Time for half measures should be over

Re: “Thirteen deaths in one day linked to drugs,” Dec. 18. The situation of opioid overdose deaths is dire. We hear proposed solutions, all halfway measures. They include providing first responders with naloxone kits, providing more supervised injection sites and exerting tighter controls on opioid prescribing by doctors.

All these will help. But there is a nearly compete solution that some countries such as Portugal have adopted.

End the “war on drugs.” Recognize that we have a public-health problem, not a criminal-justice problem. Make heroin and other opioids available free at publichealth injection sites, where addicts can also be directed to counselling for treatment and where the drugs are provided in safe quantities and administered under close supervision.

There might be some addicts who will not take part in such a system initially. However, the profits from illicit-drug sales will dry up and the criminal activities associated with its production and distribution will diminish and eventually disappear.

In addition, a tighter control on the prescribing of opioid drugs by physicians must be provided. This class of drugs is appropriate for acute pain, as from an injury or from surgery. It is not appropriate for chronic pain, which is complex in causation and initiates pain by different mechanisms from acute pain.

Further, there are rapid changes in the body’s responses to repeated exposure to opioid drugs when attempting to treat chronic pain. These include reduced effect, requiring higher and higher doses and also dependence, requiring continued intake to avoid withdrawal effects.

The time for half measures should be over. Edwin E. Daniel Retired professor of pharmacology Victoria