Heroin for opiate addiction

[ex-junkie]

Originally Posted by Spucky

@ above me,

There is a big misunderstand in this Posting, the objectivity is missing!
Some People are not ready to stop Heroin,
(and we have not the Right to decide what`s wrong and bad and what good,)
this People have to be supported until the become ready to quit.

thats wrong.

"not ready to stop". thats the biggest cop out.

do you seriously think anybody will become "ready to quit" when theyre getting prescribed heroin?!?!?!

[Spucky]

Originally Posted by ex-junkie

thats wrong.

"not ready to stop". thats the biggest cop out.

do you seriously think anybody will become "ready to quit" when theyre getting prescribed heroin?!?!?!

Not anybody but some!
The People and the society have no benefit from
someone who is not stable.

We have now the Study`s from Germany
it show that more then 10% change into a longterm Rehab.
This point reached after only 2 Years.
(because after 2 Years they stop analysis)

My Cat mostly decide to change her life when she has a lot
(more than 30 daily dose) of Heroin,
when she have not enough there was no Time to think about the life!

[kaloochi]

Originally Posted by ex-junkie

thats wrong.

"not ready to stop". thats the biggest cop out.

do you seriously think anybody will become "ready to quit" when theyre getting prescribed heroin?!?!?!

AF thinks yes. Otherwise why are people on methadone/subutex programs still trying to stop. Do you think if they went to their doc and he suddenly said 'I'm gonna start giving you H insead of sub/meth' then they'd be happy to stay dependant? It's the dependance that they/we want rid of in the end. .
You can't tar everyone with the same brush

[ex-junkie]

Originally Posted by kaloochi

AF thinks yes. Otherwise why are people on methadone/subutex programs still trying to stop. Do you think if they went to their doc and he suddenly said 'I'm gonna start giving you H insead of sub/meth' then they'd be happy to stay dependant? It's the dependance that they/we want rid of in the end. .
You can't tar everyone with the same brush

its not going to rid of their dependence though. thats the point.

if you want to stop you will. you cant want to stop being an addict, but continue to use heroin on the side. it doesnt work that way.

[Mr.A]

How was anything in my post self incriminating? Being on legally prescribed methadone isnt illegal...

[kaloochi]

Originally Posted by ex-junkie

its not going to rid of their dependence though. thats the point.

if you want to stop you will. you cant want to stop being an addict, but continue to use heroin on the side. it doesnt work that way.

AF supposes you mean their dependance on heroin imparticular. Obviously meth and bupe are both opiates so giving them wouldn't get rid of their dependance either. AF doesn't think it's a good idea to give heroin on a reduction basis to a heroin addict wanting to quit altogether because once that last dose is taken heroin is still at the forefront of their mind. If AF were given H instead of bupe tomorrow it wouldn't take away his desire to stop because he wants rid of all opiate dependency. It may be different for the heroin addict who only wants to stop becuse of the problems having to use street gear causes him.
Maintenance is different. If someone doesn't want to stop then why not give them heroin.

[OhCasey]

Its a very complicated problem and I definitely believe that some people would be better off on lifelong heroin maintance treatment. I just dont think that heroin would work that well for ending an addiction and I'd be afraid of the possibility of lifelong heroin treatment decreasing the motivation for those who truly want to be clean. I know 12 step programs generally believe that someone has to hit rock bottom before they can change and if theres the option of maintance I cant see why many would want to change.

"Swim agree with that in a Way but when you are in a Heroin-Maintenance
the "High-Factor" is very low on a "Steady-Dose"!"
The problem with that is maintaining the steady dose and fighting the urge to not use more to get high. Many heroin addicts will tell you its a very hard thing to do.

[Mr.A]

Using heroin....to treat your addiction, to heroin....that doesnt make sense.

Thats like saying "i have a cocaine problem, im out of cocaine"

Fucking rediculous. Its just addicts trying to make a case for themselves to be able to continue to use.

You cant treat an addiction with the substance your addicted to.

I am an addict, and i know, after all the bullshit is said and done, in the end, it would be awesome to just not be an addict, period.

[ex-junkie]

Originally Posted by OhCasey

some people would be better off on lifelong heroin maintance treatment.

no. they would be better off getting off heroin all together. its not impossible.

[Spucky]

Originally Posted by ex-junkie

no. they would be better off getting off heroin all together. its not impossible.

Swiny is following the "absolute Abstinence-Stigma",
(like the NA-AA)
(this is total out of Fashion!)
this lead to the Death of many sick People.
Why swiny don`t have a look to the reality about Heroin-Maintenance?
Just look, read and try to understand:

http://www.ccbh.nl/ENG/indexN4.htm
(This is a Dutch-Side but the publications are in English)
This Page is a very good one, many different Studies, from social, crimi. up to H-Consumer Health.

Heroin-Use in a Program do not mean that the People are in
a "Zombie-Mode".
Swim wrote already about that,
when you reach the Steady Dose you will not get a extreme high,
just a little bit of "normality"!
Also it not mean that you can increase the Dose sky-rocking high,
the max. Dose here is 500mg. Diaphin in a Day!

Originally Posted by Mr.A

Using heroin....to treat your addiction, to heroin....that doesnt make sense.

Swiny is making here a big Mistake, like the boulevard Media.
The H-Program means not fighting H-Addiction with Heroin,
this whole Program have nothing to do with Fighting or Treat!
It is just "a possibility" to help Therapy-Resistant People!

[ex-junkie]

Originally Posted by Spucky

Swiny is following the "absolute Abstinence-Stigma",
(like the NA-AA)
(this is total out of Fashion!)
this lead to the Death of many sick People.
Why swiny don`t have a look to the reality about Heroin-Maintenance?
Just look, read and try to understand:

http://www.ccbh.nl/ENG/indexN4.htm
(This is a Dutch-Side but the publications are in English)
This Page is a very good one, many different Studies, from social, crimi. up to H-Consumer Health.

Heroin-Use in a Program do not mean that the People are in
a "Zombie-Mode".
Swim wrote already about that,
when you reach the Steady Dose you will not get a extreme high,
just a little bit of "normality"!
Also it not mean that you can increase the Dose sky-rocking high,
the max. Dose here is 500mg. Diaphin in a Day!

yes and when they dont get high, they will just buy more on the side, so the risk of dying actually increases. after all, theyre still maintaining heroin habits whilst on methadone. worse still, the needle is half the addiction in the first place. heroin maintenance aint gonna change that.

how many people will pull the ole "poor me my life is fucked without heroin" to get a script? swim certainly would have if it were an option for her, and she still would have used more on the side. anyone is silly to think anyone is benefiting apart from the addicts themselves with heroin maintenance. of course the study subjects are going to be easy to work with, and show signs of improvement- theyre heroin addicts ffs!

furthermore, what warrants one persons case suitable for it, but anothers unsuitable? some doctors get pinged as it is for being too generous with scripts and dosage, and this whole idea is a massive fail. its not the governments responsibility to make it cheaper or easier for an addict to get drugs. what a waste of time and taxpayers money.

swim isnt going to agree on this subject and cant be bothered with this thread anymore.

[Spucky]

Do swiny read the Publication about that Heroin-Program in the Netherlands,
do she know the European Programs, did she ever look more deep inside?

Because swim think that swiny only see "The English Model"
where some Doctors just fill out a script.
But all the other European Programs looks total different from the GB.Program.
So, please read it,
this will help you to understand the Meaning of Heroin Maintenance Program!

Look, swimy also never need to go inside this Program,
but he understand the big Problem of addicted People.
This is what he mean with "People total out of our Imagination",
swiny have to understand that,
not all People are ready and willing to live without Opioids!
In a way we have to protect them and also us.

Second Point is the financial situation,
a 10 Month Rehab. cost, at least, 50.000 Euro for 10 Month,
why the Law/ ergo Us punish Addicts with a Rehab. when they are unwilling to stay clean?
This is stupid and absolute not financially feasible anymore!
Even a Prison is a high cost Factor and none have a Benefit.
In a Rehab. they have at least many People to work with the Addicts,
but in a Prison there is only one Person for 7 Inmates!

[Spucky]

Swim is just add. a coast-analysis from the Heroinprogram compared to Methadone!
He is doing it here because he can`t do it in the File-Section,
maybe someone can explain this via Pm.?

[mickey_bee]

There seems to be alot of confusion in this thread.

This thread is about using heroin primarily as a maintenance drug.
Not as a drug to use for a reduction.

Essentially the point is; You can't force an addict to stop using.

You can throw them in prison, or push them into rehab, but these methods are doomed to failure if the individual themself does not want to stop.
This is not theory, this is fact.

The idea behind heroin maintenance is accepting that in many, (but not all) cases, the approach of forced abstinence is completely unrealistic.
It's about harm minimisation. Alot of addicts will chase heroin whether it is legal or not.

However, if these addicts are given pure heroin legally, then their health is dramatically improved, their connections with crime are broken, and the individual has time to sort out their life, and in many cases start giving back to society.

As morally abhorrent as it may be to some, especially those who have battled with addiction themselves, and got out of it through their own hard work, the fact is that the current system, in the vast majority of cases, is not working.

So why not just be realistic and go for an option which saves not just money, but lives!

[dyingtomorrow]

Excellent job bringing the pertinent issues back into light, and thank you Mickey Bee for trying to get this topic back on track.

[I know it has become difficult in recent times, as a couple people here have begun to see every thread as a platform for puritanical anti-heroin grandstanding, perhaps (if they so condescend) with a sardonic mention of some attenuated link between whatever they feel like railing about and the topic everyone else is interested in discussing.]

Rep Comment: I think it is strange how at some point over the past 3 or so months, it has become acceptable to use extreme personal invective, logic fallacy, intentional misrepresentation, blatant exaggeration, and every other form of low, irrational, flame-and-"internet showmanship" type rhetoric to demonize diacetylmorphine and berate the people here who use it - something not seen on any other Drug-Specific Forum on this site. It's even stranger that so many have acquiesced to it, and that calling for rational argumentation, or mirroring in response even the tiniest fraction of the zeal spewed against heroin by certain members, has become "insulting" (only) if used to defend heroin, no matter how vitriolic the anti-heroin antagonist is. I think Puritanical was an excellent word to describe them, because even in this thread you can see the use of negative rep to post their ill-thought-out, one liner disagreements in an attempt to "harm" (as much as possible through such a medium) people who disagree with them. A spirit, which sadly, can be contagious. In contrast, the rest of the forums and topics on the site, and members who frequent them, almost exclusively reserve philosophical disagreements for actual substantive posts, and use negative rep only to guide in accordance with the rules, not out of a sense of spite. SWIM thinks this is an incredibly interesting topic (kudos to the OP) and that it is a shame to see it ruined by this, for lack of a better term, fanatacism. SWIM does not wish to get drawn into it any further than he already has. Thank you to those who attempted to stay on topic, use the rep system properly, and post well thought out arguments and responses as opposed to anti-heroin hellfire edicts.

Reputation Comments on this post:

	the insulting tone of this post is counterproductive
	Well thought out, swim understands where your coming from

[OhCasey]

Originally Posted by mickey_bee

There seems to be alot of confusion in this thread.

This thread is about using heroin primarily as a maintenance drug.
Not as a drug to use for a reduction.

Essentially the point is; You can't force an addict to stop using.

You can throw them in prison, or push them into rehab, but these methods are doomed to failure if the individual themself does not want to stop.
This is not theory, this is fact.

The idea behind heroin maintenance is accepting that in many, (but not all) cases, the approach of forced abstinence is completely unrealistic.
It's about harm minimisation. Alot of addicts will chase heroin whether it is legal or not.

However, if these addicts are given pure heroin legally, then their health is dramatically improved, their connections with crime are broken, and the individual has time to sort out their life, and in many cases start giving back to society.

As morally abhorrent as it may be to some, especially those who have battled with addiction themselves, and got out of it through their own hard work, the fact is that the current system, in the vast majority of cases, is not working.

So why not just be realistic and go for an option which saves not just money, but lives!

Youre wrong this thread is not just about using herion for maintance. This thread is to express opinions on using heroin for opiate addiction both treatment and maintance. In my opinion your statements arent very well thought out. I dont know the exact percentage of addicts that never get clean so I cant make statements about the vast majority like you but I do agree that the current system fails way too many addicts who are trying to get clean. I just think that allowing people to use heroin for lifelong maintance isnt a simple solution to a complex problem. While it may help some it also creates problems of its own. Its impossible to determine what kind of effect it would have on people who would otherwise find the motivation to get clean. It also sends a mixed message for society to support addictions of its populace. Addiction is a disease and as a society we should try and end the suffering of those afflicted with this disease. Providing addicts with their DOC prolongs the suffering and doesnt address the issue or the heart of the problem.

[mickey_bee]

Originally Posted by OhCasey

Youre wrong this thread is not just about using herion for maintance. This thread is to express opinions on using heroin for opiate addiction both treatment and maintance. In my opinion your statements arent very well thought out. I dont know the exact percentage of addicts that never get clean so I cant make statements about the vast majority like you but I do agree that the current system fails way too many addicts who are trying to get clean. I just think that allowing people to use heroin for lifelong maintance isnt a simple solution to a complex problem. While it may help some it also creates problems of its own. Its impossible to determine what kind of effect it would have on people who would otherwise find the motivation to get clean. It also sends a mixed message for society to support addictions of its populace. Addiction is a disease and as a society we should try and end the suffering of those afflicted with this disease. Providing addicts with their DOC prolongs the suffering and doesnt address the issue or the heart of the problem.

Ok, I apologise, reading the past few posts I had started to think that this was about heroin for maintenance treatment specifically.

I have experience first hand in several drug clinics in the UK, as well as having read many articles about this topic. When I can be arsed I will try and find the stats to back up some of my points, although you too should be able to find them quite easily in the meantime.

I am by no means saying that the solution to drug addiction as a whole is simple.
What is simple however, is improving the quality of life of many hardcore addicts, and, more importantly increasing the chances of their survival. That is something that would be solved if heroin were prescribed legally.
As I've posted before, look up the Cheshire police study of Dr Mark's clinic in Widnes.

It is impossible to argue that the current system is working. I even had a keyworker last year who told me that she'd stopped caring about whether people were using or not, because they invariably were.

It is true that some people manage to get clean, and stay clean, using the harshness and chaos of the addicted lifestlye as impetus.
However, this is the minority. If it was the majority then the situation wouldn't be anything like as bad as it is.

However, even these people who manage to get clean, have themselves generally spent years addicted, and tried many, many times to get clean. But, in my opinion, obviously, they were only able to get clean when they themselves were truly ready, and had decided deep down that they'd had enough.
The current system is either treatment and complete abstinence, or 'your on your own'. Which is unrealistic.

Methadone maintenance does not work. Heroin maintenance probably would work.
Obviously it wouldn't be freely available to all, and the individual would have to have been shown to be unresponsive to other treatments.

If nothing else, just the thousands of lives implenting heroin maintenance would save, (in this country alone), should be reason enough!

Personally, I am currently on methadone maintenance, and like every other person I've met at my clinic, I use whenever I can. However, I don't intend to stay on methadone/heroin for the rest of my life. I do believe that later on in life I will become more stable and want to get off these drugs.
But in the meantime, if I was prescribed heroin I know that a) I would be in much better health b) I would be in much more stable employment, and subsequently of more value to society, c) I wouldn't have to mix with often very very nasty, dangerous people.

I wouldn't want to stay on heroin forever even if it was prescribed, I simply don't want to spend my entire life not sober.
There are many people who would want to spend their entire life on heroin maintenance. These are the people who would generally spend their entire (often very short) lives chasing heroin be it legal or not.

If prescribing these people heroin improves their health, their quality of life, their input to society, reduces crime, and saves lives.......well, how can you argue with that when the current system is such a failure?

N.B.- I have neglected to use 'swim' in this post, because the police and nhs are aware of my current position, and thus I am not self-incriminating, rather stating what is already known by the state.

EDIT: You say that prescribing heroin would simply prolong the suffering of the disease which is addiction. However, it has been observed that in the areas where addicts are prescribed heroin, the dealers move away.......as they have no customers. If all the addicts who needed heroin were prescribed it, there would be no dealers, and subsequently no possibility of new users. Essentially, if this was implemented correctly, a country could, by and large, eliminate the problem of addiction within a couple of generations.

[Spucky]

Originally Posted by OhCasey

I dont know the exact percentage of addicts that never get clean so I cant make statements about the vast majority like you but I do agree that the current system fails way too many addicts who are trying to get clean.

This is a very interesting Point,
the absolute mayority of Heroin-User`s don`t stay
in a lifelong-Habit!
Statistics showed ( ) that many User become clean after average 12,4 Years
of addiction to Heroin!

Originally Posted by OhCasey

I just think that allowing people to use heroin for lifelong maintance isnt a simple solution to a complex problem.

This is the Reason why we need a kind of Ethic-commission,
with a Psychological Background to check up every individual Case!
(imo. it is Stupid to give Heroin to People who are only a few Mont addicted,
also People under the Age of 25 Years are a big Problem for swim,
they give him a lot of Headpain,
because cant find conclusion!)

Originally Posted by OhCasey

While it may help some it also creates problems of its own. Its impossible to determine what kind of effect it would have on people who would otherwise find the motivation to get clean.

Heroin in a Maintenance (European-Style)
means Supervision each Week,
where People get a reflection about their Use of Heroin,
they get support for all Social- and Health Matters.
Imo. this will help to developed a healthy Self-Reflection
and lead sooner or later to kicking the Habbit!

Originally Posted by OhCasey

It also sends a mixed message for society to support addictions of its populace. Addiction is a disease and as a society we should try and end the suffering of those afflicted with this disease. Providing addicts with their DOC prolongs the suffering and doesnt address the issue or the heart of the problem.

This is the big Social Problem,
but this Discussion is fruitless.
Did Swiny know that a Anti-Diarrhoea Medicament
that safe Life in 3 World-Countrys coast only 50 Cents?
At the Price we invest into Addiction Maintenance in a 10 Month-Mode
we could save more than 20.000 Life

[OhCasey]

Originally Posted by Spucky

Heroin in a Maintenance (European-Style)
means Supervision each Week,
where People get a reflection about their Use of Heroin,
they get support for all Social- and Health Matters.
Imo. this will help to developed a healthy Self-Reflection
and lead sooner or later to kicking the Habbit!

That sounds grand Im just not to sure about how many people could be able to productively examine their lives and make a decision like that while being prescribed junk. We all know that decision making off/on opiates is vastly changed and that opiates change your brain chemistry. Im not saying heroin maintance is evil Im just not so certain like other members here that its the absolute end to every drug related problem. I'd like to see a lot more studies done on the subject but I'd really like to see a lot more money put into studying things that could cure addiction like iboga and ibogaine.

[Spucky]

Originally Posted by OhCasey

Im not saying heroin maintance is evil Im just not so certain like other members here that its the absolute end to every drug related problem. I'd like to see a lot more studies done on the subject but I'd really like to see a lot more money put into studying things that could cure addiction like iboga and ibogaine.

On the Page before swim posted a link to all European-Study`s.
If swiny go there he will find a lot of scientific Material (a few Giga-Bytes).
Heroin compare to Methadone have a lot of advantages
and beat Methadone in many Fields like Re-Integration and Health-Matters
(eg. many Doc`s in Germany not continue
the MMT if the Patients have viral Diseases like Hepatitis C. and H.I.V.
mostly they have to change to Bupre.)

Here, Dozo, use all links: http://www.ccbh.nl/ENG/indexN4.htm

Edit:
maybe we just need a Combination between Morphine and Methadone!
Look here:

[top]Cocktail of morphine with methadone reduces tolerance and dependence

07 Jun 2005

Although morphine is well known as a highly effective analgesic,
its clinical utility is severely limited by the development of drug tolerance,
the requirement for increasing doses to maintain analgesic effect, and the development of physical dependence.
In the June 7 issue of Current Biology, researchers report a new study showing that the administration of a drug cocktail
containing morphine along with small doses of two versions of methadone, a related opioid drug,
significantly reduced both tolerance and dependence in test animals.

The work is reported by Li He and Jennifer Whistler of the Ernest Gallo Clinic and Research Center and the University of California, San Francisco.

The analgesic effects of morphine arise through the interaction of the drug with a specialized protein on the surface of cells,
the mu opioid peptide receptor, or "MOP" receptor. MOP receptors are also activated by other opioid drugs and by endogenous opioids,
such as endorphins. However, morphine is unique in that unlike other opioids,
it does not cause the MOP receptor to be internalized into the cell's interior after activation.
It is thought that the activated receptor's persistence at the cell surface leads to a compensatory overactivation
of a particular signaling pathway in the cell--a signaling imbalance that is a hallmark of opiate tolerance and dependence.
This suggests that the promotion of MOP-receptor internalization might prevent such cellular signaling imbalances,
and indeed past work from Whistler indicated that mutant versions of the receptor that are more readily internalized were associated
with reduced levels of morphine tolerance in mice.

In the new work, the researchers sought a more clinically practical approach to facilitating MOP-receptor internalization in the presence of morphine.
Reasoning that because other opioid drugs promote internalization of MOP receptors,
and that their presence in combination with morphine may prevent the persistence of activated MOP receptors at the cell surface,
the authors developed a drug cocktail containing morphine along with two chemical versions of the opioid methadone,
which is tolerated, with limited side effects, at low doses.

The authors indeed found that the combination of morphine with the methadone mixture prevented the activation of cellular signaling pathways
associated with morphine tolerance and dependence.
They also showed, perhaps most importantly, that whereas rats receiving only morphine develop tolerance to the drug,
those rats receiving the morphine/methadone cocktail did not show tolerance.
Moreover, past work has not indicated whether the promotion of MOP-receptor internalization could prevent the development of morphine dependence,
but in the new study, the authors discovered that rats receiving the morphine/methadone cocktail also experienced reduced morphine dependence.

In light of their findings, the authors propose that an opiate cocktail that combines morphine with small doses of methadone
would increase the effectiveness of morphine for the treatment of chronic pain.

The researchers include Li He and Jennifer L. Whistler of the Ernest Gallo Clinic and Research Center and University of California, San Francisco.
This work was supported by National Institute on Drug Abuse (NIDA)
grant and funds provided by the state of California for medical research on alcohol and substance abuse through the University of California,
San Francisco (UCSF) to J.L.W.

He, L., and Whistler, J.L. (2005). An Opiate Cocktail that Reduces Morphine Tolerance and Dependence.
DOI 10.1016/j.cub.2005.04.052 Publishing in Current Biology, Vol. 15, June 7, 2005, pages 1028-1033. www.current-biology.com

[mickey_bee]

Originally Posted by OhCasey

That sounds grand Im just not to sure about how many people could be able to productively examine their lives and make a decision like that while being prescribed junk. We all know that decision making off/on opiates is vastly changed and that opiates change your brain chemistry. Im not saying heroin maintance is evil Im just not so certain like other members here that its the absolute end to every drug related problem. I'd like to see a lot more studies done on the subject but I'd really like to see a lot more money put into studying things that could cure addiction like iboga and ibogaine.

When heroin is prescribed at the correct dosage, the user is not gouching out all day, it's about maintenance.

Swim is a heroin addict and on methadone, yet he goes to university and is acein' it. His only problems really arise when he doesn't have heroin. Heroin only has really pronounced effects at very high doses for people who have been addicted for some time. Swim is able to focus on his studies, and on his life when he has heroin.

Prescribing heroin to addicts is not about letting them gouch out all day, it's about giving them a large part of their lives back, and, often for the first time in years, giving them the time to start thinking about their lives again.
It is impossible to evaluate your life or your choices when you are a 'street' addict. Your entire day is spent in the quest for money and drugs, there is no time to think about more important/reflective matters.

I agree that every avenue must be explored, and perhaps there is more to learn about ibogaine's potential in curing addiction.

The point is that while we look for cures, thousands more addicts will die, who would have not had they been on heroin maintenance.

p.s.-I don't know who you're referring to when you said, 'Im just not so certain like other members here that its the absolute end to every drug related problem' , but I definetly don't think it's the be-all and end-all, I just think it is the best current option for society and many addicts!

Reputation Comments on this post:

	Good Points swiny add`s, continue!
	fantastic post - well written and good point

[ex-junkie]

.....meh.

Reputation Comments on this post:

pointless post

[ex-junkie]

Reputation Comments on this post:

pointless post


depends on how you look at it really. swim edited her post. in her opinion, it wasnt a pointless edit, but this is indeed a pointless argument.
kthanxbai.

[Spucky]

Originally Posted by ex-junkie

depends on how you look at it really. swim edited her post. in her opinion, it wasnt a pointless edit, but this is indeed a pointless argument.
kthanxbai.

Whom Post swiny talking about,
no clue!
Arrgghhhh, now i see it!


The Majority here is for a Heroin-Maintenance Program,
swim guess we are able to Change it for a better Substitution-Program,
just we need is a little bit Influence as a Lobby!

[beena]

One of the arguments against giving heroin to heroin addicts for treatment that SWIM keeps hearing or reading is based on the issue of tolerance. Users build up tolerance to heroin at twice the rate they do to methadone apparently. SWIM disagrees that this should be an issue or a problem really. Tolerance is a factor if the user is taking heroin to get high: admittedly heroin addicts over time need more heroin to achieve the same effect. But if an addict is getting a daily dose of heroin to maintain them and not topping up as well, but really sticking to the programme and their treatment properly, SWIM doesn't see that this dose would need to keep being upped. Quite the opposite: it is possible to stabilise on a certain dose and then in time reduce the dose, without significant withdrawal.
SWIM believes this strongly, because she has herself managed to bring herself off heroin totally using morphine tablets and in a relatively short period of time (about a month), managed to reduce her dose of morphine and bring herself off these too. Switching from heroin to morphine was relatively straight forward as both are opiates and morphine certainly worked to completely elimate w/d from heroin. SWIM needed about 150mg of morphine at first to just about make her comfortable. Then after a week she started reducing her dose. She reduced by 30mgs at a time and gave herself time to get used to the lowered dose before attempting to reduce again. But this process did work. When she first took 150mgs of morphine she felt pretty good after taking them. Within a week of taking this dose daily she noticed she wasn't feeling anything at all after taking them: this was obviously because she was building up a tolerance to that amount of morphine. If she was taking them recreationally and wanting to get high off them then she would have had to have upped the dose significantly, but as she was only taking morphine as a means to an end (the 'end' being to be clean from opiate addiction), she didn't need to up the dose at all and in fact was able to do the opposite and reduce the dose.
This is why SWIM thinks the tolerance argument used against the argument for heroin treatment for heroin addiction is a fallacy. Tolerance is only an issue for people using a drug recreationally - to achieve the same state of euphoria a user will need to increase the drug they are using. If using the same drug to cope with w/d and eventually get off the drug it is possible to maintain levels of the same drug and over time reduce levels.
One argument that keeps being mentioned, that seems to support the theory that heroin can't be used for treatment because of this issue of tolerance, is by heroin users that have tried themselves to come off heroin by lowering their own dose.
SWIM would argue that the reason this often doesn't work is that users have no way of knowing the purity of a batch of heroin: so the heroin they are taking one day might be weaker than the heroin they purchase and use the next. This would certainly interfere with any plans they might have to cut their dose. Also, it is hard to measure out a 'dose' of heroin accurately anyway. Another problem is just the fact of being an addict: the mentality of the person is to keep taking more and so it is really hard for an addict to bring themselves off drugs by themselves and just through their own willpower alone.
If heroin was used in heroin treatment, the purity of the drug would be consistant, the measurents would be accurate and so on. The addict would get additional support presumably from a keyworker and a plan would be put in place to help them stabilise themselves on a daily dose and over time reduce their intake of the drug until a point is reached when they become drug-free.
SWIM advocates heroin or morphine for opiate addiction purely from her own experiences of heroin, morphine and methadone. She has tried to bring herself off heroin off her own back and failed miserably as the tendancy was to use whatever was in front of her. Methadone treatment failed as she relapsed with cocaine and then bought heroin to comedown from that. She was double-dosing, taking heroin and methadone together so she chose to stop methadone altogether. On three separate occasions however she has successfully managed to come off heroin using morphine tablets (and by staying with family members whilst doing this). The only problem SWIM now has is staying off drugs: something she has so far been unsuccessful in doing.