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The drug crisis in the United States is not revealed. The nation passed 47,000 deaths to opioids in 2017. Symptoms are great as physical symptoms, like fentanyl. Drugs have spread to illegal provision and, to a lesser extent, communities are taking a series of interventions, increasing naloxone training by increasing treatment resources.
But a new analysis in politics, Rand Corporation, has concluded that the United States's focus is on staggering: the heroin of the pharmacy – well, the heroine – for a long time, heroin users did not succeed with other treatments. It is already happening in several European countries and in Canada. But culture, law and practice would be challenging in the United States.
"These are controversial interventions," said Beau Kilmer, the main writer, in RAND's drug policy research center. "There are no people who do not want to talk about it, but we have seen about 30,000 deaths and about 50,000 deaths with opioids around fentanyl. It's important that discussions about research-based intervention be based on experiences from other countries."
Here's how to prepare programs for heroin, or treatment for heroin support (HAT), work. The patient typically measures the regular dosage of pharmaco-quality heroin, also called diacetylmorphine or diamorphine, and is injected through a closed medical control inside the clinic clinic. If the idea is that the person is a legal source of heroin, less will be affected by street drug drugs, they will spend less time and energy trying to fix their next fix, and instead focus their dependence on underlying drivers.
"This is just another treatment that helps to stabilize life," says Kilmer.
Not everyone. Medications such as methadone, buprenorphine and naltrexone are treated very efficiently to treat treatments and retinal symptoms or block drug consequences. But first-line treatments do not use opioids for a long time. The main study of the prescription of the Canadian heroin eliminates the average life of 11 heroin already admitted by the patient.
The recipe consists of heroin maintenance therapy, begun in the 1920s in the United Kingdom, and resumed in the 1950s in other parts of Europe. (It was also a matter of the United States of America at the beginning of the 20th century looking at federal drug laws).
Heroin-assisted treatment is different from the concept of conserved living areas, when patients carry out their illegal drugs, and then, when they are in the doctor, they are ready to respond to insulin. These are increasingly discussed in the United States, at least a dozen cities believe.
Kilmer says that the recipe heroine was investigated with more rigorous methods. Several randomized controlled trials from Canada, the United Kingdom and the Netherlands found that the addiction to heroin was benefitting from a perspective, according to RAND study. It was likely that they would be treated with methadone treatment, and they would be less likely to use illegal heroin. The evidence also suggests that recipes heroin may be more efficient than methadone by reducing criminal activity and improving the physical and mental health of patients.
Dr. Chinazo Cunningham, a specialist at the Albert Einstein Colective Medical and Montefiore Medical Dependency Specialist Bronx, is an important alternative, but thinks they are essential in the U.S. for the moment they see the most serious problem. : "We have a treatment that works, we only have to provide people with a way out of the way," he says.
As it has been said, the first-line treatment of opioid disorders can not be achieved by people who do not have much benefit, a problem in the treatment of a black market.
"It's hard to imagine the treatment of heroin-assisted treatment, because nowadays, the main treatments such as methadone, buprenorphine and naltrexone are thinking of more, there is so much stigma," says Cunningham.
As part of the study, he conducted group and interviews with RAND in New Hampshire and Ohio counties as a result of the overdose crisis. The heroine of the recipe was a lot of ideas, and he knew skepticism about healthcare professionals, local leaders, and treatment on acceptability. People were worried about the use of heroin-assisted treatment to "enable drug use" and face the resistance of the community.
And there is a great legal obstacle. The heroine is strictly regulated 1 drug schedule, which means doctors can not prescribe. This law is to study 1 drug programs, but as with marijuana medical research, it is a difficult process because it is required by the approval of several DEA government agencies. Today, heroin is no human trials, according to the National Institute of Drug Abuse. However, the RAND report says that a pilot program can provide a return to the results from abroad.
According to the report, communities should consider Opioid Program 2, a hydromorph, using pain in the United States. There would be less barriers to establishing a pilot program. A Vancouver study found that prescription was as effective as heroin, and now, at least, ten sites in Canada offer Canadian hydromorphone injections.
However, some United States dependency experts are at least as interesting in New York; Cunningham, Albert Einstein Medical School, as co-operative Dr. Aaron Fox says he is open. In fact, it has been the first deadline for next year to study prescription heroin in other countries, with the hope of "how to make a United States driver".
He says he does not see it as a silver bullet, but it is often not the treatment that works for other illnesses.
"People need more chances to get cancer. If people do not respond to treatment, there are other treatments," says Fox. "If people can not stop or reduce their use of heroin in metamadon or buprenorphine, people need other options."
Food is seen by the sick, as the newest woman did not succeed in other treatments. He reminded that he wanted to go back to the methadone program earlier, but he was struggling and compensated. He did not want to give up.
"I did not say," I tried my best, that's it, "when other tools that are effective in other countries appear," he says. "Why not use it in the United States?"
Elana Gordon (@elana_gordon) Health Reporter and 2018-2019 Knight Science Journalism Fellow at MIT.