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Big Guy

Treat Addiction as a Disease

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You may be correct but the cost of opiates could triple and the addicts would still pay it. I do not believe that it is a disincentive. If the cost goes up, the addict will steal more to satisfy that habit or increase the number of Johns that they service daily.

Might as well make cigarets 50 cents a pack again then. Anyway, I thought you were talking about functioning addicts, not thieves and hookers. I don't consider them functioning addicts.

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The problem is addiction, not legalization or decriminalization. That is a different issue. What about the social stigma of smoking and alcoholism? They are both legal.

Actually the problem for the worst off, hardest to help, and the most visible addicts that piss the usual suspects off the most, are the homeless ones. Housing has been identified as the single most important first step towards helping these people. They can't be reached by case workers, or get a job without an address, they can't get their shit together without a place to put it. They can't be warm, dry, feel safe, get some privacy, they can't eat properly clean themselves properly or maintain any semblance of normality. Without these things every problem they and service providers have is compounded.

I submit however that the before that can happen we need to squelch out the loudest, most hard-boiled moralizers who seem to think that providing housing, welfare/GMI/Basic income etc as an even worst social ill than doing drugs.

We all know who these people are and if there is anyone who needs to be stigmatized into vanishing from society it's them.

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Actually the problem for the worst off, hardest to help, and the most visible addicts that piss the usual suspects off the most, are the homeless ones. Housing has been identified as the single most important first step towards helping these people. They can't be reached by case workers, or get a job without an address, they can't get their shit together without a place to put it. They can't be warm, dry, feel safe, get some privacy, they can't eat properly clean themselves properly or maintain any semblance of normality. Without these things every problem they and service providers have is compounded.

I don't disagree with that.

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Stigmatizing hard-boiled moralizers.

It's gotten so bad they've even managed to stigmatize people who want to help addicts into silence.

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Why do you think you know this? Addiction by its nature leads people to deny they have a problem. The biggest barrier to seeking treatment are addicts who believe they are 'in control'. That is one of the reasons why getting addicts to admit they are addicts is the first step to recovery.

Iv read about places that have forward thinking policy.

People are way more likely to get help for something treated by society as a medical problem as opposed to a stigmatized moral problem. Treatment along these lines is also a lot more likely to be effective.

And most people with serious addiction problems have admitted they are addicts dozens or hundreds of times. In the case of alcohol or opioids they often have physically different brains, and will power is not going to change that.

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Stigmatizing hard-boiled moralizers.

It's gotten so bad they've even managed to stigmatize people who want to help addicts into silence.

I'll leave the blame game to you.

Providing housing is certainly a part of it and people need a base if they are going to improve their lives, but unless they are prepared to start dealing with the issues that put them on the street in the first place, you are just providing housing to addicts who will just make it more difficult for those who are trying to get clean and move on. I don't think housing should be a right or unconditional but it needs to be available for people who really want to get out of the hole they have found themselves in. I don't pretend to know how you go about that.

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I don't think we need to think this through from scratch. I would implement the same policies that countries like Portugal have tried, and see if we can build on those successes.

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"Opioid maintenance treatment of opiate addiction, including methadone maintenance, has been found to be effective in curtailing drug use, reducing crime, enhancing social productivity, and preventing both overdose deaths and the spread of infectious diseases, including HIV."

These treatments are for withdrawal management and are only useful in conjunction with a real treatment program. Such treatments cannot help addicts who are not willing to admit they have a problem or are not willing to limit their use to quantities provided by doctors.

IOW - the paper you linked has no relation to the "solution" you advocate.

You have jumped on a band wagon based on a study without understanding what the study really says.

Edited by TimG

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People are way more likely to get help for something treated by society as a medical problem as opposed to a stigmatized moral problem. Treatment along these lines is also a lot more likely to be effective.

As someone who has had family members deal with addiction I can assure that everyone involved in Canada today sees it as medical problem from the doctors to employers to social workers. The real issue is denial on the part of the addict.

And most people with serious addiction problems have admitted they are addicts dozens or hundreds of times.

Saying the words because people expect you to say them is different from admitting them. The fact that most addicts have no problems saying the words today is evidence that your 'stigma' argument is nonsense.

Addicts will get help when they 'reach bottom' - i.e. the chaos caused by their addiction has gotten to the point where they cannot continue. Getting an addict to reach bottom sometimes requires loved ones to refuse to help anymore but if the state steps in and picks up the pieces the addict could continue on in denial. This means that sometimes the state must also refuse to help addicts.

It is a complex problem and it is difficult to know when it is best to refuse help and when help should be extended but at different times both approaches are the most appropriate action for an individual addict.

Edited by TimG

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As someone who has had family members deal with addiction I can assure that everyone involved in Canada today sees it as medical problem from the doctors to employers to social workers. The real issue is denial on the part of the addict.

That's simply not true. Doctors are only just starting to treat this as a medical problem, and some of the most effective treatments have not even been approved in Canada. Doctors almost never even order the diagnostic tests that determine what type of addict a person is. Many of them don't even know about modern treatment options.

The most common thing doctors do is refer patients to councilors and groups like AA. But without the accompanying medical treatment these referrals don't help very many people at all.

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That's simply not true.

Based on what evidence?

The most common thing doctors do is refer patients to councilors and groups like AA. But without the accompanying medical treatment these referrals don't help very many people at all.

The first priority has to be these kinds of treatments because without them any medical interventions are futile because the addict won't follow instructions. Edited by TimG

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You can advocate for what is currently being done with the issue of drug addiction as acceptable.

You can advocate for change, I have given a example of a different approach.

You can suggest another approach - one that is not being used nor one that I suggested.

Which are you doing?

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Personally, I think that if you made all drugs legal but accessible only through a prescription, and then had all addicts register, (no register - no prescription) and then provided those drugs in a clinical environment using trained healthcare professionals, the entire problem would go away within a generation.

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You can suggest another approach - one that is not being used nor one that I suggested.

I don't agree with your premise that what we are doing is not effective. We are doing the best we can with a difficult problem and no treatment is 100% effective. As I said before your argument is like arguing that cancer treatments are failing because people still get cancer. As with cancer, not all treatments work for every patient so we should look for new approaches to supplement what we are already doing but you have not established that there is a big problem with the treatments we have today. Edited by TimG

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Based on what evidence?

The first priority has to be these kinds of treatments because without them any medical interventions are futile because the addict won't follow instructions.

No the first priority in terms of medical treatment should be diagnostics, and identifying genetic and brain chemistry components. Until you understand those you don't know what treatment will work. You're describing the current approach which almost never works, which is why there's discussion on treating addiction as a disease.

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I don't agree with your premise that what we are doing is not effective. We are doing the best we can with a difficult problem and no treatment is 100% effective. As I said before your argument is like arguing that cancer treatments are failing because people still get cancer. As with cancer, not all treatments work for every patient so we should look for new approaches to supplement what we are already doing but you have not established that there is a big problem with the treatments we have today.

The problem with the current treatments is that incorporating medical treatments is a lot more effective. A person can have a predisposition to addiction because of underlying sociological issues or conditions in their lives, or they can have that predisposition because they have different genetics and brain chemistry.

Medical treatments can produce much better results for people in those former groups than counseling or self-help programs. But doctors rarely prescribe them. Opioid Antagonist Therapy should be used in such patients, but until we start doing basic medicine we don't know when they should be prescribed.

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Opioid Antagonist Therapy should be used in such patients, but until we start doing basic medicine we don't know when they should be prescribed.

http://archives.drugabuse.gov/meetings/Naltrexone.html

Naltrexone has very few and minor side effects. It is the treatment of choice in highly motivated patients, especially physicians, nurses, pharmacists and attorneys (O'Brien). However, clinical experience using naltrexone for treating opiate addiction has been replete with data on the poor medication compliance. Ling reported a 6% retention for 60 days and 2% retention for 9 months in 276 methadone maintained patients who expressed some interest in trying naltrexone treatment.

As I said above: medical interventions are useless without the therapy because addicts in denial don't follow doctor's orders.

Once a patient has agreed to enter a comprehensive treatment program these drugs can be helpful but not before.

Edited by TimG

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Then why is there an illegal trade of Oxycontin? It *is* legal after all. Or are you suggesting that we should stop requiring prescriptions to access drugs and let people by as much as they want of any drug they want?

Legalize and regulate like alcohol.

Drug crime ... gone.

.

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How do you explain illegal cigarettes, a multi billion dollar industry......

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Legalize and regulate like alcohol.

Drug crime ... gone.

You do realize that alcohol is the cause of more crime than drugs largely because it is legal?

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You do realize that alcohol is the cause of more crime than drugs largely because it is legal?

Put organized crime out of the drug business.

.

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You do realize that alcohol is the cause of more crime than drugs largely because it is legal?

Are you suggesting that the solution then is to make alcohol illegal?

Did we not already try that and fail?

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