World: Where the Nurse Prescribes Heroin - - PressFrom - US
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World Where the Nurse Prescribes Heroin

04:10  28 november  2019
04:10  28 november  2019 Source:   nytimes.com

7 die from infections linked to black tar heroin

  7 die from infections linked to black tar heroin Health officials in San Diego County are warning medical providers to be on the look out for more cases of the conditions linked to black tar heroin use.The deaths occurred from myonecrosis, a bacterial infection associated with black tar heroin use, the health officials said.

LONDON — Homeless drug users in Scotland will be allowed to inject pharmaceutical-grade heroin twice a day under the supervision of medical officials as part of a new program intended to reduce drug deaths and H.I.V. infection.

The NHS should offer heroin to drug addicts and open "consumption rooms" where users can go to inject under medical supervision in order to cut crime Dr Peter Carter, general secretary of the Royal College of Nursing (RCN), said providing heroin on the NHS would cut crime rates and help wean

LONDON — Homeless drug users in Scotland will be allowed to inject pharmaceutical-grade heroin twice a day under the supervision of medical officials as part of a new program intended to reduce drug deaths and H.I.V. infection.

a large brick building with grass and trees: The clinic opened in Glasgow after Britain’s Home Office granted it a license. Scotland’s drug death rate is the highest in the European Union.© Mary Turner for The New York Times The clinic opened in Glasgow after Britain’s Home Office granted it a license. Scotland’s drug death rate is the highest in the European Union.

From 9 a.m. to 5 p.m. seven days a week, a $1.5 million facility in Glasgow that opened on Tuesday will allow a handful of drug users to receive doses of the drug alongside other treatment for their physical and psychological health, according to Glasgow City Council.

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[ Prescription heroin ] is a life saving intervention for a small number of folks with a chronic, manageable illness that haven’t responded to The United Kingdom has used prescription heroin for nearly a century as an option for drug users who’ve repeatedly failed with traditional treatments.

Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing. Prescription opioid pain medicines such as OxyContin® and Vicodin® have effects similar to heroin .

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The pilot project, known as heroin-assisted treatment, is the first such licensed operation in Scotland, a country that has been called the “drug death capital of the world.” It has struggled to cope with high rates of fatal drug overdoses and its worst H.I.V. outbreak in decades.

The program will target those with the “most severe, longstanding and complex addiction issues,” the City Council said.

It aims to reduce the risk of overdoses and the spread of viruses such as H.I.V. by prescribing diamorphine — the clinical name for pharmaceutical-grade heroin — for patients to inject in a secure clinical room under the supervision of trained medics.

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The leader of Britain's nurses gave his personal backing for schemes to provide heroin to drug addicts on the NHS yesterday. "It might take a few years but I think people will understand. If you are going to get people off heroin then in the initial stages we have to have proper heroin prescribing services.

Nurse practitioners can prescribe medication, including controlled substances, in all 50 states and Washington DC. That said, the degree of In 21 states and Washington DC, nurse practitioners have the explicit legal authority to prescribe . The application for prescriptive authority may be separate

The clinic opened in Glasgow, Scotland’s largest city, after Britain’s Home Office granted it a license, and follows a similar initiative that began in Middlesbrough, England, last month.

Up to 20 patients are expected to take part in the first year of Glasgow’s program, with the number set to double in the second year.

“Heroin-assisted treatment is a much more clinical service aimed at getting people stable,” Andrew McAuley, a senior research fellow on substance use at Glasgow Caledonian University, said in an interview on Wednesday. “The program is a significant step forward, albeit for a very small number of people.”

The program, called the Enhanced Drug Treatment Service, is intended for those who have exhausted other treatment options such as residential rehabilitation, methadone and community addiction services. It is available only to drug users already involved with the city’s team fighting addiction among homeless people.

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Heroin should be prescribed on the NHS, according to Royal College of Nursing chief executive and general secretary Peter Carter. In an earlier debate some nurses were concerned that heroin prescribing would cost too much at a time when the NHS is under serious budgetary pressures.

Prescribing heroin for drug addicts -the fantasy must end. I note the debate regarding prescribing heroin 1 I have to admit I have done rather Prescribing of Heroin probaby affects those needing services towards the beginning of the continuum. Current NHS services tend to concentrate on Harm

The program is not intended to be long-term, with research suggesting that clinical benefits can be seen after six weeks of treatment.

It requires patients to visit the city clinic twice a day, seven days a week, a demand that may be too much for those not used to such a routine, Mr. McAuley said.

“It’s a large commitment,” he said.

Glasgow has ambitious plans to support its residents with drug-addiction issues, but Scottish officials say it has been hindered by Britain’s 1971 drug law.

Glasgow officials have pushed for years to establish consumption spaces in the city where drug users could inject their own drugs in a safe, clean environment, but their efforts have been rebuffed by the British government.

Britain’s Misuse of Drugs Act, the 1971 law, stipulates that anyone “concerned in the management of any premises” or any occupier who knowingly allows drugs to be prepared there can face prosecution.

“It is still illegal to have safe consumption sites, which puts us out of sync with most Western countries,” said Mr. McAuley, whose research group will evaluate the Glasgow program. “Glasgow is arguably the most compelling case for a drug consumption site.”

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Heroin is still used medically in some countries. The drug’s history is interesting and having an understanding of the past can allow people to better understand People who took the drug remarked how they felt a heroic feeling while they were on it. Bayer marketed heroin across the country as a

“It is medicinal heroin , so it is clean and users do not face the risk of taking a contaminated drug, like they would if they bought it on the street. Other medical leaders have previously called for the UK to follow other countries in dispensing heroin , including Peter Carter, former head of the Royal College

Austin Smith, a policy officer at Scottish Drugs Forum, a national resource of expertise on drug use issues, said, “This part of the law was to stop people opening up opium dens and was never intended to stop safe services, but that is what it does.”

More than 100 supervised consumption services have been established in countries like Australia, Canada, France, Switzerland and Germany, according to the Drug Policy Alliance, a New York-based organization that campaigns to end America’s “war on drugs.”

A report on Scotland’s drug problem that was released this month by the British Parliament’s Scottish Affairs Committee endorsed the treatment method.

“Safe drug-consumption facilities are proven to reduce the number of drug-related deaths and can act as a gateway to further treatment,” said Pete Wishart, the committee’s chairman. “Every drug death is preventable, and these centers could play a vital role in addressing Scotland’s drug crisis.”

Scotland’s drug problem has worsened in recent years, and official statistics indicate that drug-related deaths there are at a record high. Fatal drug overdoses have been highest among older users.

The number of deaths directly caused by drugs has risen in Scotland almost year on year since records began in the mid-1990s. And the number has climbed drastically: to 1,187 drug-related deaths last year from 244 in 1996, according to the National Records of Scotland.

Scotland’s drug death rate is nearly three times that of Britain as a whole and is the highest in the European Union.

By some measures, Scotland has even surpassed — by a small margin — the United States’ rate of 217 drug-related deaths per million of the population.

The number of homeless drug users with H.I.V. in Glasgow also increased in recent years, which one study attributed to the sharing of needles and other equipment. City health workers say the outbreak has still not been contained.

“This challenging social issue demands innovative treatments,” the chairwoman of Glasgow’s Alcohol and Drug Partnership, Susanne Millar, said in a statement on Tuesday.

“People might question why health services are spending money providing heroin for people with addictions,” she said. “The answer is we can’t afford not to.”

FDA issues warning for products marketed to treat opioid withdrawal .
The FDA sent a warning letter to EPH Technologies, accusing it of marketing and selling unapproved drugs. © Eric Baradat/AFP/Getty Images This illustration image shows tablets of opioid painkiller Oxycodon delivered on medical prescription taken on September 18, 2019 in Washington,DC. - Millions of Americans sank into addiction after using potent opioid painkillers that the companies churned out and doctors freely prescribed over the past two decades. Well over 400,000 people died of opioid overdoses in that period, while the companies involved raked in billions of dollars in profits.

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