Now is the time at SDA when we juxtapose!
Regina Leader Post, Feb.24 – Of the nearly 3.9 million needles distributed last fiscal year, about 3.5 million were returned for exchanges.
CBC, March 19 – New infections with HIV, the virus that causes AIDS, were detected in 174 people in Saskatchewan in 2008 […] a 40 per cent increase over the 124 new cases detected in 2007
Note: Saskatchewan’s population was estimated in 2008 at 1,020,847
More – “Multiperson use of syringes among injection drug users in a needle exchange program : A gene-based molecular epidemiologic analysis”
Syringe-sharing behaviors among injection drug users (IDUs) are typically based on self-reports and subject to socially desirable responding. We used 3 short tandem repeat (STR) genetic biomarkers to detect sharing in 2512 syringes exchanged by 315 IDUs in the Baltimore needle exchange program (NEP; 738 person-visits). Demographic characteristics as well as direct and indirect needle-sharing behaviors corresponding to the closest AIDS Link to Intravenous Experience (ALIVE) study visits were examined for association with multiperson use (MPU) of syringes. Overall, 56% of the syringes exchanged at the Baltimore NEP had evidence of MPU. Less MPU of syringes (48% vs. 71%; P < 0.0001) was seen with more rapid syringe turnaround (<3 days). IDUs always exchanging their own syringes ("primary" syringes) were less likely to return syringes with evidence of MPU (52%) than those who exchanged syringes for others ("secondary" syringes; 64%; P = 0.0001) and those exchanging primary and secondary syringes (58%; P = 0.004).
Via readers Loki and Langmann (check out their comments in this thread) including this;
Another phenomenon I witnessed in Vancouver was people deliberately infecting themselves with HIV in order to be able to collect welfare for life. If someone is able-bodied and collecting welfare, they are urged to get work. OTOH, if someone is HIV+ then they are assumed to be incapable of working (something my population of gainfully employed HIV+ patients would vehemently disagree with). Becoming HIV+ was a quick and dirty way of getting the welfare office off ones back and opening the door to all sorts of additional support.”
If you build it, they will come.
As an ex practicing Alcoholic/Addict clean and sober for 17 years now by the grace of God. My view is that until an addict or alcoholic hits a bottom that for them is hard enough to make them want to get clean and sober nothing will change for them.
So it is in their best interests for this bottom to hit as fast and as hard as possible. Enabling someone to continue to self destruct using drugs and or alcohol by the use of needle exchanges, welfare, food banks, free medication, giving the drug social acceptance is the worst thing you can do for the addicted. Cut them off, make them suffer, make using drugs hell, and then offer them an alternative, abstinence.
Then spend lots of money on treatment facilities and detox facilities. The waiting lists are way to long.
langman, thanks for bringing up the concept of doctors prescribing heroin (which gets brought up periodically). Like you, I have absolutely no interest in prescribing heroin for recreational use. This POV might be harder to justify now given that the PDE5 inhibitors we prescribe are purely for recreational use;-)
What is needed is a completely separate system for recreational drugs that doesn’t involve physicians except in cases of people who have managed to get themselves addicted and want to get off a particular drug. Being a libertarian I’d like this system to be totally private and self-organizing, but also being a realist I know that the amount of money psychoactive drug sales would generate would bring in organized crime and government. It’s hard to decide which is worse; the lieberals or Hells Angels in charge, but if currently illegal psychoactive drugs are decriminalized they will likely be sold through government regulated outlets with the government taking a significant cut of the profits.
By making the user of a drug completely responsible for making the decision to purchase a drug and determining how much they would use over a given time period, if there are any adverse consequences they have only themselves to blame. Presumably changes to legislation would be required so that drug suppliers are immune from lawsuits. Also, people should not be allowed to use the defence that their judgement was impaired by a drug — they could have prevented the whole incident by not taking the drug.
“No-one” obviously doesn’t have much experience with HIV infected individuals as I had one patient in my practice who I know deliberately became infected and several others for whom the evidence is less clear cut. In the case of the person I’m sure about, his girlfriend was HIV+ and assured of welfare for life. He kept coming in with form after form to justify being on welfare and his girlfriend (also a patient of mine) asked me if his becoming HIV+ would make things easier for them. I recall saying this would be a stupid thing to do and the next time I saw him he had generalized lymphadenopathy and a blood test confirmed his HIV positivity. He was also the happiest I’d ever seen him. Both members of this east Hastings couple are dead now but at least they died knowing they would never ever have to look for work while they lived in BC.
The one good thing about HIV in heroin users is that it progresses much more rapidly than in non-opiate users and it wasn’t long before all of the HIV infected junkie patients in my practice were dead (usually within a year). In contrast, my population of HIV+ homosexual patients were ridiculously healthy, employed and complaining about having to see me every 3 months for their antiretroviral prescription renewals as they had to take time off work to see me. Their concern was that young homosexual men who hadn’t lived through the 1980’s in Vancouver were becoming too blase about HIV thinking it was just another chronic disease like herpes. I’ve had these patients tell me of cases where a man who was HIV negative but dating someone who was HIV+ deliberately became infected. Hopefully not a very widespread practice.
You take Sally, I’ll take Sue
There ain’t no difference between the two
Cocaine, running all around my brain
http://www.youtube.com/watch?v=cXo8ngG2-Og
Me thinks I have learned more on this subject from this thread than anything I have seen in the MSM the last few years.
The dumbing-down must be intentional.
@ loki,
I have yet to meet anyone addicted to viagra such that he felt it was necessary to steal the change accidently dropped on the floor of my car, but yeah I hear you đ
I don’t know “No-One”‘s background, but I have been exacerbated on multiple occasions by the idiotic actions of patients, and as they say, I am still young.
I am a strong libertarian as well, but I am not entirely convinced libertarianism can work with all addictions, just like I don’t think it works well with psychosis. As we have from seen some of the disasters caused by our more litigious libertarian brothers in the U.S. inflicted on the apparent behalf of a psychotic patient. I think libertarianism requires, as JS Mill originally stated, a sound mind. It is difficult, to draw a solid line as addiction is really a broad spectrum from otherwise high functioning people to those who are completely irrational.
I mean take for example the small but significant number of people coming off of cocaine who experience severe depression and psychosis.
Though I do suppose that you could say ultimately they had a choice knowing the risks before hand, much like someone who likes to engage in sports risks etc.
Yet another consequence of Steve Harper’s invasive, big government, nagging nannystate approach to social problems. When are you cons gonna start practicing what you preach?
Posted by: other idea>>
âWhat would be the best way in your guys opinion to reduce the risk to non-drug usersâ.
What about banning or registering the sale of needles? Possibly the need for a prescription to get them i.e. diabetics ectâŚâŚâŚâŚPeople registered could have a exchange for free ânewâ needles program and would pay heavy taxâs for needles without trade in.
Nothing will stop addicts from getting access to their demons, but prohibited needles and costs may steer them onto something else leaving playgrounds safer.
I honestly canât see any sense in providing users with alternate means of f*ucking themselves up on the tax payers dime. When you provide paraphernalia to drug users you sanction their use (in their minds) and you free up extra money even if a little for more drugs.
The answer in my mind (if there ever will be one) lays in the community and the behavioral acceptance of the young. The roots lay in greed and liberal attitudes, the proof of their failures began in the 60âs with the hippies and once safe communities suffer their delusional ideologies today in epidemic proportions.
Posted by: Alan at March 24, 2009 10:46 PM >>
Well said, it only makes sense!!!!
Clearly enabling and assisting with self destructive behavior is not the solution.
I wonder why no one is talking about Gunny99âs suggestion. I confess to ignorance on the topic, but it seems to me that the idea of rehabilitative custody has some attraction. It also fits in with Alanâs suggestion that enabling the self destructive behavior will not help; whereas cutting them off from the enablers might.
I suspect that people will bleet about the loss of liberty and personal freedom this would entail. They might even suggest that this would be the beginning of a slippery slope to socialism where someone from the government decides what is best for you and deprives you of your right to shoot up responsibly, then to smoke pot responsibly, then to drink responsibly etc. But wouldnât it be open to argue that the addict had broken their social contract with the rest of us and that as a result we were entitled to resort to the remedial provisions implied in the social contract â the right of the society to require adherence to certain standards of behavior. And arenât we modifying their freedoms by giving them needles and the like and making them have to ask for them or buy them from a local intermediary?
This is very dangerous political/philosophical ground but does that mean we should shy away from it?
I think not â on the whole I wonder what would happen if Gunny99âs and Alanâs suggestions were explored. I for one think it would work in at least some circumstances. Just so we don’t think I am suggesting incarceration, I think there would have to be other programs too.
PS: The extreme totalitarian solution (not advocated by myself of course) would be to flood the market with undetectable poisoned heroin.
The either die or abstain from heroin solution becomes final and quick.
loki:
I work in the social servie field. I have experience working directly with HIV clients and persons with disabilities.
Although I am a conservative, I prefer to be humane and not call human beings who use herion “junkies” not that I judge you for it – I was guilty of this myself in the past.
As I said, the numbers of ppl contracting HIV on purpose is miniscule. I am sorry to hear you had one patient who stated they were trying to get HIV so they could get social assistance. Are you sure this person did not have a mental illness or perhaps they did not want to live without their partner and/or wanted to end their life? Addiction (Substance Abuse-misuse) drives many to hopelessness and suicide.
In my experience, I have not had a client express relief that they have HIV, so they can get an extra $249 per month from the government. There are always exceptions. I stand by my comments – it is a stretch to think large numbers of people are contracting HIV on purpose.
Disability Assistance and Income Assistance (formely known as welfare back in the early 80’s) are technically not the same thing. Anyone in BC can get income Assistance, you just have to demonstrate need, persons with addictions are considered persons with multiple barriers to employment and do qualify for assistance – $282 per month and $375 for shelter for a single person.
I assume your patient was aiming for Disability Assistance as it pays more – $375 for shelter plus $531 and requires one have a disability. A disability gets you an extra $249 per month – compared to income assistance – less if you have a partner and they are also recieving disability assistance.
Ask yourself who stands to gain from the belief that low life junkies are contracting HIV on purpose for an extra $250 a month max?
I find it interesting, this attitude that we should treat people who make one of the most irresponsible decisions possible (i.e. doing hard drugs) as responsible people who have rights to demand the rest of us continue to support their irresponsibility.
Where does this come from? It sure isn’t compassion to provide them with more drugs/needles for free thus promoting the drug use. It sure isn’t compassion that generates a system that makes it easier to acquire a death sentence disease instead of kicking the habit.
There is truly only one way to stop drug use: stop! These people have proven themselves incapable of making that choice, thus if we are truly compassionate then we would make it for them and most definitely NOT encourage more of it.
But hey, that’s just me and I would prefer if none of them were on drugs, because you know, there is nothing beneficial to me if they are. Call me greedy if you will, but don’t tell me it wouldn’t be better for them either.
However, if your life goals are based on having a never-ending stream of victims for which you must be their “saviour” (i.e. the professional lefty) then it is no surprise that actual solutions are not forthcoming.
Posted by: Frenchie77 at March 25, 2009 4:32 AM>>
Good comment.
Great point!
âHowever, if your life goals are based on having a never-ending stream of victims for which you must be their “saviour” (i.e. the professional lefty) then it is no surprise that actual solutions are not forthcoming.â
Resisting. Urge. To. Curse. Loudly.
I’m a diabetic. The drug plan from the place I work at pays for my needles because I require insulin. I wonder if they would pay for needles if I were addicted to heroin ?. Maybe I ought to ask.
No-one: I find it interesting that you refer to the people you deal with as ‘clients’. I too work with people who are homeless, drug addicted, alcoholic etc. I refuse to call them ‘clients’. A client is someone I want to keep around. The people I deal with, I don’t want to keep around, I want them up and on their feet ASAP. I want them off drugs, off booze, in their own residence paying their own way now. My most urgent desire is to get it done sooner, never later. Should they desire to stay where they are then I have no desire to enable them.
Knight 99, you hit it. A solution fixes the problem. Which means no more work for the hordes of bureaucrats applying it. Case in point, human rights commissions. We don’t need them for their original purpose any more, so they are of course growing in size, power and scope.
Its as if the construction workers never left the job site, just kept finding new little things to do. For 30 years. This is the nature of bureaucracies. Tax cut now please.
But on the subject of addiction, I came across this interesting tidbit this AM.
http://www.reuters.com/article/healthNews/idUSTRE52M7OV20090323?feedType=RSS&feedName=healthNews
In a nutshell, these guys did brain scans of 131 people to see if there was any structural difference between people with a family history of depression and those without. They found marked thinning of the right hemisphere cerebral cortex in those with family history of depression.
From the article: “He said having a thinner right cortex may increase the risk of depression by disrupting a person’s ability to decode and remember social and emotional cues from other people.”
… “Peterson said the findings suggest medications used to treat attention problems such as stimulants might be useful in the treatment of depression in some patients.”
Ok, so this is a pretty small study, findings are preliminary to say the least. But. They are consistent with what we see in drug use, particularly cocaine. “Recreational” drugs are a rational solution to a personal problem, which is feeling like sh1t all the time.
We also know that environment does remodel brain structure. That’s the whole basis of treatment for strokes, you use exercise and stimuli to regain function by physically changing the brain.
Cocaine changes the brain a hell of a lot faster than exercise, and not in a good way. Supporting its use through needles and welfare is NOT a solution.
On the bright side, the study opens the possibility for new depression treatment approaches based on brain remodeling. Its always better to fix the rust than to slap bondo on it, and most current anti-depressant drugs amount to that. You stop taking them and the underlying cause of the depression is still there.
Better than just shunning the junkies and letting them die in a cheaper and more socially convenient way, which is the best solution we have available right now.
Gee, there might be a research grant in that for one of you left leaning, bleeding heart academics. How about you pull your post-modern thumbs out of your @sses, sharpen up the pencil and do some useful work for a change? What a f-ing concept!
D’oh! Sorry Frenchie, that was your point. Good on ya.
I too have encountered patients who have deliberately contracted HIV. This occured even when HIV was newly emerging and understood, at that time, to be 100% lethal. The reason given for contracting it was to fit into the peer group i.e. “Everyone’s talking about their CD4 counts and their tests and their drug regimes and I’m feeling left out.”!!!
I also encountered patients whose behaviour was so reckless that, in full knowledge of the risk, they virtually guaranteed contracting HIV.
In short, human beings obsessed with short term gratification don’t behave rationally with respect to long term consequences and “programs” which enable the behaviour will ultimately be counterproductive — surprise, surprise.
Oh man, my head hurts after reading this about people wanting to get HIV.
Anyway, I vote for Frenchie as the new Drug Enforcement Ossifer Czar.
And there otto be a law…..
Or maybe a Quickening is coming.
The MCFD and MSDH in BC refer to addiction, substance abuse, substance misuse – whatever term you prefer to use as a mental health issue and is treated as such by these ministries.
Joe: I call them clients because I was paid to work with them. I was not a volunteer. Case loads are such that one does not purposely keep clients aroung to “enable” them.
There are several treatment models for substance issues. The experts have found the bio-physco-social-spiritual model to have a much higher recovery rate than the traditional AA (moral)model which has the same recovery rate as no treatment 5% – 15%.
It is now known that recovery is not a one shoe fits all. Every person is different, has different reasons for using and responds differntly to treatment methods. ie: shaming and humiliating will onl be productive for certain personality types or cultures. The same goes for Cognitive Behavioral Therapy or Reality Therapy helpful only for certain individuals. Basing ones whole identity on the “addiction” is also counterproductive for many individuals.
Below is list of the factors considered in the bio-physco-social-spiritual model of “addiction” treatment.
Biological: Genetics: includes exposure in vitro (tetrogenic)and gentic makeup & Biochemical addiction: neuro transmission, tolerance and physcial dependence.
Physco-social factors: cultural values,
social values, situational factors, ritual, developmental factors (maturity), peronality differences, trauma, identity, cognitive bias, stress, early experinces, role models, etc.
Spiritual: This is closely related to cultural and social values but focuses on individual values and belief systems.
There are other disabilities a person can fake such as mental illness like borderline personality disorder or bi-polar to obtain the xtra $249 a month. Contracting HIV on purpose indicates to me they truly are mentlly ill and need not have bothered. Anyone who purposely contracts HIV is not mentally healthy – I would say in the very least suicidal especially if they have an “addiction” and want HIV.