Category: Heroin

The main aim of the discussion is to look at whether the current way of treating addicts through a strict therapy and rehab system with multiple different drugs is as successful as many would like to believe. As previously discussed in my literature review I saw the four main drugs that are currently used to help an addict recover from heroin addiction. With results released from the British government, you can see that 40 to 60 percent of drug addicts relapse. If you change these results to look purely at the rates for heroin relapse rates you can see 91 percent of patients discharged from detox relapse with 51 percent using heroin within a week of being released. The detox where the rates are from is a 6-week detox program as well. This means it is the most common program you can find. These rates do decrease with a strong after-care ritual and having longer detox with lots of support but as many addicts cannot have access to this support this means it either needs to be accessible for everyone or a different method needs to be found.

Why should heroin addicts be helped?

One of the main arguments is that how much help the government should provide to addicts and whether it is their responsibility. I believe that there is a limit to the support the country should provide but that support should be the best to give the greatest chance of staying clean and discouraging a relapse. This support should be given because the more addicts that are helped to become clean the fewer criminality and gang crimes there will be. As mentioned in the literature review when all addicts in a town are helped to become clean the crime rates can drop as far as 96 percent. This is due to the fact often to support a drug addiction the easiest route is to sell the drugs you are using yourself. This can introduce more people into drug use and lead to a constant flow of more people becoming dependant on drugs. This is also a reason why I believe the support should be provided as it removes the need for money so they no longer are required to sell drugs. There is also the question of if the user has become addicted to heroin should the addict be treated as a criminal or as someone who is ill and therefore should be treated by the NHS with the same respect and care as every British citizen is entitled to. In October 2019, the NHS provides free care for drug addicts just the same as any other illness would be treated. They have the support, medication, and rehab provided for them.

If an addict has the intention of trying to overcome their addiction that means they’re taking steps towards recovery. Often it is said that rehab and support are only successful when the user has the intention for it to work. Therefore, I think before a user is admitted to rehab or given the option of support they should have shown the willingness of their own accord to recover. I believe this could help the relapse rate.

There are many cases of heroin addiction where people were unsure of what they were taking and then became addicted. Often people believe heroin is only an injected drug but this is a common misconception; heroin can be smoked, snorted, and injected. It is a common occurrence for people to start by smoking heroin either not realizing what it is or not realizing it can still be so addictive when smoked.

Heroin is an illegal, highly addictive drug made from morphine; a natural substance extracted from the seed pod of certain varieties of poppy plants. It is typically sold as a white or brownish powder that is cut with sugars, starch, and powdered milk. Pure heroin is a white powder with a bitter taste. It originates in South America and, to a lesser extent, from Southeast Asia, and dominates U.S. markets east of the Mississippi River (National Institute on Drug Abuse, 2018). Typically, it’s smuggled into the United States and sold off for high profit. It’s basically a system that is constantly going around and never-ending. People who are addicted to heroin have an extremely impossible time getting off the drug. Many who are addicted need to higher their doses to get high again which leads to purchasing more heroin which leads to more overdoses. The system is doomed and causes never-ending purchasing and incriminating addicts who truly suffer from a mental illness.

When it comes to treatment options between methadone clinics, rehab facilities, and hospital inpatient programs, there seems to be something they all lack. In most cases, these facilities help people and turn their lives around. These facilities are not accessible to everyone. To those without healthcare who are struggling to survive, it’s near impossible to afford proper and effective rehabilitation options. Many people in lower-income neighborhoods are stuck on drugs since their priorities with money are set to providing for their family and the drugs they’re addicted to (J Psychoactive Drugs, 2009). Poverty makes it much harder for someone who is addicted to a substance to quit. Without access to privatized businesses that call themselves “rehabs” it becomes harder for the average people to feel like their being given adequate treatment for their illness. Sometimes the feeling is true, where privatized rehabs have much more comfortable environments and higher success rates than the options presented to those without equal capital.

In America, there is a huge problem with how mental illness is viewed. Many people are told to overlook it or are that it will go away. People are rarely asked how they are doing mentally. Many individuals seem to not view mental illness as valid, due to the lack of a physical appearance. Things can become debilitating without the proper medication or treatment. This paired with the fact that mental healthcare can be expensive for those without healthcare, causes the mentally ill to not seek help Without receiving the help, they deserve the brain is on haywire. This can turn to drug abuse, becoming abusive, or even becoming a danger to themselves. What most people seem to forget is that addicts are still people, they struggle to survive. When drug abuse and mental health collide, what follows are manic episodes, violence, and more drug abuse (J Psychoactive Drugs, 2009). Without the proper care, addicts are at risk of violence, overdosing, and disease from shared needles. When addicts have access to counselors and therapists there is more of a chance to survive and help. There needs to progress in humanizing addicts to those who dehumanize them. In the United States, it is seen as shameful to be an addict, almost taboo. With people dehumanizing them it causes this big stigma.

Stigmas can be dangerous due to people being less eager to help those in need, thinking they will only be taken advantage of, seeing those in need as almost less than human. Mental health problems and substance use disorders sometimes occur together. Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices (MentalHealth, 2019). It is easy for people to take their problems out by using drugs to get rid of the emotions of thoughts and feelings of something that unsettles them. Mental illness and drugs like to hold hands together as both cause the other. It is well known that drugs can cause a person to have a mental illness problem that they never had before taking drugs.

In recent years, illicit drug overdose deaths have increased rapidly and have affected every part of the country. A key issue that communities across Canada are facing today is the use of Heroin illegally especially among youngsters and they are getting attracted towards more and more consumption of Heroin which is affecting their health and lives. Drug overdose can be accidental or intentional. An overdose occurs when a person takes more quantity of a drug than his/her body could afford or is sensitive to certain substances.

A 2019 National Report: Apparent Opioid-related Deaths in Canada by Public Health Agency of Canada, more than 11500 deaths occurred during January 2016 and December 2018. Specifically, 3017 deaths occurred in 2016, 4100 deaths in 2017, and 4460 deaths occurred in 2018, which means that every two hours 1 person is dying of an overdose. 94% of deaths are accidental and a majority of the people dying are between 20-30 yrs of age. Overdose deaths are not only happening among people with long term substance use, even who use the substance occasionally or for the first time could be a victim.

According to the tests of thousands of samples conducted by Canada’s Health regulators, the amount of positive tests of fentanyl in illegal street heroin has jumped enormously. Fentanyl is entirely synthetic and easy to smuggle because of its chemical makeup which makes it hard to detect at customs. It is cheaper and extremely potent, 50 to 100 times more potent than heroin, so it becomes an attractive substitute for drug dealers to mix it into costly heroin to stretch their supplies so they can make large profits from it. As fentanyl is a very powerful and lethal drug but street dealers are not skilled enough to keep the dose in a survivable range, even a small mistake in cutting active ingredients into consumable doses can easily become a deadly overdose. That is the main reason behind the growing number of overdose deaths. According to Dr. David Jurrlink, head of clinical pharmacology and toxicology at Sunnybrook health sciences center in Toronto, ‘The illicit drug supply has never been more dangerous because of the profusion of fentanyl-related compounds. This is why so many people are dying. They are dying because the drug they’re using contain, you know, much more opioid than they thought.’

Whereas on the other hand when heroin gets legalize under the Canadian health care system, then pharmaceutical companies would take a keen interest in it and start making these drugs. The most important benefit would be here is that when these kinds of drugs have been prepared by medical professionals with all the quality control testing, there will be no chance of contamination of deadly toxic substances. Definitely, it will be a costly option and it will increase the drug cost when we consider all the extra costs on top of it get involved, like research cost, approval and licensing cost, medical devices, and equipment cost to buy or rent, safety monitoring, Staff salaries, other operating costs. In a book named ‘A Call to Action’ by Hank McKinnell, a past CEO of Pfizer, wrote under the heading “The Fallacy of Recapturing R&D Costs”: ‘How do we decide what to charge? It’s basically the same as pricing a car … A number of factors go into the mix. These factors consider the cost of business, competition, patent status, anticipated volume, and, most importantly, our estimate of the income generated by sales of the product. It is the anticipated income stream, rather than repayment of sunk costs, that is the primary determinant of price.’

Some people who overdose while consuming drugs are alone and they have no one nearby who could help them. It is also possible that if they have consumed in the presence of someone who is not aware of the symptoms of an overdose and may be unable to respond. According to one participant of “National study on opioid and other drug-related overdose deaths: insight from coroners and medical examiners” – “Most of the people that I go to have died alone. They die in their bedroom or in their living room or in their bathroom and the majority of them [have] no one there to call 911 and sound the alarm.”

Supervised injection sites are legally sanctioned locations to provide a secure and non-judgmental environment for people to inject previously obtained drugs in the presence of trained medical professions while reducing the visibility of drug consumption on the street. People usually come here with their own dose of drugs which sometimes result in overdosing. The main purpose of these sites is to provide a safe and hygienic space with clean needles and syringes to reduce the number of overdose deaths. Registered nurses and other health care professionals are available to monitor the injection process and they could intervene with the overdose reversal medication such as naloxone and oxygen if something goes wrong. According to the Vancouver Coastal Health website: “More than 3.6 million clients have injected illicit drugs under supervision by nurses at Insite since 2003. There have been 48,798 clinical treatment visits and 6,440 overdose interventions without any deaths.” Other than that these places can also provide an opportunity for multiple contacts with health care staff, social workers, and other individuals who can help users move toward healthier choices, such as drug treatment programs, primary health care, and other social services. These sites can also help in reducing HIV and hepatitis C transmission and ensures that injecting equipment remains inside and is not discarded in the community. The establishment of these sites would have high support from communities and this support would keep on growing as these sites will save the cost of Emergency visits/calls that would otherwise make an extra charge on the public services. Injection sites would provide treatment and life-saving medical help at the same place on an immediate basis, saving them time and lives of overdose individuals. If all the circumstances are undertaken from the point of humanity, the cost and expenses (which includes placement of injection sites, medically trained staff, the equipment, and extra services that would be provided) are all pointless, as it saving someone’s life and helping our communities grow without the fear and burden of fatal and non-fatal deaths due to overdose.

Regular drug intakers hesitate to go to injection sites as medical practitioners would put a limit on their drug intake and that would not make them as high as they want to. Some regular heroin consumers even like the contamination of the fentanyl because it gives them more joy, while their bodies get used to the actual heroin and there is no more excitement left there. They have their personal preferences and they trust their regular dealers and try to buy from the same person. And if they get it from unfamiliar sources or somebody else that they have not met before then they take more precautions and try some sampling techniques before taking it as their regular dose. Regular users became aware of these overdose risks by facing them personally, witnessing others, learning from peers, public campaigns, or harm reduction workers. According to the study “Toots, tastes and tester shots: user accounts of drug sampling methods for gauging heroin potency” by Sarah G. Mars, Jeff Ondocsin, and Daniel Ciccarone published online dated 16 May 2018, “The use of drug sampling as a means of preventing an overdose from injection drug reduces the quantity absorbed at any one time allowing users to monitor drug strength and titrate their dose accordingly”. There are few methods of sampling of heroin, sometimes used in combination like snorting, smoking and tasting in a small amount before injection, injecting partial “testing shots” or “slow shots” and then wait for some time before proceeding to a full shot. They prefer to do it in pairs or groups and then take feedback from others or observing them using the same batch to judge the amount that they can intake for intending results for themselves. But professionals completely disagree with this tasting sample technique and have a different opinion on it. Linda Richter, Ph.D., director of policy research and analysis for the National Center on Addiction and Substance Abuse, “It only takes a tiny amount of the drug to cause a deadly reaction.”

Conclusion: Illicit drug overdose deaths increased sharply in Canada nowadays and have broken records year after year. This is only possible if the legalization approach is adopted and integrated into the system so that it benefits society and addicts. Few proactive and preventive measures like putting control over illicit street drugs, providing the safe and reliable legal source to buy and medically professional supervised injection sites to inject, keeping stronghold on the pricing policies of legal heroin, educating people about the deadly outcomes even with very small amount of contaminated drugs, encouraging them to enroll for addiction programs can be taken into consideration to reduce the occurrence of overdose events and prevent fatal outcomes in overdose situations.

Using tyrannical, arbitrary rule, the Taliban terrorized the millions who resided in the Middle East. The false promises of rule of law and stability imposed by the young Islamic and Pashtun fighters, ultimately lead to their replacement of the current government. The Islamic Militants’ violence against innocent civilians, and the war waged against their own country is evidence of their dictatorial rule. The Taliban ensured the people of Afghanistan would be provided with freedom and protection, but it soon turned into oppression and restriction.

The Taliban are known for being a religious and political military organization that enforces their propaganda upon the people of Afghanistan. To this day, they still wage war within the country. The Taliban infamously used the internet and different platforms of media to spread their ideas or constrict the thoughts of the people. In 2001, the Taliban “banned all types of media except their propaganda Voice of Sharia radio and very few newspapers and magazines run under strict state control” (HuffPost). By doing so, the Taliban were able to control what information the people of Afghanistan received, which in effect, restricted what they believed and influenced their thoughts. One of the ways they utilized media platforms was by creating a Twitter account with 65,000+ followers that goes by the name Zabihullah Mujahid (Ozy). Using that account, they created a supposedly fake person with the responsibility of responding to matters of the United States and its president. The Taliban would also claim that supporting the Karzai government (the current Afghan form of government), at any degree would be un-Islamic and support could be punished by the ‘holy warriors,’ or Taliban members (HuffPost). Usually, they implemented their propaganda through using shabnamah, pamphlets posted on the doors of public places such as mosques, schools, or houses, that contain threats such as cutting of their fingers or toes. In the end, the Taliban successfully delivered their propaganda which was portrayed when they became the new government in Afghanistan.

At the height of Taliban rule, the constant utilization of violence and oppression completely isolated Afghani civilians, giving the Taliban complete control. After a Taliban attack in Mirza Oleng, Zabiullah Amani, a spokesman for the Sar-e Pol governor stated, “Some were beheaded, some had their bodies pierced, and some were thrown off the mountain.” The Taliban arbitrarily terrorized innocent civilians using extreme brutality. From frequent bombings to meticulously planned assassinations, the people of Afghanistan were in continuous fear. The Taliban ruled under an extreme version of sharia law, including amputation, stoning, crucifixion, etc., which used the excuse of their Islamic religion to warrant cruelty. People were scared to leave their homes with the worry of being killed, leaving them unable to work and make an income. With economics and incomes at a stand still, and taxation from the Taliban, they were left without the resources to survive and to fight back. According to a BBC investigation in 2017, television, music, and cinema were banned. By banning the only resources Afghanis had to the world around them, they had no idea what brutalities were occurring, nor could they organize to retaliate. They were completely paralyzed giving them no options to stand up, and if they did, they were at the risk of being killed. If they rebelled, they were at a drastic disadvantage fighting against a military with modern technology and weaponry, when they were barely allowed the technology needed to live. The tyranny imposed by the Taliban left Afghani civilians powerless, immobilized by fear and authority.

As a result to the power the Taliban held in Afghanistan and other countries in the Middle East, the amount of personal freedom was restricted greatly. Freedom was especially limited for Middle-Eastern women, and many of the activities or choices they held on a daily basis were stripped away from them. If women were not dressed accordingly to Taliban standards, or if they were not accompanied by a mahram, a close male relative, in public, the women would be publicly abused in methods of whipping, beating, or verbal abusing. Women were forced to wear a Burqa, which was a long veil that covered them from head to toe (Rawa). Even deciding what women could wear under the Burqa was controlled by the Taliban, they were not able to wear bright-colored clothes because it was thought to be sexually attractive, nor could they wear wide legged-pants (Rawa). Women were also limited to the medical treatment they received, due to the Taliban banning the ability for women to be treated by male doctors. The ramifications included womens’ deaths because of the failure to be treated for illnesses. Unfortunately, women were not the only people affected by the Taliban’s rule. For example, both genders were banned from listening to music and watching movies, videos, or television (Rawa). The Taliban only wanted Afghans to see or hear what they wanted to be true. The Taliban deemed many things as un-Islamic and by creating their own rules which everyone, especially women, must abide by, they limited much of the freedom and natural rights of the citizens of Afghanistan.

Due to the Taliban’s harsh interpretation of Islamic law, the constrictions of education were extremely rigid. In many places under their jurisdiction, women were not permitted to attend school, while only few other places allowed education until children reached a certain age. Without proper education or literacy, they could not obtain jobs that require the knowledge taught in school, nor could they be intelligent enough to rebel. Women had to resort to attending underground schools in order to obtain an education, or even learn how to read. If caught, they faced many punishments including death, poisoning, and more. “‘It’s risky for the teachers and it’s risky for the students, but these underground schools show the thirst people have for education under the Taliban,’ said Shukriya Barakzai, a parliamentarian who ran her own underground school when the Taliban held power in Kabul in the 1990s” (Washington Post). When the Taliban was mostly removed, girls began to return to school, in small separated classes nonetheless. Many people felt as if the new government was not making this problem a top priority. According to Global Citizen, “The rights group’s new report says the government of Afghanistan has not devoted enough of its budget, most of which comes from international donors and foreign aid, to rebuilding its education system and ensuring that girls have equal access to education, calling it ‘a project that is half finished at best, and crumbling.’” Even today, girls are only allowed education until puberty and face cruel attacks, which include deadly acid attacks that have resulted in the loss of eyes and burned faces. The Taliban’s rule has left a lasting imprint on Afghan society that will not be undone for many years to come. The tension and turmoil caused by the Taliban will always remain, and education is still widely restricted.

During the Taliban’s rule, a war within the country was waged for a substantial period of time, inducing many troubles for the people of Afghanistan. War is extremely costly, especially for an extensive amount of time. This resulted in the economy taking a deep downwards turn, so people could no longer afford to take care of their families or themselves. “Due to 20 years of war, the sources of income for people and the socioeconomic fabric of the country have been damaged severely’, says Muhammad Naizmand, spokesman for Afghan Red Crescent, a branch of the International Federation of the Red Cross/Red Crescent in Kabul. With the economy spiraling downhill, people were struggling, and “These people don’t have any home, any food, any income” (Csmoniter). Not only did the Taliban drain Afghanistan of its economic resources, but they also prohibited the buying and selling of an opium poppy, a drug, which was a large source of income for the country. “The militia announced recently that virtually all the country’s growers had heeded the ban. That would mean that the source of the world’s heroin has abruptly shrunk by 75 percent” (Rferl). Although this was beneficial as it decreased the amount of drug use, it decreased the amount of businesses and jobs people depended on to make a living. The Taliban spent a considerable amount of money and time in an attempt to stay in control, misadvertently causing the downfall of Afghanistan’s economic structure.