Abstract
Intravenous drug use is a dangerous, yet increasing activity around the world. Persons who inject themselves with illicit drugs are at risk for several complications such as infection caused by contaminated needles. These infections can be serious and often lead to hospitalization as well as other health-related complications. A situation that often arises is determining the best type of treatment for IV drug users who are being discharged from the hospital. Physicians and pharmacists are commonly faced with choosing outpatient IV antibiotic therapy versus oral antibiotics when treating infections caused by IV drug use. This presents an ethical dilemma, particularly concerning the ethical principles of beneficence and
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Unfortunately, the trend in intravenous drug use has increased in recent years. Results from the 2013 National Survey on Drug Use and Health show that of individuals aged 12 or older in America, current users of cocaine and heroin were approximately 1.5 million and 289,000 respectively (Substance Abuse and Mental Health Services Administration, 2014). As the number of intravenous drug users continues to rise, so does the risk of dangerous and potentially fatal complications that are associated with illicit drug use. In this population, death rates are higher due to overdose, AIDs-related mortality, and other blood-borne viruses (Mathers et al., 2013). Mortality rates remain high even though precautions have been taken to reduce them. According to Lavender & McCarron (2013), “Mortality in injecting drug users is up to 22 times higher than for the age-adjusted population, despite increased provision of needle and syringe programs, reduced needle and syringe sharing, and higher uptake of hepatitis B vaccination” (p. 511).
In addition to higher rates of mortality, intravenous drug users are at increased risk of infection. Mertz, et al. (2008) stated, “Malnutrition, immunodeficiency, homelessness, and needle-sharing contribute to a high infection rate in these patients” (p. 2). Common infections range from simple cutaneous abscesses and cellulitis to more serious infections such as
Vancouver Injection Drug User Study (VIDUS) is a project that gives a prospective study and has over 1500 IDU 's enlisted to assist since 1996 and gathers data on drug use, health, sexual activity, etc. Some of the topics discussed included: prison culture, availability and price of drugs and equipment, drug use, VIDUS shows that the risk of HIV infection indicated that incarcerated injection drug users were associated with a greater risk of 2.7 times (Small, Kain, Laliberte, Schechter, O 'Shaughnessy & Spittal, 2005).
In August of 2016, twenty-six people lives changed, and may never be fixed. In only one week these twenty-six people overdosed on heroin, which three of them died (Police). This is the unseen epidemic because of how unaware people are. People are blind to the prevalence in our community, rising rate of deaths, and seizures, lastly that Narcan will become counterproductive. This unseen epidemic is growing faster than anyone knows, and has to be addressed head on.
Needle exchange programs have long been a controversial subject with both the general population and government lawmakers. The primary objective for needle exchange programs (NEPs) is to prevent the spread of blood-borne disease and is very successful in doing so. But, issues of morality due to the perception of drug enablement and the stigma of intravenous drug users (IDUs) and their potential effects on the decline of society are continually used as arguments for those against NEPs. It has been proven through many studies that these programs not only reduce harms associated with intravenous drug use, they are also cost effective and reduce the circulation of used syringes to the general population. Beyond epidemiological efforts, NEPs also provide a de-stigmatized center for gathering and offers health services such as HIV testing, counselling and referrals to treatment for drug addiction. This paper aims to highlight the efficacy of needle exchange programs, safe injection sites and address the social and political issues associated with them.
Vancouver is a city with multiple “claims to fame”. Known to be one of the worlds most livable, expensive, and beautiful cities, it is also well known for its large population of drug users, and the detrimental effects intravenous drugs have had on the Downtown East Side community. One of the major concerns connected to intravenous drug use is the large proportion of users who report a history of needle sharing, greatly increasing their chances of contracting HIV, Hepatitis B or C, and other injection related infections (Strike, Myers & Millson, 2004). With an estimated 15000 intravenous drug users (IDUs) currently residing in Vancouver, and up to an estimated 125000 nationally, the Canadian government has taken a proactive “Harm Reduction” stance allowing the implementation of controversial Needle Exchange Programs (NEPs) throughout most of the country (Weekes & Cumberland). Canada’s first NEP opened in Toronto in 1987, with Vancouver following suit in 1989. While it was still considered an offence to possess drugs under the Canadian Criminal Code, section S.462.2 stated that it was “not an offence […] to distribute needles to prevent the spread of HIV infection” (Weekes & Cumberland). The goal of these early NEPs was to supply IDUs with injection equipment to eliminate the necessity for needle sharing between users, operating on a strict “one for one” model. For each used needle returned, it would be replaced with a new, sterile
This literature review will focus mainly on the drug use of heroin, the scary numbers behind the drug and the sudden rise of overdosing on the drug across the United States. Issues that will be discussed are what is Heroin, what’s in Heroin that makes it addicting, how it can increase the users risk of contracting other life threatening diseases and where it’s use and abuse are most popular across the United states and we will take a look at multiple studies that show examples of our new drug problem in the United States. While we looked at how homicide rates have dropped while in class, the flip side to that is that the amount of drug usage has risen.
Drug abuse and addiction is something that is still overlooked throughout the United States. This issue is real and life threatening; it should be treated as so. “Safe injection sites” are not valid responses to the widespread occurrence that takes more lives each
An increase in drug use, specifically opiates, has overwhelmed the United States. This behavior has led to a rise in the transmission of HIV/Hepatitis C which would be otherwise preventable. The needle exchange programs in Moorhead, Milwaukee, and Scott County are working to lower the transmission rate and increase participation in treatment programs.
If you watch the news it should come as no surprise that drug abuse and overdoses have increased dramatically in the United States. According to the National Institute on Drug Abuse, as many as 36 million people abuse opioids throughout the world with 2.1 million in the U.S. who currently suffer from opioid abuse disorders (National Institute on Drug Abuse, 2014). These astonishing numbers are only marginalized when comparing them to opioid related deaths in the United States. With an increase of 137 percent since 2000, deaths from drug overdoses now occur 1.5 times more often than deaths from motor vehicle accidents (Rudd Aleshire, Zibbell & Gladden, 2016). The opioid epidemic in the
On the other hand, people who are against of needle exchange programs claim that the needle exchange programs don’t save lives but instead it can cause drug-related deaths. Even though NEPs help reduce the transmission of HIV and other diseases, they still encourage people to use more drugs, which could lead to death. Addicts are prone to death, perhaps not from HIV, but from overdosed, collapsed veins, poisoned dope, or the violence and criminality that go along with the illicit drug trade. According to the Centers for Disease Control (CDC), there are more than 33,000 people who died from drug overdose in 2005. As a result, drug overdose become the second
As we all have researched and found out the devastating numbers to the opioid epidemic “the abuse of prescription and non-prescription opioids is one of the greatest threats facing public health in the United States today. It is estimated that as many as 2.5 million people in the US are suffering from opioid addiction related to prescriptions, and an additional 467,000 are addicted to heroin”(2017).
America is in the midst of yet another drug-related epidemic only this time it is the worst opioid overdose epidemic the world has seen since the late 1990’s. According to the Center for Disease Control and Prevention (CDC 2016), “since 1999, the number of overdose deaths involving opioids has quadrupled.” Opioids (including prescription opioids and heroin) killed more than 33,000 people in 2015, more than any year on record. (Rudd, Seth, David, School, 2015). With overdoses from heroin, prescription drugs, and opioid pain relievers surpassing car accidents as the leading cause of injury-related death in America, it became clear that swift and comprehensive legislation was needed for treatment, recovery support and prevention education in communities
Opioid use in the US has increased over the years, and this has led to an increase in substance abuse. Substance abuse is not only associated with use of illicit drugs but also prescription drugs. In 2015, of the 20.5 million reported cases of substance abuse, 2 million had an abuse disorder related to prescription pain relievers and 591,000 associated with heroin.1 The increase in substance abuse disorder has led to an increase in opioid related death. In 2015 drug overdose was the leading cause of accidental death in the US with 52, 404 lethal drug overdoses.2
This leads to a bigger problem for our youth, where 81% of OTC drug abusers also end up using marijuana and hallucinogens (King 68). Over a million arrests are made every year for
“Typically, someone like myself with the score of dope would come in this alley here to consume it…What happens when I run out of dope is I look for more on the ground (Thefilmfano, 2006).” Globally, around 16 million people inject drugs (World Health Organization, 2015). Injection is a common way for drug addicts to consume drugs; meanwhile, injecting drug users (IDUs) have a higher risk of morbidity and mortality than the general population (Marshall, Milloy, Wood, Montaner & Kerr, 2011, p.1429). In North America overdose is the leading cause of high mortality rate of IDUs. However, since the opening of the first legal supervised injection facility (SIF)—InSite at Vancouver has significantly reduced the
Autonomy: patient has right to decide what they want to do. A lot of state laws do not ban selling the syringes and needles without prescription, so most of the time pharmacists get to decide if they want to sell these products or not, however, this action greatly violates the principle of autonomy. Drug addicts have the rights to make their own choice in terms of living on drug free versus drug addictive lives, moreover, while addicts try to obtain sterile syringes and needles, it illustrates