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MAPTalk-Digest Friday, December 31 2004 Volume 04 : Number 228

001 Police Say Stiffer Laws are Needed to Impact Drug Problem
    From: Herb <>
002 Chronic Candy Responds to Furor Over Product
    From: Herb <>
003 The Nose Knows and the Teller Tells
    From: Herb <>
004 Re: MAP: Re: DPFWI: FDA approves new drug for severe pain
    From: "D.H. Michon" <>
    From: Herb <>


Subj: 001 Police Say Stiffer Laws are Needed to Impact Drug Problem
From: Herb <>
Date: Wed, 29 Dec 2004 08:09:01 -0800

Police Say Stiffer Laws are Needed to Impact Drug Problem

note: video


Subj: 002 Chronic Candy Responds to Furor Over Product
From: Herb <>
Date: Wed, 29 Dec 2004 09:36:50 -0800

Chronic Candy Responds to Furor Over Product


Subj: 003 The Nose Knows and the Teller Tells
From: Herb <>
Date: Wed, 29 Dec 2004 16:53:50 -0800

The Nose Knows and the Teller Tells


Subj: 004 Re: MAP: Re: DPFWI: FDA approves new drug for severe pain
From: "D.H. Michon" <>
Date: Wed, 29 Dec 2004 21:01:53 -0600

- ----- Original Message ----- 
From: "Thomas J Hillgardner" <>

"No offense intended!"
Good, then we can discuss this impassionately, for the exercize..
"But like anything in life, not every person
 maintained on methadone is dedicated to staying clean."
I guess that's true, strictly construed. But there are many issues which can 
be extrapolated from that simple statement. First, it *should be* up to 
them, individually, to decide how to run their body and cognitive state as 
long as they harm nobody else nor their property. For many of us, this goes 
to the core of the Drug War debate. Second, the data seems pretty clear that 
addicts who leave maintenance have astronomical rates of relapse. I put it 
to you that the average addict who is at least trying to maintain has 
will-power far in excess of the average Joe. Once off maintenance opioids 
(and methadone is far from perfect, more opioids need to be available for 
the purpose), however, will-power just isn't enough with which to do battle 
with your own brain and central nervous system. On my third major try I made 
it over 8 years - free of all opioids. Like most opioid-abstinent de-toxers, 
however, I began to drink. It seemed like success at the time to go from the 
stigma of using narcotic drugs to the socially-approved ethanol. 
Unfortunately I didn't know yet that I was HepC positive and alcohol was one 
of the worst drugs I could possibly use. Thus we don't have the perspective 
with which to judge what others should do. This should be a core value of 
our movement.
" I pass two methadone clinics on the frequent walk I take from my house to 
the Long Island Rail Road station in Jamaica.  At one of them there 
frequently appears to be purveyors of other narcotics and pain killers in 
the  vicinity.  There is stigma and then there is reality.  I cannot tell 
you whether it is the clinic customers that are hawking "supplies" or other 
folks who perceive that as a good market place location.  (In fairness, it 
is also one block from the welfare office (a different stigma) and the
 LIRR (no stigma)).  But it is a fact that someone is frequently selling 
drugs on the street near that location."
Clinics enforce strong rules about hangin in the vicinity of the clinic. 
Just to be seen hangin around is usually grounds for summary dismissal with 
no appeal. There are always plenty more addicts who want the spot. It is, 
therefore, most likely that the addicts themselves are being targeted by 
peddling elements - adding more weight to the stigma. If it happens to be 
due to the active involvement of clinic patients history shows us that they 
will be soon busted and, as methadone patients, they will pay a heavy price 
indeed when the celldoor slams behind them. IMO, this all argues for more 
and lower-threshhold opioid treatment. More importantly, it argues for 
moving stable methadone-patients into an office-based, 
physician-prescribing situation and out of the clinics.
" Also, isn't that SAMSHA study using the same faulty reasoning to reach its 
conclusion that deaths from methadone overdose are not caused by methadone 
diverted from clinics as it uses to support its conclusions
 that the increased potency of marijuana has led to an increase in emergency 
room admissions?  Isn't it irrational to conclude from "mentions" in the 
DAWN studies that the named drug "caused" the hospital admission?  Just like 
with marijuana, perhaps the increase in mentions may be due to an increase 
in the number of users."
A good point but, IMO, the fact that bad info led them to believe the 
problem was bigger than it was does not negate the fact that far more of the 
methadone recovered after OD was in the tablet form used by pain patients. 
I'm shooting myself in the foot here because I have chronic pain and my 
addiction was, in fact, iatrogenic.
" Does anybody have the stats on the number of persons enrolled in methadone 
programs for comparison to the DAWN mentions?"
The number usually encountered, 184,000, is too low. The number has been 
given of 215,000 and is probably closer to the mean.
"  Even the SAMSHA folks admitted that their "data remain[ed] incomplete." 
Yet they sure had enough paper on hand to put out a press release trumpeting 
their conclusion from their incomplete data set."
True enough. I guess bureaucrats don't care *what* the real numbers are or 
what they show, just as long as their own numbers are wrong and are used to 
tamper with our lives.
> Thomas J. Hillgardner, Esq.
> 82-63 170th Street
> Jamaica, New York 11432-2035
> (718) 657-0606
> On Wed, 29 Dec 2004 01:21:54 -0600 "D.H. Michon" <>
> writes:
>> Thomas Hillgardner wrote: "Or how much can you get for a few tabs of
>> Prialt
>> (ziconotide) on the street downtown near the methadone clinic?"
>> As a methadone-maintained addict I take exception to the comment
>> above, and
>> on a drug law reform list no less! Having stated that, I realize it
>> was
>> written with tongue in cheek and presume no offence was intended.
>> But Jesus
>> H Christ! - we got enough stigma! - we don't need any more.
>> Especially when
>> the government itself issued a study that showed diverted methadone
>> did not
>> come from methadone clinics but from pill mills. To whit:
>> SAMHSA News Release
>> Date: February 6, 2004
>> Media Contact: Leah Young
>> Phone: 301-443-8956
>> Methadone Deaths Not Linked to Misuse of Methadone from Treatment
>> Centers
>> Methadone-associated deaths are not being caused primarily by
>> methadone
>> diverted from methadone treatment programs, a panel of experts
>> convened by
>> the Substance Abuse and Mental Health Services Administration
>> (SAMHSA),
>> reported. The methadone report was released today by SAMHSA's Center
>> for
>> Substance Abuse Treatment Director, H. Westley Clark, M.D., J.D.,
>> M.P.H., at
>> the Sixth International Conference on Pain and Chemical Dependency
>> in New
>> York City.
>> The consensus report, "Methadone-Associated Mortality, Report of a
>> National
>> Assessment," concludes that "although the data remain incomplete,
>> National
>> Assessment meeting participants concurred that methadone tablets
>> and/or
>> diskettes distributed through channels other than opioid treatment
>> programs
>> most likely are the central factor in methadone-associated
>> mortality."
>> SAMHSA convened the panel to determine whether its methadone
>> regulations
>> were allowing diversion of methadone from clinics or whether the
>> rise of
>> methadone mentions in hospital emergency rooms and reports of deaths
>> were
>> due to methadone coming from other sources. Hospital emergency
>> department
>> visits involving methadone rose 176 percent from 1995 to 2002. The
>> rise from
>> 2000 to 2002 was 50 percent, according to SAMHSA's Drug Abuse
>> Warning
>> Network. The panel of state and federal experts, researchers,
>> epidemiologists, pathologists, toxicologists, medical examiners,
>> coroners,
>> pain management specialists, addiction medicine specialists and
>> others was
>> convened in May 2003
>> "The participants in the meeting reviewed data on methadone
>> formulation,
>> distribution, patterns of prescribing and dispensing, as well as
>> relevant
>> data on drug toxicology and drug-associated morbidity and mortality,
>> before
>> concluding that the cases of overdosing individuals were not
>> generally
>> linked to methadone derived from opioid treatment programs," SAMHSA
>> Administrator Charles Curie said. "SAMHSA will continue to monitor
>> the
>> situation to insure that SAMHSA's supervision of opioid treatment
>> programs
>> is always in the public interest."
>> "The Office of National Drug Control Policy (ONDCP) is pleased that
>> the
>> consensus report findings demonstrate that the controls on methadone
>> are
>> working," Dr. Andrea Barthwell, Deputy Director for Demand Reduction
>> at the
>> White House Office of National Drug Control Policy, said. "We
>> applaud the
>> diligence that the providers of methadone have shown in keeping this
>> a safe
>> modality for the patients they serve and the communities in which
>> they
>> reside."
>> The panel based it conclusion that methadone is coming from other
>> sources on
>> data showing that the greatest growth in methadone distribution in
>> recent
>> years is associated with its use as a prescription analgesic
>> prescribed for
>> pain, primarily in solid tablet or diskette form, and not in the
>> liquid
>> formulations that are the mainstay of opioid treatment programs that
>> treat
>> patients with methadone for abuse of heroin or prescription pain
>> killers.
>> "Methadone continues to be a safe, effective treatment for addiction
>> to
>> heroin or prescription painkillers," Dr. Clark said. "While deaths
>> involving
>> methadone increased, experiences in several states show that
>> addiction
>> treatment programs are not the culprits."
>> The expert panel learned that in North Carolina only four percent of
>> the
>> decedents were participating in addiction treatment at or near the
>> time of
>> death, and in Washington State use of multiple drugs was reported in
>> 92
>> percent of deaths involving methadone. In Texas, cases of overdose
>> involving
>> persons being treated in opioid treatment programs declined between
>> 1999 and
>> 2002.
>> The experts noted that the increasing numbers of prescriptions for
>> methadone
>> are paralleling the increase in prescriptions for oxycodone,
>> hydrocodone,
>> and morphine, as physicians prescribe to ameliorate chronic pain.
>> The panel recommended creation of case definitions that would make a
>> distinction between deaths caused by methadone and deaths in which
>> methadone
>> is a contributing factor or merely present. They want health care
>> curricula
>> to train health care professionals in both "the diagnosis and
>> treatment of
>> addiction and appropriate pharmacotherapies for pain."
>> The experts surmise that current reports of methadone deaths involve
>> one of
>> three scenarios: illicitly obtained methadone used in excessive or
>> repetitive doses in an attempt to achieve euphoric effects;
>> methadone,
>> either licitly or illicitly obtained, used in combination with other
>> prescription medications, such as benzodiazepines (anti-anxiety
>> medications), alcohol or other opioids; or an accumulation of
>> methadone to
>> harmful serum levels in the first few days of treatment for
>> addiction or
>> pain, before tolerance is developed.
>> SAMHSA, a public health agency within the U.S. Department of Health
>> and
>> Human Services, is the lead federal agency for improving the quality
>> and
>> availability of substance abuse prevention, addiction treatment and
>> mental
>> health services in the United States.
>> ----- Original Message ----- 
>> From: "Thomas J Hillgardner" <>
>> To: <>
>> Sent: Tuesday, December 28, 2004 10:17 PM
>> Subject: Fw: MAP: Re: DPFWI: FDA approves new drug for severe pain
>> > "Side effects may include dizziness, drowsiness and altered
>> mental
>> > status, with patients confused at times."  Yeah, but is it good
>> with a
>> > couple of beers?  Or how much can you get for a few tabs of
>> Prialt
>> > (ziconotide) on the street downtown near the methadone clinic?
>> This is
>> > going to solve the drug problem?  As with most pain relievers, if
>> you
>> > build it, they will come.  I wonder how much is an overdose
>> quantity?
>> > Its pretty funny how both the Elan Pharmaceuticals spokesperson
>> and the
>> > FDA doc were like "there is no other drugs for pain relief after
>> > morphine."  Talk about living in an altered state of
>> consciousness!
>> >
>> > My perspective never is mainstream, but I would like to think that
>> the
>> > recent FDA debacle with the Cox-2 inhibitors really has to make
>> the words
>> > of the D.C. drug warriors - that marijuana is not safe - ring
>> hollow to
>> > even the most unquestioning lout.  The plain vanilla truth is
>> that
>> > 20-year longitudinal studies on every conceivable side effect are
>> what is
>> > required to assure the public that a substance is "safe."  This is
>> never
>> > done for any substance.  Instead, limited studies are required and
>> there
>> > is a monitoring program under federal law requiring health
>> practitioners
>> > to report all events of severe adverse reactions to the
>> administration of
>> > any FDA-approved drug.  And where there are billions of dollars to
>> be
>> > made selling hope and with the public clamoring for medical
>> > breakthroughs, the FDA does not require an applicant to
>> demonstrate that
>> > a drug is safe before allowing it on the market.  An applicant
>> need only
>> > show that it appeared safe in clinical trials.  It is the media
>> that has
>> > led the American public to believe that FDA approval = safe.
>> Nothing is
>> > ever safe or secure in the real world where there are risks
>> inherent in
>> > going out or staying at home.
>> >
>> > There is even one medication that is advertised on TV that when
>> they get
>> > to the side effects disclaimer, there is a mention of rare reports
>> of
>> > death.  And the government is concerned that marijuana is not
>> safe.
>> >
>> > Thomas J. Hillgardner, Esq.
>> > 82-63 170th Street
>> > Jamaica, New York 11432-2035
>> > (718) 657-0606
>> > 
>> >


From: Herb <>
Date: Fri, 31 Dec 2004 09:12:55 -0800



End of MAPTalk-Digest V04 #228

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