Monday , November 29 2021

Call for US to Tippollja of & # 39; Erojla prescription program: Shots



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F & # 39; many European countries and Canada, patients with opioid addiction on & # 39; long term are prescribed & # 39; heroin & # 39; pharmaceutical grade they inject into & # 39; clinics such as Medical Clinic in Patrida & # 39; Berlin. Some addiction specialists want to try similar programs in the United States.

Alliance & # 39; Print / Alliance & # 39; picture by & # 39; Getty Image


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Alliance & # 39; Print / Alliance & # 39; picture by & # 39; Getty Image

F & # 39; many European countries and Canada, patients with opioid addiction on & # 39; long term are prescribed & # 39; heroin & # 39; pharmaceutical grade they inject into & # 39; clinics such as Medical Clinic in Patrida & # 39; Berlin. Some addiction specialists want to try similar programs in the United States.

Alliance & # 39; Print / Alliance & # 39; picture by & # 39; Getty Image

The drug crisis & # 39; the US does not appear to throw & # 39 ;. Experience the nation & # 39; 47,000 outbreak & # 39; b deaths & # 39; overdose related & # 39; opioids in 2017. The increasing drive is a powerful and inexpensive synthetic such as fentanyl. Were widespread in the illicit supply & # 39; drugs, and f & # 39; & # 39 communities; response been trying range & # 39; intervention, a training & # 39; increasing naloxone to increase treatment resources.

But a new analysis by the policy think tank, the Rand Corporation, concludes it is time to process approach from outside the US: to offer pharmaceutical heroin – yes, heroin – as a form of & # 39; treatment for users a & # 39; long heroin unsuccessful with & # 39; other treatments. Already happening in & # 39; many European countries and Canada. But will challenge the culture, laws and practices in the U.S.

"These interventions are controversial," says the main author Beau Kilmer, who coordinates the center & # 39; research on drug policy & # 39; RAND. "There are some people who do not even want to have conversations about it. But because we b & # 39; opioid death near 50,000 and deaths & # 39; fentanyl near 30,000, it is important to have discussions on these interventions are based based on research and on the basis of experiences in & # 39; other countries. "

See how programs offering prescription heroin, or heroin-assisted treatment with (HAT), work. Patients typically get regular doses measured & # 39; & # 39 heroin; pharmaceutical grade – also known as diamorphine or diacetylmorphine – and inject under medical supervision close within a designated clinic. The idea is if people have a legal source & # 39; heroin, they are less likely to do overdose on a tainted street drugs, spend less time and energy to try to fix their re, and instead they can focus on the underlying drivers of their addiction.

"This is just another treatment that can & # 39; helps stabilize the lives", says Kilmer.

It is not meant for everyone. Drugs such as methadone, buprenorphine and naltrexone are very effective treatments that function b & # 39; different ways to deal with cravings and symptoms & # 39; withdrawal or blocking drug effects. But these treatments & # 39; the first line does not work for some users & # 39; opioids have been outdated. In the main study of Canada prescribed heroin, eligible patients had already tried to capture the average heroin & # 39; 11 times.

The heroin & # 39; prescribing a form of & # 39; a & # 39; maintenance therapy goes back to the beginning of & # 39; 1920 in the UK, and repeated in the nineties in & # 39; other parts of & # 39; Europe. (It was even something in the United States before the federal laws of widespread drug of the early 20th century).

The heroin assisted treatment is different from the concept of & # 39; sites & # 39; supervised consumption, where patients bring their own illicit drugs and then jinjettawhom while the medical staff is present, ready to respond in & # 39; & # 39 case; overdose. These are discussed increasingly in the United States as at least a dozen cities consider.

Kilmer says that prescribed heroin has been researched by & # 39; more rigorous methods. Several randomized controlled trials in Canada, the United Kingdom and the Netherlands found that people addicted to heroin benefited from the approach, according to the analysis of & # 39; RAND. Were more likely to remain in treatment compared with & # 39; those taking methadone, and were less likely to return to the use of & # 39; illicit heroin. Evidence also suggests that prescribed heroin can & # 39; to be more effective than methadone in reducing criminal activity and improve physical and mental health of patients.

For Dr. Chinazo Cunningham, addiction specialist in College & # 39; Medicine Albert Einstein and Montefiore Medical Center in the Bronx, alternative approaches are important, but she thinks it is more imperative in the United States to focus on what is consider the most pressing issue now. "We have a treatment that works, we just need to nipprovduh b & # 39; accessible way for people", says.

As it stands, the vast majority of & # 39; people who could benefit from treatments & # 39; The first line for disturbing the use of & # 39; opioids are not finding, problem even driving a black market for treatment.

"It's hard for me to imagine treatment with the help of & # 39; heroin because I think now talking about more mainstream treatment with methadone, buprenorphine and naltrexone people, there is already so much stigma around", says Cunningham.

As part of the review, conducted RAND groups & # 39; attention and interviews in & # 39; & # 39 many counties; New Hampshire and Ohio adversely affected by the crisis & # 39; overdose. The idea of ​​& # 39; prescribed heroin was new to many and was satisfied with & # 39; skepticism about its acceptability by health professionals, local leaders, and those who were being treated. The people worry that with heroin assisted treatment "allows the use of drugs" and faced community resistance.

And there is a huge legal hurdle. Heroin is strictly regulated Schedule 1 drug, which means that doctors can not provide for that. Is it legal for research on Schedule 1 drugs, but as seen in medical research on marijuana, is a difficult process that requires approvals from various government agencies including the DEA. M & # 39; no human trials ongoing for heroin, according to the National Institute on Drug Abuse. Still, the RAND report says the pilot program can & # 39; offer know if the results can translate abroad states.

The report says b & # 39; alternate way, communities can consider studying opioid Schedule 2, hydromorphone, used for pain and. there are fewer obstacles to set up a pilot program. Study f & # 39; Vancouver found that it was effective as prescribed heroin, and now at least seven & # 39; sites in Canada offer idromorfju injected patients.

Still, there seems to be some interest from & # 39; at least a few specialists & # 39; dependence in the United States. In New York, the colleague & # 39; Cunningham in College & # 39; Medicine Albert Einstein, Dr. Aaron Fox, says he is open to it. In fact, he is spending the early part of next year on the permit to study heroin prescribed in & # 39; other countries, with hopes & # 39; "figuring out how to do a pilot" back in -US

He says that jarahx as a silver bullet, but often not working as treatments for other diseases, either.

"People need additional options for something like cancer. If people fail to respond to treatment, there are other treatments", says Fox. "If people are not able to stop or reduce their use of heroin when they were recorded on the methadone or buprenorphine, we need other options for people."

What fuels seeing patients, as recent woman, that simply was not successful b & # 39; other treatments. He recalls that he must again & # 39; back to the program & # 39; methadone previously, but was struggling and was compensated. He did not want to stop.

"I will not say," I did my best, so ', when these other tools shown to be effective in & # 39; other countries, "he says. "Why not use that in the United States?"

Elana Gordon (@elana_gordon) Is a reporter & # 39; Knight Science Journalism health 2018-2019 Fellow at MIT.

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