Presciption Drugs and the Rising Death Toll

The news that over 1300 people die each year from prescription drug overdose is very alarming and tragic. Those who die from prescription drugs, particularly opioids include: 1. people (eg., chronic pain patients) who are legitimately prescribed these drugs and deliberately or accidently overdose 2. people prescribed methadone or buprenorphine, who die particularly in the first week of dosing (methadone) and/or misuse it (eg., inject accumulated doses or take-aways in one hit - methadone and bup) or use it with other depressants (meth and bup) 3. people who have bought methadone off the street or been given it in exchange for other drugs, who may have low tolerance and/or misuse it (see above) 4. people who are prescribed the drugs without good reason, eg., dr shoppers or from drs who knowingly prescribe to drug addicts. Fentanyl is a favourite and a killer (1000s of times more potent than morphine: One client who has been clean for 4 years now lost 11 friends to it - patches boiled and injected are lethal). 5. Opiates bought or obtained illegally that are normally prescribed or classed as prescribed as opposed to illicit drugs. Deaths from prescription opiates outweigh deaths from heroin now, here and in the US and many of these are related to methadone. For example 50% of all overdose deaths in Scotland are related to methadone and 60% of injections in the MSIC are prescribed opiates (morphine - Oxycontin and MS Contin, crushed, filtered and injected - they advertise 'workshops' there to show them how to do it 'safely'). Anex have suggested that the same tactics we have used to reduce the road toll should be applied to reducing death from drug misuse. The gist of the Anex argument is that just as we do not ban driving and we take (HR) measures to reduce the road toll, so we are obliged to regulate (license; not prohibit) drug use and to use similar measures to reduce harm when drug injecting. However, the analogy with the road toll when used to bolster the HR agenda is fundamentally flawed. Although driving (as does use of medication) carry some risks, it is not driving as such that is at fault, it is the illegal or reckless things drivers do that cause road deaths, for example speeding, ignoring road signs, drink driving or using mobile phones etc., which are prohibited. Again it is not the legal and prescribed drugs such as pain killers properly used that is the problem it is the reckless and illegal actions of those who abuse these drugs that causes the deaths. Suggesting that we should decriminalise illegal or reckless drug use is like saying we should decriminalise speeding, drink driving etc. Obviously a ridiculous and unacceptable proposition. The same argument is used to suggest that the reason injecting drug users (IDUs) get Hep C at very high rates is because there are not more and better distribution to drug users of clean needles. For a start there has been no decrease in the rate of Hep C among IDUs since the implementation of NSPs from the 1990s. Moreover, yearly surveys of IDUs at NSPs has shown that Hep C eventually reaches saturation levels even among this group: the $ms on NSPs has made no difference to Hep C rates, it has never been properly trialed or researched and it has been a waste of money, based on ideology (it seemed to intuitively make sense) and not on evidence. However, what is blindingly obvious is that the only way to prevent Hep C transmission is not to inject drugs and this means that the responsibility for their infection and the infection of sexual partners etc, lies entirely with those who chose to inject drugs. What we are obliged to do is to assist them to do stop. In the late 1990s the death toll from heroin was over 1100 annually; it fell to around 300 in the following years following the disruption of heroin supplies ( the 'heroin drought', mainly due to Howards 'Tough on Drugs' policy). Last year it has risen to just over 700 and is predicted to go higher. To this can be added the deaths due to prescription drugs including about 350 to 400 each year from methadone: higher than the road toll which has declined in terms of the numbers of cars on the roads over the last 20 years. We have also seen a softening of law enforcement and of deterrents in recent years with a gradual return to the HR policies of the 1990s when anyone could openly buy a cap of heroin on the streets of Cabramatta for less than the cost of cannabis as it was proclaimed that enforcing the law would drive the drug trade underground and result in more deaths. The absurdity of this argument is obvious, but is still used today to promote the existence of the MSIC