British Columbia -- ground zero for the opioid epidemic in Canada and long a principal point of ingress for heroin -- pioneered the harm-reduction approach with the world's first safe injection sites; now addiction researcher and MD Mark Tyndall wants to go further and end accidental overdoses from fentanyl and other additives by giving registered addicts access to an armored, biometrically controlled "opioid vending machine" that dispenses prescribed amounts of hydromorphone pills without subjecting addicts -- whose lives are often chaotic due to homelessness and the need to steal or prostitute themselves to avoid dope-sickness -- to a bureaucratic process at a pharmacy or clinic.
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According to American Medical Association, the use of heroin as an injected drug, has decreased over the past few years. For those concerned about the harm that sharing needles can do to spread communicable diseases and increase the harm done to at-risk individuals, that's great news. Unfortunately, the use of shooting horse has given way to something that can be just as dangerous to drug users in an entirely different way.
In the most recent issue of the peer-reviewed Journal of the American Medical Association (paywall, of course,) researchers noted that, increasingly, heroin users are turning to heating the drug so that the resulting vapor can be inhaled. That's called chasing the dragon, ya'll and, just like actual dragons, the practice is very bad news. By inhaling heroin, you might be dodging infected injection sites, collapsed veins or disease, but you're opening the door to serious brain damage.
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Looking at more than 30 studies and case reports, which included the cases of two other patients at their hospital, the team settled on some basic observations.
For one, while there’s sparse information on how often addicts are inhaling heroin, the little data that does exist suggests it’s the fastest growing method of use, the team found. In countries such as Sri Lanka, Norway, and India, over two-thirds of heroin users admit inhaling it regularly. In the US, injection is still the most common method, but inhalation is increasing, especially in cities and areas east of the Mississippi. It’s also becoming more popular among teens.