I support prescribing heroin to IV drug users, as do many other professionals working in support services. At the moment, the most effective method of detoxifying clients from heroin is a diminishing-dosage methadone treatment program. It works because it allows the user to detox from heroin safely and without pain, while assisting in a break from the lifestyle the user may have built up during their addiction i.e petty crime or street begging, or poor physical health. It makes a break from the heroin lifestyle as it is not a drug that is used intravenously; IV use is what puts a chaotic heroin user at most risk, as injecting brings with it a multitude of problems including absesses and aggressive infections of injection sites. However, methadone itself is often more difficult to fully detox from, as the physical side effects following complete withdrawal appear to be more painful and long-lasting than the heroin itself. Users will often find themselves addicted longer to the drug that was supposed to save them from drug addiction in the first place.
There are problems, though, with prescribing heroin in order to stabilise and then detox chaotic IV drug users. The first is that many heroin users would find it difficult to make the change from IV use to an oral method of drugs use, as the initial effects of the drug are faster and more intense when it has been injected intravenously. These people live for the drug, they cannot help it, it is no longer a choice for them, and they are likely to try to attain the strongest effect that they can from the drug and may be unable to make a choice not to. If someone gives them free heroin to use in a non-intravenous manner, they may find a method of injecting it, possibly putting themselves at a higher risk than they would be using street heroin. Methadone cannot be used intravenously, and is highly effective in assisting drug users in combatting the need to inject. Chaotic drug users also find it difficult to limit their use, and it would be far easier for them to source some street heroin to ‘top themselves up’ than it is to find methadone. It might also make it difficult for the licenced supplier to monitor if the client is using on top of their prescribed dose: at the moment, those on methadone prescriptions undergo weekly urine tests in order to ensure they are not using other drugs (usually heroin) along with their methadone.
For those worried that they would be paying for ‘junkies’ to use, you already are. Not only if you have been robbed or mugged, but also in the tax monies used to pay for the legal services (police time, court time, prison time) and healthcare services (A&E departments, needle exchanges) that chaotic drugs use demands. Allocating more public funds into drugs treatment is merely a relocation of these monies, it would not necessarily cost more and is likely to be more effective, both for the users and the general public. Methadone treatment programs cost less to the tax payer than the further-reaching implications of that drug user continuing in a chaotic lifestyle. I see no reason at all why legalising heroin for this purpose would be more expensive.
I would also like to point out that drugs dependency is not a choice. I work with these people, and nobody would choose that lifestyle. In the vast majority of cases, there is a long history leading up to the initial stages of addiction and also to the losing battle against the drug itself. The histories increase in severity and plain awfulness as addiction continues, making it more and more difficult to get free of, either in the long- or short-term.
Crime rates would drop like a rock if all drugs were legalized, leaving a lot of unemployed cops, lawyers, judges, prison guards, etc.
Its anybodys guess how much they will drop, depends on how much current crime is drug related due to the high black market price of weeds(marijuanna) and flowers(opium).
No need to rob someone to get your drugs if they were legal and only cost a few quarters, just panhandle each day to get your fix.
Cops would have to spend a lot of their empty time going after real criminals, lowering the crime rate even more(e.g. in America each year cops stop and search millions of people in order to arrest 750,000 people for possessing marijuanna).
Can you imagine how many extra real criminals might be caught if those millions of man hours that cops now spend on drug crimes were instead spent on catching real violent criminals?
It would take an honest cop(lawyer, judge, prison guard, etc.) to admit it, since without drug laws, most of them would end up unemployed and nothing for them to do.
Slight hijack: can anyone tell me how the “high” from heroin is different (or not) than that produced by legal opiates like morphine? I was put on morphine in the ER upon shattering my leg, and while the relief from pain after 5 days of completely useless weaker drugs was absolutely wonderful, I fail to understand why anyone would want to do it recreationally. It was necessary at that moment, but certainly not fun. But then maybe I’m just a freak.
Heroin is a derivative of morphine. Besides the potency (heroin is two or three times stronger) the pharmacological effects of morphine and heroin are indistinguishable.
[whiney voice]Won’t someone think of the Afghani farmers![/wv]
I think a registered addict program for the serious opiates is a good idea for the reasons everyone here (this is the SDMB after all) has outlined. The problem would be preventing new users from springing up to get heroin, I guess. This is no different than the problem as it exists now, but without all the associated crime. I see that as a net benefit.
Practically speaking, this is the US after all, a proposal for a registered addict program would be “LEGALIZE HEROIN?!!!” in all the news outlets. Whoever had the guts to propose it first would have to be sacrificed, I imagine.
I sense a tilt in the direction of considering other options. In Florida, what with Noelle and all, you’d think…
When 60 Minutes did a story on the Brit, who was smoking heroin legally, I wasn’t able to distinguish between him smoking that, and a regular tobacco ciggarette. His behavoir appeared normal to me.
It seems the big money that stands to be made behind all of the illegal drugs, is what helps drive a good portion of the craziness behind it. I seriously doubt if most of these drugs could be obtained by a prescription at a very affordable price, that gangs and others involved in the business aspects of it, would still take an interest in it if they still couldn’t make the handsome profits they were making before.
AFAI remember from my pharmacology lectures, Heroin passes the blood-brain barrier more quickly than Morphine. Once in the brain, it is transformed to morphine. Since the abrupt increase of concentration that generates the euphoria, Heroin should do a “better” job.
Eva Luna: Apart from emergency situations, morphine is administered slowly (orally or slowly i.v.). Hence the lack of euphoria.
Well, I may have rather over-stated my position, but I do think there’s the germ of a serious point lurking in it somewhere.
The current perception of heroin addiction (not entirely an accurate perception, but the one people deal with) is that it involves an inevitable decline into petty crime, squalor, deteriorating health, and death. Even so, there are people who choose this lifestyle, because it’s more appealing to them than what they’ve got without the drug.
Getting people off hard drugs is not simply a medical problem; it’s also a social one. People need to be able to see that they’ve got better options available to them than the drugs. From Gin Lanes in the eighteenth century to depressed council estates in the current one, drug abuse is fuelled by social depression - by the perception some people have that the drugs are all they’ve got to make life bearable.
So … any strategy that involves making drugs more available (say, by legalization) is going to have to go hand in hand with some strategy to make them less appealing … or it’s going to have, at best, a superficial palliative effect. You may have fewer drug-related crimes, but you are likely to wind up with a lot more addicts, and that will bring its own set of social problems in its wake.