Sunday, October 28, 2007

Whats The Story, Morning Glory?

Remember in high school whenever you had to study for that all important exam? What was the first thing that you did in order to prepare yourself for this? If you were, and still are, anything like me then the first thing that you tended to do was anything but study. I’ll never, ever forget how suddenly even the most mundane of chores somehow managed to become mythical in proportion, waiting ever so patiently until they had my undivided attention. Over the years not much in regards to my procrastination skills have managed to change.

Now instead of school, I generally have work related projects competing for my ever diminishing attention span. It seems that whenever I sit down to my computer to complete one of the many never ending stream of projects that the Property Manager keeps sending my way, I find myself very easily distracted away from the task at hand. Like some pathetic sort of sycophantic fan, each day I am compelled to check out one of the many entertainment type gossip blogs. My morning simply can’t start until I’ve managed to get a wee taste of celebrity dirt. I mean, I have to be looking good when held up against comparison, say, to Ms Spear’s current foibles, etc

Now, if I may take the time to wonder aloud how it is possible that she has found herself in this recent set of misdeeds and misadventures. I thought that these type of people generally paid good money to certain types of employees to ensure that this type of stuff stayed very much in the background not front and centre of the public stage. And seriously, how badly messed up are you to allow things to reach this point? I mean even Kurt Cobain and Courtney Love, who in a strictly legal sense, lost custody of their newborn for her first three months and technically had to surrender their physical custody of her, all four of them - including Frances’ first nanny - managed to live under the same roof this entire time.

Come on Britney, give your head a very serious shake. If two of the most notorious heroin users were capable of successfully pulling this off, you at the very least could at least make a little bit of an effort to show up for your custody hearings and actually show up on time. My guess would be that this would strengthen your case significantly. Certainly passing a drug test here and there wouldn’t hurt either. Also, what kind of drugs is this chick on anyway that she has allowed herself to become this unglued?

I’ll be the first to admit that the entire drug landscape has most definitely change a lot over the past decade. No where do I find this very apparent then witnessing this change each and every day at my methadone clinic. The general demographic of the typical methadone patient has undergone quite the change here in London, Ontario, Canada from the first time that I started MMT in the summer of 1999 - in fact, in less than a ten year time period.

The number of patients actually at the clinic who are on MMT is 800 compared to the 162 patients back in 1999. Typically, the current wait time to start treatment works out to approx two and a half weeks, whereas the first time, I ended up having to wait almost three months. I ended up lucking out getting in at that time simply because there had been a cancellation on their waitlist. If not for that cancellation, I would have ended up waiting four months before I would have been able to even start MMT. From my experience, when a junkie finally reaches out and starts asking for help, being put on someone’s waitlist is not any kind of solution but rather, an additional problem.

In the years between each MMT, the opiate landscape in this city changed so that what I remember from a decade ago, no longer exists today. While talking to my doctor recently, he mentioned of the 800 patients currently on methadone at the clinic barely a handful had ever seen heroin. Or almost 780 patients - out of 800 - being treated with methadone, were not, by exact definition, heroin addicts. Yes, they were opiate addicts because each and every one of them had issues with narcotic analgesics, but they certainly could not be easily lumped into society’s usual perception of the dirty, disgusting junkie.

Of course, in the end, this is all just semantics. Obviously, the growth of the clinic here in London, Ontario these past tens years is a result of a number of factors occurring simultaneously. Obviously, there is a growing need for this type of facility and from the perspective of a business plan, a need which if operated properly, will also prove to be financially rewarding for any investors i.e. the doctors that decided to expand their much smaller clinic from the previous decade into a clinic requiring considerably more support staff, etc.

Now a clinic of its current size will definitely be much more noticed by John T Public because depending on its location, the influx of nearly 1000 individuals that for the most part walk to the beat of a different drummer would hardly be invisible. Not many would be thrilled to have this particular group doing not much more than loitering near their homes or business each and every day. If it were just the patients of the clinic that the neighborhood had to be concerned about then that would be one thing but inevitably, it is the baggage that accompanies each of these patients that ends up being the biggest concern as generally they have less to lose.

Now if most of the opiate addicts in London, Ontario are not addicted to heroin, what the heck are they doing then? Apparently the majority are hooked hardcore on oxycontin. Or at least so says the five part series that our local paper, the London Free Press, started running in yesterday’s paper. This special report plans on covering all aspects of this addiction and how it is affecting our community as well as what we as a community can and should do to help.

The article from today focused on how oxycontin was doing much more than killing pain for two men while yesterday the series shared the story of one young housewife and mother of two’s battle with this drug.

Following is the introduction article to the series which was written by London Free Press reporter, Randy Richmond, that you should be able to read in its original form here. There was a second article regarding pharmacists and how they feel caught in the middle.

Oxy, part 1

Oxy, Oxygen, M&Ms, 80s, Oxycotton.


The drug sweeping London’s downtown streets, workplaces and suburbs goes by many nicknames.

But it has one effect on police, civic officials, social service and health-care workers, users and those dealing in drug subculture -- alarm.

And it’s ravaging London like few other cities in the province, police say.

A $3.7-million, five-year plan to combat substance abuse will be unveiled at city hall Monday.

"It is the drug of this city right now," said Sgt. David MacDonald, head of one of the police’s two street drug units.

The opioid called oxycodone is so powerful, so easy to get and so hard to kick, it’s fueling crime, ravaging the vulnerable, and turning ordinary middle-class citizens into sellers and buyers.

What makes it tough to tackle is the source. It’s not made in makeshift labs, grown in basements or shipped in from other countries. Most comes from London doctors’ offices, then gets ’diverted’ to the underworld.

Signs of its rise are everywhere:

  • OxyContin, the most popular oxycodone based painkiller, is the most commonly injected drug among needle users in London, recently surpassing heroin.
  • Opioid abuse is rising to one of the top three problems cited by people seeking help at Addiction Services of Thames Valley. In most areas, it is tied with or nearing crack, cocaine and cannabis.
  • In Ingersoll, opioid abuse ranks behind only alcohol, traditionally the No. 1 cited problem among people getting outpatient counselling.
  • The Children’s Aid Society of Middlesex London is seeing more and more parents hooked on OxyContin and other painkillers.
  • In 2004, only 86 police occurrences, such as break-ins and thefts, could be identified as fueled mainly by oxycodone addiction.

By 2006, the number of police occurrences had jumped to 261.

- OxyContin is the drug of choice -- supplanting crack --among sex-trade workers in London, police say, and 100 per cent of the about 80 women working in the sex trade use drugs.

The diversion and rising influence of oxycodone-based prescription drugs is one of the forces prompting the city’s community services boss, Ross Fair, to present a plan to politicians to attack substance abuse in London. The five-year plan rests on four foundations -- improvements in prevention, harm reduction, treatment and enforcement.

Only a large-scale co-ordinated effort will work, Ross says. "Addiction is a big hairy beast."

The city would pay a third of the $3.7-million price tag, the rest coming from Ottawa and Queen’s Park.

The plan would target the most vulnerable first: the homeless, sex-trade workers, street youth.

Key points include:

  • Create a downtown street outreach initiative, with nurses and addiction workers.
  • Expand existing safe haven drop-in programs, such as Mission Services, My Sisters Place, Centre of Hope and AtLohsa, so full day and evening service is available
  • Push senior levels of government for more treatment, and wait-time standards.
  • Increase London police so the force can focus on illegal activities associated with drug dealing and prostitution.

The strategy also has clear targets:

  • Reduce the number of sex- trade workers 50 per cent in three years
  • Cut to zero the number of overdose deaths among homeless.
  • Increase the number of homeless in addiction programs by 200 over five years.

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