Pubdate: Tue, 20 Aug 2019
Source: Daily Courier, The (CN BC)
Copyright: 2019 The Okanagan Valley Group of Newspapers
Author: Matthew M. Elrod


Dear Editor:

Contrary to Joe Fries' editorial "Abstinence works best" (Courier,
Aug. 16), Rhode Island treats addicted prison inmates with methadone,
buprenorphine and naltrexone. Like methadone, buprenorphine is an
opioid agonist, or replacement opioid. Naltrexone is an opioid
antagonist that blocks opioid receptors.

The benefits of opioid substitution therapy are well-established, in
and out of prison. It reduces crime, prevents overdoses and the spread
of infectious diseases, denies profits to criminal gangs, allows
addicted individuals to function normally within their families, jobs,
and communities, and gets them off the hamster wheel of raising money
by hook or by crook to pay criminal gangs for illicit opioids of
unknown potency and purity.

Drug users forced to go "cold turkey" are at greater risk of fatal
overdose, having lost their "tolerance" without having overcome the
conditions and trauma that lead to their addiction, nor their risk of
relapse. Opioid replacement provides a tapered path to abstinence.

We allocate about 80% of our drug control budget to law enforcement,
about 15% to treatment (of varying quality) and about 5% to harm
reduction. Every dollar invested in harm reduction saves several
dollars in downstream social costs; first responders, ER admissions,
the treatment of blood-borne diseases, long-term care for the brain
damaged, coroners, support for the bereaved and orphaned, etc.

If we do not provide harm reduction services, like syringe exchange,
opioid replacement and supervised-injection sites, we will have less
resources for treatment - abstinence-based, prison-based and otherwise
- - and fewer drug users seeking it.

It's true that "you don't treat a disease by feeding it," but nor
should we treat childhood trauma with punishment.

Harm reduction is first aid.

Matthew M. Elrod

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MAP posted-by: Matt