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However...drug-seeking behaviour precedes the advertisement of drugs, which is a relatively new phenomenon. I doubt a few ads are responsible for Americans consuming more than 80% of the world's opium supply.
What I have trouble reconciling are the demands from advocacy groups for access to more drugs when N. Americans are already over-drugged.
Money might be part of it. Would be interesting to see, as the American economy declines, if other countries will start to use more drugs as their wealth increases.
A real-life example: two people, both with back pain from degenerating discs in the spine (pretty much universal, if you're over 30). One person decides she doesn't like to take drugs. She finds out about physiotherapy and exercises you can do to strengthen the back, and is now doing fine without drugs, golfing, walking, and going on trips. She still has pain sometimes.
The other person: he goes to his dr, who prescribes high doses of Dilaudid. He is now almost completely debilitated, walking with a cane, and will probably be in a scooter within five years.
BTW, person #2 is younger than person #1. She got better care not because of her doctor, but because as a retired nurse, she doesn't trust the health care system implicitly. She took matters into her own hands to make sure her condition was treated properly.
The way our health care system is set up, it's much, much easier to get a script for Oxycontin than get physiotherapy for your back pain that will actually help resolve the problem rather than making you dependent on opioids to get through your day.
I know a woman who weighs +300 pounds. She was off work for many months due to severe debilitating back pain, as being obese puts an enormous strain on your back. Instead of working with her to see how she can take the weight off (she might be a good candidate for bariatric surgery, for instance), her doctor gives her Oxycontin 80 mg 3 times a day. She is a pretty young woman in her 30s who is heading straight for early retirement due to disability before she is 50.
It's not about blaming the victim. It's about using the resources of our health care system appropriately, actually treating people for their medical problems rather than just tranquillizing them.
If people are in severe pain and nothing can be done, by all means, give them whatever drugs they need. But in my experience, people are not given all the treatment options that could help them because giving them pills is easier and cheaper.
So, ok, so you see both sides, but the ones we ARE talking about here are the ones who have "unmet medical needs", and so lets just suppose they HAVE tried all avenues and their pain persists. Also, there are a lot of conditions that heroin can be used for besides pain, that bit of knowledge has been drummed right out of modern consciousness, thanks to the War on Drugs and the pharmaceutical corporation's efforts.
And for them, and for the cases where doctors have ALLREADY been prescribing morphine for a long time and the patient is "physically dependant" ["addicted" too, perhaps, or not], there is really no good reason to make life so utterly horrible in the context of prohibition.
We see the opiate addict doing well when they have their supply, and only being messed up without it. We see the cost of aquiring the drug is so high that crime is almost a rational decision... and "if society is going to insist on prohibition, then to heck with them" sentiments arise!!
So lets talk about these ones. I understand, there is a lot of physical therapies that are not fully utilised, and some people do take the "easy way" too readily - but that is best addressed in a situation where prohibition does not make it impossible to even discuss openly!! It is not comfortable to be saying "hey doc, I would like to try the physio, but I have started taking heroin recreationally before my accident, and so I need to know that I can get the help with my pains if I quit the dope"'.
Ok, not a great example, but the thing is that if we started seeing HEROIN AS MEDICINE, and got it out from under the War on Drugs, and prohibition, scenario, there would be a lot more room for getting that message out.
Also, who is to say that the Doctors get to be the one and only deciders as to what I can put into my body? Especially when those doctors are being led around by the pharma-Giants!! Of COURSE they don't want us using heroin, there is not much profit in that for the shareholders of Pharma-Giant stocks. [heroin cannot be patented, and it can be grown, so there is no monopoly, etc., possible - same with all "plant based medicines"]
Remember - we have the MU Opiod receptor built right into our nervous system. I could postulate that it's presence makes opiates the obvious choice over something like Vioxx. It is my inalienable right to make us of it, it is a human right because the MU Opiod receptor is part of my human makeup. What do you say to THAT idea? [am I stretching a bit now? lol]/
I thought that was a great example, actually
You bring up a good point; withdrawal can cause pain, and folks need to be helped with that in a non-judgemental way.
Wellll...pharmacologically speaking, the reason any drug works is because it interacts with our bodies in some way, be it receptors, or interfering with a process. And that's how poisons work, too. There really isn't any divide between natural and chemical; it's all chemical, really. Your body doesn't know if something came from a plant or a factory.
That said, I agree with empowering patients, telling them the truth about what's going on with them and not getting all paternalistic.
Well we certainly agree that having an authority telling us what is allowed in our bodies is not right... and it has not worked very well as far as addressing the drug problem in our society.
Perhaps it is time to bring up the question: Why do we have PROHIBITION?
When we look at why prohibition was started, we see that there was some "side issues" and coniving going on, and that tells us it was not all about "whats best for society".
More interesting - what forces are behind having prohibition continue? It gets a bit weird at this point, but the truth might be that illegal drugs createss the opportunity for "an alternate revenue stream" that is so wealthy that it cannot be ignored. More wealth than in LEGAL drugs perhaps, and ranking about THIRD in the world's richest "industries", behind only oil and weapons. See? - it cannot be ignored.
So, who gets to play with this money? What nefarious activites does it fund? Now it gets interesting... There is no small amount of evidence to show that the CIA is actively involved in the trafficing of heroin and other illegal drugs. They do this in order to help fund certain groups and activities. This "political tactic" was well establised by the French under deGaulle and Pompideau [I read a lot about it this summer]. The French Resistance, during and after the WW2, was funded with heroin trafficing, and the government of France's role was to secure both the routes and the refining labs. They were "paid back" by doing the dirty work such as assassinations and guerilla warfare [which was done by organised crime groups].
Now that you know this bit of history, it is not such a stretch to consider that the CIA is using heroin trafficing to get some "unsavoury jobs" done too. Vietnam was one such case, holding back the communist Chinese... heroin did a huge part of that job. South America is of great interest to the CIA now. Socialism or Communism is generally the target of these "heroin funded operations".
Anyhow, the CIA and USA foreign policy has become dependant on this revenue stream. No matter how much the War on Drugs is hurting America and Americans, they continue with it - prohibition is a key part of the fight against socialism.
It appears I may have painted myself into a corner - we agree that authority figures should not be telling us what we can or cannot put into our bodies, but prohibition is here to stay, so there is little that can be done. Well, perhaps getting the real story out will help!!
Sineed, you said above...
I'm not sure that that's the case , that there is only one such facility in the province. What place did you have in mind?
Hope you can provide research data [not some herbal claptrap] for that statement that alcohol withdrawal gets worse each time because bluntly, it's not even close to a medical fact.
Whoever thinks there's only ONE detox in all of Ontario-- you joking me? Where ARE you getting your information?
Here's the list JUST for Toronto:
Medical & Non-Medical Withdrawal Management Facilities
It's not even called "detox". Hasn't been called that for 20 years so if you used a search engine, try again.
I also don't get your idea that withdrawal for alcohol gets worse every time. It's not in any research I ever studied, working in the field or in college. It isn't even in my experience which is fairly extensive in the field.
What can occur from long term alcohol use is that tolerance levels can lower. Then again, most people's levels of tolerance for psychotropics tend to lessen as they age.
Withdrawal from ANY substance that has withdrawal symptoms [and there aren't that many] is based in length of use, amount of use, whether or not that use is intermittent or constant, physical capabilities at the time of withdrawal, actual physical dependence which varies from person to person, and whether or not medical intervention is available or suitable. Some very heavy users will not have *any* withdrawal at all. It's about personal tolerance.
Sineed: Your pharmacological understanding of substance use seems to be based in old fish tales, mishmashed misconstruction of medical data and anecdotal stories, not medical science.
Hi, oldgoat! There are plenty of rehabs in Ontario, but only one that is medically supervised, and it's part of CAMH. If you go into rehab elsewhere, and you experience a seizure, they'll rush you to the hospital, but they don't give you appropriate medical treatment at the rehab. Certain people need medically-supervised rehab, like people with heart problems and people with a history of serious withdrawal reactions. And they do withdraw people in hospitals sometimes, though often they don't bother, which is why they keep booze in the hospital pharmacies.
And it's unconscionable. Like I said, the reaction gets worse every time.
I can't seem to make the link function work anymore; anyhow, here's the article:
http://www.aafp.org/afp/20040315/1443.html
Granted, the whole "kindling" theory is controversial, but the observation that subsequent episodes of
alcohol WD worsen is documented. From the Journal of Neurological and Neurosurgical Psychiatry:
I suggest PubMed for medlit searches if you don't have access to university net
resources.
With regard to rehab, see my reply to oldgoat. I know it's hard to believe. Basically, alcohol WD is the
most dangerous WD and in some cases, it needs to be medically managed.
Treating the alcohol addiction is an entirely separate matter, and I think that's where the confusion is coming from.
What's up, TV Parkdale? Still p/oed at me because I corrected you about OPSEU?
Edited to add: what the heck is up with this sidescroll?
I just gave you a list of detoxes and you are still stuck on this fallacy. Ossington and St. Mikes are IN hospitals.
If someone is having a seizure from alcohol withdrawal in a medical facility they are given lorazepam [aka "Valium loaded"] not booze so wherever you are getting your information it is completely erroneous.
Do we need more detoxes? I'd say "yes" unequivocally.
But please don't use a fallacious argument to prove it.
And in fact, if someone is given a Valium load to withdraw from alcohol--the usually have NO symptoms of withdrawal at all.
First off I have no idea what you're on about with OPSEU. This debate is one, that is another.
I agree that hardcore alcohol use withdrawal needs some medical intervention because valium and alcohol are the two drugs that will cause seizure and death in withdrawal. Medical supervision does not necessarily mean having a doctor checking up every hour.
However, ia valium load is a simple enough proceedure. It can be done at a hospital emerg and the person can be sent to a non-medical facility. It's done every day because once valium loaded, the half life covers the period of time when the seizure can occur.
And as you said, that idea withdrawal gets worse is controversial. There's not enough evidence to prove it and in fact, the evidence in most research at CAMH does not support the theory.
The reason, I suspect that it is also controversial is because to do such a study the researcher cannot give the subject a valium load which is not only cruel, it is physically dangerous and deadly in some cases.
Sounds like a case of using the poor as lab rats, to me.
PS: I think the sidescroll crap is caused when a link is too long. Try just putting the words "MED STUDY" or whatever, then putting the link via the link button and see if it goes cyberpoof.
I didn't say the idea that alcohol WD gets worse is controversial; I say the "kindling" theory for why it gets worse is.
If CAMH doesn't support the idea of alcohol WD getting worse with subsequent WDs, why does it say it does in their publication, Management of Alcohol, Tobacco, and other drug problems: a physician's manual? (I have a copy in my office.)
I found out about the single medically-supervised rehab by calling DART, the Drug and Alcohol Registry Service, on behalf of a family member who is not in Toronto. And I was gobsmacked; I figured all the big cities had 'em.
BTW, I had a look at your links, and the ones you specifically mention, St Joe's and St. Mike's, aren't medically supervised. The St. Joe's one even specifically says so, and the St. Mike's one is affiliated with the hospital, but it's on Sherbourne St, not in St. Mike's.
I used to work in a medically supervised withdrawal unit, over at ARF on Russell St, before it got absorbed by CAMH and closed its inpatient unit. CAMH now offers its medical withdrawal service at the Queen St. site, with 24 hr nursing care.
I maintain the confusion here is over the "medical" part. Sure, there's all sorts of rehab (although we agree not enough), but what I'm talking about is the sort of thing I used to see: a genuine case of delirium tremens, where the patient got 260 mg of diazepam and was still shaky, or a guy who developed a heart arrhythmia from WD and the doctors ordered an intravenous heart drug. They didn't have to send him out to deal with this because he was already in a hospital, and that's what I'm talking about.
But most people don't need this level of care.
My knowledge of pharmacology is actually fairly extensive.
Wow, what a fascinating discussion... thanks. I just posted on RabbleTV about this topic.
http://www.rabble.ca/rabbletv/program-guide/2010/09/not-rex/not-rex-spen...