PRESCRIPTION DRUGS FOR STREET ADDICTS?

Could the increasing misuse of prescription opioids among street-drug
users actually benefit public health?

That's the provocative question criminologist Benedikt Fischer, an
addiction researcher with Simon Fraser University's Faculty of Health
Sciences (FHS), posed in a recent essay in the journal Public Health,
co-authored with B.C.'s provincial health officer Perry Kendall and others.

The authors note that when addicts of injected street drugs such as
heroin forge prescriptions or engage in "double doctoring" to get
legal opioids such as dilaudid and oxycontin they are significantly
less likely to inject the drugs. And that reduces the risk of
blood-borne diseases such as hepatitis C or HIV.

And while crushing and injecting prescription opioids still poses a
health risk, there's still less danger of overdosing because the
potency of prescription drugs is consistent and known, unlike illicit drugs.

What's more, the misuse of prescription drugs also reduces crime
because addicts aren't robbing people for funds to buy heroin.

The authors see such behaviour as filling an unmet need because
methadone and other heroin-substitution treatments are limited in
Canada and the U.S. In B.C., which has one of the higher per-capita
methadone treatment rates, there's only enough methadone for 50 per
cent of the people who are regularly injecting opioids.

Fischer, who joined FHS's Centre for Applied Research in Addictions
and Mental Health (CARMHA) in September 2008, says the paper's
purpose was to open up debate. "There's a shift away from heroin and
increasing use of prescription opioids and everyone seems to be
panicking about it," he says. "We're just trying to do a bit of
constructive thought-provoking in the interests of public health.

"We don't want anyone to be using drugs illicitly. It's not good for
public health. We're just saying, relative to the previous
predominant reality, (pharmaceutical substances) may not be all bad."