Heroin in the hospice: opioids and end-of-life discussions in the 1980s

Which drugs should be available for people nearing the end-of-life and suffering pain? What are the limits of appropriate opioid use in modern medicine and within society? The story of heroin in palliative care during the 1980s remains largely untold, and it’s one thoroughly infused with politics, social values and cultural norms of the time.

I write about this in my forthcoming book and in the newest edition of the Canadian Medical Association Journal. Here are the highlights.

1. In 1979, a celebrity doctor and syndicated columnist, Kenneth Walker, who wrote under the pseudonym W. Gifford-Jones, launched a nationwide campaign to legalize heroin (diacetylmorphine) for Canadian patients with terminal cancer.
2. This story showcases how the politics of pain, opioid addiction, and proper end-of-life therapies present enduring challenges in Canadian society, challenges which remain vital today
3. The early 1980s was an historical moment that saw a renewed discussion of opioids in end-of-life care, but also a time in which the prescribing of strong opioids such as oxycodone began to increase in the United States and Canada.
Please read my full article in the Canadian Medical Association Journal.

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Cancer controversies and traditional medicines

Today I write for the Saskatoon StarPhoenix and Regina Leader-Post.

The story of cancer patient Ric Richardson, a Métis man from Green Lake, challenges us to think about patient autonomy, medical traditions and Saskatchewan health care.

Just as crucial, his story forces us to reconsider the use and acceptance of traditional Aboriginal knowledge — not only in medicine but in society more broadly.

The full story can be read here:

http://leaderpost.com/opinion/columnists/cancer-controversies-and-traditional-medicines 

Dallas Buyers Club and Saskatoon Marijuana

I just penned a short piece on Dallas Buyers Club and the current debates about medical marijuana in Saskatoon, SK for the Star Phoenix.

Dried Buds
Dried Buds

With the federal election fast approaching, the Harper government’s move to enlarge Canada’s marijuana industry, and the RCMP’s potential actions against dispensaries here in Saskatoon, a lot is happening!

 

The piece begins this way:

In the award-winning 2013 movie, Dallas Buyers Club, we are exposed to heroic patient activism during the AIDS crisis in the U.S. Based on the true story of AIDS-stricken Ron Woodroof, a hard-partying Texas tradesman, the film shows a strikingly thin Matthew McConaughey battle his sickness and the legal authorities in Texas.

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Woodroof, who’s unhappy with his illegally purchased AIDS medicine, and on the edge of death, seeks out alternative and experimental drugs from a doctor in Mexico. Then Ron, being the savvy entrepreneur that he is, quickly establishes a club (a dispensary) to sell his unregulated, sometimes dangerous, imported medicines. In doing so, he operates outside the law and is forced to confront the existing power structure of drug regulation. At one point in the film, Ron storms a town hall meeting of citizens, drug company leaders, and regulators and starts finger-pointing. “People are dying. And y’all up there are afraid that we’re gonna find an alternative without you.”

Saskatoon’s current struggle with illegal marijuana dispensaries has many parallels.

Mark Hauk, who operates Saskatoon’s first medical marijuana dispensary, is one of 13 pot club owners across Canada who has recently received a notice from Health Canada warning of possible RCMP raids.

These stores and clubs are illegal because they procure and sell their products outside the federal medical marijuana system, which was overhauled and expanded last year to allow industrial-scale production of pot products that are mailed directly to licensed patients.Dallas-Buyers-Club-poster-2013-movie-poster-HD

While this system was certainly upgraded through the Harper government’s Marijuana for Medical Purposes Regulation, there are still areas for improvement.

According to Neil Boyd at Simon Fraser, “…it is really quite bizarre that they’re using a mail-order system for marijuana as medicine; that’s not the way medicine is usually dispensed. Medicine is usually dispensed through a visit to a physician and through a pharmacy.”

The entire opinion-editorial, which is called “Pot problems have a familiar ring,” can be found here.

Happy Halloween, and a Freaky Fen-Phen Article

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Happy Halloween, everybody!

The best part of the day is not the cute kids in their adorable costumes. Or the wild parties. Or seeing Michael Jackson’s Thriller over and over and over again. No. The best part has to be the treats.

As I was casually munching chocolate bars with my coffee this morning (Wunderbar is my favourite, hands down!), I thought about the implications. For many Canadians and Americans, cleanses are the answer. Some hit the gym, while others get more drastic and take all sorts of diet pills. Often, it is buying the hot new diet pill, like Time magazine shouts below.

Fen-Phen was one of the hottest diet drugs of the 1990s; unfortunately, it proved dreadfully unsafe. In the Encyclopedia of Pharmacology of Society, I offer a short overview of this weight loss therapy. I recount some of the more ghoulish aspects of the drug. I provide insight into the macabre nature of diet pills, much as I did with another frightening article called Trimming Down.

sage coverfenphencover

This textbook, which is about 2000 pages, will be a fantastic resource for all those people wondering about the role of drugs – including diet drugs – in everyday life. Honestly, the price of the book is blood-curdling, but it’s certainly worth the chills. It answers some crucial questions: How powerful is the drug modern industry? What’s it’s role in society, and how are we influenced by it? Who are the major players? And what does the future of drugs hold?

So, have a great Happy Halloween. Enjoy the candy and costumes. Me, I’m going to probably dole out some treats and watch the Princess Bride, as per household tradition. Remember, a book of Pharmacology and Society’s girth would be a great tool to take out all manner of goblins, ghouls, or rodents of unusual size (ROUS)!

Cheers! Enjoy your treats.

 

Is it Time to Treat Heroin Addiction…with Heroin?

This article was posted on Alternet.org and ActiveHistory.ca http://activehistory.ca/2014/12/heroin-as-treatment-the-calculations-of-a-new-junk-equation/

Heroin as treatment? The calculations of a new ‘junk’ equation

By Lucas Richert

“I have learned the junk equation,” wrote William Burroughs in his semi-autobiographical 1953 book, Junkie. “Junk is not, like alcohol or weed, a means to increase enjoyment of life. Junk is not a kick. It is a way of life.” According to Burroughs, the beatnik, spoken word performer, and author of such other novels as Naked Lunch and Queer, heroin was a way of life for habitual users and addicts. It was not simply a drug that enhanced the quality of one’s everyday experiences, nor was it a means to be a more productive individual. Rather, junk was an end in itself.

Burroughs, for his part, used methadone treatment to deal with his junk addiction. Heroin has had a long and troubled history. It started out like many other illegal drugs, including cocaine, LSD, and mescaline, and was initially touted as a wonder drug. Accepted as a legitimate product in the marketplace and tool in the doctor’s black bag, it was widely available in the U.S. and Canada during the 19th century.