HellsBells Posted January 11, 2010 Posted January 11, 2010 The issue of administering free needles to drug users stirs up quite a bit of controversy wherever its tried. There is a lot of debate over the issue in Vancouver right now as to whether free injection sites should continue or not. Personally I'm torn on the issue. On one hand, I think that the idea of providing a safe and clean space for junkies to use should reduce morbidity and mortality amoung them. It also allows health care workers to monitor these people and provide information about rehab programs that they may not have access to out on the street. As far as the pamphlets go, I think that $32,000 is a small price to pay, as even a single person admited to the hospital for treatment of chronic diseases such as HIV or HEP C could cost hundreds of thousands of dollars. However, I think that Herbie (no flaming from me, I promise) has a good point. What is the point of having laws against drugs, if we are going to look the other way, and offer a kind of backhanded support to illegal drug use with things like safe drug injection sites and informative pamphlets? If that is the case it would be much more ethical, not to mention logical, to just decriminalize the whole mess and have done with it. But... the chances of that are slim to none, as long as America has its death grip on "The War on Drugs" even the mention of decriminalization is political suicide. Even up here in liberal Canada, we couldn't even get weed decriminalized (although we came close).
tskstorm Posted January 11, 2010 Posted January 11, 2010 I don't see why B's shouldn't be able to give narcan in an auto injector. But really, those B's pushing for that and wanting to give drugs should continue their education and become paramedics. I don't give 2 shits about this brochure. I can't believe they'll make a political mess out of it. Well I guess I can. If we can stop one call @ 3 AM when I'm sound asleep for an OD this brochure is OK in my book. I am so sick of pumping narcan in all these idiots. There are more Medics pushing them to get it then Basics. It eases the load on the Medics, and on the 9-1-1 system. Easy to say everyone should become a Medic, but the city would be bankrupt ... city is already cutting EMS budget every year, imagine having to pay 3000 newly upgraded medics and still manage budget cuts!! and some medical facilities accepting used needles for disposal, as long as they put them into an empty gallon milk or water jug first. They are required to accept them .. any dr's office, or clinic, or hospital etc...
Kiwiology Posted January 12, 2010 Posted January 12, 2010 I agree Phil, we haven't had a hard problem here since the mid eighties when the Government figured out it was easier to just put everybody on $3 subsidsed methadone. Any time you talk about legalising drugs (we have a HUGE meth problem here) the "straight" people jump up and down and go on and on about "but everybody will start using it because its lega!" well here is a newsflash bro, that's absolute crap! Alcohol, tobacco and prostitution are legal here but I ain't out doin them! We can but try I spoze eh
tniuqs Posted January 12, 2010 Posted January 12, 2010 ='HERBIE1' date='11 January 2010 - 11:31 AM' timestamp='1263234707' post='233458'] This will be an unpopular view and I can't wait to see how many people give me a negative response to it. Don't care... Ok my opinion is different than yours, a negative response no, an alternative perspective yes. To me, this is like throwing up your hands and giving up on the problem. Ask yourself has declaring a "War on Drugs" actually worked ? Your jails are filled to the brim and it still goes on in the prisons ... billions of dollars spent and in many foreign countries as well by the USA ... an EPIC FAIL it just doesn't get clearer. One must reevaluate why this "War on Drugs" heck even in counties that have the immediate death penalty and very little due process of law, yet the narcotics trade still is rampant, one must answer the question WHY first to realistically solve any problem. This is a societal issue and Phil is very correct we are observing escalation and no where near effective control, yet this IS a tangible way to slow the spread of "A" disease ... the disease of addiction in this case as the means of delivery can be positivity affected for very little cost. 32 G is nothing in the grand scheme of things I must applaud NYC for their Condom and Needle and Education incentive's. (is ther not contact information for those that wish to get off the needle) I bet there is ... look to history during the WW2 a comic book for the troops was printed informing them about Venereal Disease and it worked too. This whole notion of things like handing out clean needles to addicts or putting out a how to inject heroin manual is insane. How does this really help the drug addict, or even society in general? Of all the friends, coworkers, and acquaintances I have, from all walks of life, I know of NOBODY that has become infected with HIV or even things like Hepatitis B from anything other than engaging in at risk behavior. How is this insane, your assumption that one must partake in risky business to become infected is very serious folly. I know of many HCW that have been infected, Dentists, Surgeons, RNs and EMS (HIV,HEP+++)... remember that we as providers have contact almost daily, because a needle poke or cut gloves/hand in a trauma, well that never happens. Could this incentive actually decrease OUR risk ? Please don't be so short sighted the long term affects could save lives and maybe someone you know or work with. Treat the addict, come down HARD on the dealers, or decriminalize, which takes the motive out of the equation- profit. No take the profit margin out and then you chop organised crime off at the knees, control the drug, prohibition never works. This has worked in many places in Europe, THEY think North Americans are insane because they continue to stick to a dogmatic approach. If we are treating this idea- putting out a pamphlet- as a PSA and a public health initiative, then why don't we hand out info on ways to get free booze to alcoholics too? After all, people engage in all types of illegal activities to support that habit which results in injuries and health problems to them and to others, costs millions of dollars, so what's the real difference here? In Fact Alcohol is the MOST abused drug in our society (and we do try to educate in the schools first tons of education on that but alcoholism does not spread disease to a care giver or another individual and herein is the difference. That said ETOH costs the Health Care Systems World Wide 10 x more than any white powders do. We're OK with the notion of handing out free needles to drug addicts yet someone with a legitimate medical condition like diabetes needs to BUY their own needles. More of a availability issue but if Diabetics left sharps in playgrounds, on buses, in public rest rooms or in say Vancouver on the Ferries, well then we should consider giving Diabetics free sharps too. A place away from the public eye were the can get help if they wish. Doesn't anyone else think this is crazy? Let the flaming begin... No Flames just another way of skinning a cat because WE in NA are not being very successful using the same methodology of the past. Kiwi: I agree Phil, we haven't had a hard problem here since the mid eighties when the Government figured out it was easier to just put everybody on $3 subsidsed methadone. If only NA was as smart ... cheers
HERBIE1 Posted January 12, 2010 Posted January 12, 2010 Herbie, I respect your opinions & most of the time I think you are right. We did have the same situation here with free/purchase needles, but now all get them free. What concerns me is the attitude that all junkies (herioin/narcotic users) are street scum that dont deserve the same treatment as everybody else. There are just as many people addicted to narcotics that live in the suburbs. Lets not forget them. There is another solution that I alluded to earlier. Legalise it. This does a number of things & will actually over a relativley short period reduce the number of addicts. Legalisation will reduce crime, make the drug more available & able to be taxed. Lets supply it to registered users. Supply them with a safe place to inject. but then all the mystery of performing an illegal act will be gone. Criminality will be gone & if you go one step further & legalise cocaine as well, then all the money spent on detection, all those billions, could be redirected into providing a first rate FREE ems system to all US citizens!!!!! I never said all drug abusers were street scum. Problem is, once someone starts abusing drugs they are engaging in the behavior that puts them at risk for contracting all the diseases associated with that behavior, as well as the associated traumas you get while living that lifestyle. Do some people infect their spouses with HIV or Hepatitis- yes, but does anyone really think this is anything more than a small subset of this group? Legalizing may be too much, but I agree with decriminalizing a small amount of it to where profits are not worth the effort anymore. Obviously that would save BILLIONS of dollars, which could then be spent on prevention and treatment.
aussiephil Posted January 12, 2010 Posted January 12, 2010 I never said all drug abusers were street scum. Problem is, once someone starts abusing drugs they are engaging in the behavior that puts them at risk for contracting all the diseases associated with that behavior, as well as the associated traumas you get while living that lifestyle. Do some people infect their spouses with HIV or Hepatitis- yes, but does anyone really think this is anything more than a small subset of this group? Legalizing may be too much, but I agree with decriminalizing a small amount of it to where profits are not worth the effort anymore. Obviously that would save BILLIONS of dollars, which could then be spent on prevention and treatment. It was a comment in general not directed at you herbie, sorry if there was any confusion
melclin Posted January 12, 2010 Posted January 12, 2010 I am all for harm minimization, although I'm sure of the efficacy of pamphlets specifically. I listened to a couple of speeches recently. One by Dr Alex Wodak and another by Norm Stamper. Both on the uselessness of the "war on drugs" (seems likes its been a popular topic on ABC radio of late) and the supposed benefits of the legalisation and regulation - it seems solid to me. They've got my vote. People will always want to have sex, get wasted and seek various other thrills. Simply trying to stop them doing it is short sighted and unrealistic. Chastity this and promise ring that, prohibition, banning condoms, zero tollerance drug policies...none of these things ever seem to work. You may as well accept that people will always want to be involved in this kind of behaviour and try and minimize any harm that comes from it. 1
under-dreaming Posted January 12, 2010 Author Posted January 12, 2010 I hope NYC sees some positive results from this. I didn't realize that NYC EMT-Bs are close to getting protocols for administering Narcan via auto-injector. That should make a world of difference for your system I would imagine. Good luck with that. One probable outcome of this pamphlet could ultimately be not just a decrease in transmission of diseases or mortality from OD, but from the overall increased awareness of the possibilities and implications that arise from heroin use. It's my belief that many people get into these drugs because of education... or the lack thereof. While the addiction itself may be too much to handle for most, those who are still in control may have a new opportunity to get out while they can. If this pamphlet were to reach that person and provide information that was previously not understood, well... you never know, they may just get out of it in time. One can only hope, right? This pamphlet is a step in a new direction. One that may have been called for considering the ineffectiveness of present legislation and dogma.
HERBIE1 Posted January 12, 2010 Posted January 12, 2010 The issue of administering free needles to drug users stirs up quite a bit of controversy wherever its tried. There is a lot of debate over the issue in Vancouver right now as to whether free injection sites should continue or not. Personally I'm torn on the issue. On one hand, I think that the idea of providing a safe and clean space for junkies to use should reduce morbidity and mortality amoung them. It also allows health care workers to monitor these people and provide information about rehab programs that they may not have access to out on the street. As far as the pamphlets go, I think that $32,000 is a small price to pay, as even a single person admited to the hospital for treatment of chronic diseases such as HIV or HEP C could cost hundreds of thousands of dollars. However, I think that Herbie (no flaming from me, I promise) has a good point. What is the point of having laws against drugs, if we are going to look the other way, and offer a kind of backhanded support to illegal drug use with things like safe drug injection sites and informative pamphlets? If that is the case it would be much more ethical, not to mention logical, to just decriminalize the whole mess and have done with it. But... the chances of that are slim to none, as long as America has its death grip on "The War on Drugs" even the mention of decriminalization is political suicide. Even up here in liberal Canada, we couldn't even get weed decriminalized (although we came close). As we know, bans do not accomplish anything other than providing a revenue stream for "entrepreneurs". Here in the states, Prohibition (alcohol ban in the early 20th century) only provided a means for the Mafia to come to power. Drug "bans" have only caused gangs and drug traffickers to make BILLIONS of dollars. Gun bans- same result. Regulate, tax, decriminalize small amounts- there are ways of reducing the profit motive, which drives this whole thing. Like you mentioned, it's not likely to happen, and if it does, then doesn't it also mean we are still throwing up our hands and giving up on the issue? Tough call, but how can we put people in jail for years for drug offenses, but turn around and offer free needles to junkies and even show them how to "properly" use those drugs? It boggles the mind and seems pretty darn hypocritical, if you ask me.
tskstorm Posted January 12, 2010 Posted January 12, 2010 I hope NYC sees some positive results from this. I didn't realize that NYC EMT-Bs are close to getting protocols for administering Narcan via auto-injector. That should make a world of difference for your system I would imagine. Good luck with that. They are no where close, but it has been brought up a few times. Further As per the protocol update I received today to go in effect by 4/1/2010 EMT-B's in NYC can ADMINISTER Epi-pen auto injectors for asthma and anaphylaxis on standing order. Previously for anaphylaxis it was a medical control option, and was not an option at all for asthma. My understanding is the asthma protocol has come from paramedics riding a BLS truck (means they can only function in as an EMT) calling Medical Control to ask for a discretionary order to use the on board epi-pen while awaiting medics for a tight asthmatic in severe respiratory compromise. The order was granted, with good out come.
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