Study toasts free drinks for homeless alcoholics

  1. http://www.todayonline.com/articles/93482.asp

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  2. 17 Comments

  3. by   leslie :-D
    i agree, a very bizarre study.
    the only 'benefit' i could see is the reduction in illegal behaviors from the alcoholics or other perpetrators. it sounds as if they're basically being sheltered from beatings, sleeping in freezing temps, and/or petty theft to get $ for their etoh.

    leslie
  4. by   Ted
    Interesting. A couple of thoughts crossed my mind after quickly reviewing this article.

    One. I recall watching a television documentary several years back where one country was treating herion addicts with herion. (Understand that I'm recalling a show saw many, many moons ago, and that my memory usually leaves much to be desired.) (Forgot which country did this. Amsterdam, maybe?? :imbar) What impressed me, though, was that this particular method of "treating" the "herion problem" seemed to help. Basically, the addicts lived productive lives (they were able to work) and, for good or for bad, took their daily "prescribed" dose of herion. What also impressed me was the relatively lack of negative judgement, or negative stereo-typing (by this country's people) towards those involved with this program. If I recall correctly, this lack of "negative judgement" included no legal ramifications towards those who took the herion and the medical professionals who treated them. This country's philosphy in "treating" the people on herion seemed to be a win-win situation; it seemed to be working. The people involved with this herion program, besides leading productive lives, also seemed to have a rather normal self image (they were not homeless nor were they in jail doing time for their "habit"). I remember watching this program (several years ago) and thinking maybe we have something to learn from this philosphy towards addiction.

    Two. This article describes a "mindset" or medical treatment philosophy that may not be too different than the practice we may experience within our own professional lives. Let's take in imaginary case involving Mr. John Doe. Mr. Doe is admitted to our med/surg unit for a broken ankle. He slipped on some ice while walking his dog, fell and couldn't get up. (Ouch!!) Mr. Doe happens to drink 6+ glasses of wine of day. His daughter speculates that he probably consumes at least a quart of wine per day. After a discussion with Mr. Doe, our favorite Dr. Know-It-All orders one glass of wine per meal as part of Mr. Doe's medical regime. Apparently, Mr. Doe has no plans to stop drinking soon. I've received many orders like this (for similar situation) throughout my modest career as a nurse. In all honesty, I used to be bother by them. I'm not so much anymore. Why? First, Mr. Doe is not admitted for ETOH addiction and withdrawal management, two, Mr. Doe doesn't want to stop drinking and, three, I don't want the guy to go through DT's!!! (Not a very fun thing to manage!!).

    With the above fictional scenerio, I am NOT saying that this is the BEST course of action to provide Mr. Doe in managing his ETOH addiction. He could very well have a liver disease associated with all of the years of his drinking. Most certainly ETOH counceling is in order to at least provide eduction focused on the serious problems associated with chronic alcoholism (live disease, etc.). I personally believe that people should be made very well aware of the potential harms surrounding a life-style decision to drink lots of ETOH, or smoke, or eat lots of McDonald hamburgers and french fries (guilty! :imbar), or take herion. But there may be a better time and place to suggest and provide meaningful, long-term "treatments" for such life-style "addictions".

    I am impressed, after reading the above article, that someone decided to take a somewhat "different" approach in managing a complicated situation. Maybe, down the road, those involved with this program may decide to quite drinking all together. (I admit that I do hold a bia against drinking. But these "issues" are my "issues".) Maybe not! But this "different approach" in managing this problem, according to the article, seems to be working. It will be interesting to read future follow-up studies (if any are made).
    Last edit by Ted on Jan 5, '06
  5. by   URO-RN
    I dunno...it's like inviting someone who is suicidal to play a round of russian roulette.
  6. by   fergus51
    Harm reduction is much more popular in Canada than it is here in the US. I think it's the best approach to some problems. The safe injection site in Vancouver (where heroin addicts can shoot up) has been quite a success.

    Most claimed some benefits from the program in Montreal. Hard to argue with that.
  7. by   Ted
    I respectfully do not agree with that comparison. Those who are suicidal and those who have addictions are two very different types of people; two very different (and complicated) situations. That analogy can prove more confusing than helpful. Many, many people addicted to whatever do not necessarily want to kill themselves. The end result of a long, chronic addiction may be death. But the intent to die most probably doesn't exist for the person with the addiction.

    I do think we need to explore more and different options in "treating" people with addictions, though. This article shares one option. . .
  8. by   URO-RN
    [quote=efiebke]
    I respectfully do not agree with that comparison. Those who are suicidal and those who have addictions are two very different types of people; two very different (and complicated) situations. That analogy can prove more confusing than helpful. Many, many people addicted to whatever do not necessarily want to kill themselves. The end result of a long, chronic addiction may be death. But the intent to die most probably doesn't exist for the person with the addiction.
    Ummm...that's fine, but everyone knows the effects on family, work, society of drug and alcohol abuse.
    Pacifying (spelling sorry, i am tired)the problem is not dealing/confront itt.
  9. by   Ted
    Yes. And I've experienced some of the more dysfunctional aspects of alcoholism in my family. Gratefully, I've also experience the healing touch of recovery too. I also believe that what exists in the country by way of "help" for those with addition ain't working too well. The addict suffers. The family continues to suffer. Maybe a change in how addiction is viewed is in order??? And maybe with a change in view may come a change in managing addiction???

    Without a doubt, it's a complicated subject. It's one worth study, discussion and education though. It's not going to be solved over night, for sure (my loving wife as asking that I get off the computer and visit with her for a while!! :imbar :chuckle).

    I do see the merit in exploring different and hopefully helpful ways in "treating" those with addictions. It was interesting to me to read how this article gave account to a newer and different approach to alcoholism. After reading it, it got the ol' brain working. OUCH! :chuckle
  10. by   fergus51
    [QUOTE=URO-RN]
    Quote from efiebke

    Ummm...that's fine, but everyone knows the effects on family, work, society of drug and alcohol abuse.
    Pacifying (spelling sorry, i am tired)the problem is not dealing/confront itt.
    Sometimes it does temporarily help though. These people are healthier than they would be otherwise. What's the alternative for them? They aren't likely to head into rehab any time soon.

    This came up with the safe injection site. The OD rate dropped dramatically. People are alive who would otherwise be dead. Others have been refered into treatment. The alternative would be to continue doing what we already knew didn't work (arrest them, release them, repeat).... Until someone can come up with a perfect solution, I think harm reduction is better than nothing.
  11. by   pugmum
    Quote from fergus51
    Harm reduction is much more popular in Canada than it is here in the US. I think it's the best approach to some problems. The safe injection site in Vancouver (where heroin addicts can shoot up) has been quite a success.

    Most claimed some benefits from the program in Montreal. Hard to argue with that.
    Respectfully I would say be cautious in thinking that the safe injection site has been a success. A safe site was thought to decrease the amount of deaths on the street from bad drugs, also to give users a "safe place" to shoot up, get rid of needles and provide clean needles. And it has helped to a certain extent.

    Nearly every night on the news though, we see stories of how the site is not working. If you talk to the merchants, they are chasing off junkies 24/7 because they all congregate in front of their businesses and scare off customers. The area has attracted more users, and as a consequence, the crime rate is up...heroin, meth, and crack are expensive habits to maintain.

    Have the rates of hepatitis and HIV/AIDS decreased....I don't think so. But one of the best arguments is if we can prevent hepatitis/HIV/AIDS, it is much cheaper for our health care system (and it is).

    I had to drive through "that area" about a month ago, with a colleague who had never seen that part of the city. Looking through her eyes, I am not surprised at her shock. That area of the city is deteriorating with people shooting up on the street (so much for the safe injection site), sleeping on the street, and yes, dying on the street.

    I can't believe I live in a country that purports to have one of the best health care systems in the world. A safe injection site is only a drop in the bucket.
  12. by   Roy Fokker
    Ted,

    If you knew how many people there are who use heroin but also lead not just normal but successful lives, it'd blow you away...

    Yes, I'm talking about heroin use.
  13. by   fergus51
    Quote from sickandtired
    Respectfully I would say be cautious in thinking that the safe injection site has been a success. A safe site was thought to decrease the amount of deaths on the street from bad drugs, also to give users a "safe place" to shoot up, get rid of needles and provide clean needles. And it has helped to a certain extent.

    Nearly every night on the news though, we see stories of how the site is not working. If you talk to the merchants, they are chasing off junkies 24/7 because they all congregate in front of their businesses and scare off customers. The area has attracted more users, and as a consequence, the crime rate is up...heroin, meth, and crack are expensive habits to maintain.

    Have the rates of hepatitis and HIV/AIDS decreased....I don't think so. But one of the best arguments is if we can prevent hepatitis/HIV/AIDS, it is much cheaper for our health care system (and it is).

    I had to drive through "that area" about a month ago, with a colleague who had never seen that part of the city. Looking through her eyes, I am not surprised at her shock. That area of the city is deteriorating with people shooting up on the street (so much for the safe injection site), sleeping on the street, and yes, dying on the street.

    I can't believe I live in a country that purports to have one of the best health care systems in the world. A safe injection site is only a drop in the bucket.
    Sure, that area in the city has all the nasty consequences associated with a bunch of junkies, but all those nasty consequences were in Vancouver before, just in different places. You could get drugs on Hastings faster than you could get coffee at Tim Horton's and people always had to find a way to pay for it. The safe injection site was never meant to solve those problems. It's done what it was meant to do (harm reduction for that specific population at risk) better than any other method in Vancouver.
  14. by   pugmum
    Quote from fergus51
    Sure, that area in the city has all the nasty consequences associated with a bunch of junkies, but all those nasty consequences were in Vancouver before, just in different places. You could get drugs on Hastings faster than you could get coffee at Tim Horton's and people always had to find a way to pay for it. The safe injection site was never meant to solve those problems. It's done what it was meant to do (harm reduction for that specific population at risk) better than any other method in Vancouver.
    I agree that the safe injection site was never meant to solve all of the social problems. But I do think we have to be cautious in saying that it is a success. If we say that by providing them a safe place to shoot up has resulted in a decrease in death rates, or a decrease in the incidence of HIV/hep then it is a success. But if we had 5 out of 100 before, and we now have only 4, is this such a great success?

    The free heroin program was supposed to be so terrific when begun, too. Unfortunately, the "requirements" for the program were so stringent, many addicts could not get the free stuff.

    I agree that the problems have always been there. I agree that buying drugs on Hastings is easier than buying THs. If I wanted to buy, that's the first place I'd go because its so available.

    Three weeks ago I was at a workshop for the latest and greatest in HIV/Aids treatment... one stat that struck me was that the incidence of HIV is increasing in our young female population, and skyrocketing in our Aboriginal population. True, not all in this group use the site, but it is frightening to hear about it, especially when you think about the population of the downtown eastside.

    I think we have to define what we mean by success. I truly believe that harm reduction on its own without other treatment and social programs will not work. If we were really committed to harm reduction, then why not have drug of choice available whenever and whenever you wanted, and remove the social stigma associated with drug addiction.

    I truly wish we had more treatment beds.... Sorry, but this is an emotional issue for me. I am feeling very badly because our neighbour's 16 year old son became addicted to heroin...good family, involved parents....yadda, yadda. I watched this kid grow up. He's on the downtown eastside right now.

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