Heroin for opiate addiction

[Spucky]

@ Swinbeena,
swim really thinks that many User of Illegal Heroin never shoot until the Top-Dosis,
many People cant reach it anymore.
When Swim was addicted he mostly get only his Monkey killed,
even he had a lot he not done something extravagantly.
Imo. this Discussion about high dose until coma is, like you think, overrated!

The max. Dose in Germany is 500mg. Diaphin and many People,
like the Statistic showed, use much less!
(500mg. is a lot of Stuff, compare to the Stuff on the Scene)

And to the negative Reputation on the page 2. please go and learn something
about Pharmacological Design, there are already "retarded- aka pro-longed" Diaphin-Pill

An application for approval of diacetylmorphine (DAM) tablets was submitted to Swissmedic
in December 2005.
3.5. Support for research
• Diacetylmorphine (DAM) tablets for oral administration
In 2005, the previous years’ activities were continued, with the emphasis on the evaluation and
conduct of studies with a view to the registration of DAM (heroin) tablets.
Since 1998, DAM tablets have been one of the dosage forms prescribed as part of the HAT
programme in Switzerland. While the i.v. solution was registered by the Intercantonal Office for
the Control of Medicines under the proprietary name of Diaphin in December 2001, the tablet
form has yet to be approved. In the autumn of 2003, a cohort study designed to investigate the
safety of heroin tablets was initiated by the FOPH. The results of this and earlier studies form the
basis of a submission to the Swiss Agency for Therapeutic Products (Swissmedic).

and it is not difficult to create them more Individual!
Swim never said something like you complain!

Swim add more Material for Reading!

[electrolingus]

Originally Posted by Spucky

@ Swinbeena,
swim really thinks that many User of Illegal Heroin never shoot until the Top-Dosis,
many People cant reach it anymore.

This is not always the case. For many heroin addicts it has to do with the the environment in which they were introduced to the drug or the environment in which they are currently using in. Environment plays a huge factor when it comes to the use of IV drugs. If one is introduced to heroin through.. Lets say ones university friends who would never even think of injecting the drug. Well that person is less likely to progress to IV heroin use as opposed to someone who is readily exposed to IV users.

Now, lets say ones environment consists of neighbors, friends, and even family members who readily use IV heroin. In this case, ones very first use of the drug could be with a syringe. For the record, swim grew up in upper class suburbia and holds a masters degree and his first use of heroin was by IV route. Go figure?


The use of heroin as a detox drug is just not medically sound or in the clients best interest. There are now medications that are better suited for this purpose, such as buprenorphine.

Heroin as a maintenance drug however is another matter. Yes, it may work for 'end of the line' IV heroin users who have tried every method in the book as far as maintenance or detox but with little or no success. But where do you draw the criteria line for heroin maintenance? In the early days of methadone MT, the mass majority if not all of the clients were IV abusers who were basically deemed untreatable. Now days you have MMT clients whose average daily heroin usage consisted of less than $20.00 by insulfation. So, would it be in a clients best interest to make heroin MT available to anyone with a heroin addiction?

Once again from a clinical standpoint, if ones method of use needs to be by IV route to produce the best result for maintaining a clients overall MT success, Morphine Sulfate would be the better choice. MS provides a more stable peak time with a minimal tolerance factor (at least in relative comparison to heroin).

Reputation Comments on this post:

Great post this info was much needed

[OhCasey]

Originally Posted by electrolingus

Now days you have MMT clients whose average daily heroin usage consisted of less than $20.00 by insulfation.

Now a days you have MMT patients who would never touch heroin. I'd be interested in seeing some actual numbers but in my experience most of the people I know on MMT are users of doctor prescribed pharmaceuticals. My personal sample size is relatively small. I just think the answer in treating addiction should be explored in a lot of other avenues before we start resorting to lifelong opiate maintance.

[Spucky]

Originally Posted by electrolingus

The use of heroin as a detox drug is just not medically sound or in the clients best interest. There are now medications that are better suited for this purpose, such as buprenorphine.

Heroin as a maintenance drug however is another matter. Yes, it may work for 'end of the line' IV heroin users who have tried every method in the book as far as maintenance or detox but with little or no success. But where do you draw the criteria line for heroin maintenance?

Heroin for a Detox is another question imo.!

Heroin for Maintenance need imo. very strong and high Access-Rules,
at this Time 2 Longtime Therapy`s, two kicked out of MMT.,
long-lasting Addiction (above of Ten Years), etc.,
like now in the European Programs!
If there is a Heroin-Maintenance coming we need a Council
like Swim wrote already: With a Doc for addiction,
a Psychologist, a Evaluator, maybe a whole bunch of People with knowledge
about this Person and his desires and problems!

Swim hope and guess HMT. will never be a Program
for "Junkie XY-08/15",
on the other side who have the Right to denied access to a Medicament
for People who are not fit in this criteria`s?

Swim is happy that this is not his decision!
(because it`s soooo muzukashi!)

[electrolingus]

The following link provides in depth data on a one year cumulative study of the socioeconomic impact and the effect on overall quality adjusted life years(QALY) of its participants. Although this study deals with MMT only clients as a control group in comparison to co-prescribed heroin and methadone clients as the experimental group and not for heroin MT only clients, the results are interesting just the same.
1297.pdf

Now back to Heroin MT on its own. One other factor that has been overlooked is that a good number of heroin addicts are also poly addicted. SWIM is frantically researching the statistics in this regard but not all MMT clients are dismissed as non-compliant for continued opioid use only. Many clients will revert to the use of secondary drugs of choice such as cocaine, methamphetamine, or benzodiazepines. So, would it be clinically viable to rule out clients with a history of chronic polysubstance abuse as possible candidates for HMT or should HMT be made specifically available to these types of individuals simply due to the statistical fact that they have been deemed non-compliant to/by more conventional MT methods?

IMO (in my opinion), any form of long term MT should be about what is best for the outcome of the client. In order for treatment to be nominally successful, it must incorporate a lifestyle change. For SWIM, the biggest problem was not only the use of heroin but it was also the way in which he used it. The 'needle' was as much an addiction as the drug its self. Just to give an example of this; If swim was somewhere where people were snorting coke, swim would pass it up with no problem. However, if swim were to have had some syringes on him at that time, he wouldn't have made it back home for a couple of days and most likely would have land himself in the clink. OK, so this is not the best example of a lifestyle change because if swim were truly trying to make the best of MT, he wouldn't be around coke users in the first place, but progress is progress.

The final factor that needs to be considered is the health of the client as well as the health risks to unrelated individuals. The only medically approved method of daily ongoing IV therapy is via heparin lock or pic line. The majority of late stage/treatment non-compliant addicts have health issues directly related to IV use. Simply legally allowing this behavior will not make the client any more healthy.

What is best for the greater good of the whole almost always trumps what is best for the individual. IMO, swim doesn't see HMT as the clinically sound choice for either. As for the study mentioned at the beginning of this post, swim would be curious as to the results for beyond the one year time line. IMO, that data would tell a different story.

[Spucky]

Originally Posted by electrolingus

The final factor that needs to be considered is the health of the client as well as the health risks to unrelated individuals. The only medically approved method of daily ongoing IV therapy is via heparin lock or pic line. The majority of late stage/treatment non-complient addicts have health issues directly related to IV use. Simply legally allowing this behavior will not make the client any more healthy.

They have already "Inhaler" for Heroin-Use!
(Swim think they are working like a Vaporizer,
but he never seen one)

But i wrote it already on the Page before,
addiction is not only a combination with a Drug,
addiction is much more diversified.
Heroin or other Opioids are only a tiny Factor!

So we need Time, and security.
This is the only Way out for many many People!

[xxdan123xx]

Swim thinks it would be interesting if morphine or oxycontin were on the list as he knows many people(all in his head) who prefer Oxy to Heroin. Swim however would pick Heroin hands down to anything else except perhaps injectable solution dilaudid. He had this at the start of his H addiction and it was the most warm fuzzy high he had ever felt. ANd he just ived 5 bags of qualty heroin not 5 mins ago

[Spucky]

Swim just is in need to tell all the Swinys that we had a election in our Government last evening
and yeah, Heroin now is ready for prescription in Germany.

Our Fight for a more Human-Minded Medizin WIN!

Swim is sooooooo damned Happy!

http://www.tagesschau.de/inland/diamorphin102.html