Tuesday, March 31, 2009

TAXING METHADONE PATIENTS - A TERRIBLE IDEA:

The Charleston (WVa) Gazette on March 21 reported on a bill introduced into the State legislature that would impose a unique tax on methadone treatment providers. The Chairman of the Committee on Health and Human Resources (!), Mr. Don Perdue, rationalized this plan claiming methadone treatment “has become a lucrative industry” (compared to what – radiology, cardiology, dermatology . . . ?). Even Mr. Perdue acknowledges that any tax would inevitably be passed on to the patients.

The fact that all methadone treatment in West Virginia is “for-profit”, and the inadequate availability of other forms of addiction treatment, reflect lack of State support for services that are desperately needed. It is simply wrong – and counter to the interests of every West Virginian - to focus on patients seeking to turn their lives around as the source of funds that the State can’t or won’t provide.

NIMBY AT ITS MOST VISCIOUS:

The March 30 Clanton (Al.) Advertiser, and subsequent posted comments, represent the height of mean-spirited, misinformed, non-christian vitriol aimed at individuals who are seeking nothing more than a chance to live free of the horrors associated with dependence on illicit drugs (http://www.clantonadvertiser.com/news/2009/mar/30/appeal-methadone-clinic-fails). Among the venom that appears in the comments applauding rejection of a methadone treatment facility is this gem: "I personally don't mind them having methadone if it kills that many drug users." An appeal to humanitarianism clearly would miss the mark, but one might think some citizens would be moved purely by the general community's self-interest in ensuring treatment availability for those who want and need it.

Tuesday, March 24, 2009

CAN THE NEW BRUNSWICK (CA) HEALTH MINISTER REALLY HAVE SAID THAT:

A letter to the Telegraph Journal, 23 Mar, attributes to N.B. Health Minister Mike Murphy the statement, "Methadone... can be a bottomless pit - people get on it and they don't get off."

The writer goes on to note, ”The whole point of methadone maintenance treatment is that it's possible to be on methadone and hold down a job, raise a family - in general, have a life. If someone eventually weans off methadone entirely, that's fine, but just being on methadone is a huge step forward both for that individual and for the community as a whole. … A person on methadone is a person who has crawled out of the "bottomless pit" of addiction … and has a chance at building a life for themselves. Too bad New Brunswick has a Health Minister who's so poorly informed on this issue.”

URL: http://telegraphjournal.canadaeast.com/front/article/611551

Monday, March 23, 2009

THE WAR ON DRUGS: A DEVASTATING PUBLIC-POLICY DISASTER

That's the headline of an opinion piece written by four clinical and public health specialists in British Columbia (CA), and that headline says it all. It appeared in Lancet, vol 373, March 21, 2009. The concluding paragraph: "Clearly, the preponderance of evidence shows that the UN drug-control framework has not only been ineffective but has resulted in a range of severe unintended harms."

Authors: Evan Wood, Daniel Werb, Brandon Marshall, Julio SG Montaner, and Thomas Kerr, Brit Col Centre for Excellence in HIV/AIDS St Paul's Hosp; Fac of Medicine Univ of Brit Col; Sch of Pop and Public Health of Univ of Brit Col.

Monday, March 16, 2009

NEW BRUNSWICK POLICE CHIEFS INSIST ON MORE SUPPOT FOR METHADONE MAINTENANCE:

Police chiefs in St. John and Fredrickton (New Brunswick, Ca.) call for Provincial Health Minister’s support for expanding methadone treatment. According to the Fredrickton Chief, “We know with a large proportion of those cases [involving opioid dependent individuals], once they get onto methadone, they're not doing crime . . . Methadone is saving people's lives because it's giving them an opportunity to stabilize." Full story in the 16 March Telegraph-Journal at: http://telegraphjournal.canadaeast.com/city/article/604147

Friday, March 13, 2009

RUSSIA NOW WORLD'S TOP HEROIN USER:

According to someone who should know - the head of Russia's anti-narcotics bureau, Victor Ivanov. In an interview with BBC on 10 Mar he estimated there are 2.5 million heroin users in Russia. The report of his comments includes not a word about treatment, and in fact there is virtually no treatment available - methadone and buprenorphine are both absolutely forbidden. So what does the drug czar of Russia suggest? "He said it was time for the international community to take action against Afghan narcotics by spraying poppies and offering farmers incentives to grow other crops." Even for cynics it is difficult to comprehend how a person in authority can embrace an approach that America has demonstrated, conclusively and at a cost of many billions of dollars, is utterly futile! full story: http://news.bbc.co.uk/2/hi/europe/7935527.stm

CLINICIANS’ PREJUDICE WHEN IT COMES TO REPORTING PREGNANT DRUG USERS:

An old but still powerful reminder that clinicians, no less than society in general, have strong bias with regard to ethnicity and economic status. A study by Chasnoff and colleagues in 1989 in Florida screened 715 pregnant women for drugs. Whites and Blacks had approximately same frequency of positive toxicology: 15.4% and 14.1%, respectively, but “…black women were reported [to health authorities] at approximately 10 times the rate for white women, and poor women were more likely than others to be reported.” Yes, the study is 20 years old. Anyone have a basis for believing clinicians’ attitudes have changed? Article in NEJM 322(17):1202-1206.

Tuesday, March 03, 2009

NOT SHY ABOUT INTENTIONS (NIMBY in Tennessee):

Members of the Planning Council of Church Hill, Tenn., "weren't shy about their intentions" to make it almost impossible for a methadone treatment facility to be established in their city. Clinics would only be permitted in "industrial zones ... and would also have to be more than 1,000 feet from a school, day-care facility, park, church, mortuary, hospital, public recreation area, residential dwelling or establishment that sells alcoholic beverages."

There's a need to protect hospitals from patients receiving medical care? And just what fears might there be about a clinic's impact on mortuaries (or their owners or "clients")? And churches - no voice of compassion from the priests?

"Mayor Dennis Deal said . . .'I know you’ve got to have these (clinics), but you’ve also got to protect the taxpayers.'” Aside from the patent disingenuousness of the professed need for "these clinics," does the Mayor think his constituency will be well-served by abandoning addicts who desperately want and need and could benefit from treatment?
For the full story

Sunday, March 01, 2009

METHADONE AND DRIVING: FURTHERING STIGMA, IGNORING THE EVIDENCE!

The Police Chief in Laconia, NH, is demanding a proposed methadone clinic hire an off-duty police officer whenever it is open - allegedly because of fear the methadone may render patients "unstable to drive safely" (the functions of the off-duty officer are not specified). Decades of studies and surveys around the world (most recently a 5.5 year study in Norway published this week in the Journal Addiction) document that methadone maintenance treatment is not associated with increased driving risks.

During these very difficult financial times a Police Chief should perhaps be applauded for seeking ingenious - even if disingenuous! - reasons for gaining overtime opportunities of fellow officers. In this instance, however, the Laconia Chief is displaying ignorance of or disregard for the facts and is doing the entire community a terrible disservice. Full story click here