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Group plans safe place for heroin addicts to ride out highs

WBUR reports on the plans by Boston Health Care for the Homeless for "a room with a nurse, some soft chairs and basic life-saving equipment" at Mass. Ave. and Albany Street, which has become an epicenter of the city's opiate crisis:

Gaeta says she and her colleagues are desperate to offer an option for the people they see overdose every day, whom they must sometimes step over to get into the program’s clinic.

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Not five years ago it would have been impossible to propose this idea without being seen as enabling criminal narcotic drug abuse. Americans are beginning to see opiate addiction as primarily a health issue not a criminal issue.

I suspect there are a few reasons including 1) 4 out 5 heroin users became addicted to opiates using legal prescription meds prescribed by doctors to manage pain. Those are regulated and expensive so eventually many addicts turn to relatively cheap black market heroin. 2) Addicts are in every town in Massachusetts. 3) Lots of people are dying from overdoses some due dealers cutting heroin with Fentanyl.

England and other european countries have gone even further in treatments for addicts: Doctors Are Giving Heroin to Heroin Addicts

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Americans are beginning to see opiate addiction as primarily a health issue not a criminal issue.

It was a criminal issue when only minorities and poor white people were affected. Once middle- and higher-class white people started getting addicted, all of a sudden it's a health issue.

Prescription opiate pain meds were obviously the catalyst to the rapid advancement of this problem, but I don't believe for a second that if it were still 95% poor/minorities getting addicted that it would have become perceived as a health issue.

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It only took one comment to draw out someone looking to attack people rather than the problem.

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The commenter is pointing out the undeniable fact that, with more and more middle-class (or even affluent) white people affected by opioid addiction, the conversation is changing. Consider this story in the Times, about white parents of addicts urging a "gentler" drug war. Do you think a parent's plea for a "gentler" drug war would have been printed on page A1 of the New York Times if that parent hadn't been white?

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Yeah, It's now all about nonwhites acting as terrorists by pumping all the white people with heroin so that they die. Yeah, that's it.

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Nobody's accusing minorities of pumping white kids with heroin. The issue is that until relatively recently, rich and even middle-class white people were largely isolated from the opiate issue, but now they're not. Before, many of them advocated throwing the book at those people, but now that it's happening to them, it's suddenly become a health issue rather than a criminal-justice issue. Hypocritical as hell? Yes. Racist? Perhaps. But no need to come up with your own conspiracy theories about it.

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Definitely now my "conspiracy theory". But it would be to a non-educated layman.

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Meant to say "NOT" and not "NOW".

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It's part of the conspiracy

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lol. Thanks for being a good sport.

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I've always considered the opiate abuse problem to be more of a suburban thing. Heroin is huge in the suburbs now. I know of too many young 20ish aged men dying from overdoses. I lost a family member to heroin od many, many years ago.

My daughter works at a hospital in Gloucester, she says about half of the patients coming in are overdoses, and that was before the Gloucester PD stepped in with a new program.

It's really huge up there. I've heard the seaport area in Gloucester is a spot where many of this stuff is coming in, not sure if its' true.

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wasn't attacking anyone. thanks for putting words in my mouth though.

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And in the 1980s cocaine was used by white, upper-class yuppie types. I've heard people even describe the stock market boom of the early 1980s as caused by this.

Yet there was no talk then about drug addiction as a health issue. The 80s were the height of the drug war.

Take your axe-grinding about racism (read: your own racism) elsewhere.

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However the reality is that many addicts don't want to be somewhere being watched when they get high. This bad idea may catch a stray here and there but the addicts I see every day are too busy enabling each other, looking for ways to get the cash together to buy that next high, and being high. They really aren't going to buy drugs and go to some place to safely do their drugs. NONE of them believe they are going to OD when they shoot up, smoke or snort their stuff.

It sounds nice but the reality is totally different. It IS an idea that enables drug use anyway.

The crimes they commit when they steal, get violent, trespass and generally act like animals can't be overlooked. Some of these people are quite dangerous and this bleeding heart pie in the sky agenda of treating everyone like poor victims kind of pisses me off.

Yes people need to be treated for this disease. There needs to be a LOT of out of the box thinking in order to battle this epidemic but not making the addict take ANY responsibility for being in a situation that they put themselves in is a mistake. They have to own their addiction in order to beat their addiction and giving them a safe place to OD is never going to actually treat their addiction or cure them. It just makes it easier for the EMT's to shove a Narcan tube up their nose.

And making this a Class or Race issue is just going off on a tangent that doesn't address the situation at all.

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Doctors are a huge part of the opiate crisis. I had surgery that definitely did not require pain mess that strong but was prescribed a full bottle of OxyContin which had the option for a refill. I took one pill and did so very reluctantly. I thought it was foolish of the doctor or medical team to offer that many painkillers right off the bat to someone who had minor surgery. A friend of mine who had very minor day surgery also was given oxys and I remember him scoffing at a bottle of 30 pills. Doctors are busy but handing out so many of those pills so easily is what is causing people to get addicted. There should be an evaluation or at least a manual request for refills after a very small quantity.

Not nearly enough is being done to police and discipline doctors for these crazy prescriptions. I'm guessing because they work in such a well-respected career that nobody wants to step on their toes. If such a high percentage of opiate addicts began from prescription medicine, why aren't there immediate things being put in place at hospitals to reduce this nonsense? I guess the answer is politics and money but the healthcare industry is setting people up for this.

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New bill in state house proposes to limit new prescriptions of oxy and percacet etc to 72 hours worth of opiate. I think we'll see doctors and legislators continue to work on a plan together until they find one that both thinks will improve pain mgmt outcomes without leading to addiction and without too much inconvenience for patients and doctors.

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I had tooth pulled a couple of years ago and the dentist asked me if I already had some Percoset or some other painkiller at home. I said no and she was very surprised. I guess it's assumed we all have a supply at home?

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A few years ago I had a root canal, and the oral surgeon asked if I wanted a scrip for Vicodin. I said no, Advil was fine!

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If such a high percentage of opiate addicts began from prescription medicine, why aren't there immediate things being put in place at hospitals to reduce this nonsense?

Yes, I feel the same way about automobiles... all those deaths from car crashes are coming from people driving cars, so clearly we need to act immediately, without giving thought to long-term consequences, to make sure we stop putting these dangerous devices in the hands of John Q. Public. Auto dealerships are just selling them once after another, with no regard to public safety!

Doctors, believe it or not, are pretty competent people, on the whole. Their profession is the most highly-regulated in the country, and the barrier to entry is enormous. It's entirely possible that there are a few bad actors, but there are now massive systems in place to weed them out, and those same systems make it impossible for normal people to live their lives. I have a chronic back condition that flares up once or twice a year, during which time I basically can't get out of bed without something stronger than Advil. Every time it happens, I get to call and make a doctor's appointment, take a day off from work, and slowly make my way in to see him, all the while worrying that I'm presenting as a drug-seeker. Then I get my 3-day supply of medication, and wait six months for the cycle to repeat. Why can't the doctor just call in a refill, you ask? Because the state regulatory commission has flagged me as a possible risk of doctor-shopping, because six years ago, I went to the ER after hours with awful back pain right when the condition first flared up, and was prescribed two vicodin by the ER doc, with instructions to visit my regular doctor the next day. Bang. Two doctors prescribing the dreaded opiods, and now I'm on The List.

Amazingly, I have managed to hold down a job throughout this process, and have yet to turn to the dread specter of heroin.

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There seems to be a lot of muddle about prescription drugs, abuse of prescription drugs, and heroin use. And 72 hours...when you in pain or are caregiving someone in pain and you have to run out constantly to refill mess and live with the anxiety of running out of said meds...ugh. That does not sound like a solution to me.

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The flip side of this is that doctors today - especially younger doctors - take an entirely different attitude toward pain management than they used to. Where once there was a paternalistic attitude that you should bear your crushing pain with good grace and any pain medication you needed was a reflection of your poor character, now the improved outcomes of proper pain management are clear. People live longer, and are more independent, productive, and happy, when they are not subject to constant, life destroying pain. The pain management options reflect this, with everything from Fentanyl patches, to OCs, to oral morphine.

Not every patient with a boo boo or surgical incision needs to jump straight to the most powerful narcotics, but those options need to be on the table. My father is living with advanced cancer that is attacking his bones, and let me tell you, bone pain doesn't look like much fun. Without the pain management cocktail that his doctors have cooked up (oral morphine 2x daily with Vicodin for breakthrough), I'm pretty sure he would have eaten a bullet by now.

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the reality is that many of the OD's that you are seeing at Albany and Mass Ave are a combination of methadone and benzos; both medications that are legally prescribed. Once an OD comes into the BMC ER and the assessment includes a positive methadone in the patient's system there is NO way for the ER to alert the methadone clinic due to HIPPA issues. Now this OD has already cost the taxpayers firefighters time and the EMT's time and transport to have this dead end occur. The patient leaves the ER and returns to the methadone clinic the next morning as if nothing has happened. Yes folks we have a BIG problem on our hands!

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And I ask with total respect since you sound as if you know what you're talking about. I've always been generally anti-criminalization but I'm torn--the "it's a disease" approach seems to normalize it if not actually condone it--I mean, if this is a "disease" it's one that we want to prevent, not just manage. These aren't diabetics who can "lead a healthy, normal life" if we just help them along--it's a pretty miserable life, even if you have a cozy room to shoot up in. I'm honestly stymied.

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Let ERs and others who treat ODs to tell methadone clinics and other treatment centers so they have the full picture.

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I see so many addicts now in Chelsealand... every morning at 630a as I wait for the bus i can count the folks in the square nodding off.

People keep talking about the zombie apocalypse... maybe this is it?

(that and as life goes on, the more the movie "A Scanner Darkly" is coming true)

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They already do a lot of work with suboxone and have staff throughout the shelters in Boston who have been working with addicts for years.

This could work because BHCHP works with the whole person. They try their best to build trusting relationships with everyone they help. I don't have a magic wand to make it happen but I'm sure some of the users will enter treatment with BHCP's help.

On another note, someone has to do something about that intersection. There is always a panhandler or two but last Friday I was at the light on Mass Ave in the lane to take a left to get on the Expressway and a group of five or six men approached my car. One started spraying my windshield (groan) and the others bent over and started shouting "Hey lady. Hey! Can you give us money? HEY!" (I was taking inventory of my purse - the oldest aversion technique in the women's book) and started bumping up against my car.

I'm no scaredy cat but I was a bit shaken by the group I pulled to South Bay and called the Roxbury police station. The weary officer said she knew exactly the place and would send a car out to broom then. It's a shame that they're out on the streets but I just want to sit at a red light and take my turn without being harassed.

Note: Edited "spaying my windshield" to "spraying my windshield"

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get a gun and merc the next garbage tier human that gets in your way

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Does getting in the way of an Internet comment section count?

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The most frustrating thing about it all is that, plain and simple, there is no solid medical cure in this day and age for addiction.

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and unfortunately, AA, NA, and other similar recovery programs have dominated the discussion for so long that doctors and therapists prescribe them unremittingly, without evidence that they work.

C.f. this recent piece on NPR, "With Sobering Science, Doctor Debunks 12-Step Recovery":
http://www.npr.org/2014/03/23/291405829/with-sobering-science-doctor-deb...

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