Indian State to Introduce Opioid Substitution Program

MethadoneManTo mark World AIDS Day the state government of Gujarat, in India, is introducing a free opioid substitution program to registered addicts in the city of Surat. IV heroin users will be given an oral formulation of either buprenorphine or methadone, with the dual aims of reducing the use of needles and aiding recovery.

Both substances are used to treat addiction; as Ritambhara Mehta, head of the psychiatry department at Government Medical College Surat explained, they “[work] against other drugs consumed after taking it. It doesn’t let the patient feel the high once consumed.” Greater access to these treatments is clearly positive, with a long history of their administration having demonstrated significant benefits, including “a reduction in deaths, HIV infection, crime and drug use with improvements also seen in physical and mental health and social functioning.” They are also more effective than any other option at attracting and retaining addicts.

While hardly a new idea, access to these treatments remains a significant problem, with “less than 10% of those in need of treatment” receiving it, according to the World Health Organization. It is presently available at only 35 centres across India, a country with a population over one billion, one million of which are registered heroin addicts, with estimates of the total addict population reaching as high as five million according to a UN report.

The expansion of India’s capacity to provide opioid substitution treatment should be applauded, but we might use this opportunity to think about how we can improve their availability and efficacy, globally.

Barriers to Access

Across the world, many addicts self-administer substances like buprenorphine and methadone to treat addiction due to difficulty accessing these treatments through official channels. Programs like the one beginning in Gujarat often have highly restrictive criteria. A study of one such program in Sweden found many addicts being turned away because they “had hidden their drug use from friends, family, and colleagues and lacked documentation in the form of contacts with healthcare, dependence treatment, social services, or the police.”

In addition, even those who gained access were often subjected to involuntary discharge for “missed clinic appointments, disorderly or threatening behavior, and drug crimes.” Evidently, barring people who exhibit behaviour typical of hardcore addiction from addiction treatment is not the wisest of options.

Finally, and this may be the greatest lesson for improving opioid substitution programs, “all the interviewees voiced the opinion that [Opioid Substitution Therapy] subjects patients to control measures and authority, and some even characterized the treatment as degrading.” If access to methadone and buprenorphine reduces death, crime, and the spread of HIV, then it is well worth considering making it available to those who do not wish to subject themselves to the scrutiny and restriction of freedom of government-run programs.

This is to look only at the consumer side. In many countries, strict and often punitive regulation of substitution treatments is a hindrance to providers, as can be seen in Germany, where poor training and a lack interdisciplinary cooperation are also leading to a dwindling number of physicians able to supply the treatment

Lastly, while buprenorphine and methadone have the highest rate of retention, they do not attract or retain all addicts. They may benefit from supplementary treatments like oral diamorphine, and greater legitimacy for treatments which do not aim at abstinence.

Still, all things considered, the expansion of treatments for addicts is always a positive and welcome development.

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TripSit Mobile App Released

unnamedTripSit is pleased to announce the release of our free mobile app, which is now available on the Android Marketplace. The TripSit mobile app connects mobile users with TripSit’s harm reduction resources through a handy and intuitive interface.

TripSit collects relevant and easily digestible data on most recreational drugs, including dosage guidelines and interactions with other substances, and publishes it online for free use, while continuously reviewing it to make sure it is up to date with the most recent scientific and anecdotal research. Our app pulls data directly from our database, and provides users with an easy interface to access this information from a mobile device. Users can look up important drug information using our factsheets, search our Wiki, visualise drug combinations from our combo chart or connect to our live chat to receive help from the TripSit team directly.

Get it on Google PlayWe hope this application will be helpful, and that it will connect users with the harm reduction information they need while out and about. This is a first release, and we encourage users to send feedback or report any issues to the TripSit team – you can find out how to do this by choosing the ‘Contact’ item on the app menu, or simply send an email to feedback [at] tripsit.me

Please note that, as with all TripSit resources, the information is presented is for educational purposes only, and cannot include everything required to make informed decisions regarding drug use; all drugs affect every user differently. Dosage and combination data is provided as a general guideline, not as a recommendation and not as medical advice. If you believe you are in need of medical aid, then seek medical attention immediately. TripSit does not endorse drug use, and while our team makes a best effort to provide accurate information, we do not claim that it is 100% correct. Always do your research and be safe.

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New Tripsit.me Website

stars_postTripSit is pleased to announce the release of its new website, with a new branding and design. Hopefully this makes the user experience superior and our content easier to access and read. Using this platform we hope to continue providing quality content about drug and harm-reduction related issues.

All of our previous posts have been imported into the new website and will remain accessible, even preserving the URLs they had previously, so external links will not be broken.

We are happy to hear feedback about any aspect of our services, be it the content or design. If you have any suggestions, feedback or ideas, then feel free to leave a comment on one of our posts, use the Contact page or send an email to feedback [AT] tripsit.me .

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The Dexterous World of DXM

396px-RomilaradDextromethorphan (DXM) is a dissociative and hallucinogenic drug which is commonly found in cough medicine; its widespread reputation among popular culture and in some sections of drug culture is that it is a drug of convenience, used only by teenagers without access to illicit drugs, taking advantage of their ability to purchase it over the counter in a pharmacy or order it online. However, among some sects, DXM is respected as a powerful and complex psychedelic which can produce experiences wholly different yet similar in worth and intensity as the more traditional hallucinogens. Continue reading The Dexterous World of DXM

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Introduction to Plugging

Rekord-SpritzeProfessional and recreational drug users alike utilise a number of different routes of administration when ingesting their drugs, which allows them to affect certain variables of a drug’s resulting experience: things like the bioavailability (how much of a drug will be absorbed), onset, duration and dose required. This is often a trade-off, as different ROAs come with different advantages and disadvantages; 2c-b for example has quite an unpredictable onset time taken orally, while nasally the onset is very predictable at the cost of being legendarily painful.

One route of administration which is gaining popularity in the modern drug scene, but remains with some stigma and a lot of misinformation, is that of rectal administration or “plugging” – medically this can take a few forms, though in the context of recreational drug use this is usually the insertion of a drug solution into the rectal cavity, where the mucous membrane will allow blood vessels to absorb the drug directly – also known as an enema. Continue reading Introduction to Plugging

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