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Your Opinion about a Diacetylmorphine (Heroin) Maintenance Program in Australia

shimazu said:
because if that person wanted to feel good they should get a job and buy their own pleasure instead of making everyone else carry the burden. Im not anti-opiates or anything, I just dont like when people dont carry their load in society. Not saying you specifically, but almost every person Ive known that was on Maitenance (whether it be Methadone or Subs) was a waste of space as far as being productive goes. I used to do heroin (not as much as others on here Im sure) and stopped before I ruined my life. If you cant see youre addicted than you are never going to quit.
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What does this have to do with using heroin over another form of maintenance? You seem to be suggesting that most people on maintenance 'don't carry their load', so what difference does it make whether it's heroin or methadone that they're maintaining on?
 
Because then the whole program is a big lie.

Nobody is going to get clean doing heroin every day. The point is to slowly taper down off the drugs until you can completely get off them. Thats not going to happen on heroin.
 
shimazu said:
because if that person wanted to feel good they should get a job and buy their own pleasure instead of making everyone else carry the burden. Im not anti-opiates or anything, I just dont like when people dont carry their load in society. Not saying you specifically, but almost every person Ive known that was on Maitenance (whether it be Methadone or Subs) was a waste of space as far as being productive goes. I used to do heroin (not as much as others on here Im sure) and stopped before I ruined my life. If you cant see youre addicted than you are never going to quit.
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You realize that such a program would result in significant financial savings in terms of reduced crime & reduced healthcare costs? Studies have shown that they universally pay for themselves and then some, usually to a substantial degree.

As for 'every person you've known,' thats great and all, but have you considered that maybe you just hang out with assholes? Or maybe those people are seriously ill, and opiates are their way of coping? You shouldn't make broad, sweeping judgments about a huge segment of humanity based on the few people you know.

Either way, don't pretend this is about "your" tax dollars, because an addict on the street costs 10x more than an addict on maintenance.

Nobody is going to get clean doing heroin every day. The point is to slowly taper down off the drugs until you can completely get off them. Thats not going to happen on heroin.
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No that isn't the point, and it's not the point with methadone or bupe either. The point is to make the addict healthier (less of a drain on the health system, if you want to look at it that way) and more functional (less of a drain on the criminal and welfare system, again, if that's how you look at society, though it seems like a rather sad outlook). Once their lifestyle improves, then you get them into long term treatment which addresses the cause of their addiction and then, when they're ready, they slowly come off the drugs.

And for the record, that's exactly what happened with most of the people in the Swiss program. They stabilized on a dose, got off the streets, got psycho-social help, and many eventually reached a stage where they felt comfortable slowly coming off heroin. And it has a far, far higher success rate than methadone/bupe maintenance, rehab or 12 step programs.

So don't pretend this is about money, and don't pretend this is about tough love to get people clean clean, just call your fucked up worldview what it is, you think drug addicts deserve to suffer.
 
you guys arent going to see what I see so theres no point in arguing. I dont really agree with Maintenance programs to begin with so thats probably a factor. I quit cold turkey
 
shimazu said:
you guys arent going to see what I see so theres no point in arguing. I dont really agree with Maintenance programs to begin with so thats probably a factor. I quit cold turkey
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Maintenance has nothing to do with withdrawals, or quitting, it's about taking people who feel that they need opiates to live a happy and fulfilling life (and 99% of them, in my experience, are self medicating depression or some other form of mental illness, or physical pain) and giving them a means of doing so without having to live a life of crime using black market drugs, so you can get them somewhat stable and in touch with treatment programs which will allow them to address their underlying problems that lead them to the initial addiction, thereby helping them reach a stage where they no longer feel that they need the opiates to be happy.

But I've said that multiple times and you're obviously not listening, so maybe what they really need is to just toughen up and go cold turkey like Shimazu here, since he obviously knows everything there is to know about addiction and is able to speak for every opiate addict everywhere, ever. After all, just forcing people to go cold turkey has such a massive success rate and doesn't at all result in almost instant relapse for most addicts 8)
 
Lets keep this on topic please. I've unapproved some posts that have no relevance here. Shimazu, you're entitled to your opinion but this is not the place to post it. It'd be wise if you had taken note of opi8's original post:

opi8 said:
It'd also be great if this could be a sensible discussion on the topic at hand, not "give me free heroin too plz!1!111", "let all the junkies die, the world will be better off anyway" or sensationalist bullshit that I can read on any other online forum, reader comment section, or even editorial section of whatever newspaper I have laying around.
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To clarify, what I posted wasn't my opinion it was my understanding of an argument used against this. No fun if we all agree or just insult each other ;)

The counterpoint regarding subs/methadone making it to the street to fund stronger opioids seems valid, but I just don't see a system like this not leading to pharmaceutical heroin on the black market. Whether that is a good or bad thing is another matter. I'm sure everyone can think up situations in which people could divert some/all of their doses. Perhaps they aren't addicted at all and are fooling the system (surely it would be a high reward practice, with a much lower risk than trafficking drugs to Asia yet people still do that); perhaps they are on a higher dose than they need, either by manipulation or doctor error, and they choose to make money from the extra; perhaps since starting they self-tapered or switched to another opioid so they can make more money; perhaps some users become known to less scrupulous individuals who steal their medication; etc...
 
Which is all fair enough, but even a heroin maintenance program with no takeaway doses would be vastly preferable to the current system for most addicts.
 
With regards to someone going on heroin maintenance without a heroin habit, it's simply not going to happen. The procedure is not at all what many uninformed people believe. You cannot walk into a doctors office, get a script for methadone, bupe (or heroin if that is ever an option), walk out with a months supply and then proceed to get rich. You are asked your current dose, you are blood tested, you start at a low dose - a dose that had me in half withdrawals for a week before I became mildly better, and you are supervised each dose for a ridiculous amount of time.

This is a major part of the problem. IGNORANCE, SCARE TACTICS FROM RIGHT WING NUT-JOBS. The public knows SHIT FUCK ALL about 1) being an addict and how fucking hard it is to live like that, and 2) being on a maintenance program and how fucking hard THAT is.

The ignorance about this is something that really infuriates me. Before I first started my methadone maintenance, the only person I could confide in was a close, childhood friend who is reasonably straight. Eventually I told him I'd decided I was going on Methadone. When I met up with him a few months later (he lives interstate) and had to go and get my dose, he thought I would come out smashed. He thought I went into a chemist and they injected me with methadone, in his eyes it was simply a legal substitute for heroin. I couldn't believe the ignorance, the only person at the time I trusted to confide in. I told him I was not well, needed help, and he did provide that. However, the complete ignorance of even one of my closest friends about maintenance floored me. It's a bit off topic, but if that's what somebody I'd known for decades, been completely honest with him the whole way and was getting support from thinks Methadone Maintenance is, I assume the rest of the country thinks methadone is like a free ride to get as fucked up as we like, for free, on THEIR tax money (even though it costs us struggling financially a hefty amount in Australia, and an absolutely ridiculous amount in America) for something that pharmacies get given for free (if what I understand is correct).

I'm pissed and benzo's so I won't say any more tonight, except to tell shimazu that you're lucky I took the evening off after reading your first. You are the kind of person I really despise, don't talk to me again.
 
opi8 said:
With regards to someone going on heroin maintenance without a heroin habit, it's simply not going to happen. The procedure is not at all what many uninformed people believe. You cannot walk into a doctors office, get a script for methadone, bupe (or heroin if that is ever an option), walk out with a months supply and then proceed to get rich. You are asked your current dose, you are blood tested, you start at a low dose - a dose that had me in half withdrawals for a week before I became mildly better, and you are supervised each dose for a ridiculous amount of time.
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I understand it wouldn't be easy, but wouldn't the rewards be high enough to lead people to try? I'm sure pharmaceutical-grade heroin would fetch a dime on the street. All you need is to understand the process and manipulate it. People could lie and take cheaper opiates for a while so they show up on any initial tests. Any ongoing testing could likely be scammed too - if they test only for metabolites (e.g. morphine or morphine metabolites) then that's easy to take something else, or if they test directly for heroin then you can take less in dose and/or frequency and take advantage of the fact the everyone metabolises and excretes drugs at different rates, or somehow using fake samples or some other solution that people who stand to make a lot of money could no doubt concoct.

Basically, unless each dose is completely supervised I'm convinced people would get around any safeguards, as they have with every other drug that is supposed to be controlled.

(again, I'm not arguing against heroin for OMT, I'm just playing devil's advocate ;))
 
If they lied about their usage, they would overdose. There's no way in the world the first dose of an opiate maintenance drug would be allowed to be taken home. It's not the case with current drugs, and wouldn't be the case with heroin. I can't see how it could possibly be scammed. They inject you (with a much smaller amount than you probably need to begin with, as is the case with current maintenance opiates), you drop dead, I don't think they're going to trust you. Maybe I'm not seeing your point, Im a bit out of it. This time I'm really gone until tomorrow.
 
DeathDomokun said:
I can't see too many people wanting a nurse at the clinic sticking a syringe up their ass, multiple times a day, daily. Especially Australian men.
I don't think giving addicts heroin for an undefined time is the answer to addiction, although I do think this option should be available.
I mean if someone is using opiates for psychological issues (which I think is quite common?) then we should be looking to resolve those issues as opposed to just supplying them with good/clean heroin for an undetermined time. As I said, irrespective of whether it will help someone with an addiction (subjective topic/question) I'm all for it.
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I could be wrong but iirc in Switzerland they found heroin maintenance to have better results than other forms of maintenance, I believe the idea is that once you remove all the problems associated with black market drugs and allow addicts to use their DOC it is a lot easier for the addict to work on getting their lives on track and adressing the issues that drive them to abuse drugs. In the long term I do believe they have found many to commit substantially less crime and reduce their drug use in general. Aside from this, it is well known that many on ORT continue to use black market heroin occasionally, giving them heroin makes them less likely to use black market dope which is obiously more risky and also more expensive, which leads to crime such as theft and diversion of methadone/bupe takehomes. Heroin maintenance isn't foolproof, but I wholeheartedly believe it to be the best option for medium to long term heroin addicts, not only for reducing opioid intake but improving quality of life in general.

In the UK they have definately allowed diamorphine and morphine maintenance, I am not sure of the exact circumstances, I know it isn't/wasn't (don't know if its still going) very large with only a few hundred I think being on h maintenance, a well known opiophile was on it I know that much. I think Canada proposed a trial using hydromorphone as a maintenance drug and possibly heroin as well, not sure if it went ahead or what the results were, was fairly recently iirc so maybe it is still going on. I might do some digging later on.
 
opi8 said:
With regards to someone going on heroin maintenance without a heroin habit, it's simply not going to happen. The procedure is not at all what many uninformed people believe. You cannot walk into a doctors office, get a script for methadone, bupe (or heroin if that is ever an option), walk out with a months supply and then proceed to get rich. You are asked your current dose, you are blood tested, you start at a low dose - a dose that had me in half withdrawals for a week before I became mildly better, and you are supervised each dose for a ridiculous amount of time.
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Sorry for the double post, I posted before reading the whole thread, while I wholeheartedly support heroin maintenance and other forms of ORT I personally know someone who did exactly what you described, and they ended up on a daily dose of methadone well above 100mg (much closer to 150, and I am fairly certain they needed permission from a medical board of some kind to get over 120). This is obviously not the norm but you can't refuse to acknowledge that it can and does happen, even if you start on a low dose you can end up on a high dose relatively quickly if that is your intention, as it was in the case I am referring to. For the record though this person doesn't sell their take homes.

One of the problems with using methadone for maintenance seems to be that once the dose stops making a person feel how they want, they go to the doctor (who is generally willing to oblige) and ask for a dose increase. I don't think at present there is enough being done to adress why people develop these addictions and giving them more is seen as an easy way to alleviate drug cravings, it is way too common for people on MMT to end up on daily opioid doses multiple times greater than what their heroin using equivalent was, as a result it often results in patients being on MMT for many years or even their whole lives.
 
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maybe I was being a bit harsh yesterday but the only way id support a program like this is if it were funded completely by the addicts. I dont think it is fair for non-drug users to have to pay into a program they will never even use/know what it is. I dont hate people who use heroin or opiates, I hate people who sit around all day and use drugs. Those people put a bad label on drug users everywhere, so someone like me who works 40+ hrs a week, pays all his bill and taxes on time, gets lumped into the same group simply because of a substance we both take.

Im sure there are pros to a heroin program. But to deny any cons is just wrong
 
^ That's ridiculous. Have you skipped over everything others have said indicating that the cost to the tax payer is far higher when people have to support their habit through illicit means?

Even despite that, your logic makes no sense.

shimazu said:
I dont think it is fair for non-drug users to have to pay into a program they will never even use/know what it is.
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Do you realise how stupid that is? By your rules, no tax dollars should go into any health care that doesn't involve you. Now I understand the US has a fucked up health care system, so maybe that is lost on you. But by the same tune, it's like saying you don't support taxes going to public transport infrastructure, because you drive. Don't use this road on the other side of the city? Why should your tax dollars pay for it? Taxes are ideally used for the greater good. It may surprise you to realise, that that isn't always about YOU.
 
^ Never mind that these programs actually 'save' tax money because they remove strain from the healthcare and legal systems.

The 'I don't want my tax money being spent on giving drugs to people!' argument is just absurd.
 
you know whats cheaper on society? people who support their habits through their own work.

and if tax dollars are for the greater good, why spend it on people who KNOWINGLY took those substances, got addicted, and now are depressed because they are addicted, instead of someone who did nothing like that and has been a regular person in society. Since you are all fond of statistics, what is the percentage of addicts to non-addicts? Thatd be a good number to start with to see how many people will actually benefit from a program like this.

And I have no problem paying into health care for legitimate medical needs. I dont consider Rehab/Maintenance Treatment as a legit medical need. Im sorry, I just dont.

Lets put it this way, I wouldnt give an addict money to get heroin personally, so why would I want the govt to take my money to do what I just wouldnt do?

and dont say "well were gonna cost more if we dont get it"

THATS YOU COSTING SOCIETY MORE

not me, YOU.

Just like YOU chose to put the needle in your vein, YOU ignored every possible warning from school/adults/ addicts themselves (every addict will tell you to not do dope), and now you want US (collective taxpayers) to help with YOUR recovery.

Take some responsibility for your actions
 
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shimazu said:
you know whats cheaper on society? people who support their habits through their own work.

and if tax dollars are for the greater good, why spend it on people who KNOWINGLY took those substances, got addicted, and now are depressed because they are addicted, instead of someone who did nothing like that and has been a regular person in society. Since you are all fond of statistics, what is the percentage of addicts to non-addicts? Thatd be a good number to start with to see how many people will actually benefit from a program like this.

And I have no problem paying into health care for legitimate medical needs. I dont consider Rehab/Maintenance Treatment as a legit medical need. Im sorry, I just dont.
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Well that's great for you off in La La Land where everyone is perfectly happy and healthy and nobody ever takes drugs or becomes an addict or makes stupid decisions or has fucked up lives, but you can't make these kind of decisions on ideals. In a perfect world of course we wouldn't have drug addiction, but in case it slipped by you this isn't a perfect world, and we have to deal with what we've got.

The reality is, addicts aren't going to just get up and go get a job and pay for their drugs that way, even if it was possible, and to expect them to is kind of absurd.

The fact that you'd rather leave them as a drain on the healthcare and legal system instead of taking a rational approach says a lot about your sense of entitlement and your lack of basic understanding when it comes to these issues.
 
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