Doctors push for cocaine prescription

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A national conference on cocaine is due to discuss whether the drug should be prescribed to long-term addicts.

Switzerland has had a programme of heroin prescription for the most hardened addicts for ten years and some doctors believe cocaine addicts could benefit from a similar treatment.

But others have their doubts. Officials from the Federal Health Office are especially concerned about the political impact of introducing cocaine prescription.

There are an estimated 90,000 cocaine users in Switzerland. However, most of them use the drug only on a recreational basis and would not be included in any prescription programme.

The conference, which starts in Bern on Thursday, brings together Switzerland’s leading addiction specialists, as well as officials from the Health Office.

Multiple dependencies

Daniel Meili, who heads Zurich’s heroin programme, says a typical candidate for cocaine prescription would be an addict with multiple dependencies.

“Of the 150 heroin patients I have here, perhaps a third of them could also benefit from cocaine prescription,” Meili told swissinfo. “They come here to get the heroin, but they are also addicted to cocaine, which they buy on the illegal market.”

“They can spend between SFr10,000-20,000 a month to feed their habit, which means they are often involved in crime.”

Supporters of the programme point to evidence that patients on the heroine scheme have improved health and more stable lifestyles, including proper accommodation and even regular work.

But Meili says that patients who continue to be addicted to cocaine don’t reap any of these benefits.

High mortality

“The mortality risk among these patients is quite high,” he said. “Without treatment, many of them will die in the next ten years.”

But Switzerland’s Federal Health Office is not convinced that introducing cocaine prescription is the answer.

“There’s just no evidence that such a scheme would be successful,” said Markus Jann, head of the drug addiction department.

“We would be very hesitant about trying such a thing, and anyhow we have more important addictions to tackle, such as alcohol or tobacco.”

The Swiss government also feels that this is not the ideal time politically to start talking about something as controversial as cocaine prescription.

Later this month parliament is due to vote on a much-delayed revision of Switzerland’s narcotics law, which if approved, would decriminalise cannabis.

The Federal Health Office – which spent months drafting the legislation and lobbying for it – fears that a rash move towards cocaine prescription could encourage opposition to the law.

But Thomas Zeltner, the department’s director, recently said there would no legal impediment in the way of a pilot project of cocaine prescription. This is a softening of his earlier position, when he insisted cocaine would never be prescribed in Switzerland.

Financial support

Ultimately the decision on a pilot project rests with cantonal authorities. In Zurich there is strong support for such a scheme, although officials there had been hoping for some financial support from the government.

“If Zurich wants to try, we won’t be against it,” Jann told swissinfo. “We will follow it with interest, but there’s no reason for us to finance it.”

“There are many different options for treating cocaine addiction without working with cocaine itself. We haven’t tried everything yet.”

At the conference, Zurich doctors and social workers are expected to unveil a plan for a trial project of prescription involving around 20 patients.

Half of them would be people already on heroin prescription who remain addicted to cocaine, and the other half would be very heavy cocaine users whose health is seriously at risk.

“Obviously it would run in a similar way to heroin prescription,” explained Athos Staub, president of ARUD, a group dedicated to reducing the risks of drug taking.

Party drug

“Just because cocaine is called the party drug doesn’t mean we’d be handing it out on a Saturday night. People would have to come to us and take the drug at our centre,” Staub continued.

Both Staub and Meili are insist that cocaine prescription is worth trying.

“People said ten years ago that heroin prescription wouldn’t work,” said Meili. “In fact it has helped a lot of people.”

“Over the past ten years the problems with cocaine have been getting worse, and based on what I see now, I think legal prescription of cocaine could… help people to live rather than to die.”

swissinfo, Imogen Foulkes

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June 3, 2004
Doctors push for cocaine prescription
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Would they give people powder to snort? or would they inject it with their heroin?

I'm not sure such a program would work with cocaine since most addicts will want multiple doses before they are satisfied and even then many/most will probably still go to the streets to get more.

Who knows though the doctors developing/designing this program probably took this into account and it may turn out to be a successful program.
 
sounds really destructive more than anything
A heroin script is understandable as "the most hardened addicts" need it to FUNCTION and generally apply every few hours. Severe cocaine addicts can get along fine physically without another hit - and even the mental desire is worsened without gaps between

State supplied, low cost cocaine so you can what - go to the washroom every 3-5 minutes for the next corrosive snort, shot or hoot? Then what; low dopamine levels and a slowly worsened desire in the "sober" periods? That's not functioning to me
 
If you consider the fact that addicts will do what they need to do then this might be a somewhat positive program. First off they are focusing on people they are already treating. Since some of these people are addicted to cocaine too the treatment is in someways useless because in the end they still have to go back to the streets or wherever to get their cocaine exposing them to negative influences. Compare that to an environment where treatment, and help is available and the advantages are obvious.
 
But to stay satisfied, wouldn't a cocaine addict have to spend most of his day going in and out of the clinic for redosing? I guess it's better than the alternative.
 
Crazeee said:
People would have to come to us and take the drug at our centre

ahhh

But to stay satisfied, wouldn't a cocaine addict have to spend most of his day going in and out of the clinic for redosing? I guess it's better than the alternative.

Again, am wondering how so. To what avail - when the shortened gaps provide for less chance of (at least somewhat) escaping the psychological desire? For myself as well - a night of cocaine use (especially IV) would absolutely devastate the next week+ of social ability and general functioning. Even given that such could be exaggerated in personal case; what exact good comes in others?

getting at a personal opinion.. that periodical empty pockets are often the best anti-drug. and in the case of cocaine addiction - it really seems doubtful that those suddenly available paychecks are going to go elsewhere than providing for the 5 minute re-quenching of a devastating thirst
 
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Yeah....this is not going to work for a drug that lasts 1/2 hr. :)
Perhaps they could fashion some sort of time-release prep.

ebola
 
Cocaine is too short acting to be a maintinence drug ...heroin lasts 4-5 hours, so dosing isnt that much...but cocaine is administered every 10-15 minutes, sometimes shorter

They'd have alot better luck with a methamphetamine type prescription deal, since it lasts so much longer...

I think stimulant maintinence is a bad idea though...because they are so toxic and hard on the body...its not like opiates, where stuff like pharmacuetical heroin or methadone or morphine is pretty much non-toxic to the body and can be taken for decades....not many people last decades on speed and cocaine, only a small percentage do and with substantial damage...
 
I'm curious as to how fiending for cocaine works out while under the influence of heroin. It would seem that it would be to a lesser degree, or even almost non-existant. Anyone have information or experiences to share on this?
 
alostlittlebird said:
But to stay satisfied, wouldn't a cocaine addict have to spend most of his day going in and out of the clinic for redosing? I guess it's better than the alternative.

Haha that'd be great.

1 line please.

1/2 hour later

1 line please

1/2 hour later

2 lines please


.........
 
id have to stay at the clinic all day long.........


mabye they could make a cocaine nasal spray to help ween addicts off though??
 
giving cocaine to cocaine addicts? that's just a bad idea. coca tea, maybe. there already exist medications (buproprion & l-deprenyl for example) that have potential for easing the transition from coke head to sobriety, just not enough studies have been conducted.
The "withdrawal" seen after long-term cocaine use is just the depression & anxiety caused by the brain not producing enough dopamine. Too bad for that person. Giving the patient more cocaine is just putting off the inevitable, whereas giving a heroin addict heroin makes slightly more sense to me (i believe heroin addiction can be kicked in a week while methadone withdrawal can take a month, and methadone is harmful to vital organs). Basically, you could argue the benefits of giving coke addicts prescription coke, but only to the ones that don't want to quit yet... which opens up a whole other ethical issue regarding keeping addictive drugs in the black market.
^^^ my $0.02
 
^^ methadone is generally non-toxic and not harmful to the organs(in the same way morphine is), it can be taken for long amounts of time...there are people who have been on it for 30+ years and more and have no damamge at all (cept physical dependance)..there are rumors saying that done rots the teeth, gets in your bones, etc...but its just an opiate thats a little longer acting than others, so I think the teeth rotting thing is more due from past drug lifestyle than the methadone itself...They had problems with ORLAAM however causing a dangerous heart rthymth problem, and they pulled that off the market...It affected around 15 people in europe who had heart palpitation/rhymth problems..
 
I think a monthly supply should be given out in sterile injectable solution, nasal spray, or 99% powder (cocaine sulphate to eliminate that damn problem with moisture absorbtion and -hcl salts). Quitting any drug is possible, but most people don't have the time or will powder, hence the term maintainence (of the addiction). The article mentioned a pilot prescription, because they know that coke only last an hour or two at the most. If they focus their attention on it, a lot could be done with cocaine. New ways of dosing, like the little electronic things diabetics use to check blood sugar, and administering it could be created. Technology is amazing these days, I'm sure a needless syringe could be created (I think it already has) and used for injections, eliminating the disgusting track marks of needles. Cocaine wine shold be available. Drinking it would be very appealing, but since the shit is so expensive people no longer take it orally. Once you get down to bare essentials this is just another problem created by prohibition.

As far as the heroin problem: I still don't get why methadone is given in place of the less dangerous diacetylmorphine. That shit is terrible and the only reason it was created is because the Germans lost their opium supplies in WWII and needed a substitute. There's no shortage of opium in the world these days, so there should be heroin for heroin addicts...not worse shit. If not that, why not something like OxyFAST 20mg/ml oral liquid that is given to pain patients. Methadone is like prescribing 4-MAR to cocaine addicts...terrible.
 
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