Opioid addiction is an emerging epidemic. Traditionally, the most commonly abused opiate drugs were morphine and heroin. Today, the problem is complicated by the rising use of opiate painkillers, such as oxycodone and hydrocodone.

While opiate pills are incredibly effective at managing pain in the short-term, usually after surgery or injury, they pose a serious risk of long-term dependence, abuse and overdose. In fact, the World Health Organization (WHO) estimates that 15 million people worldwide are addicted to opiates and 69,000 die from overdose every year.

Because they affect the part of the brain responsible for respiratory regulation, a high dose of opiates can cause a person’s heart to stop beating. Even in the case of a non-fatal overdose, a prolonged lack of oxygen can still cause irreversible brain damage.

There are growing concerns within the global health community over the strong link between opiate painkillers and heroin use. In the 1960s, more than 80% of people following an opiate addiction treatment reported starting with heroin. Newer research from the early 2000s reveals that 75% of people receiving opiate addiction treatment reported starting with prescription opiate painkillers.

Naloxone, a powerful emergency drug that reverses the effects of overdose, is used worldwide to prevent death once an overdose occurs. In most countries, naloxone is only available to health professionals and emergency responders.

This means a person must receive immediate medical attention at the onset of overdose symptoms. However, the people most likely to witness overdose include friends and family members. WHO recommends that naloxone be made available to friends and family members as well as health care workers in order to increase people’s chances of surviving an overdose.

It’s important to note that preventing overdose does not in itself control opiate abuse. People also need to stabilize their health in order to control their addiction in the long run. Canada recently pioneered an experimental health policy with that intention. September’s amendment to the nation’s Controlled Drugs and Substances Act will allow doctors to prescribe controlled amounts of heroin to addicts in order to stabilize their dependence.

The policy aims to achieve two main goals. First, by administering addicts a controlled amount of heroin under professional supervision, doctors hope to avoid the type of overdose wherein someone takes a lethal amount of an opiate substance at one time. Second, they hope that the provision of medically “clean” heroin will prevent the spread of HIV/AIDS and other infectious diseases through intravenous needle sharing.

Canada’s new policy reflects a global movement to rethink opiate addiction treatment. Whereas the traditional view on drug policy has been to incarcerate drug users, some countries are implementing legally-sanctioned alternatives.

For instance, Switzerland, Germany, the Netherlands, Norway, Luxembourg, Spain, Denmark, Australia, and Canada have supervised injection centers where opiate addicts can get safe injection kits, information about addiction and overdose, treatment referrals and access to medical staff. Some centers also offer counseling and hygienic amenities, like toilets and showers.

What supervised injection centers and Canada’s new policy have in common is the belief that addiction is a disease before it is a crime, and should be treated as such. Thus, it becomes the responsibility of a country’s health care system and government to provide safe care.

But what would Canada’s new policy look like in a global context? To start, countries looking to implement a similar policy would need to have reliable health care infrastructure — that means sanitary medical facilities, trained health workers and strong security. Unfortunately, that rules out many low-income nations who don’t have the financial means to uphold such standards.

On the other hand, the United Nations predicts that drug use over the course of the next 35 years will have a disproportionately high effect on urban populations in developing nations. Finding new ways to manage addiction could help developing nations spend less money on prisons where addicts typically end up serving long sentences at the cost of the state.

Moreover, if intravenous drug use happens under medical supervision, then people in condensed urban communities would be less exposed to contaminated needles, illegal drug sales or other intoxicated people.

The amendment to Canada’s drug policy demonstrates how drug policy is changing worldwide. Opiate abuse is just one example of how trends in drug use are an important factor in policy reform.

– Jessica Levitan
Photo: Flickr