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Letters: Why enable? An answer

By providing addicts a place to shoot up, staff nurses can intervene in hundreds of overdoses and provide other medical treatments.
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Editor, The News:

I firmly agree with Larry Campbell’s statement that “crime rates drop and addicts become more stable when [they receive] heroin from a doctor instead of a dealer or pimp” (Campbell, Boyd, & Culbert, 2009, p. 127).

Dr. Martin Schechter of the University of British Columbia, provided Vancouver addicts with the first opportunity to receive medical-grade heroin administered by a doctor after he brought NAOMI (North American Opiate Medication Initiative) to life. He demonstrated that once people were stabilized by these treatments, they were “very orderly” (Campbell et al., 2009, p. 229).

However, the positive results were not publicized until after the controversial topic was met with great complaint.

To begin, I disagree with most skeptics who saw NAOMI as the next progression in a series of wacky harm reduction ideas (giving addicts needles, giving them a place to shoot up, and now providing them with dope for free).

What critics did not realize was that Vancouver’s needle exchange program helps prevent the transmission of blood borne diseases, such as HIV and Hepatitis C, and also benefits the communities in which they operate, by keeping discarded, used syringes off the streets.

By providing addicts with a place to shoot up, such as Insite, means that staff nurses can intervene in hundreds of overdoses and provide other medical treatments.

Furthermore, clients can be referred to addiction counseling, hospitals, housing, and other services.

NAOMI allowed addicts access to a safe environment where they could receive untainted heroin and the staff had control, knowing exactly what doctors were injecting into addicts.

NAOMI, along with the other services Vancouver was providing addicts, resulted in them becoming more stable, physically and mentally.

I concur with Schechter’s NAOMI project, the study of whether giving heroin to entrenched drug users would be more effective than providing them with methadone, and that doing so improved both the psychological and social functioning of addicts and reduced their involvement in crime.

An analysis of those accepted into the study revealed that, on average, they had been injecting drugs for 16.5 years and all used heroin nearly every day, commonly supplementing it by smoking crack cocaine.

The participants had severe health and social problems, including precarious housing arrangements and dealt with regular unemployment.

During the staggered 12-month testing periods, “115 people were given medical-grade heroin, a control group of 111 received oral methadone, and 25 subjects received injectable Dilaudid, a pharmaceutical grade potent painkiller” (Campbell et al., 2009, p. 228).

During the time of their initial involvement, “participants spent a median of 15 days involved in illegal activities out of the prior 30 days and spent a median of $1,500 on acquiring drugs in the same-time period” (ibid, p. 228).

A hotline was established to log complaints from the neighborhood, wherein many of the residents were concerned that the NAOMI clinic would create more street disorder. However, not a single call was received.

Finally, the NAOMI Trial results were published in the New England Journal of Medicine and showed “participants treated with diacetylmorphine reported improved physical and mental health, were 62 per cent more likely to remain in addiction treatment and 40 per cent less likely to take illegal drugs and commit crimes to support their habit than were those treated with methadone”. After a year, “88 per cent of those treated with diacetylmorphine remained in treatment, compared with 54 per cent in the methadone group” (Oviedo-Joekes, Nosyk, Brissette, Chettiar, Schneeberger, Marsh, Anis, & Schechter, 2008).

Data from NAOMI and other long-term studies with medically prescribed heroin showed that many of the patients of these studies also transition from injection to oral treatments, detox programs and abstinence.

Therefore, Larry Campbell’s statements that “crime rates drop and addicts become more stable when [addicts] get heroin from a doctor instead of a dealer or pimp” as well as Schechter’s expectations were both proven correct (ibid, p. 127).

There’s no arguing NAOMI, the distribution of medical-grade heroin from a doctor to an addict resulted in addicts’ involvement in crime to decrease and improved their mental and physical states.

I think it would be incredibly fascinating and valuable to the public, for some the addicts who went through the NAOMI project and then a detox program, to hear how the experience improved their quality of life.

Jane Hanson, 16

Maple Ridge

 

Editor’s note: The above was submitted, with permission, by Dale Hardy, a Social Justice 12 teacher for Adult Education in Maple Ridge.