free pipes/clean needles?

[sgt.null]

Crack pipe plan fights illness

The Ottawa Citizen
Aug 22-06
Handing out clean crack pipes seems to be having an effect in Ottawa. Drug users are switching from injecting to smoking, and smokers are sharing pipes less frequently. Switching to crack-smoking might not seem like good news, but it is, from a public-health perspective. There is a higher risk of transmission of disease from sharing needles than from sharing pipes. Pipe-sharing is still risky, though, because viruses can enter through cuts and blisters on the lips. That's why the city started handing out clean pipes with single-use mouthpieces. At the Int. AIDS Conference, an epidemiologist from the University of Ottawa presented the results of a study that showed the two trends: the switch from shooting up to smoking and the tendency to share pipes less often. Among those who shared pipes, more than a third said they shared every time they smoked at the start of the program. A year later, 13 per cent shared every time. Ottawa's outgoing police chief, Vince Bevan, opposed the clean-pipe program, arguing that it approves and enables illegal behaviour. In practice, it seems unlikely that clean pipes will have any immediate negative effect. If you were starving and you had before you a rotten apple and a fresh apple, you'd take the fresh one first. Similarly, an addict would choose a clean pipe. If there were no fresh apple, only a rotten one, you'd eat that. A person who wasn't hungry wouldn't eat either apple, and a person disinclined to do drugs won't choose to smoke crack because clean equipment is available.
Ottawa does, however, need more research into the habits and attitudes of drug users to learn whether the pipes are having unintended consequences. Opponents of harm reduction say it will remove the stigma that is one of the barriers to drug use. It's possible that will prove true over the long term. And we still don't know how many cases of HIV transmission the city's clean-pipe program has prevented. The fact that crack-smokers tend to have other HIV risk factors, including intravenous drug use, might make it difficult to study crack-smoking in isolation. The numbers so far do support the harm-reduction proponents. The debate isn't over, though, because opposition to harm reduction isn't about numbers. It isn't even about health. It's about principle. Harm reduction is an admission that it is difficult and perhaps impossible to eliminate drug use. Opponents fear that could evolve into societal acceptance of drug use. Harm reduction, though, is not only about reducing illness among drug users. It's also about reducing the harm drug users do to society's health. It's hard to find a moral principle that can compete with that practical imperative.

so do we fight crime or make it easier on addicts?

[duchess of malfi]

As someone who works in the health care field, I wish every city would hand out clean needles, etc. It is not to make it easy for drug addicts - it is to stop one of the biggest vectors of transmission of HIV and HepB.

[Avatar]

I agree with Duchess. I would have said no about the pipes until I read this, but yes to the needles. But if giving out the pipes means less people shooting up, well, that's good too.

But it's the clean needles that are really important. It's not like the person isn't going to shoot up with a dirty needle. He'll shoot up anyway. So you're not actually making anything worse.

--A

[sgt.null]

well lets take that to the logical conclusion and just buy their smack? the working poor have trouble getting proper meds but criminals get clean works? bad idea.

[Avatar]

Of course it's a bad idea. Far better to let them spread disease and maybe speed up their deaths huh?

(Anyway, you might recall that I'm in favour of government sponsored drugs for addicts. I have this crazy idea that if you make it unnecessary for people to commit crimes to get their drugs, then less crime might actually be committed.)

--A

[A Gunslinger]

I agree with Duchess. I would have said no about the pipes until I read this, but yes to the needles. But if giving out the pipes means less people shooting up, well, that's good too.

But it's the clean needles that are really important. It's not like the person isn't going to shoot up with a dirty needle. He'll shoot up anyway. So you're not actually making anything worse.

--A

I would only be in favor of this if the government also required that the user of the clean needle or pip would agree to recieve government-sponsored treatment for the addiction. Yes, the short term danger of needle infection is avoided, but also the long term issue of the addiction (the real drain on a society's resources) is addressed.

[Avatar]

Thing is, the addiction doesn't have to be a drain on society's resources.

--A

[A Gunslinger]

Thing is, the addiction doesn't have to be a drain on society's resources.

--A

How? Eventually an addict will need long term care, as will everyone as they age, However, the addict is unlikely to have been able to create any kind of resource base with which to take care of him or herself when the need kicks in.

[Fist and Faith]

I've never so much as had a puff of marijuana, or the slightest interest in it. But the day they start handing out free needles and heroin, I'm shooting up. I can't wait! I'll sleep on the sidewalk the night before like for Star Wars tickets!

OK, I guess it's not as clear-cut as that. Though I'm not one of them, I'm sure there are people who don't do drugs only because they're illegal. Maybe others because they're scared of dirty needles.

I see the wisdom of making it easy to get clean needles. Mind you, I don't like the fact that I'd be paying for it! But I guess I'm paying for health issues when they share needles.

Of course, it would be a HUGE boon to our economy, and do away with many crimes, if drugs were legal - and taxable.

But there's still something wrong. I envision a sci-fi story, set in the near future, where the population is healthy, safe, and drug-addicted. I don't think we can stop drug use. Humans have always used something or other. Hell, I saw a nature show where elephants and other animals were eating fermented fruit, and staggering around! Yeah, it was a hilarious as you're imagining!

There's lots of Av's in the world. Some people can use something on occasion, have a fun trip, and that's it. But the number of people who can't stop there, and end up dead from an overdose, is legion. If fear keeps some of them from ever trying it, I'm not sure it's the worst thing.

I simply don't know. Both sides have validity.

[Cail]

I would only be in favor of this if the government also required that the user of the clean needle or pip would agree to recieve government-sponsored treatment for the addiction. Yes, the short term danger of needle infection is avoided, but also the long term issue of the addiction (the real drain on a society's resources) is addressed.

Agreed.

[duchess of malfi]

I would only be in favor of this if the government also required that the user of the clean needle or pip would agree to recieve government-sponsored treatment for the addiction. Yes, the short term danger of needle infection is avoided, but also the long term issue of the addiction (the real drain on a society's resources) is addressed.

Agreed.

As a taxpayer I would much rather pay for free needles and addiction treatments than to pay for the much higher costs of paying for someone's hospital care as they lie dying from hepatitus or AIDS. Not to mention the sheer risk to paramedics, nurses, doctors, and other front line patient care personnel to get exposed to these blood bourne diseases when these folks are hospitalized from getting needle sticks, bites, etc. We had a psych patient who was a homeless drug addict with AIDS go nuts and bite a bunch of nurses one night. At least if this guy had access to free needles, and used them, he might not have had AIDS, and he might not have exposed all of those nurses to it, either. He might have still been a crazy drug addict, but at least he (and his nurses) might have been spared that part of things.

[Prebe]

Harm reduction, though, is not only about reducing illness among drug users. It's also about reducing the harm drug users do to society's health. It's hard to find a moral principle that can compete with that practical imperative.

I really like that line

If fear keeps some of them from ever trying it, I'm not sure it's the worst thing.

I can certainly see the principle, but I'm also sure there's always going to be a clean needle or pipe out there for the first hit.

[sindatur]

Giving someone a free needle everyday, is gonna cost what, $150.00 a month for the needles plus the administration costs. Paying for someone's HIV medications is $2000 a month, plus Dr visitis, plus xrays, plus blood work. The needles are certainly much less expensive if they prevent someone from catching HIV.

If it makes it easier to for them to kill themselves with the drugs, well then, you won't have the expense of supporting them.

Of course I would like to see some (At least attempts at) rehabilitation involved, but, that would have to be handled with kid gloves, as people would turn away from the program if you were heavy handed in demanding the rehab.

[A Gunslinger]

Giving someone a free needle everyday, is gonna cost what, $150.00 a month for the needles plus the administration costs. Paying for someone's HIV medications is $2000 a month, plus Dr visitis, plus xrays, plus blood work. The needles are certainly much less expensive if they prevent someone from catching HIV.

If it makes it easier to for them to kill themselves with the drugs, well then, you won't have the expense of supporting them.

Of course I would like to see some (At least attempts at) rehabilitation involved, but, that would have to be handled with kid gloves, as people would turn away from the program if you were heavy handed in demanding the rehab.

I'll leave it to the pros. Now gimmie that deck...I'm shakin'!

[sgt.null]

i have seen the light. thank you. but lets be fair. lots of junkies are getting sick from bad dope. plastic fever. so let's buy them better dope.

and since you don't want me to be a burden, pm for my address where you can send money to me so I can buy some good dope.

let's not encourage people to work and contribute.

lock up addicts.

[Avatar]

Thing is, the addiction doesn't have to be a drain on society's resources.

--A

How? Eventually an addict will need long term care, as will everyone as they age, However, the addict is unlikely to have been able to create any kind of resource base with which to take care of him or herself when the need kicks in.

True. I suppose that part of my point of view comes from the fact that in SA, if you haven't made provision for your old age, you're screwed. The government doesn't help you.

Regardless though, I think that by controlling, (not legalising it mind you, just controlling) hard drugs, much of the harm to cosiety will already be reduced.

I think that by far the majority of harm to society as it were comes from the very fact that drugs are illegal. It makes users criminals by definition. And it is to crime that they turn once other options are exhausted.

Do you think a junky want to go out and hustle and steal and cheat for his fix? Hell no. So why force him to?

If the government registered addicts, and provided them with their requirements, say in exchange for community labour, (which would give back to the state, you'd make a big dent in drug-related crime pretty quickly.

I totally agree though that addiction treatment should be available. But health-care is going to be a minor issue only. Junkies don't usually linger...they get clean or die. Provide the heroin, and if they want to stop, provide treatment.

Like Sin says, (Nice to see you again btw Sin), if having easy access means they die faster, well, that's less time you have to provide for.

Fist is right. We'll never stop it, which means that we're wasting time and money and effort to patch holes in the dyke where new holes appear all the time.

As for the number of people who can't stop...well, there are a lot of them. But it's actually a very small number in comparison to the people who can. Only some 1% of people who smoke marjuana become heroin addicts.

Effectively, it's only a small proportion of the population. And really, when it gets right down to it, who am I to stand in their way if they want to kill themselves? At least my way will reduce the anguish all round I think. (I'd add in dorms and a cigarette allowance to the community work thing.)

Many, perhaps most, of the problems associated with addiction are a direct result of its illegal status. You can't stop it. you might as well exert some control over its direction. Gods know that the other way hasn't worked so far. Maybe its time for a change?

(And for Gunslingers benefit, (since he's been absent so long), I'll mention that several experiments, most notably the Swiss Experiement, bear out my reasoning. If you search the 'Tank for the term, you'll find links etc. from when we discussed it before.)

--A

[sgt.null]

you can stop most of it. just crack down on it. stop coddling and start punishing. don't let any of them think its ok to be an addict. we are now geared to excusing the addict's behaviour. hard labor will change many.

[Avatar]

Oh please Sgt. How are you going to crack down on it more? Do you think doubling the amount of money spent on the useless war on drugs will help?

Do you think people will stop doing drugs because of harsh penalties? Harsh penalties haven't stopped them. The death penalty in some countries hasn't stopped them.

--A

[PannionDude]

"Do you think people will stop doing drugs because of harsh penalties? Harsh penalties haven't stopped them. The death penalty in some countries hasn't stopped them. "

Clearly the death penalty stopped those it was applied to...heh, unfair but I couldn't resist. I think Dilbert once pointed out that the idea that killing practitioners of a behavior doesn't reduce its occurence is absurd.

Drug abuse is illegal primarily because the behavior of drug addicts tends towards other crimes. One solution I like (stolen from a sci-fi book somewhere) would be to make available drugs, but include a microscopic device (I know, I know, future tech...sigh) that notified the gov as to your location in them. Thus, gov issued drugs would be cheaper than real ones, and it would be unfeasible to commit crimes while enjoying their effects. Further, the gov could work with the addicts on getting them unaddicated.

Funny solutions aside, I like Sgtnull's approach to the problem. We must continue to enforce the laws that we create. To do otherwise is contrary to our democracy. If the people come to believe that the War on Drugs is useless, let them say so by their votes. If a substantial amount of the populace agrees that dope should be legal, let them find a leader and strive to elect him or her.

[Avatar]

Haha, I should have said that the prospect of being executed does not prevent people from using drugs in countries where their use is punishable by death.

Crimes on the whole are not committed while enjoying the effects of drugs though, they are committed in order to enable people to enjoy those effects.

As for continuing to enforce the laws that we create, it simply seems pointless to expend vast quanitites of time, money and manpower for what is demonstrably no tangible result.

Do you believe that the war on drugs is effective?

--A