Canada explores wilderness of prescription heroin
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There has been a rise in opioid abuse over the past decade, causing an epidemic. In fact, heroin use has more than doubled among young adults ages 18–25 in that time.

In efforts to combat this crisis, this week, President Obama launched a blitz on the heroin and opioid addiction crisis, announcing new initiatives and calling on Congress to fully fund the effort with $1.1 billion dollars.

Initiatives include increased access to substance abuse centers and mental health services, education, and increased support for veterans with substance abuse.

Canada, on the other hand, has chosen an alternative route to tackle this crisis. New regulations in Canada allow doctors to apply for special permits that allow heroin to be prescribed to patients who suffer from heroin addiction under supervision in specialized circumstances.

Statistics show that almost all of the people who used heroin also used at least one other drug, and 45 percent of people who used heroin were also addicted to prescription opioid painkillers.

According to the Centers for Disease Control and Prevention (CDC), in 2014, opioid deaths were up 369 percent, while deaths from heroin jumped 439 percent.

Many of the overdoses come from the unintentional and likely unknown mix of fentanyl in the heroin. The addition of fentanyl makes the heroin a lot stronger and overdoses are occurring more frequently.

Diacetylmorphine, which is pharmaceutical grade heroin will be accessible to patients who have not responded to traditional methods of treatment.

The argument behind this practice recognizes that prescribing heroin to severe addicts may not cure them of their habit, but suggest that it may lessen their exposure to life-threatening health risks, such as drug overdoses, blood-borne viral infections and endocarditis, an inflammation of the chambers of the heart. They are also arguing that it will lower crime rates and health care costs.

Several European countries have similar heroin treatment policies. While the United States has not gone this far, there is a history of treating addiction with alternative methods.

In previous years, alcoholic beverages were provided for patients with a history of alcohol abuse either in packaged alcohol or intravenously to prevent withdrawal. This is no longer practiced and several medications are used for the treatment of alcohol withdrawal instead.

While there very well may be a decrease in some of the complications seen in heroin use, there is nothing to guarantee that patients will only get their heroin from the clinic, because giving prescribed heroin does not take away the addiction.

Heroin is extremely addictive no matter how it is administered. What happens if someone wants the medication while the clinic is closed, or wants more than the prescribed amount?

This means those patients are still subject to overdose, viral infections such as hepatitis and HIV, and bacterial infections.

This program also does not treat the underlying problem of addiction and possible co-morbidities such as anxiety and depression, which are common amongst addicts. The main stay for addiction treatment includes detoxification, behavioral counseling, treating co-morbidities and close follow up.

In addition, Diacetylmorphine, prescription heroin, still has a great deal of side effects. Long term use of heroin, pharmaceutical grade or street, causes deterioration of the brain’s white matter, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations.

In addition to mood disorders, anxiety, depression and insomnia, heroin also affects several other body systems. It causes constipation, lung complications, sexual dysfunction and irregular menses.

While something must be done to address the heroin and prescription drug epidemic, it is unclear if prescription heroin is a good start. More studies should be done to see if complications are fewer and lives are being saved.

Dr. Lisa Ashe serves as the Medical Director of Be Well Medical Group — a leading concierge medicine and wellness group currently serving the Washington D.C., Maryland and Virginia metro areas.

The views expressed by contributors are their own and not the views of The Hill.