AFGHAN OPIUM GROWERS MIGHT HAVE COMPETITION AMONG BUYERS!

Stop the Drug War (DRCNet) just posted an article about the Senlis Council proposal to have the opium crop in Afghanistant bought up by folks who would use the product to produce analgesics for use around the world.

Seems to me that regardless how much the good guys offer to pay for opium to produce analgesics, the bad guys will offer more to pass the stuff on to the illicit market. One just can't resolve the problem by a focus on supply if one ignores demand. And, of course, with all that new incremental legal opium products, who says the INCB will "permit" countries around the world to buy it? Anyway, meanwhile, what a boon this plan would be for the golden triangle farmers! Wow - I wish someone sold futures on the opium production outside afghanistan if this plan ever is put into practice!

DEMAND FOR METHADONE TREATMENT

In the London (Ontario) Free Press of Aug 22 is a story headlined: "Methadone Clinic Overrun by Visitors." It's a good news story - testimony to the motivation that exists among opiate dependent individuals for treatment. Reference is made to "stunning numbers" of applicants for admission. The hoped-for common sense response will be for City Government to plan immediately for rapid expansion of treatment capacity to accommodate promptly all who can benefit.

SEEKING GUIDANCE IN ALL THE WRONG PLACES

The Vancouver Province newspaper (August 25) headlined, "Feds turn to Europe for advice on drugs.." Specifically, the report was of Canadian officials seeking guidance on "whether to kill insite, Canada's only safe-injection site." The visit is to Copenhagen and Stockholm - both undeniably lovely destinations, but neither of which has any experience whatever with "safe-injection sites." It would make vastly more sense for officials from those Scandinavian countries to visit Vancouver's program, which has been proven by independent evaluaiton to be extremely effective.

CALLING OUT DRUG CAVALRY

An LA Times story on Sept. 6 headlined, "Calling in the Drug Cavalry - Afghanistan turns to experienced Colombian narcotics officers for answers."

The reality is that neither Colombia nor any other country has succeeded in significantly curtailing the production of drugs in the face of persistent worldwide demand - except for the Taliban, but they're presumably not candidates to serve as consultants. Meanwhile, pouring more US taxpayer dollars into fighting the war on drugs in Afghanistan's poppy fields seems a dubious stragety, when over $300 million failed to prevent a one-year 60% increase in production.

A definition of insanity is doing the same thing over and over and expecting different results. It's time for a candid reassessment of this particular war and the premises upon which it's being fought.

ADMINISTERING SUBOPTIMAL DOSES OF METHADONE

In a study carried out in 1996-97 but just published now (J Subst Ab Treatm, vol 31, 187-194, 2006), HIV risk behaviors were compared among subjects assigned to various agonist medications for opiate dependence - LAAM, buprenorphine and methadone. One out of four subjects was given “…a fixed daily dose of 20 mg of METH [i.e., methadone] and served as a control group.”

The authors of the paper are Lott, Strain, Brooner, Bigelow and Johnson. Seven years before the trial commenced the then-Director of the National Institute on Drug Abuse had stated, "...in this age of AIDS, a low dose policy is not simply inappropriate, but can be fatal to the IV drug abuser in treatment as well as his or her sexual partners and children." (Schuster CR: NIDA Notes. Spring/Summer: 1989)

It is difficult to comprehend the rationale for unnecessarily subjecting people to potentially fatal outcome, even during the course of a study of limited duration and even with provision (when it’s not too late!) for “therapeutic rescue.”

Comments welcome.

CANADA REFUSES TO CONTINUE SAFE INJECTION SITE

In a just-released press statement (excerpts below) the Canadian government has demonstrated an extraordinary disregard for facts and for common sense. It assesses the Vancouver initiative based on objectives that are not applicable; the site is intended to save lives and reduce morbidity - not cure addiction. Applying the same outcome measures would lead to rejection of all of the the myriad treatments utilized in response to diabetes, cardiac disease, hypertension, etc. - to say nothing of palliative care for the temrinally ill.

Ignored by the Canadian Prime Minister and his team is the scientific evidence that the Vancouver site has in fact achieved its primary objective of saving lives! Government also seems blind to the utter failure - by any and all criteria - of what continues to be the mainstay of its anti-drug strategy: prosecution and incarceration of users. What a tragedy.

News Release September 1, 2006: No new injection sites for addicts

OTTAWA - Initial research has raised new questions that must be
answered before Canada's new government can make an informed decision about the
future of Vancouver's drug injection site or consider requests for any
new injection sites says Federal Health Minister Tony Clement.

"Do safe injection sites contribute to lowering drug use and fighting
addiction? Right now the only thing the research to date has proven
conclusively is drug addicts need more help to get off drugs," Minister
Clement says. "Given the need for more facts, I am unable to approve
the current request to extend the Vancouver site ..."

COMMUNITY OPPOSITION TO METHADONE

It never ends: within 48 hrs opposition against methadone treatment facilities in four widely disparate communities:
BALTIMORE Sun, 30 Aug: "Action halts again on drug center bill
Treatment advocates fear City Council is blocking effort to ease clinic openings";
FORT PAYNE, Alabama, Times-Journal, 31 Aug: "Clinic remains opposed locally";
BLUEFIELD, West Virginia, Bluefield Daily Telegraph,01 Sept: "Right to know: Rule change needed to better inform pub [about proposed methadone clinics]; and
CHERRYFIELD, Maine,(http://www.wcsh6.com/news/local/article.aspx?storyid=40993),1 Sept"
"Cherryfield Residents Voice Objections To Proposed Methadone Clinic"

So the question is: what, after 40 years of consistently demonstrated effectiveness of methadone maintenance for individual patients and communities, what can be done about this? How can the federal government, that has repeatedly and unambiguously endorsed methadone's effectiveness for decades, turn around public opinion in order to advance its mission of making treatment a reality for a much larger proportion of those who could be benefited? What can the provider organizations (especially the American Association of Treatment of Opioid Dependence - AATOD) do?

Comments/suggestions most welcome!