What you need to know
81,003 people died from drug-related causes in a 12-month period last year, according to CDC data. This is the highest number of overdose deaths in U.S. history.
Should heroin-assisted treatment be legalized in order to address heroin and opioid addiction?
Yes, we should implement HAT programs
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Using street drugs in excess leads to a higher spread of infectious diseases, a higher chance of overdosing, and is overall very dangerous to addicts. Most are unaware of what they are ingesting as street drugs are usually laced with rat poison and fentanyl. Regulating drugs will decrease the risk of these factors and allow addicts to use their drugs under the watch of medical professionals. The principle of non-maleficence is a key ethical consideration in cases as it requires that no act of commission or omission harms a patient. If we all were stand back to let addicts use street drugs, we are harming them by omission. HAT programs and safe injection zones allow medical professions to step in if there are accidental overdoses and reduce the spread of diseases by giving sanitary needles.
One common misconception about addiction is that the drug itself is the main cause of it. There was a famous study where rats were put into cages and given two types of water: normal water and water laced with cocaine and heroin. The rats would drink the laced water until they died. Bruce Alexander, a psychology professor from Vancouver, noticed that the rats had nothing to do in the cage besides drink water. He recreated this experiment but modified it by adding a park in the cage, which has been described as “heaven” for rats. It has cheese, other rats, toys, and tunnels to give them a happy life. He found that none of the rats overdosed or used the drug water in excess. In reality, the “real” cause of addiction are external factors such as socioeconomic status, unemployment, or history of addiction in their family. The bioethical principle of beneficence, the idea that medical professionals must treat and benefit their patients, aligns with heroin-assisted treatment. If we give addicts a safe, comfortable, and clean environment, it could lead to fewer people using drugs in excess and improve life quality.
One of the most important considerations of a bioethics case is the principle of autonomy; a person’s ability to make a logical and rational decision. Nobody wants to be addicted to a drug or to feel that it “owns a piece of your soul.” Addicts desperately want to use HAT programs to overcome their addictions or at least feel safe in case they overdosed. There is a clinic in Vancouver that offers heroin to addicts and it has consistently been operating at full capacity. The clinicians have had to turn addicts that beg to join it. If addicts are asking for these programs to help them recover, we should provide them.
If you would like to see what a HAT clinic looks like, please watch this news segment about the Vancouver HAT clinic (2:00-2:27). Do not watch this if you are uncomfortable with needles.
No, we shouldn’t implement HAT programs
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Many people believe that HAT programs are providing non-users with drugs or giving free drugs away to addicts. Using the logic from the theory of beneficence, why would doctors willingly supply people with a highly dangerous and addictive drug? Heroin is legally classified as a Schedule I drug, it has no medical purposes, in the United States. In addition, doctors don’t believe that they should prescribe a new drug to get over heroin and opioid addiction as the patient is taking in more drugs and relying on a new one at the end of the day. Supplying drugs defeats their purpose as “the goal is to get [heroin] away from addicts.”
Should the government spend taxpayer dollars to build clinics designated to supply people with heroin? Is it the best use of space? Currently, there is a scarcity of space in hospitals and money in hospitals due to the impact of COVID-19. The principle of justice is about whether the allocation of resources is fair. According to the Vancouver clinic, it costs about $21,600 USD to supply heroin for one addict for one year. It could be argued that the money for the clinic should go to pandemic relief.
Dr. Carl L. Hart, a professor at Columbia is known for advocating for leisurely drug use and the decriminalization of all drugs. He argues that the majority of people use drugs for fun and aren’t addicted but society vilifies them. Addiction is caused by a mixture of socio-economic factors than the drug itself. If the US were to decriminalize and distribute drugs, where would the line be drawn? If HAT programs are only available to addicts, an important requirement for similar programs in Europe and Canada, people that are at-risk will still turn to street drugs. It would be too complicated to come up with a program that the law, government, and medical field all agree on.
Solutions and Responses
Heroin and opioid addiction is one of the most heartbreaking and isolating problems in our society. We have pushed addicts away by not having adequate resources to help them overcome their addiction. The solutions and mindset that is currently set have not properly addressed this issue as the number of overdose deaths have steadily increased and gotten worse from the COVID-19 pandemic. We must all remember that addiction is an isolating issue that can take over someone’s life; we must have more compassion towards addicts. I urge all of you to view addiction as an issue that we must all solve together as a group rather than an individual battle.
Three of the key takeaways are that if we don’t act now, more people will be harmed; addicts want this treatment; and, HAT would actually treat and help addicts overcome drug addiction. The only solution to this issue is for the United States government to implement HAT programs and places for people to ingest drugs under supervision (in case of an overdose). However this requires the U.S. government to decriminalize and legalize all drugs. This process is more complicated by having policy makers and medical professionals agree on the requirements to qualify for the program. Some requirements that I believe are important are:
- Only available to existing addicts that have shown signs of wanting to recover or have attempted other rehabilitation programs.
- Must be available to people regardless of race, economic status, gender, sexuality. This includes being available in areas of high rates of addiction and overdoses (for example, it is near a known drug site).
- Must provide addicts with oral methadone in order to curb cravings
Let me know what you think!
In the comments section, please let me know:
- What is your perception of addiction and how has it changed?
- Do you believe heroin-assisted treatments should be implemented? What are your requirements?