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nabraxas

Out-of-date drug laws are hurting people

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03 September 2008

SOON Afghan farmers will start planting the poppy fields that are the main source of the opiates that feed the world's illegal heroin trade. Billions of dollars will be spent trying to destroy the crops and stop the trafficking.

Drug addiction and the ramifications of the illegal drug trade need to be dealt with. But there is another drug problem that arguably causes far more suffering but gets only a fraction of the attention: the chronic underuse of opiate-based painkillers in poor countries.

Global consumption of these drugs has more than doubled in the last two decades as the alleviation of pain has come to be taken more seriously. Yet in the developing world they are hardly ever used: there, according to the International Narcotics Control Board (INCB), 80 per cent of the world's population consume just 6 per cent of its morphine, the most widely available opioid for treating moderate to severe pain.

If you are dying of cancer, for instance, in most of western Europe, North America or Australia you can expect a reasonably comfortable end, while in almost any low-income country you will die in great pain. The pain means you won't sleep, your personality will change, you will lose the capacity to care for your family, and you may commit suicide. If it is your child who is dying, you will have to watch helplessly.

Unless urgent action is taken, ever more people will be condemned to a similar fate. On top of the existing AIDS crisis, the developing world is facing a cancer epidemic. Extreme pain is a feature of both conditions. By 2020, there will be 16 million new cancer cases globally each year, according to the World Health Organization, the majority in the developing world where fewer people are succumbing to infectious diseases while more adopt cancer-causing behaviours such as tobacco use.

AfrOx, based in Oxford, UK, which aims to tackle Africa's looming cancer epidemic, is one of a number of organisations arguing that pain control should be an immediate medical and humanitarian priority. This can be done relatively cheaply: a month's supply of morphine costs just a few dollars. So where are the hold-ups?

A major one is the overzealous regulation of painkilling drugs. Under the UN Single Convention on Narcotic Drugs, which dates from 1961, governments are obliged both to prevent trafficking and abuse of opiates and to ensure that people in pain have access to medical opiates. Unfortunately, most countries concern themselves only with preventing abuse.

As a result, patients are forced to travel hundreds of kilometres to the few doctors who can legally prescribe opiates or the pharmacists permitted to dispense them. Doctors risk arrest if they provide pain relief to children, or write prescriptions for more than a few days' supply of pain medicine. The WHO estimates that every year tens of millions of people with severe pain get no effective treatment, in part because of restrictive drug laws.

Some countries have changed their laws to allow improved pain control. Since 2004 Uganda has abolished laws dating from colonial times that prohibited anyone but doctors from prescribing narcotic painkillers, and now allows trained nurses to prescribe them too. This makes sense as 60 per cent of people in Africa will never see a doctor, according to the African Palliative Care Association in Kampala, Uganda. Meanwhile, many Indian states have eased regulations that previously made it difficult to transport morphine from the manufacturer to the hospital.

These measures show what can be done, yet pain control is still out of reach of the majority of people even in Uganda and India. M.R. Rajagopal, a palliative care expert at the SUT Academy of Medical Sciences at Thiruvananthapuram in the south Indian state of Kerala, told the World Congress on Pain in Glasgow, UK, this month that morphine reaches fewer than 1 per cent of Indians who need it.

In many places, the officials who organise a country's supply of opiate-based painkillers are unaware of the unmet need. And such is the fear that patients may become addicted that many doctors are reluctant to prescribe opiates even to those who are terminally ill. This may stem from a mistaken association between medical use of opiates and the violence, poverty and ill-health that often accompanies dependency on illicit drugs. In fact, only a minuscule proportion of people treated with opiate painkillers develop a compulsive need to continue using the drugs, although they may develop symptoms such as anxiety if a drug is stopped too abruptly.

Last week, the 2008 World Cancer Summit in Geneva, Switzerland, endorsed a declaration that makes tackling barriers to pain control a priority. This is an important and commendable step. But dealing with this level of suffering will require a concerted international effort. Illicit trade in medical opiates is extremely rare. Now the signatories to the international convention must show that they can meet another key obligation: ensuring the adequate use of medicinal opiates in pain control.

Rachel Nowak is New Scientist's Australasian editor

http://www.newscientist.com/channel/opinio...nhealthy%20laws

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good point nabraxas!

nobody deserves pain, and as far as i know the world is strongly undersupplied with pharma grade opiates.

a 90 year old man i know, get's his pain relieved with some sort of morhine patch (i haven't checked this product out yet) but anyway, my point is that at some stages they gave him high doses of paracitamol to alternate the morphine and this i believe cause quite some strain on his liver at times as he's skin seemed to turn a bit yellow...

anyway, i believe morphin is putting less strain on the body than paracitamol.

so maybe hospitals use now more paracitamol than morphine just becaus of the "bad" association people have now with opiates, which is totaly the wrong way.

Edited by planthelper

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People should defiantly have access to medicines they need.

However, for the most part, putting things like this into practice will just dramatically worsen the pandemic of opiate addiction.

Here in the west the majority of prescription opiate use I have seen has been drug abuse. In the third world it will be given to people that our western minds label as needing them (many of which may indeed need them) and a very large proportion of those people will then sell them on the black market to get money to feed their family or send their gandkids to elementary school. In the process they will fuel peoples addictions and have to deal with black market drug dealers which may decide to optimize profits by simply gutting them with a machete rather than paying them.

So while I do agree that there are many people that badly need access to pain relief you cant simply throw 14 metric tons of highly addictive opiates into a situation without considering the other social factors at play.

Illicit trade in medical opiates is extremely rare.

What fantasy land is this person living in?

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An african guy was interviewed on BBC world radio a couple of weeks ago about this and he put it down to doctors not wanting to prescribe it for fear of addiction and general ignorance about opiates, that's most likely where this journalist got her inspiration from to write this article. The podcast should still be available from BBC world service.

Under the UN Single Convention on Narcotic Drugs, which dates from 1961, governments are obliged both to prevent trafficking and abuse of opiates and to ensure that people in pain have access to medical opiates. Unfortunately, most countries concern themselves only with preventing abuse.

Sounds like a great law to me! As the article stated it is the individual countries who are to blame, not the law!!

India did the right thing to cut through senseless bureaucratic red tape that prevented transport of opiates to the hospital but it sounds more like human error is to blame here than laws, IE: "In many places, the officials who organise a country's supply of opiate-based painkillers are unaware of the unmet need. And such is the fear that patients may become addicted that many doctors are reluctant to prescribe opiates even to those who are terminally ill."

Edited by baphomet

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However, for the most part, putting things like this into practice will just dramatically worsen the pandemic of opiate addiction.

What is 'wrong' with opiate addiction? If supply is not an issue, what harm is there with opiate use besides potential overdose?

I'd be more worried about the unregulated use of coal tar(paracetamol) that any child can get over the counter from a supermarket.

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Have you ever watched someones health and mind slowly deteriorate in a legal opiate daze?

I'm guessing not

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Have you ever watched someones health and mind slowly deteriorate in a legal opiate daze?

yes I have. dazed but happy.

when his wife withdrew the morphine because she didn't like the fact he wasn't "with it", the pain ov the cancer in the lining ov his lung kicked in & he was dreadfully unhappy not just because ov the pain, but because he was now aware that he was dying & that he was an extreme burden to his family who were tending to all his bodily functions.

it was cruel.

if euthanasia is not an option then keeping someone so doped up that they're not aware ov anything...not just the pain...doesn't seem too bad to me.

Worldwide i think that illicit trade in medical opiates would be extremely rare in comparison to any other drug, or even to designer clothing.

Edited by nabraxas

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yes I have. dazed but happy.

when his wife withdrew the morphine because she didn't like the fact he wasn't "with it", the pain ov the cancer in the lining ov his lung kicked in & he was dreadfully unhappy not just because ov the pain, but because he was now aware that he was dying & that he was an extreme burden to his family who were tending to all his bodily functions.

it was cruel.

if euthanasia is not an option then keeping someone so doped up that they're not aware ov anything...not just the pain...doesn't seem too bad to me.

Worldwide i think that illicit trade in medical opiates would be extremely rare in comparison to any other drug, or even to designer clothing.

Designer clothing.. :huh: WTF has that got to do with it? It's all related to the price of fish in china!

Seriously though.. Many countries have a BIG problem with the illicit sale of medical opiates, Methadone, Oxcontin, Morphine, Subutex, etc! And any idiot can make heroin out of morphine anyway!!

And your friend who was prescribed opiates for a terminal illness should have remained on opiates IMO, that is the correct USE of opiates and is completely different to handing them out to perfectly healthy people! That is ABUSE! There's a big difference!!

Edited by baphomet

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I was primarily referring to when it is not particularly required nabraxas, ie. 'abuse'.

Take a dude with some medical problems- none of them extreme, incapacitating, or causing unbearable pain who would likely live another 20 years- then watch him get progressively more and more severely addicted to opiates until his health crashes, he becomes severely malnourished, can barely manage to walk unless its in the direction of opiates, the mind is 80% gone, perpetually begging and feinding for more drugs no mater the quantity he takes nor the cost be it financial or to his health and sanity, his family having to spend every waking moment watching him to keep him from managing to accidentally take a lethal dose of the god damned happy pills in his vacuuous state which appears as a near equivalent of senile dementia.

The strength of your advocacy of free access to these drugs just Might be reduced a bit, mine was.

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What A "Shame" we don't let dying people say when is enough, What A "Shame" people suffer in pain Needlessly, What A "Shame" Our Comfort comes @ the Misery of Other's, What A "Shame" we feel the need to Control the Lives and Aspirations of Other's when we have our Own lives, Don't get me wrong it's Good to help if one see's a Need.

Of Course Society need's order as such,but the Private lives of individuals should be just that, And No one has the right to Project thier own image onto another, I myself pushed myself to the Edge with My own Smoking behaviour Etc for 27 years, Change Could not be pushed on me, I had to realise for my self when the Lesson had gone for long enough, IVe been vaporising for 3 Months now and will never Smoke plant material on a regular basis again & smoking cannabis(rather than Hash) is definately Taboo for me now. I Myself think Smoking "Dope" is an Apt expression indeed, however I cannot hope to project that onto people.

It Amazes me that People consider Eating Cannabis such a Risky thing, When the truth is it is the road to their salvation from Aberrant Behaviour Patterns, Particularly "Drug" /Addictive Behaviour. Vaporising & eating have delivered me from the Misery of 12 years of "Diagnosed" PTSD, I am the Happy go lucky, confident, connected individual i once was in my youth again once more. Prior to 3 months ago it was 30 to 40 ciggarettes a day, Never happy with the "DOPE" i was smoking, now it's whatever with the Canna, & Whoa i get Such Intense Pleasure and "Enhancement" with MY $320.00 "Aromatherapy" Unit, I actually had what seemed to me to be a Virtual Death Experience, that helped Wipe My faulty Cultural Programming, and start fresh :) Thats my take on my Experience With "Drug" Addiction, However it's just Anecdotal Evidence in the Face of Cannaphobes and thier cohort's.

There is a Huge Cannabis Trade in Australia and only approxiamately 5 to 8% of people Vaporise thier cannabis(upto 95% effeciencey compared to 30 % for bong's etc. on a very $expen$ive product) considering co$t and health implication's I just Dont Get the Resistance, And Believe me there is Surprising Resistance from otherwise health concious people, Wierd Shit Man :(

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Edited by cannaboiler

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People are trained over many years to use opiates correctly and it should not be left to people who know nothing about them to take them at will, especially when they don't need them! That said, they are often underprescribed in cases such as my fathers who was pressing the morphine button non stop but not enough was being released and he suffered needlessly before his death. If you believe in euthanasia thats one thing, I tend to lean this way and I think people should not be made to needlessly suffer but to say that all drugs should be legal and freely available is another thing and IMO is naive in the extreme!!!

If you are saying that people should be able to access and use any drug they want you are wrong IMO and I think rather than go through all this again I should reply to the last thread in which this issue was discussed then link people back to that in future when this issue comes up, what you are saying is madness!!!

Please be careful what you say about cannabis and remember not to incriminate yourself! Oh and for the record, cannabis effects people differently and made me paranoid, psychotic, unmotivated, etc and had a detrimental effect on my life!

Edited by baphomet

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Sorry bro you lost me when you said "one day if i start Smoking again" clearly you dont understand cannabis as much as you think you do, Just my opinion one of 6 billion or so on this Fucked up Planet with its Fucked up state of affairs, Ghandi wasn't afraid to express his Veiws and Refuse to Co operate with Orthodox Thinking, why the fuck should little old me be afraid. I have Nothin to Loose (Bullshit Property etc) Nor do I want it( Yeah one crazy anglo hey)

Whats Crazy is subscribing to the "Western Mind" a house of cards,In My opinion of course. Youtube "Terence Mckenna" on cannabis he'll back me up, Just because he's Dead dosn't make him irrelevant, "Listen" to him on Culture if you claim to have an open mind. Not That I have an investment in that :)

Oh Psycotic Try Serapax, Valium ,"Smoking" alcohol, Full blown Depression and an encounter with police, yeah i understand Psychotic Bro,Don't take it as an attack, just an opportunity to hear a little reality about Real Dangers and "Perceived" Dangers, different "States" of reality.

The only thing i Fear is Fear, let em kick the door down and Fine me Boo Hoo, Thats the Problem with this world no one wants to rock the Boat, or Make Wave's better to fear authority, believe the Preist and Pay the Criminal, and complain about a shity life to no body listening @ the pub,

Yeah like i said I was An Addict never again, freedoms not taken away, it given away( I know because i "Did" )

Edited by cannaboiler

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cannaboiler are you saying not smoking helped your PTSD? ! Vaporising or eating is better for people with PTSD! have I confused PTSD with post truamatic stress disorder?

As for rocking the boat I have been hiding in mine for years and I was not the one who started rocking it!

I am a newbie! I am ill informed! I am uneducted! but I am willing to put my head on the line for the truth!

Prohibition has affected me and my family to a point where I a can no longer hide in the closet and feel it is time to stand up for my personal BELIEFS!

Because of prohibition, Lies, poorly defined legislation and shit policies I am going to suffer! Had the truth not been hidden from me I may not have made some of the poor decisions that have affected me.

Simple scenario would be a person sniffing petrol instead of using a natural entheogen. No person in thier right mind would sniff petrol if they were educated, informed and knew what other options were available! (I have never sniffed petrol so I could be wrong, might be the second time).

So many single movements and voices are having no affect, We all agree that prohibition has failed but we fail to unite in a single cause!

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Cannaboiler, it's not so much to do with you getting in trouble from the authorities, it's more about respecting the forum rules really.

On the other hand entheofarm you are being a little vague, while I am in awe of your bravery and that of cannaboiler I wish you had been a little more clear about what it is your trying to say, just be sensible about the wording of it.

PS: I'm sure many people who sniff petrol are aware of alcohol and other drugs.

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It's amazing how they go around the world pontificating, bullying, butchering countless men, women and children by reigning fire and death on them from a great height, invade countries, effectively steal their resources....all on the pretext of a massive and blatantly obvious lie, yet smoking a simple joint is deemed an "offence".

This can't go on, the system will collapse one day, we are just unfortunate that we live in these "interesting" times.

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WTF has the Iraq war got to do with drug laws? Just because war and corruption are a reality that means that marijihuana should be legal? I suppose cause there are wars there's nothing wrong with everyone smoking a "simple" crackpipe then either?

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WTF has the Iraq war got to do with drug laws? Just because war and corruption are a reality that means that marijihuana should be legal? I suppose cause there are wars there's nothing wrong with everyone smoking a "simple" crackpipe then either?

Wow.

I was simply making an observation, voicing an opinion.

I am sorry you have a problem with that, baphomet.

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I think you are being a little too sensitive.

You were making an observation and a statement, and I simply asked a couple of questions. Sorry if I sounded rude.

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The strength of your advocacy of free access to these drugs just Might be reduced a bit, mine was.

i've known a fair few junkies who've screwed up, & i know few alcoholics who've screwed up really bad. I don't think either drug should be illegal.

no-one has the right to tell me what i can or can't do with my body.

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no-one has the right to tell me what i can or can't do with my body.
Generally I agree with statements to that effect. If I want to tattoo a cobra on my penis thats my right! If I want to take an herbal medicine before resorting to allopathic medicine and doing so wont endanger others thats my right. If a well informed and psychologically sound person wants to drop acid I say rock on.

However, there are exceptions mainly centering around the safety of others and how psychologically sound a person is. For instance, if a person is clinically insane with aggression issues they should not be allowed to buy guns. Severe addiction with constant intoxication is also a psychological impairment and people such as that often have a tendency to do things which endanger themselves or others that they would never do while sober and not addicted. Therefore there should be safeguards to protect people who may not be in full command of their senses or sensibilities. I do know that I have no desire to commit suicide now and if I were to get accidentally addicted to a medication and spiral so far downward that the addiction was endangering my life or sanity I hope people wouldnt say 'well its his body, its his right- let him be'. If I managed to sober up despite their indifference (its very hard for a addict to sober up with no support) I'd be slapping the shit out of any fucker that said such a thing :slap:

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good point and maybe why some of us are sensitive?

Yes I was very vague, sorry, I think people when given proper education regarding drugs are then able to make educated decisions. Due to the so called 'war on drugs' people have made ill-informed and poor decisions, everyone has been affected in someway by alcohol or tobacco be it directly or indirectly. IMHO opinion I would not have drunk so much as a youth had I known what I know now. Which is that I know so little about so much. Vague again sorry.

As for the 'War on drugs' 114. A State shall not, without the consent of the Parliament of the Commonwealth, raise or maintain any naval or military force.

Don't you need military to conduct a war?

Edited by entheofarm

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Therefore there should be safeguards to protect people

Totally agree, but making things illegal or virtually impossible to obtain legally does no-one any favours.

Many countries have a BIG problem with the illicit sale of medical opiates, Methadone, Oxcontin, Morphine, Subutex, etc!

can anyone provide stats to back that up? i've had a look but can't find anything.

i know America has a problem, but i've only very rarely seen morphine on the street in the UK, never in Aus.; & as far as i'm aware it's not a problem in India or SE. Asia.

I don't really know though & would like to see some facts.

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Have you ever watched someones health and mind slowly deteriorate in a legal opiate daze?

I'm guessing not

I'd rather watch that then watch someones health and mind deteoriate by staying up for 12 days smoking crystal in psychosis all the time (mowing through an 8-ball in a couple of days) and drinking bottles of spirits on a daily basis.. theres been so many times where I've said that I wish my cousin was on opiods instead of meth because as the years progress I'm getting more and more worried that his dopamine depletion will be so severe that he's never going to be able to feel any sense of reward again, which just makes it harder and harder to kick for good.

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If I managed to sober up despite their indifference (its very hard for a addict to sober up with no support) I'd be slapping the shit out of any fucker that said such a thing :slap:

"good point and maybe why some of us are sensitive?"

:wink: Yup!

"can anyone provide stats to back that up? i've had a look but can't find anything.

i know America has a problem, but i've only very rarely seen morphine on the street in the UK, never in Aus.; & as far as i'm aware it's not a problem in India or SE. Asia.

I don't really know though & would like to see some facts."

Just cause you can't find statistics about something on the net doesn't mean it's not real! Start by watching THIS! It's a Canadian documentary about oxycontin addiction called cottonland. The people in this film buy their pills from someone who gets a script from a dodgy doctor then sells each one and makes thousands.

Also I can tell you for a fact that if you travel to Frankston station in Melbourne you will see countless white trash scumbags standing around selling buprenorphine, MS contin, Kappanol, etc. Likewise some states like Perth have almost no heroin and prescription opiates are used in its place. My friend just got back from Germany and says that many people there buy pure methodone liquid or subutex. Maybe the sale in illicit pharmaceutical opiates passed you by unnoticed in the UK? Or maybe you haven't been there for a while because subutex is a BIG problem there as is Methadone, although in the UK it is mainly sold in pill form. This may help: http://www.guardian.co.uk/uk/2007/sep/16/u...onsandprobation

Likewise I can assure you that prescription opiates are a big problem in Asia and many other countries, mainly subutex in Asia and it is spreading all around the world:

http://www.parentscontreladrogue.com/index%20ang.htm

http://www.iht.com/articles/2006/06/12/news/drug.php

http://allafrica.com/stories/200808060629.html

"I'd rather watch that then watch someones health and mind deteoriate by staying up for 12 days smoking crystal in psychosis all the time (mowing through an 8-ball in a couple of days) and drinking bottles of spirits on a daily basis.. theres been so many times where I've said that I wish my cousin was on opiods instead of meth because as the years progress I'm getting more and more worried that his dopamine depletion will be so severe that he's never going to be able to feel any sense of reward again, which just makes it harder and harder to kick for good."

Meth is without a doubt more damaging in each dose than heroin or opiates (unless you overdose) which is why it should be illegal, our governments need to protect people who are stupid enough to use it from their own stupidity and protect us from dangerous psychotic people such as them!

"making things illegal or virtually impossible to obtain legally does no-one any favours."

You wouldn't say that if you were being attacked by a psychotic meth head who hadn't slept in a week! Nor would you say that if you were drugged with scopolamine and had your organs removed!

"I think people when given proper education regarding drugs are then able to make educated decisions"

Some people are just too stupid to listed or understand, many realise that it is dangerous but do it just to be cool!

To be honest I'm tired of going over the same shit all over again! Please don't be insulted but IMO some people here must either fall into the above 2 categories or simply not have enough life experience to know what they are talking about!

Watch!!! http://video.google.com.au/videosearch?q=t...emb=0&aq=f#

http://video.google.com.au/videosearch?q=T...;aq=-1&oq=#

http://video.google.com.au/videosearch?q=t...e+face+of+meth#

THE END!!! (or at least it should be!)

Edited by baphomet

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