POLICE ASSOCIATION OF NOVA SCOTIA 65 Occassionally patients will sell their own prescription on the street. "A while back," says Sgt. Jobe, "we picked up a guy who was buying and selling from his car. He had over 2500 pills in his possession. For every way we find to stop it, someone will figure out a new way to keep it going." Everett Harris is Director of Addiction Services in Cape Breton. He agrees that the use of opiates can cause people to engage in serious risk-taking behaviours. "These drugs involve desire, need and craving. Using needles, engaging in anti-social behaviour, and becoming involved in criminal activity can all be part of the package." But Mr. Harris cautions us not to push the panic button when it comes to OxyContin until we have time to see what the implications are. "There is always a learning curve when a new drug comes on the market and it's still too soon for us to know whether OxyContin is actually creating more drug-related problems, or just diverting the focus away from other drugs. What we may be experiencing is the normal stir that generally accompanies a new drug on the market." However, Mr. Harris also says that over the last five years, Addiction Services has experienced a steady increase in people seeking treatment for problems associated with prescription opiates in general. For reasons that are not yet known, that increase is comprised mostly of men. Because of the nature of opiates, addiction is difficult to treat. These drugs stimulate the opioid receptors in the central nervous system, activating responses ranging from pain relief to euphoria. "If you bombard yourself over a period of time with opiates," explains Mr. Harris, "you burn out the receptors that make the natural feel-good things happen. When you stop taking the drug, even though you do all the right things, you may not feel good for a long time." Dr. Peter Littlejohn says with all the attention OxyContin has been receiving lately, some of his patients have become worried that their use of oxycodone will cause them to become addicted. Although the possibility exists, he says the probability is small -- about 2 or 3 persons per thousand. "Pain is the perfect antidote to opiates," says Dr. Littlejohn. "When a patient is experiencing pain, the euphoric effect of the drug is greatly reduced and the body does not develop the craving associated with addiction. But taken for recreational purposes, these drugs are highly addictive and dangerous." To combat the problem of these opiates, especially OxyContin, getting into the wrong hands, Sgt. Paul Jobe believes that doctors and pharmacists must be extremely diligent when prescribing and dispensing the drug. He also believes that patients who have large supplies on hand at home, should take precautions. "People are being released from hospitals sooner now, and more terminal patients are spending their last days at home. That means there are more drugs kept in homes and often become the target for criminal activity." Dr. Littlejohn believes there are more of the opiate drugs around because people are feeling confident to come forward more with their pain. "Patients these days have the expectation that their chronic pain can and will be treated. And physicians are more willing to do it." Although Dr. Littlejohn sometimes gets patients who try to con him, and he agrees that some prescriptions are being diverted, he doesn't think the problem lies there. "I believe a lot of these drugs are coming in from outside and I believe that organized crime is involved." There seems to be little dispute, however, that abuse of prescription drugs is on the rise, particularly the opiates. Sgt. Jobe believes the key to stopping illicit drug trafficking is to stop the users. "If there is no desire, or need, for the drugs, the dealers will be out of business." He believes this can only be done through more treatment programs, and better education. Much of his time is spent speaking to youth groups and at schools to bring the message home that drugs are a poor choice. "Anti-smoking campaigns are working, and I believe the same approach can work with this problem." Everett Harris agrees. He believes with the involvement of the entire community, a wide-spread attitude change can happen as it did with smoking and impaired driving. Law enforcement, the health care system, government agencies, law makers, the media and the public at large all must take a unified stand. "We need more research to determine just what the problem is, and there has to be a commitment from policy makers at all levels. We need more treatment intervention, and better monitoring to see that programs are working properly. And we have to get the message out that taking drugs for recreational purposes is an unhealthy choice." Peter Littlejohn agrees that the problem is more profound than just keeping the bad guy away from the drugs. He believes we must find a way to make addiction a health care problem and not a policing problem. "This is a brutal and nasty business. We need to get the addicts out of the milieu of crime and violence and give them a health care setting where they are respectfully treated -- a better place to go than where they are now." Although Dr. Littlejohn believes the programs we have in Cape Breton to treat addiction are good, he says it's only a drop in the ocean. "We need more facilities so we can get the addicts off the street and away from the dealers." (...continued) As originally published
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