Harm Reduction Is giving out needles to addicts really still "harm reduction" in this age of Fent and Nitazenes?

[sHR00m]

I know it's always been a controversial topic, but up until very recently I'd always understood the logic, that it helps prevent the risk of spreading infections / diseases, as being the main driver behind the schemes.

But I heard someone legitimately question the other day, how can it still be called "harm reduction", when facilititating easy access to injecting street drugs cut with things like fent and nitazenes? Injecting these things is going to kill a lot more people, a lot more quickly, than any infectious diseases!

He's not wrong!? I think he seriously has a very good point.

It might it be time to re-consider this policy, at least in areas where the prevalence of fent or nitazenes is known to be very high, and the area is seeing lots of fatalities. Mostly in certain areas of some of the big US cities, like San Fransiscos' Tenderloin, Philadelphias' Kensington, and Los Angeles' Skid Row, seeming to have the most catastrophically out of control problems.

Not sure if it's media bias on YouTube etc, but the political leaders of San Fransisco, mayor London Breed etc, are constantly getting a terrible reputation for being on the ridiculous side of "woke" with being far too soft on crime and other issues. But as far as I can tell it really does seem to be such woke policies that are at least playing a part in the problem.

Pretty much everything humanly possible has been tried to combat opioid epidemics. One of the first things tried was coming down as hard on those addicts as possible (criminalization, brutal policing, limiting access not just to paraphernalia but also to information, etc). These approaches horribly failed and subsequently were (largely) abandoned, not because they were inhumane or undone by woke liberals but because they turned out to be either ineffective or worsen the situation. The only things that have been proven to work in the past were factors such as substitution programs, decriminalization, harm reduction campaigns, needle exchange, drug checking, consumption rooms, etc.

All of these factors are known to have problems associated with it and are occasionally debated controversially but they overall turned out to improve the situation more than worsening it. The mantra changed to prolonging the life of the addict until they manage to overcome their addiction. This formula has been proven to work to drastically improve various bad opioid epidemics if implemented properly.

You could argue that the situation in North America is worse than ever and unlike anything that we have seen so far, which is true but instead of doing something drastic, we could also do something different. Lets take substitution programs. Now in times of fentanyl, nitazenes and god knows what there is no good reason not to straight up hand out pharmaceutical heroin to addicts instead. Other countries have done it before with success. Hardly anyone in his right mind would prefer fentanyl or nitazenes over pure diacetylmorphine (unless their tolerance forces them to).

Back to your original question, is it still harm reduction to give out clean needles to people who probably kill themselves really soon by injecting horrible cocktails? I'd say yes, this is still harm reduction just like giving someone information how to safely inject is still harm reduction in the same situation. Just stopping either will hardly do more good than bad.

 

[sHR00m]

I agree with this. Because now in Canada everywhere street addicts are prescribed the “safe supply” of brand name dilaudid tablets in the quantity of 30-36 8mg tablets per day. Some also get amph, and coke substitution “safe supply” medications.

And what happens is they do their weekly screening an still piss dirty weekly for fentanyl… clearly it isn’t helping them get off fentanyl, in fact it’s giving them a guaranteed consistent currency to trade for fent daily. They should umm, cut them off the dilaudid if they’re not using it properly? Not keep giving them means to get fent.

The whole program is obviously something trial and error that they implemented with pure intention. Just by now it should be apparently what the true results are. I’ve never seen the major (and even smaller) Canadian cities sooooo rampant with homelessness and street level using. The problems are not being solved period

I never understood why Canada used a short acting, very abusable opioid as choice for "safer supply". One that even encourages cooking up pills for IV use as its largely useless otherwise. It doesn't surprise me that this doesn't work well. Other countries had better results with straight diamorphine. Also from what I heard coke consumers get stuff like MPH as "safe supply" which is not surprising that it isn"t working either. BTW one possible explanation why safer supply users of opioids still pee dirty for fent could be the fent that is cut with various other street drugs as well.

 

[GulpingBatteryLiquid]

I'd guess it's because opioid addicts often find methadone boring and either top it up with heroin on the side, or just sell the pills and go back to full time heroin

In parts of England if methadone treatment doesn't work they'll put you onto 100% pure NHS diamorphine (I'd wager that many who know this fumble the methadone treatment deliberately lol)

 

[pixies+]

I never understood why Canada used a short acting, very abusable opioid as choice for "safer supply". One that even encourages cooking up pills for IV use as its largely useless otherwise. It doesn't surprise me that this doesn't work well. Other countries had better results with straight diamorphine. Also from what I heard coke consumers get stuff like MPH as "safe supply" which is not surprising that it isn"t working either. BTW one possible explanation why safer supply users of opioids still pee dirty for fent could be the fent that is cut with various other street drugs as well.

It baffles me.

And to put pill vending machines on the street just blows my mind. Not everyone had access, of course.. but Jesus fucking Christ.

 

[paranoid android]

It baffles me.

And to put pill vending machines on the street just blows my mind. Not everyone had access, of course.. but Jesus fucking Christ.

Where the fuck did this happen?

 

[pixies+]

Where the fuck did this happen?

In BC

 

[paranoid android]

It for sure happened here in NS… I’m almost positive (but can’t remember 100%) BC as well.

In Nova Scotia? Didnt know you guys where that liberal yet lol. Granted didnt think a pill vending machne would even happen in BC. That seems mental to me. What where they giving out?

 

[pixies+]

In Nova Scotia? Didnt know you guys were that liberal yet lol. Granted didnt think a pill vending machne would even happen in BC. That seems mental to me. What were they giving out?

These people aren’t I’m from NL too.
For real dude. There was one over in Dartmouth that I know of for sure … can’t guarantee any other ones.

It is mental. It didn’t last long… lol

Dilaudid — since I can’t find the article I’m like 200% sure I read lol I’m gonna back peddle that statement because I can’t prove it and I don’t wanna spread more bullshit.

 

[paranoid android]

These people aren’t I’m from NL too.
For real dude. There was one over in Dartmouth that I know of for sure … can’t guarantee any other ones.

It is mental. It didn’t last long… lol

Dilaudid (obviously) and morphine I know for sure.

Holy fuck who put in the vending machines?

 

[pixies+]

Let me look this up to make sure I’m not talking out of my ass

 

[pixies+]

https://www.cbc.ca/news/canada/nova-scotia/dispension-technology-drug-overdose-deaths-crisis-kiosk-medication-low-barrier-1.5689699

 

[pixies+]

This is killing me lol
I can’t find a reliable source to show that they actually rolled them out here. Shouldn’t be that hard to find… so I guess I was talking outta my ass. Go figure.

they had 3 of them ready to go but maybe they got pulled back before they actually put them on the streets.

And maybe I’m confusing a lot of the safe supply pick up shit with some other things that I’ve picked up on over the last 5 years or so.

And maybe I’m also getting it confused with “safe supplies” - there are machines for crack pipes, new rigs, test kits and shit like that.

I have found solid evidence showing BC and places in TO have had them. But pretty sure they’re trying to scale back and be done with them.

Sorry for the confusion. I don’t wanna add to the nonsense that gets spread around about it all.

 

[StraightObtuse]

I know it's always been a controversial topic, but up until very recently I'd always understood the logic, that it helps prevent the risk of spreading infections / diseases, as being the main driver behind the schemes.

But I heard someone legitimately question the other day, how can it still be called "harm reduction", when facilititating easy access to injecting street drugs cut with things like fent and nitazenes? Injecting these things is going to kill a lot more people, a lot more quickly, than any infectious diseases!

He's not wrong!? I think he seriously has a very good point.

It might it be time to re-consider this policy, at least in areas where the prevalence of fent or nitazenes is known to be very high, and the area is seeing lots of fatalities. Mostly in certain areas of some of the big US cities, like San Fransiscos' Tenderloin, Philadelphias' Kensington, and Los Angeles' Skid Row, seeming to have the most catastrophically out of control problems.

Not sure if it's media bias on YouTube etc, but the political leaders of San Fransisco, mayor London Breed etc, are constantly getting a terrible reputation for being on the ridiculous side of "woke" with being far too soft on crime and other issues. But as far as I can tell it really does seem to be such woke policies that are at least playing a part in the problem.

You know opiate addicts aren't the only ones who need needles.
Also, i used back when there was no needle exchange, no amazon or online vendors, and they were a rarity. We'd use the same needle for months. The tip would break off in people's arms. A single needle would be passed between 5 people. Once my friend lent us his needle that had dried blood in it. We knew he had HIV and decided we'd just clean it really well. All my old using buddies have Hep C, i am the only one that by some miracle was spared.
The current guidance is to use a new needle EVERY time you stick yourself. Miss the vein? Toss the needle, get a new one. Coming from my era, it almost seems extravagantly wasteful, but they recommend that because a needle blunts very quickly. Without services like exchanges you will have people absolutely butchering their vascular systems with blunt needles, spreading diseases to each other, their partners, then throughout the community, and meanwhile overdose numbers stay largely the same. Not to mention exchanges provide sharp disposal and bins, and i like not walking through the park without having to watch my step or take a fun prophylaxis visit to the ER.
"Tough on crime" stances have been consistently shown to be ineffective while harm reduction practices, when implemented with strong community support, consistently improve outcomes.
More research concerning "tough on crime" laws demonstrates that harsher sentancing doesn't provide an equal amount of deterrence. In fact there is a "sweet" spot and after that, increasing the penalties rapidly results in diminishing returns until it stops increasing at all. It's not "woke" and "soft on crime" to refuse to pay in to a system that isn't working in practice and isn't supported by the data. That's not a political position, it's a rational one.
If we look to the data and let that drive how we approach this issue, instead of relying on "common sense" (which is very often wrong), moral outrage, or partisan politics, we may have a chance to save lives, instead of simply ruining them.