B.C. doctors given Health Canada approval to prescribe heroin

its not even about what you see as inferior or not, its about what the PATIENT sees as inferior... someone who thinks methadone is better for letting them be productive in life? give them methadone, another who works better with hydro morph? give them fucking dilaudid... why this replacement bullshit? prescribe what the patient feels is best for THEM
 
Obviously, I'm not talking about giving every addict their doc, I didn't make myself clear; their are alternative treatments and medications that many addicts respond very well to -bupe for example is seen as a lifesaver by many (including myself), I meant there should be many approaches to treatment, as there are many kinds of addict-for some, it's mmt, and that works very well for them, but I've also had friends who use on top regularly, give a dirty sample and get dropped from treatment, and they run straight back to street dope; the meth just didn't work for them.

Then of course, there's abstinence (NA-style); I've known people clean up for 20 years, and they move past it.Then, of course there others I know who clean up, relapse, then clean up again in a regular cycle. When treating addicts, stability is the goal. As I said, there should be a range of solutions to achieve this; for the minority, being prescribed their drug of choice could be the only way of providing them with stability and a deserved chance at a normal life.

In our diamorphine test pilot, as I pointed out, the vast majority led very healthy and productive lives, according to the study I read. So, I think diamorphine could be a valuable option for treatment, but only if nothing else works. (I personally think it should be a last resort, as this drug is very powerful, not to mention it's the most addictive opiate bar none). Caution is essential here; as you pointed out giving every addict pharmaceutical heroin could be an absolute disaster.
 
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WatMyConditionIsIn said:
its not even about what you see as inferior or not, its about what the PATIENT sees as inferior... someone who thinks methadone is better for letting them be productive in life? give them methadone, another who works better with hydro morph? give them fucking dilaudid... why this replacement bullshit? prescribe what the patient feels is best for THEM
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lol I like that policy, but I think the "current best practice" is to prescribe what's best for the patient, not what the patient feels is best.
 
Just give the patient whatever they ask for? The point of going to a doc for treatment is to get better, at a minimum, to normalize the addicts live so they can be productive and happy. Suboxone does that for me. I would love it if poppy tea were freely available like it used to be. Too bad. However, a doc shouldn't be helping the patient kill themself. If you think the six should just prescribe whatever the patient wants in whatever doses, and to give drug in an ambulatory setting like suboxone you will only be feeding an addiction and making it worse.

In the seventies in Florida there were methadone programs that did basically that, but only methadone. Patients ended up on doses of as high as 600mg a day before the gov't stepped in and said wtf were you thinking? What an addict thinks is best for them is unlikely to be accurate. A pure, uninterrupted supply of morphine may sound awesome but an overdose is likely, and disintegration of the patient's life almost assured. There probably are a few patients who won't respond to anything but their doc, but at a minimum their doses need to be highly controlled and frequency of administrations limited. However that doesn't mean this is an approach that should be tried with any but the most severe cases.
 
Hammilton said:
Patients ended up on doses of as high as 600mg a day before the gov't stepped in and said wtf were you thinking?
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Kinda off topic, but at my clinic, there are at least two patients who are on daily doses higher than 600mg. One is at 645mg, the other at 720. Only reason I know is because we're... acquaintances. And I think those doses would kill an elephant (so yeah, a little high there).
 
This is FUCKED, I thought that guy with the 190mg morning + a 20mg at night I met just as I was leaving outpatient (he was going in to try and reduce that dose and I don't know he managed to get it this way, ie the dosage) was receiving a retarded amount, goddamn.
 
WatMyConditionIsIn said:
sorry but i gotta be pesimistic bout this... 15 patients??? thats all? fucking bullshit that they only allow the most desperate access to this program. so what now? you gonna have methadone patients "failing" on purpose to get on scripts for down? just fucking realize that if we (society) are willing to script opiates for opiate addicts just give them their DOC. if an addict prefers hydromorphone to oxy, or codeine to diamorphine, just give them their DOC for fuck sakes... fucking harper and his goons...
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I have a pretty good idea where you are from since you used the slang down for Heroin :) . Granted it might be a term used in other cities as well.

Ideally one could walk into a pharmacy and ask for morphine, diamorphine, dilaudid or whatever. But they where lucky to even get this small program with the government we got now. Harper and his fellow cavemen hate addicts and seem to have much the same attitude as Reagan did towards them. Hopefully this will open more programs for people across the country if we kick these neanderthals back to their caves in Calgary in the next federal election.
 
Oh they're out, all those scandals just keep on rolling, the robocalls is probably the reason why he has a majority passing tons of bills at once and let us discover what the changes are a year later. Ontario mass voting blue was bizarre. I was happy with the status quo of them being in the minority so they could be told "No." to everything since 2006 heh. Justin the First will rise and the BBQ will most likely again.
 
but doctors prescribe other drugs based on what the patient feels works best for them. if i go on ssris and paxil doesnt work then i can tell my doctor and i will be allowed to try prozac, or cymbalta, etc. if i have anxiety and diazapam makes me too drowsy to function then i can try clonazepam, or ativan. why are opiates the pariah of prescription drugs? and the notion that heroin should be a last resort because its the most powerful and dangerous opiate? bullshit. methadone is at least as powerful/dangerous/and habit forming as heroin
 
I'm with fellow Harper subject WatMyConditionIsIn...when i was slamming dilaudid...the only problems were putting all my money into it (when you chase dat rush, it's gonna get expensive, even if you have a decent "friend" selling you them). When I was doing that I had zero problems with productivity and feeling whole as a person. During my 11 months on methadone I spent 18 hours sleeping, it fucked my endocrine system (I know all opioids are supposed to be able to do that eventually....but I disagree it would have happened with the dilaudid habit I had going, which while not small, wasn't huge in it's mu agonism like methadone was....ALL DAY LONG). Now that I'm on suboxone I'm a little better, but I still find it a bit insulting that if i was to get my doc here (those awesome white triangle brand name dillies 8mg) I couldn't do anything with them and I'd get sick as all hell. I'm thinking the testosterone and prednisolone I'm taking to rebalance my system are helping more than the suboxone itself.
 
I'm trying something like that as well; apparently sub reduces testosterone over time...is that working out for you? I've been on sub 8 years now-long-term scripts are common here. Course, the longer you stay on it the harder it can be to quit.
 
WatMyConditionIsIn said:
but doctors prescribe other drugs based on what the patient feels works best for them. if i go on ssris and paxil doesnt work then i can tell my doctor and i will be allowed to try prozac, or cymbalta, etc. if i have anxiety and diazapam makes me too drowsy to function then i can try clonazepam, or ativan. why are opiates the pariah of prescription drugs? and the notion that heroin should be a last resort because its the most powerful and dangerous opiate? bullshit. methadone is at least as powerful/dangerous/and habit forming as heroin
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I agree that the stigma behind Heroin is ridiculous. The only reason so many junkies end up dying of smack OD's is because there is no way for a addict to know the potency of a particular batch. Not to mention what it may be cut with. That is one reason why i have stuck with pharmaceutical opiates and have never bothered with Heroin. That and the price of the stuff. But it's not really a new concept to use Heroin or as it's called when you get a script or shot at the hospital of it diamorphine for acute and chronic pain. I really don't know why it was taken off the market in Canada as it's a perfectly good painkiller and as morphine can cause alot of side effects for certain people it could be used in cases where people get too sick from morphine. Granted dilaudid and fentanyl could be used in such a case as well and they are way more potent then pure diamorphine. So it is rather silly that you can get a drug as potent as fentanyl for pain relief but not Heroin.

Interestingly enough one of the best doctors I've ever had was a English doctor and she mentioned diamorphine as a possible medication to help the severe attacks of trigeminal neuralgia i get. Then she remembered that it's not on the market anymore in Canada :\ . There doesn't seem to be nearly as much stigma in using diamorphine in the UK for relief from severe pain. It's sure as shit alot safer then being pumped full of Demerol which some doctors still don't mind doing.

As for drug withdrawals i would much rather come off a opiate then venlafaxine or alcohol. Hell gabapentin withdrawal causes more physical pain for me then coming off opiates such as morphine or dilaudid and the withdrawal lasts much longer. Yet alot of doctors push this shit off on patients as a non addictive painkiller 8)
 
I don't know who said it, but I disagree. It's much easier to come off methadone than heroin. You can actually work during methadone withdrawal.

Another, more obvious advantage of methadone is you don't have to shoot it. With heroin, you have to shoot or smoke it two or (better) three times a day. Which also means you have to go back to the clinic two or three times a day.

This is one of those examples in which what the patient wants and what's best for the patient may differ.
 
yeah but my point is that its different for every patient, just because methadone withdrawal was easier for you (it actually was for me as well) does not mean it is for everyone. i agree there are pros and cons for both but it just makes more sense to have as many different tools in a doctors tool kit as possible, especially when those tools are available but just are seen as morally "wrong" by the people who implement laws but most likely have never gone through opiate withdrawal ever. why limit the possible solutions to this problem by having only 1 (well, 2 since bupe became available in canada) drug to treat a very complicated and individual medical problem like opiate addiction? its like how they think in AA/NA, that all junkies are the same and one solution will work for everyone, its not that simple

and you only "have" to shoot heroin when your supply is limited and you have to get the most out of every bit of it. i agree most ppl would probably still smash it bc of the rush, but even shooting medical grade heroin 4 times a day in a safe setting is better then shooting street heroin every day nes pas?
 
There are pros and cons to each.

Heroin has a rather short half life so lends itself to more frequent dosing than methadone, but the side effect profile is generally considered more tolerable amongs the "classic" opioids rather than 'done, what with the increased risk of death.

I think the Swiss heroin maintenance programs used smoked heroin, actually. People got 200mg or something of pure heroin base twice daily. I think they might have got carries?

Either way, whatever works for you is best. I know methadone looks good on paper (potent, long half life, other painkilling f/x), but the reality is a some people don't like it very much and would prefer "classical" opioid maintenance. (see also: people on BL talking about switching off 'done!)
 
I'm not sure which ROA was used for our UK diamorphine scheme. Regardless, I don't know a single user who wouldn't pick pharmaceutical-grade heroin over methadone. We have a tier-based system here; meth for the more "chaotic" user, with the end goal being to stabilize them on short to long-term suboxone scripts, and in some extreme cases residential treatment is provided (although funding is extremely tight)....I've no idea how diamorphine would be incorporated into this system-what exactly would the criteria be to obtain a heroin 'script? Provide enough dirty samples?

Bringing in a new substitute option would radically change our treatment of heroin addiction in my country, and I would welcome it (and not just because I want to use diamorphine, honest)...however, politicians are fucking pussies; I doubt they'd risk angering their electorate by prescribing heroin to addicts. (Can you imagine the shrill headlines from the gutter press?!)
 
i was slamming dilatta 32's called exalgo was doing like 10 a day!if they gave me what i wanted in a program i would never get off the needle even if it was 16 mgs a day but i know one thing i would be more productive and be happy,its my fucking body my life just let me get on with life and be happpy damn it!!!
 
Envision an America where there are no drug dealers on sidewalks selling drugs, shooting each other and destroying neighborhoods.
Imagine a world where all drugs are sold in a state-regulated store by a clerk making 12 dollars an hour.
Picture a world where al-Qaeda and other terrorists do not make billions guarding the drug trade and selling drugs.
Think of an America where felony crime is reduced by half which allows the police to focus on the deadly DUI, the child predator and other public safety threats.
Consider the prospect of redirecting the 72 billion tax dollars currently spent chasing non-violent drug users & their suppliers.
See a world where, if one day you or a loved one has a drug problem, you see a doctor not a judge.

This world is possible when we find the courage to end Modern Prohibition.
 
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