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Heroin Addiction and HIV infection – Dirty needles and a place for harm reduction

December 11th, 2009

Co-authored by: Jamie Felzer

Many people today know about the dangers and risky behaviors (sharing needles, unsafe sex, and mother-to-child transmission) that can increase the risk for HIV/AIDS infection. The question lies in whether or not they are able to take appropriate actions to prevent contracting the disease themselves.

Heroin addiction, dirty needled, and HIV infection

Many heroin addicts, especially those that are homeless or extremely poor, will use whatever heroin they can get, regardless of the risk it puts them in.  A study done in a San Francisco park frequented by almost 3000 IV drug users found that in times of heroin withdrawals, addicts would use dirty  needles, sometimes with visible traces of blood still on them. The need to overcome their withdrawal was more important to them than worrying about the risk of contracting HIV or any of the other countless diseases that can be contracted from such use.

Many of the users surveyed were poor and sometimes didn’t even have enough money to buy their own supply of heroin so they often pooled together what they had with others. They all shared the heroin, cooker and needle to get a fix for the time being.

Regardless of the consequences of HIV contraction, users needed their heroin.

In this community many of the users knew about the risks of sharing needles and were well aware of recommendations that they not share needles or bleach them.  The users actually found health outreach workers slogans patronizing because although they would have  loved not to have to worry about sharing needles, often the more imminent need is getting that fix or suffer being extremely sick from withdrawals.  Given the relatively rare harm-reduction sources available, they were able to use the clean needles given out by some health organizations but at other times had to be resourceful and use what they had regardless of the possible consequences.

There are 1.2 million people living with HIV in the US right now out of a 33.2 million total in the world. 2.5 million people recently acquired the disease and 18% of those new infections were from injection drug users (IDU).  HIV/AIDS is a preventable disease. If we allow users to have easier access to clean needles, we can help decrease the number of IDU infections. If you aren’t sure what your status is, get tested! HIV Testing

Here’s a great resource for finding needle exchanges operating in the U.S. : NASEN


Social Misery and the Sanctions of Substance Abuse: Confronting HIV Risk among Homeless Heroin Addicts in San Francisco. Philippe Bourgois; Mark Lettiere; James Quesada. Social Problems, Vol. 44, No. 2  (May, 1997), pp. 155-173. University of California Press on behalf of the Society for the Study of Social Problems.

UNAIDS Website

Posted in:  Addiction Stories, Drugs, Drugs, Education, For addicts, Opiates, prevention, Tips
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Drug use isn’t the problem – Addiction and the question of legalization or decriminalization

December 1st, 2009

I don’t keep it a secret that I used to have a very serious drug problem. If you haven’t read it by now, my drug use started early on along with a whole bunch of high-school friends. They smoked weed, I wanted to fit in, and the rest is history.

But guess what? Most of them turned out fine.

Drug use versus addiction

Only about 3 of us ended up screwing up a major part of our lives because of our drug use. One friend died 8 years later from AIDS after finding out way too late about an HIV infection he got from shooting up heroin. Another dropped out of college and never made it back. I developed a massive habit that only grew bigger when I shifted from simply using drugs to selling them. Then I got arrested, served a year in jail and went to rehab. That sucked.

The thing is that I don’t think drugs were the source of our problem.

I’m pretty sure I’m going to get my own genetic code sequenced some time in the near future in order to certify this, but I think we all had way too much of the impulsive, rush-seeking in us to allow the rules of society to keep us down. If it wasn’t for the drugs, something else would have probably gotten us sooner or later. I know that, to date, my own love for speed (as in miles per hour) and motorcycles already got me in 3 pretty serious accidents.

What I know now is that once you start using drugs on a regular basis the issue of how you got there no longer matters. Your brain controls your behavior and when drugs control your brain, you’re out of luck without help.

Is the answer legalization or decriminalization?

I think legalization is a mistake. Making a drug legal gives the impression that the state sanctions its use. Heroin, cocaine, crystal meth, ecstasy, and yes, even marijuana cause problems for people. I think that sending any other message is dangerous.

It’s not a coincidence that most people with substance abuse problems in this country (about 15 million) are pure alcoholics. Want a guess at the second biggest group? The marijuana dependent group is about 5 million strong. The rest of the drugs pick up only a few millions in total. Any move towards the legalization of any new drugs will most likely increase their use and therefore the number of addicts.

Still, decriminalization could be the answer. I’ve been meaning to write a post about Portugal’s decriminalized system for a while and haven’t gotten around to it. The bottom line? People found with illegal drugs are given a ticket and sent before a committee. The more visits one has in front of the committee the more forceful the push towards treatment. Still, unless a drug user commits another crime aside from the  possession of drugs they aren’t sent to jail.

As it stand right now, 30%-40% of our prisoners are in for simple drug offenses. That means not only billions in wasted incarceration costs every year, but also billions and billions more useless dollars thrown away at future sentences, court costs, and more (health care, probation and on and on). As it stands now recidivism rates, especially within the addict population are at 70% or higher! Unless these people get treatment, they will go back to jail! It’s that simple. Really.

So what should we do?

Many people aren’t going to like my view point. Those of us in the addiction field are supposed to scream as loudly as possible that drug are bad and that their eradication should be a major goal of our system. I disagree. Sue me.

I think we need to put the money we’re putting into jailing drug addicts into treatment. Even if it saves no money in the present (it will) we’ll be seeing huge savings over time as less of these people go to jail, more of them earn wages and pay taxes, and less of them make wasteful use of other resources like emergency rooms and social services.

And guess what? It will make our society better. We’ll start taking care of our citizens instead of locking them up. We’ll be showing Americans that we believe they can overcome rather than telling them we’d rather see them rot in jail than help them. We’ll be cutting down the number of single parent households and along with them god only knows how many more seemingly endless problems.

That’s my story, an I’m sticking to it.

Posted in:  Education
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