Canada: Vancouver Mayor Pushes Stimulant Maintenance Plan

Vancouver Mayor Sam Sullivan, who wants to begin a groundbreaking plan to provide cocaine and methamphetamine users with prescription stimulants, has released the results of a poll he commissioned that showed strong support for the notion among Vancouver residents. The survey released last Friday showed that 61% of respondents would support such a program to deal with rampant drug abuse in the city's Downtown Eastside.

The mayor needs to win an exemption from Canada's drug laws from the federal government. Under Sullivan's plan, called CAST (Chronic Addiction Substitution Treatment), up to 700 chronic cocaine and meth users would be provided with maintenance doses of stimulants. The release of the poll results is designed to increase pressure on the federal government to approve the experimental program.

The poll also found that an even larger majority of Vancouver residents were skeptical of traditional abstinence-based drug treatment programs. According to the poll, 71% of respondents believed such programs actually worked for less than one-quarter of participants.

"The public appears to be aware that large numbers of addicted people will continue to be involved in crime and disorder as a result of long-term drug use," Sullivan said in a press release last Friday. "We know that many drug users do not respond, in the long term, to traditional abstinence-based treatment programs."

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Amphetamine perscription

Thank you Mayor Sullivan!

Keep on going this way. You're the first official that I know of to adress the issue and propose cocaine/amphetamine maintenance.

I myself used illegal speed daily for years. Three years ago I could persue my family doctor to perscribe amphetamine for me so I could quit the illegal street stuff. This has drasticly increased the quality of my daily life.

Where before I never saw a doctor, now I see my doctor each two months. I'm having my blood presure measured and I also always look how much I weigh (I don't want to go under 67 kilograms). I alway's get perscriptions for the next two moths. Having amphetamine prescription get's the stress out of your dope life. For me this means that I use much less then what I was used to. Also the stabile quality of the speed (it's prescribed, it's alway's the same purity of product you get) alows you to get controle over your use. For me it's more like a daily routine now. I try to not make it an issue for myself and again: this keeps the stress out of the dope issue.

I'm sure this approach will work for some of the people who use drugs. And just because of that we should really try it out.

Let's go advocate for it on a bigger scale ok?

Stijn Goossens

Amphetamine maintenance

It is great to see politicians prepared to think outside the box, especially on issues that most other politicians would rather side step in order to maintain their voter credability, even when logic and science are on their side. Mayor Sullivan is following a Vancouver tradition of forward radical thinking on drug issues which, if successful, will reap long term health gains long after the inititial furore caused by such a concept dies down.

Stimulant users are the poor relations most of the time when it comes to chronic and problematic drug use and because so few interventions are tried with this group, the health consequences are rarely addressed until the user has began diversifying or entering a poly drug using situation, raising the potential for far greater harms than those arising from primary stimulant use, including HIV and hepatitis.

In addition a policy such as this ensures that those users remain within the health care network, whereby primary health care issues can be addressed and tackled rather than have them remain on the margins unlikely to engage with health care providers who are seen as having little to offer and thus being outside any possible positive health influences.

Radical solutions have a tendancy to prove their detractors wrong in the long run if given the chance.

Grant McNally

stimulant maintainance

This is a rather lengthy post, although I have tried to be as succinct as possible. First some history: I am a recovering methamphetamine addict of some ten odd years, in which time I have received every conventional treatment; from years of daily 12 step meetings, to multiple admissions for relatively lengthy inpatient treatment in a psychiatric rehab facility (Homewood in Ontario). I live in Victoria, just across the water from Vancouver, so my experience would presumably reflect that of many potential participants in the proposed stimulant maintainance program there. I have no professional qualifications in medicine or psychology, so the opinions expressed herein arise purely from my own experience and study over the past nine years. It has been my experience that most of the deleterious effects of stimulant addiction are due not to the physiological impact of the drug itself (amphetamines are relatively non-toxic, as long term theraputic use has shown). Instead, it is behavioural factors (primarily related to self care) that cause the extreme physical and psychological deterioration associated with the chronic use of drugs like methamphetamine. Most addicts don't eat, sleep, brush their teeth, or maintain other, usual standards of personal hygiene. As a result, many addicts succumb to secondary psychological and physiological effects resulting from chronic sleep deprivation, mal-nutrition, and a strong inhibition against seeking or allowing attention from doctors or other health care providers. Most methamphetamine addicts, particularly younger ones, become strongly enculturated in their lifestyle - creating huge barriers to treatment and recovery. I believe a properly administered maintainance program to be the best possible response to these issues as they stand today. Conventional treatment options have proven to be notoriously ineffective. This is not, in my opinion, due to any inherent flaw in methodology. I think that conventional, inpatient rehab could be effective if stays were sufficiently long. The usual 28 days that most facilities offer is completely inadequate. If these programs are to produce lasting results, a stay of six months to a year would be more reasonable. Unfortunately, not only would this be very expensive, the length of time in treatment would itself present a barrier in encouraging people to seek treatment. The only viable alternative that I can see is a maintainance program, probably extending over a period of several years, coupled with ongoing, intensive outpatient treatment that would have to address the problems of concurrent disorders, poverty, and an almost complete lack of life skills. Implementing such a program would present many challenges of course, but may be the only way that a significant number of addicts could ever get and stay clean. I sincerely hope that this option is explored in enough depth, over enough time, to generate some solid, clinical results. Unfortunately, I estimate the odds of the current administration allowing such a trial to take place to be next to zero. It looks like we are doomed to at least several more years of ineffective, 'prohibitively' expensive, and socially irresponsible American style approaches that any remotely objective observer could only conclude have been a disaster from almost every perspective...

Stimulant prescribing

There was a 12month trial in Liverpool ,UK, some years ago where dependent drug users were given the drug of their choice in whatever form was suitable such as ciggarettes laced with heroin or cocaine,tubes with heroin in for snorting,cociane amps, methedrine amps. The programme was a success .However,those opposing such tolerance used the anti-smoking trick to pull the programme.
In the 1960's in the UK prescribing methedrine and cocaine besides heroin and morphine was normal procedure.

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