaine on subs. I really just needed to change the situation to make everything stop, now everyones clean and these tales are at least 1.5 years old so whatever happened worked.
 
Short half-life; high receptor affinity; not my first pick for sure. But, if there is proof beyond a reasonable doubt that patient x is functioning significantly better in society (e.g. being able to maintain a part-time job + no longer stealing), then why not?

Let's be clear: I'd rather that all substances were legalized and appropriately regulated, but this to me is progress as it was unthinkable just a few years ago, and a little progress is better than none at all.
 
@szuko: I think it has to do with the fact that just keeping withdrawals at bay is not enough. There is part of the brain that wants to get a rush. When I was on subs I was just emotionally numb.
 
Iv dilaudid was the worst opiate habit I ever managed.

The intensity an short duration seem like the last thing you'd want to taper with
 
Morphine I could see...but dilaudid is such a short lasting drug your arms would look like pin çushions. Why not just give heroin? It lasts longer than dilaudid anyways...weird choice for opiate replacement therapy
 
manboychef said:
Subs did not work for me. I ended up using IV cocaine. It is as screaming skull states, the bupe does nothing to help you with your addiction for it only controls the dependence. I actually had the means to go to rehab and take time off work to get my life together. Most people do not have that, or maintenance would probably be their last resort. No one wants to have a habit of any type, least of all one that does not satisfy you.

Hydromorphone is most definitely an odd choice. I think finances might have a lot to do with it.
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well what did you do to try and treat your addiction?did you try meetings or therapy of any sort?i guess i just dont understand how the roots of addiction are treated, if its even possible..

lol of course taking another opiod will help addicts..its just replacing one with another..maybe maintenance is the best solution for most if not all addicts?
 
I went to meetings daily. The real problem I faced was that at the time subs cost me near six hundred a month. This lead to me working constantly to keep my bills met. This is no life for a recovering addict. One really needs time to reflect on their life and make changes. Being the executive chef of a busy restaurant and working eighty to ninety hours a week was no good.
 
Yeah, the exorbitant price of brand name Suboxone is outrageous. I can't believe that any doctor thinks its a good idea to take a junkie off the street and tell them to go spend nearly as much as they would on heroin just getting by. And there's generic buprenorphine available, it's just never prescribed, partially due to the DEA regulations and "addiction specialists", and also because IV users are prone to shooting up their naloxone-free sublingual tablets to get a rush. I'm sure it's possible to develop a longer-lasting abuse-resistant formulation of heroin or morphine, but there have been no developments in that regard that I'm aware of.
 
I mean, I'm all for subs or 'dones but medical grade liquid dilaudid injections? Of COURSE he can put on weight, be active, he feels freaking great and is getting shot up with liquid heaven for free and being touted as a successful recovering opiate addict. And dilaudid gives the rush they want. Why feed into a needle addiction too? I feel like that is asking the addict to make zero effort on their part. It's not supposed to be easy. It sure wasn't/isn't for me! Maybe that's why I'm so angry.

End of rant.
 
hydromorphone would seem to be the worst choice because it gives the best IV high out of all the opioids. In fact it give a rush that none of the others give so it is in my view the most prone to abuse.
 
PropLugger said:
I mean, I'm all for subs or 'dones but medical grade liquid dilaudid injections? Of COURSE he can put on weight, be active, he feels freaking great and is getting shot up with liquid heaven for free and being touted as a successful recovering opiate addict. And dilaudid gives the rush they want. Why feed into a needle addiction too? I feel like that is asking the addict to make zero effort on their part. It's not supposed to be easy. It sure wasn't/isn't for me! Maybe that's why I'm so angry.

End of rant.
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There are some people that are incapable of being successful on either methadone or suboxone. This treatment is reserved for the most addicted and dependent people there are. I believe the reason they are offering this is so that the addict does not put himself at risk of bloodborn diseases, or law enforcement. Basically, they want to see how this addict does with their life when their addiction is met without having to source money and drugs illicitly.
 
PropLugger said:
I mean, I'm all for subs or 'dones but medical grade liquid dilaudid injections? Of COURSE he can put on weight, be active, he feels freaking great and is getting shot up with liquid heaven for free and being touted as a successful recovering opiate addict. And dilaudid gives the rush they want. Why feed into a needle addiction too? I feel like that is asking the addict to make zero effort on their part. It's not supposed to be easy. It sure wasn't/isn't for me! Maybe that's why I'm so angry.

End of rant.
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Why is pleasure so hated in our society? You said it yourself, he's active, has put on weight, is able to be productive and so on. Why do you care how he feels while doing so? Shouldn't it be his business as long as he's a productive member of society and does no harm to others?

I agree that from a medical standpoint, supporting IV use as opposed to oral, or any other ROA for that matter, is not the wisest, which is why I still don't understand why they chose hydromorphone of all things. But the general idea that the person must suffer because they got addicted, which is now more widely accepted as being a mental disorder, is just atrocious. If somebody's got clinical depression, do you also think society should make the person suffer more, because "it's not supposed to be easy"?

Some of the thinking in our society is so backwards at times...
 
belligerent drunk said:
Why is pleasure so hated in our society? You said it yourself, he's active, has put on weight, is able to be productive and so on. Why do you care how he feels while doing so? Shouldn't it be his business as long as he's a productive member of society and does no harm to others?

I agree that from a medical standpoint, supporting IV use as opposed to oral, or any other ROA for that matter, is not the wisest, which is why I still don't understand why they chose hydromorphone of all things. But the general idea that the person must suffer because they got addicted, which is now more widely accepted as being a mental disorder, is just atrocious. If somebody's got clinical depression, do you also think society should make the person suffer more, because "it's not supposed to be easy"?

Some of the thinking in our society is so backwards at times...
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I think this is the salient point of the article; the recognition that drug users who can access effective treatment can become productive members of society. If someone manages to become a productive member of society while self-medicating, is that really much different from going to a doctor and having them treat you like a guinea pig for the latest legal anti-depressant?

Even worse is the situation in the U.S., where you can pick up a felony charge for possession of amounts that are clearly intended for personal use. Effectively that means drug users are being robbed at gunpoint (by the police and courts) of their future potential and end up stuck a permanent undercaste of people who are more likely to end up severely depressed and suicidal than ever again becoming productive members of society.

It doesn't take an Einstein to realize this is the law wilfully enforcing an anti-social order to the benefit of the prison corporation shareholders and detriment of everyone else. This is a deeply shameful status quo, it must not be accepted any longer.
 
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