OATR "Best of the Web in Counseling and Mental Health"

A huge thanks to for featuring OATR on their Mastering Counseling podcast in their Best of the Web in Counseling and Mental Health segment! You can listen to the segment at 37:50 toward the end of their September 4 podcast. Link to the podcast:

A text version of the segment appears below:

"What they offer is simple and straightforward… they provide a free resource of information about opioids, addiction and dependence, and available treatment options, as well as a directory of methadone clinics in the U.S. and Canada.

On their web site you can learn about opiates… including what they are, what types of opioids are out there, and what the effects of opioids are. They also offer information on addiction, including abuse, depdence, withdrawal, and the signs of addiction. Lastly, they offer informatioon on treatment, with articles and resources on Opioid Detoxification, Methadone Maintenance, Anesthesia-Assisted Opioid Detoxification and so much more!

They also offer a wide variety of links to other resources on opiate addiction and treatment, such as a Suboxone Treatment Directory and a Methadone Clinic Directory. When it comes to opiate addiction and treatment, their whole site is a fantastic resource for both therapists who are treating those with opioid addiction, and patients who are battling opioid addiction themselves. Many congrats to them on their selection and we highly recommend you check them out!"

FDA approves Probuphine, a six-month maintenance treatment

August 19, 2016

A couple months late on this one, but back in July, a new type of buprenorphine treatment received FDA approval. The drug is branded under the name Probuphine and is being marketed as a buprenorphine implant that will last for 6-months, requiring only 2 treatments per year. This is an interesting development because both methadone and oral buprenorphine (Suboxone) maintenance - the two most dominant types of maintenance treatment for opioid addiction - both require that the patient dose daily.

Below was taken from an article about Probuphine on The page contains a lot of info and covers the most frequently asked questions. Read more below and check out the rest of the page, as it looks like a good starting resource to learn about this new opiate addiction treatment method.

FDA approves Probuphine, a six-month maintenance treatment - July 14, 2016

Death from opioid abuse – including heroin and prescription painkillers – is at an all-time high in the United States. But a new treatment option could be a "game changer" in the fight against opioid addiction, experts say.

Probuphine®, a tiny implant inserted into the arm, delivers a constant low dose of buprenorphine – a medication already used to treat opioid addiction – for six months.

The implant offers advantages over taking a daily pill or sublingual film of buprenorphine. Treatment compliance is far less of a challenge, since patients can't skip, forget or abuse their medication. They also don't have to deal with getting a prescription refilled. Some doctors say the implant is safer and easier to tolerate because it delivers even levels of buprenorphine into the bloodstream. The long-acting implant also reduces the risk of accidental ingestion by a child, and diversion of buprenorphine for illegal resale.

Continue reading at

More drug agents dispatched to Baltimore to assist with RX thefts

June 7, 2015

Baltimore - Several weeks after the death of Freddie Gray, in which six police officers have now been charged in connection with his death, more 'federal agents' (ie, DEA officers) are being sent to Baltimore to assist in investigating the mass looting of prescription drugs during riots following Gray's death. Apparently, the thefts of over 175,000 doses of narcotics have been reported from 27 different locations in Baltimore, and the number of stolen narcotics is actually expected to be much larger as many of the thefts (possibly up to half) have not yet been reported.

Freddie Gray died on April 19 while in police custody. Mass riots and looting then broke out and it was reported in USA Today that May was "one of the most violent periods in the city in nearly four decades, with 43 murders reported." An excerpt from the article published on USA Today that is dated June 5th is available below. The complete article can be read by following the link at the end of the excerpt.

More drug agents dispatched to Baltimore to assist with RX thefts
USA Today - June 5, 2015

Additional federal agents are being dispatched to Baltimore to assist in the investigation of mass prescription drug thefts from 27 pharmacies and clinics during rioting following the April 19 death of Freddie Gray while in police custody.

An estimated 175,000 doses of narcotics have been reported missing; authorities have expressed concern that the wash of drugs may be a trigger for the recent spike in violence.

Last month was one of the most violent periods in the city in nearly four decades, with 43 murders reported.

Drug Enforcement Administration spokesman Todd Edwards said Friday that about 10 additional agents would likely be deployed from Washington to assist in the theft investigations.

Edwards said that fewer than half of the drug entities have filed loss reports, indicating that the estimated drug losses would likely rise.

The pharmacies and clinics were looted in the wave of rioting prompted by Gray's death following his arrest by local police.

Continue reading at USA Today...

Prescription heroin offered in Vancouver outside of clinical trial for first time

November 27, 2014

For the first time in North America, prescription heroin is being offered outside of a clinical trial. The first patients who will receive the prescription heroin had previously participated in a study in Vancouver that looked at using prescription heroin as a treatment option for opioid addiction. You can read more below in an article published yesterday on CBC News.

Prescription heroin offered in Vancouver outside of clinical trial for 1st time
CBC News - November 26, 2014

Vancouver has become the first city in North America where prescription heroin is offered to addicts outside of a clinical trial. For more than a year, doctors at Providence Health Care have been battling with federal Health Minister Rona Ambrose over the right to continue prescribing heroin to patients who had finished being part of a clinical research trial.

In May, the doctors won an injunction at B.C. Supreme Court, allowing them to receive prescription heroin through Health Canada and supply the drug to 120 of the severely addicted people who were previously part of the trial. Now, doctors at the Crosstown Clinic — located in Vancouver's Downtown Eastside and run by Providence Health Care — have received their first batch of prescription heroin produced in a lab in Switzerland. They were to begin dispensing the drug today.

It's the first time in North America that a clinic has been able to dispense heroin outside of a trial, a spokesman for Providence Health Care hold CBC News today.

Dr. Scott MacDonald, who runs the Crosstown Clinic, said the first patients to receive prescription heroin outside of a clinical trial will be a small number of people who took part in his two research trials, and want to remain under medical care. "It is very dangerous and life destroying to have to ingest in an alley, to use illicit heroin three, four times a day. That destroys lives. This is an alternative," he said.

MacDonald says some patients who took part in the trials have been able to reconnect with families and bring stability back to their lives, instead of shooting up in alleyways three or four times a day. "I think all the clinicians at the clinic have seen the great beneficial effect that this treatment can have on people — hard-to-reach populations that may have been using on the streets for 15, 20, 25 even 30 years," he said.

"There is a small percentage of people who aren't engaged in treatment with methadone, the standard treatments. We don't have enough options for them. This is one option, and we need it here in Vancouver."

MacDonald said about 120 patients will be able to access the heroin at his clinic today, and he has applied to have a further 30 to 40 people be able to access the drug. All of the patients must use the drug under the care of a doctor, at the Crosstown Clinic, and cannot take the heroin to use somewhere else, MacDonald said.

Continue reading at CBC News...

New resources added to links page

September 17, 2014

I've added a few new websites to the links and resources page, including two blogs I've recently discovered. The whole links page has also been revamped a bit so it looks a bit less cluttered.

First is Studio L Online, authored by K. Lanktree, self-described Freelance Writer, Recovering Opiate Addict, Former IV Drug User, Methadone Patient and Harm Reduction Advocate. The second blog I came across is The Methadone Maze, a unique blog run by a couple who share their experiences of navigating through the maze that is methadone maintenance treatment. Coincidentally, the authors of both of these blogs are MMT patients who reside in Ontario, which is also where I am from. The site gets quite a few visitors from Ontario as well so I am sure they will find these two blogs especially interesting.

And finally is streetRX, a unique site that displays on a map the latest street prices people have paid for prescription drugs. Several countries are covered, including Canada and the U.S.A., as well as Australia, the UK, and a few other European countries. The site allows visitors to anonymously submit street prices paid for specific prescription drugs. All three of these sites are definitely worth a visit and a bookmark.

Vermont Quits War on Drugs to Treat Heroin Abuse as Health Issue

August 26, 2014

Here is an excerpt from an article that was recently published on Bloomberg Businessweek dealing with Vermont's shift in drug policy from prosecution towards treatment. The complete article can be accessed using the link at the bottom of the post.

Vermont Quits War on Drugs to Treat Heroin Abuse as Health Issue
Bloomberg Businessweek - August 21, 2014

Vermont Governor Peter Shumlin devoted his entire State of the State address in January to what he called Vermont's "full-blown heroin crisis." Since 2000, he said, the state had seen a 250 percent increase in addicts receiving treatment. The courts were swamped with heroin-related cases. In 2013 the number of people charged with heroin trafficking in federal court in Vermont increased 135 percent from the year before, according to federal records. Shumlin, a Democrat, urged the legislature to approve a new set of drug policies that go beyond the never-ending cat-and-mouse between cops and dealers. Along with a crackdown on traffickers, he proposed rigorous addiction prevention programs in schools and doctors' offices, as well as more rehabilitation options for addicts. "We must address it as a public health crisis," Shumlin said, "providing treatment and support rather than simply doling out punishment, claiming victory, and moving on to our next conviction."

Vermont has passed a battery of reforms that have turned the tiny state of about 627,000 people into a national proving ground for a less punitive approach to getting hard drugs under control. Under policies now in effect or soon to take hold, people caught using or in possession of heroin will be offered the chance to avoid prosecution by enrolling in treatment. Addicts, including some prisoners, will have greater access to synthetic heroin substitutes to help them reduce their dependency on illegal narcotics or kick the habit. A good Samaritan law will shield heroin users from arrest when they call an ambulance to help someone who's overdosed. The drug naloxone, which can reverse the effects of a heroin or opioid overdose, will be carried by cops, EMTs, and state troopers. It will also be available at pharmacies without a prescription. "This is an experiment," Shumlin says. "And we're not going to really know the results for a while."

Continue reading at Bloomberg Businessweek...

UK Heroin addicts to be given free foil from NHS

August 8, 2014

Today the UK Government announced that, starting in September, the NHS and privately-run treatment centers will be legally allowed to distribute free foil to heroin users. As injecting is the most harmful method of consuming drugs, especially over the long term, encouraging the use of foil as an alternative to injecting can be seen as a valuable harm reduction strategy that is both cost-effective and easy to implement.

As noted by Release, a drugs law organization in the UK:

"Smoking/inhaling heroin and crack greatly reduces the chances of a fatal overdose, the likelihood of transmitting a blood borne viruses (HIV, Hep C & B), and eliminating the risks of abscesses, DVT, gangrene and other injecting-related complications. Inhaling is not without its risks, notwithstanding, the thermal effects on the lungs and the risks of infections that are contained within the drug, e.g. anthrax and clostridium or infections from non-injecting routes but, on balance of associated harms, it is still considered better than injecting."

Heroin addicts to be given free foil to help them kick their habit
The Independent - August 7, 2014

Heroin addicts are to be given free foil - to heat up the drug - in an effort to help them kick the habit and cut the risk of contracting disease, the Government will announce tomorrow.

They will be offered the foil to encourage them to inhale, rather than inject, class A substances, as part of programmes to tackle their addiction.

Addicts use aluminium foil to warm heroin and breathe in its fumes in a practice nicknamed "chasing the dragon". Substances such as crystal meth and cocaine can be inhaled in the same way.

Critics will raise questions over any move that enables drug users to maintain their habit, but the independent Advisory Council on the Misuse of Drugs (ACMD) concluded last year that offering foil can help an addict's eventual recovery.

Providing aluminium foil is safer than addicts buying tin foil used in cooking as that contains vegetable oil which can be toxic when breathed in.

Health experts also argue that smoking heroin stops users contracting blood-borne viruses like HIV and hepatitis B through shared needles, cuts damage to veins and soft tissue and reduces the risk of overdose.

Continue reading at The Independent...

History of Opium

July 23, 2014

Talking Drugs has released the first article in a three part series that will examine the shift in attitudes towards opiate users in UK society. The first part deals with the history of opium, including its medicinal use in Ancient Greek and Ancient Egypt, the Opium Wars between China and The British Empire, and the proliferation of opium in mainstream Victorian society, both in its raw form and in the form of an alcoholic tincture. I have included a preview of the article below, though the whole article is licensed under the Creative Commons and can be republished freely with proper attribution.

Part I: Opium Wars, Crown Drug Pushers and Victorian Indulgence
Talking Drugs - July 23, 2014 (Author: Liam Deacon)

Britain's history with the opium trade, along with its attitude toward domestic use of opiates, is both shameful and hypocritical. Nearly 200 years ago the country was waging bloody wars in the east to push the drug and bankroll a growing Empire while allowing its use at home. Now, the government fights an entirely different kind of war -- one that has in recent decades both stigmatized and criminalized users, pushing many dangerously to the fringes of society and stoking health crises among these affected groups.

In this three part series we examine that stark attitudinal shift toward opiate users; how our culture went from degrees of acceptance, to despising them as an underclass of society.

For the first piece we explore the sordid history of state drug pushers who operated in the name of the Crown and "free trade" to engineer markets in the east, while supplying its own one in the UK.

Opium and its derivatives have been in use for thousands of years, administered as far back as the Ancient Egyptian era to "prevent the excessive crying of children," and utilized medicinally by Ancient Greek physicians, among them Hippocrates.

In the far east, the opium poppy was reportedly first introduced some time between 600 and 800 A.D., following which recreational use of the drug rose in China. Roughly 1,000 years later, use had increased to such an extent that the sale and smoking of opium was outlawed in 1729 as the country's leaders deemed the societal impact too dangerous. During this era, much of the opium entering the Chinese market was coming from British controlled India, and the British Empire was keen to ensure the drug be accepted as a tradable commodity due to the rising importance of China as a trade partner. It's new illegality presented a considerable obstacle to this.

Throughout the 18th and 19th centuries China was exporting a seductive array of luxury goods that the British couldn't get enough of; silk, porcelain, and that most archetypal of English drug, tea. The problem for British traders was that China was declining to buy anything in return, accepting only silver as payment for their goods. Thus, a trade deficit emerged for the British.

As was typical of colonial hubris at the time, however, the British remained undeterred in pushing their offerings on China. Indeed, the country may have had no need for Britain's "strange and useless objects ... [and] manufactures," as Emperor Qianlong penned to King George II in the 18th century. What it did have, though, was a thriving domestic market for opium, and so, Britain became one of the world's greatest drug pushers, intentionally seeking to get the Chinese population hooked in order to maintain a market.

Continue reading at Talking Drugs...

Opioid substitution therapy could reduce deaths post-release from prison

July 14, 2014

A study published in Addiction Journal has concluded that opioid substitution therapy (OST) in prison and post-release could reduce the mortality risk during the immediate post-release period. The study was conducted in Australia and consisted of opioid-dependent individuals who had both entered OST and been released from prison sometime between 2000 and 2012. The abstract and link to the full study text is posted below.

The impact of opioid substitution therapy on mortality post-release from prison: retrospective data linkage study
Degenhardt L et al. Addiction 2014 Aug; 109(8):1306–17.

AIMS: Release from prison is a high-risk period for mortality. We examined the impact of opioid substitution therapy (OST), for opioid dependence during and after incarceration, upon mortality post-release.

DESIGN: A cohort was formed of all opioid-dependent people who entered OST between 1985 and 2010 and who, following first OST entry, were released from prison at least once between 2000 and 2012. We linked data on OST history, court and prison records and deaths.

SETTING: New South Wales (NSW), Australia.

PARTICIPANTS: A total of 16 453 people released from prison 60 161 times.

MEASUREMENTS: Crude mortality rates (CMRs) were calculated according to OST retention; multivariable Cox regressions for post-release periods were undertaken to examine the association between OST exposure (a time-dependent variable) and mortality post-release, for which covariates were updated per-release.

FINDINGS: There were 100 978 person-years (PY) post-release; 1050 deaths occurred. Most received OST while incarcerated (76.5%); individuals were receiving OST in 51% of releases. Lowest post-release mortality was among those continuously retained in OST post-release CMR 4 weeks post-release = 6.4 per 1000 PY; 95% confidence interval (CI) = 5.2, 7.8, highest among those with no OST (CMR = 36.7 per 1000 PY; 95% CI = 28.8, 45.9). Multi-factorial models showed OST exposure in the 4 weeks post-release reduced hazard of death by 75% (adjusted hazard ratio 0.25; 95% CI = 0.12, 0.53); OST receipt in prison had a short-term protective effect that decayed quickly across time.

CONCLUSION: In New South Wales, Australia, opioid substitution therapy in prison and post-release appears to reduce mortality risk in the immediate post-release period.

Access the full article in PDF form at Addiction Journal...

Opiate overdose deaths rising across Canada

June 27, 2014

According to a report from the Canadian Drug Policy Coalition released last week, overdose deaths from prescription opiates have seen a sharp rise, now accounting for approximately half of all drug-related deaths in Canada. From a CTV News article on the report: "Current federal drug policies are "failing" to promote health and safety amongst those who use drugs, the report says. Drugs users have to rely on a "patchwork" of provincial programs and services that are in place to help them.

Opiate overdose deaths rising across Canada
CBC News - June 18, 2014

Deaths linked to opiate overdoses are rising sharply across Canada owing to an increase in prescription drug use, says a report released Wednesday by the Canadian Drug Policy Coalition.

The report says often these deaths could be prevented and many result from over-prescribing of pain medications.

"It's a national issue, it's a growing problem," said Donald MacPherson, executive director of the Canadian Drug Policy Coalition.

"Canada is the No. 2 user of opiates in the world next to the U.S., so there's a lot of prescription opioids out there in the market."

The report calls for more education of patients taking opiates, appropriate prescribing guidelines for physicians and widespread training and use of naloxone, a drug designed to immediately reverse the effects of an opiate overdose.

"Most overdoses are preventable, they don't need to happen, they don't need to result in death. That's the tragedy here," MacPherson said.

Continue reading at CBC News...

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