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Europe: Scottish Labor Politician Fights for Harm Reduction as Party Turns Hard-Line on Drugs

On the eve of a major conference on new approaches to Scottish drug and alcohol policy Monday, outgoing Member of the Scottish Parliament (MSP) Susan Deacon, blasted her party's increasingly hard-line approach to drug policy, defended harm reduction approaches, and called drug prohibition "the product of a bygone age." The harsh critique of the Scottish Labor Party's disdain for methadone maintenance, push for abstention-based drug treatment, and enthusiasm for taking children from drug-using parents came in an opinion piece published in the Sunday Herald, "The Political Addiction to Tough Talking on Drugs Has Failed Us All."

https://stopthedrugwar.org/files/susandeacon.jpg
Susan Deacon
Deacon, the MSP for Edinburgh East and Musselburgh, is a member of the Scottish Royal Academy's RSA UK Commission on Illegal Drugs, Public Policy and Communities, which will issue a report in March. She is also a former Labor health minister who will retire after the next elections. And she is increasingly at odds with her bench-mates on drug policy. The party's recent moves toward abstinence-based "contracts" for addicts and away from previous support for methadone maintenance prompted Deacon to respond with vigor.

"The fact is," she wrote, "it's time to get real. The demonization of drugs and drugs users may make for rabble-rousing speeches and sensationalist headlines but it does little to promote understanding of what is really going on in our society, to help those whose lives are affected. Here in Scotland, we have seen too many knee-jerk responses and blanket solutions. Policy and practice should not be framed by immediate reactions to the latest tragic incident or research report. We need a pragmatic approach to drugs policy -- not a moralistic one."

The notion that methadone maintenance had failed was "nonsense," Deacon wrote. "What about the people for whom methadone has helped them to move away from criminal activity, to hold down a job or to look after their children?" Deacon called proposed moves to restrict treatment options "utterly perverse" and said the idea of taking children from drug-using parents was "paternalistic and simplistic."

But while she explicitly defended harm reduction as a policy approach to drug problems, Deacon also attacked drug prohibition. "UK drugs control laws are more than 30 years old, a product of a bygone age," she wrote. "A growing number of voices, both at home and abroad, are raising questions about whether the current national and international legal framework is fit for purpose -- this discussion cannot be a no-go area."

Oddly enough, Deacon's intra-party foe on drug policy, MSP Duncan McNeil called her critique "conservative." McNeil, who first proposed the idea of "contracts" for drug users, said of Deacon: "The harm reduction policy was well meant and necessary, but things move on. Susan has her views on this subject but she has become very conservative.
"The Labor Party has gone through an extensive consultation on this, but Susan didn't take part in the debate on it at conference."

While her own Labor Party was one target of Deacon's opinion piece, she also aimed to inoculate Monday's Scottish parliament's Futures Forum from more reflexive drug fighter chest-beating. The forum brought together more than 250 senior police officers, academics, community leaders, and health professionals seeking a "fresh perspective" on Scotland's approach to drugs and alcohol.

According to one account of the forum, Deacon may have found a more receptive audience there than within her own party. That account found leading police official and drug policy experts talking bluntly about the need to get beyond "macho posturing" and how the Misuse of Drugs Act was "not fit for contemporary purpose."

With endemic heroin and alcohol abuse, and now, the newfound popularity of cocaine, Scotland is in need of new approaches to drug policy. With politicians like Deacon fighting regressive tendencies in her own party and ongoing efforts like the Futures Forum and the RSA UK Commission on Drugs underway, Scottish politicians will have the knowledge base to act. Whether they will have the political will to apply that knowledge remains to be seen.

Addiction Treatment: Congress Allows Certified Physicians to Take On More Buprenorphine Patients

On December 8, Congress moved for the second time to increase the number of patients to whom a doctor can prescribe buprenorphine, an opiate agonist used to treat heroin dependence. Under an amendment to the Controlled Substances Act, certified physicians will be able to prescribe for up to 100 patients.

When Congress passed the Drug Addiction Treatment Act of 2000 allowing for the first time medical office-based opiate addiction treatment, it limited the number of patients who could be treated in any one practice to 30. Last year, Congress changed the cap to 30 patients per physician. To qualify for the new, 100-patient prescribing limit, doctors must have been certified to prescribe buprenorphine for at least one year.

"Of the estimated six million people in the United States who are dependent on opioids, many of them have been forced to wait for the medical treatment they so desperately need simply because of a mandated 30-patient 'cap' on how many people a doctor may treat," said Edwin A. Salsitz, MD, of Beth Israel Medical Center in New York City. "Enactment of the legislation will begin to address this inequity."

Salsitz was quoted in a press release from Reckitt Benckiser Pharmaceuticals, the company that manufactures Suboxone and Subutex, the formulations of buprenorphine approved for opiate dependency treatment by the Food and Drug Administration.

"This is the best-kept secret in opioid addiction and it shouldn't be," said Timothy Lepak, president of the Connecticut-based National Alliance of Advocates for Buprenorphine Treatment. "I'm puzzled that there's any limit whatsoever."

The amendment passed as part of the bill reauthorizing the Office of National Drug Control Policy (ONDCP), the drug czar's office.

Prescription Heroin Brings Ethical Dilemma

Localização: 
Vancouver, BC
Canada
Publication/Source: 
Inter Press Service News Agency
URL: 
http://www.ipsnews.net/news.asp?idnews=35648

Europe: Give Addicts Prescription Heroin, Says British Police Commander

Heroin addicts should be prescribed the drug through the National Health Service (NHS) to reduce crime, a senior British police officer told a conference of the Association of Chief Police Officers (ACPO) this week. The forthright advice came from Nottinghamshire Police Deputy Chief Constable Howard Roberts, who is vice-chairman of the ACPO drugs committee.

The remarks came as ACPO considers whether to seek changes in British drug policy and amidst news reports that some 150 heroin addicts are already receiving prescription diamorphine (heroin) from NHS. Roberts made clear he was expressing his personal opinion, not speaking for ACPO.

"We should actively consider prescribing diamorphine, pharmaceutical heroin, to those seriously addicted to heroin as part of a treatment program for addiction," he said in comments reported by ITV News. "My motives for making such a statement are frankly this: there is an undeniable link between addicted offenders and appalling levels of criminality, as heroin and crack cocaine addicts commit crime from burglary to robbery, to sometimes murder, to get the money to buy drugs to satisfy their addiction. The resulting misery to society is huge."

According to the Home Office, heroin addicts commit 432 crimes a year, Roberts noted. "Therefore the logic is clear, I suggest, that we take highly addicted offenders out of committing crime to feed their addiction, into closely supervised treatment programs that, as part of the program, can prescribe diamorphine," said Roberts.

Roberts' comments won the immediate support of the think tank DrugScope, whose chief executive, Martin Barnes, said: "We support calls for the extension of heroin prescribing, which for some problem drug users can be an extremely effective form of drug treatment. It can have immediate health benefits for the drug user and can for some be the best route to becoming drug-free. There is compelling evidence that heroin prescribing, although more expensive than some forms of drug treatment, is cost-effective in reducing drug-related crime and other costs to communities."

But there is no word yet on whether the British government or the ACPO will be as enthusiastic.

Police Chief Says Give Heroin to Addicts

Localização: 
United Kingdom
Publication/Source: 
ITV News
URL: 
http://www.itv.com/news/britain_03c584f22d6bf8d9fab067ee174c5a2f.html

Welcome to the New Drug Scare of 2007

Localização: 
United States
Publication/Source: 
Stats
URL: 
http://www.stats.org/stories/welcome_drug_2007_sept27_06.htm

Swiss Heroin Model Reporting Benefits

Localização: 
Publication/Source: 
Swiss Info
URL: 
http://www.swissinfo.org/eng/front/detail/Swiss_heroin_model_reporting_benefits.html?siteSect=105&sid=7032610&cKey=1157366472000

In Memoriam: Methadone Pioneer Vincent P. Dole

(This memorial piece for a great pioneer in addiction treatment was written and distributed by his friend and colleague, Dr. Robert Newman.)

Dr. Vincent Dole (an internist) and his late wife, Marie Nyswander, MD (a psychiatrist), began their collaborative research with methadone with a handful of long-term heroin-dependent individuals in 1964. They did so in the face of overt threats of harsh criminal and civil action by federal narcotics agents. Their courageous, pioneering work demonstrated that methadone maintenance is a medical treatment of unparalleled effectiveness -- a superlative description that is as applicable today as it was four decades ago. As a result, well over three-quarters of a million people throughout the world are able to lead healthy, productive, self-fulfilling lives - over 200,000 in the United States, an estimated 530,000 in Western Europe, and many tens of thousands more in Eastern Europe, Middle East, Central Asia, Far East, Australia and New Zealand.

After the remarkable transformation they observed in their first few patients, Dr. Dole and Dr. Nyswander went on to provide direct supervision of the first methadone maintenance treatment program at Beth Israel Medical Center in New York. In so doing they demonstrated that it was possible to replicate on a large scale the therapeutic success they achieved in the small, controlled, research environment of the Rockefeller Institute (now Rockefeller University). Dr. Dole was also responsible in the early 1970s for convincing the New York City Department of Corrections (at the time headed by Commissioner Ben Malcolm) that detoxification of heroin-dependent inmates in the city's main detention facility at Rikers Island was imperative to save lives and lessen suffering (there had been a wave of suicides at the time that had been attributed to severe opiate withdrawal). The detoxification program continues to this day, and has become a model for enlightened corrections officials in other countries.

Dr. Dole and Dr. Nyswander's contributions, however, transcend the life-saving clinical impact on patients and the enormous associated benefits to the community as a whole. They had prescience to hypothesize, years before the discovery of the morphine-like endorphine system in the human body, that addiction is a metabolic disorder, a disease, and one that can and must be treated like any other chronic illness. What was at the time brilliant insight on their part is today almost universally accepted by scientists and clinicians alike, and remains the foundation upon which all rational policies and practices in the field rest.

In his mid-80s Dr. Dole traveled to Hamburg to be present at the naming ceremony of the Marie Nyswander Street; in less than ten years Germany moved from methadone being illegal to having over 60,000 patients in treatment! His efforts during recent years were devoted to fighting the stigma that, tragically, remains so widespread against the illness of addiction, the patients and the treatment.

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