HAVE YOUR SAY Write to the editor and get it off your chest claire @ cjwellings . com
SUPPLY AND DEMAND
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Safe supply ’, the provision of pharmaceuticalgrade opioids to
Bill Nelles describes how British Columbia ’ s ‘ safe supply ’ scheme is providing oral opiates to at-risk populations
regular opioid users , is certainly where the rubber meets the road . For many injecting users , it ’ s a critical health issue – but the medical professionals here appear stuck in the familiar argument of ‘ will it cause benefit or harm ?’
The issue is triggering a robust conversation amongst doctors . On one side are older doctors who are strong traditionalists and who believe in conventional oral treatments like methadone and buprenorphine but no further . They allege there is diversion and danger , and feel such prescribing could attract people otherwise doing well on traditional medications .
On the other side are the doctors conducting pilot studies to see if opioid users currently outside of treatment will be attracted to a safe supply of strong oral opioids rather than using the poison that passes for heroin on our streets . The people being recruited are experienced opioid users , not people naïve to opiates , and the participants are the group most at risk of overdose here in British Columbia ( BC ) – men between 35 and 60 who are not engaged in traditional maintenance treatment .
Safe supply is now official health policy and supposedly prioritised but it ’ s not at all clear
that our equivalent of the GMC , the BC College of Physicians , is collaborating with this . Eight years ago the college , shocked by the increasing numbers of opiatedependent patients with chronic pain , set daily prescribing limits , ( since somewhat relaxed ) and encouraged family doctors to limit prescribing opiates for three to five days . Around 2010 the BC opiate crisis began first with overdoses from pharmaceutical drugs , but as these became scarcer illicit fentanyl became the dominant supply .
The college has accepted supervised injectable maintenance but the provision of oral opioids is causing more concern . Research and statistics are needed to find what is really happening , and these are being gathered . However , enquiries made with the BC Coroners Service indicate no corresponding increase in deaths due to prescribed opioids since these pilots started .
And the really good news is that our left-of-centre pro-reform party recently won a large majority in our provincial elections . This bodes well for progressive health policies . With Scotland leading the Euro league table for overdose deaths , and Portugal second to bottom , I know which direction I want my province to take . I just wish my beloved UK would follow suit .
Bill Nelles is an advocate and activist , now in Canada . He founded the ( Methadone ) Alliance in the UK
‘ There is no such thing as ‘ medical marijuana ’. To use the term is not only wrong but dangerous as it refers to the whole drug , consisting of hundreds of different compounds .’
CANNABIS DANGER
In response to Nick Goldstein ’ s article ( DDN , October , page 12 ), there is no such thing as ‘ medical marijuana ’. To use the term is not only wrong but dangerous as it refers to the whole drug , consisting of hundreds of different compounds . However two of the extracts of cannabis , THC and CBD , purified and having undergone mandatory clinical testing , have been passed for medical use .
THC in the synthetic form of nabilone ( Dronabinol , Cesamet , Marinol , Syndros ) increases the appetite of cancer patients , is an anti-emetic and a sleep apnoea reliever . It is also effective for HIV / AIDS induced anorexia and chemotherapy-induced nausea and vomiting only . CBD as Epidiolex is used for two types of severe epilepsy .
Professor David Nutt is quoted – why ? He is a selfconfessed pro-legaliser and was sacked from the ACMD for his views .
The whole truth of the harms of cannabis use is still not publicised fully . It has been proved to cause psychosis , brain damage , cancers , dependence and addiction . It adversely affects the immune , heart and reproductive systems . It causes depression , aggression , violence , suicides , respiratory and cognitive problems .
Today ’ s cannabis is many times stronger than that used in the past . It is a truly dangerous drug . Mary Brett , chair , Cannabis Skunk Sense ( CanSS , www . cannabisskunksense . co . uk )
BACK TO FRONT
It ’ s so goddamn backwards and behind . ‘ Fistful of lethal opiates please doc ?’ Yeah sure , no problem . ‘ Medical marijuana prescription please for this agonising pain that keeps me from my family and awake at night ?’ Absolutely not , it ’ s junk for druggies . Kelly-Marie Nettleton , DDN Facebook page
DDN welcomes all your comments . Please email the editor , claire @ cjwellings . com , join any of the conversations on our Facebook page , or send letters to DDN , CJ Wellings Ltd , Romney House , School Road , Ashford , Kent TN27 0LT . Longer comments and letters may be edited for space or clarity .
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16 • DRINK AND DRUGS NEWS • NOVEMBER 2020 WWW . DRINKANDDRUGSNEWS . COM