EXPANDED DRUG TREATMENT NEEDED TO SAVE LIVES

I want to encourage awareness of the plight of addicts and the lack of
treatment options available to them. It is not unlike the crisis that
struck us six years ago when OxyContin was claiming the lives of many
struggling with opiate addiction; the death toll is rising again.

I am unable to state the number of lives lost within the past year or
two, but as director of the AIDS Coalition of Cape Breton and Sharp
Advice Needle Exchange I have witnessed the loss first-hand. Unlike
the vast media attention that was given to lives lost during the
OxyContin crisis, lives lost today are kept quiet and under wraps.

In addition to the rise in the death toll, numerous overdoses have
occurred that have not resulted in death. These near fatalities are
never mentioned in the media.

Thanks to the great work of the Partnership on Drug Abuse and its
encouragement of prescription drug monitoring, OxyContin isn't as
readily available as it was six years ago.

OxyContin was not the only problem; the problem was, and still is, all
opiates. It just so happened that at that time of the crisis,
OxyContin was the most accessible.

Recently in our news, a warning was issued of a new drug on the scene,
hydromorphine (Regional Police Chief Warns Hydromorphone Abuse
Growing, Aug. 1). This isn't a new drug; it's been around as long as
OxyContin or longer, and has been widely used for the same purpose.

The same goes for Dilaudid, Percocet, morphine, methadone, fentanyl
(patch or pill form, either can be injected) or any codeine-based pain
medication.

The message I am trying to relay is that opiates are here and they are
here to stay. There is such a taste for opiates here in Cape Breton.

Could it be possible that if an attempt is made to make prescription
opiates unobtainable a much more lethal and addictive street drug will
take the place? Maybe that drug is heroin.

Heroin is already available in Halifax and is a major problem in New
Brunswick. We have been fortunate enough to have avoided it to this
point.

I would much rather see a person addicted to a prescription drug than
to a street drug. At least prescription drugs are manufactured with
standards. We have no idea of the cut, strength or content of street
drugs.

Our community acted quickly on the OxyContin crisis and was eventually
able to convince our provincial government to provide Cape Breton with
a methadone maintenance program. We can now proudly boast that Cape
Breton has a top notch, medium threshold program that runs smoothly
through Addictions Services and is appreciated greatly by all those
who benefit from it.

It is not enough! We need two programs. The existing program, however
beneficial, does not meet the needs of the more severely,
poly-addicted individuals who do not qualify. Our program cannot
handle the numbers of addicted people who need it. There is a long
waiting list. We need a low threshold program.

Low threshold: Methadone is provided primarily to opiate users with
few restrictions regarding use of other drugs or involvement in
rehabilitation. Typically, "carries" are not allowed; clients must
visit the program site daily to drink their methadone. (A carry means
that a participant in the program is allowed to take methadone home,
usually enough for three or four days, without ingesting it in front
of the pharmacist.)

Medium threshold: Methadone is provided primarily to opiate users,
with moderate restrictions regarding the use of other drugs or
involvement in rehab. Participants are generally given five chances to
abstain totally without threat of discharge. Typically, carries are
allowed after proven abstinence and program compliance, with ongoing
monitoring.

In addition to the loss of lives, the strain on the economy from just
one addicted individual is enormous. If the only source of income is
from stealing, a user will have to steal about $500 per day worth of
goods and fence that for a mere $100 to support a $100 a day habit. In
one year, the average user would have to steal about $181,000 worth of
merchandise.

If the person is caught and imprisoned, it costs Canadians $66,381 per
year to house a male prisoner and $110,473 per year to house a female,
according to recent figures. It also costs Canadians $16,800 per year
to supervise an offender on parole.

One of the most significant risks is in the sharing of injection drug
equipment, which can often result in the spread of HIV/AIDS and
Hepatitis C. The financial burden these two blood-borne diseases pose
on our health care system is astounding; lifetime cost of treating one
person living with HIV infection was calculated as $153,000 back in
1997.

Cape Breton has the highest rates of Hepatitis C in Nova Scotia. The
cost of medical care for a person who is Hepatitis C positive is about
$125,000. The cost for a liver transplant is $228.000.

Even if the addict never becomes infected with a blood-borne pathogen,
the countless trips to emergency for serious problems such as
abscesses, cellulitis and even endocarditis cost health care dollars.
In comparison, the cost of methadone maintenance for one person per
year is about $3,500. Methadone is an investment in lives as well as
in the economy.

With all the evidence and facts based on research, it is time to push
for more treatment options, including low threshold methadone
maintenance and youth treatment centres. Let's take control before any
more lives are lost.

We can't stop the flow the drugs or the harms related to drug use but
we can control and manage them.