Drug Dependency Treatment and Rehabilitation Act (642)

Passed the General Assembly August 18th, 2022. 18 AYES, 0 NAY, 0 ABSTAIN

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Drug Dependency Treatment and Rehabilitation Act

A resolution to reduce Kodiak citizen drug dependence rates. Punishing people for taking illegal drugs only goes so far. What people need is treatment, and a long term plan to get people off their dependence on drugs. These schemes aim to fight the drug issue by reducing demand and assisting rehabilitation, instead of limiting supply and introducing penalties. While some may think of this as enabling, research has proven that this is a good way to fight drug abuse in the long run.

Article 1 - Drug Dependency Rehabilitation and Treatment

1.1 - Mandate suspected drug dependents to be subject to testing in health facilities if drugs can be proven to be in their system during the time of arrest.

1.2 - Mandate medically diagnosed drug dependents to attend treatment and rehabilitation procedures.

1.3 - Allocates 30 million florins per quarter for implementation of this policy.

Article 2 - Right Of Anonymity for Drug Dependents

2.1 - Obligate medical diagnosis of drug dependence and related procedures to grant suspected dependents or diagnosed dependents the right to remain anonymous through test exchange programs between facilities so each facility does not know the identity of the subject they're testing. Each subject and test are to be assigned an identification number to preserve the confidentiality of the subject. After testing, the tests are then to be sent back to the original facility into numbered lockers corresponding to the subject's identification number for the subject to collect.

Article 3 - Approaches to Drug Dependency Rehabilitation and Treatment

3.1 - Legalize methadone, buprenorphine and naltrexone, opioids that acts on the same targets in the brain as drugs such as heroin and morphine solely for medicinal purposes to treat opioid addictions, help re-establish normal brain functions and decrease cravings. All medications help patients reduce drug seeking and related criminal behavior and help them become more open to behavioral treatments.

3.1.1 - Methadone and buprenorphine suppress withdrawal symptoms and relieve cravings.

3.1.2 - Naltrexone blocks the effects of opioids at their receptor sites in the brain and should be used only in patients who have already been detoxified.

3.1.3 - Both a buprenorphine/naloxone combination and an extended release naltrexone formulation are similarly effective in treating opioid addiction. Because full detoxification is necessary for treatment with naloxone, initiating treatment among active users will be difficult, but once detoxification is complete, both medications have shown similar effectiveness under testing circumstances.

3.2 - Approve bupropion and varenicline to be available over the counter for nicotine dependents.

3.2.1 - Varenicline and bupropion work differently in the brain, but both help prevent relapse in dependents trying to quit nicotine addiction.

3.3 - Approve naltrexone, acamprosate and disulfiram to treat alcohol addiction. While these drugs are experimental, they have shown great potential and promise in clinical trials.

3.3.1 - Naltrexone blocks opioid receptors that are involved in the rewarding effects of drinking and in the craving for alcohol. It reduces relapse to heavy drinking and is highly effective in some patients. Genetic differences may affect how well the drug works in certain patients.

3.3.2 - Acamprosate may reduce symptoms of long-lasting withdrawal, such as insomnia, anxiety, restlessness, and dysphoria. It may be more effective in patients with severe addiction.

3.3.3 - Disulfiram interferes with the breakdown of alcohol. Acetaldehyde builds up in the body, leading to unpleasant reactions that include warmth and redness in the face, nausea, and irregular heartbeat if the patient drinks alcohol. Compliance, meaning taking the drug as prescribed, may be a problem, but it may help patients who are highly motivated to quit drinking.

3.4 - The practitioner, before dispensing medicinal drugs to patients for treatment, is mandated to submit to the Ministry of Health and Education a notification of intent to begin dispensing such drugs for that purpose, including certifications that the practitioner is a qualifying physician, defined to mean a physician who is licensed under State law and meets specified training and experience requirements, has the capacity to refer the patients for appropriate counseling and other appropriate ancillary, and that drugs have been approved for use in maintenance or detoxification treatment and have not been the subject of an adverse determination, including requiring additional standards regarding the qualifications of practitioners to provide such treatment or requiring standards regarding the quantities of the drugs that may be provided for unsupervised use.

3.5 - Mandate the Ministry of Health and Education to issue a treatment improvement protocol containing best practice guidelines for the treatment and maintenance of opiate-dependent patients and to develop the protocol in consultation with the consulted parties and other substance abuse disorder professionals, with the protocol guided by science. Mandate the Ministry to set forth specified procedural requirements to make the guidelines effective.

3.6 - Increase investment programs training specialists to manage behavioral treatments, such as group and individual therapy as well as telephone quitlines.

3.6.1 - Behavioral therapies help patients by modifying their attitudes and behaviors related to drug use, increasing healthy life skills and assists them to persist with other forms of treatment, such as medication. Patients may receive treatment in many different settings with various approaches, all proven by scientific testing to be serviceable.

3.6.2 - Mandate the total number of patients of either a sole practitioner or of a group to 30 patients at any one time/authorize the Ministry of Health and Education to set different numerical ceilings according to the number of practitioners in the group practice.*

3.6.3 - Encouragement of participation may be achieved by granting scholarships to interested students in related fields. This may balance out the specialist deficit once 3.1.2 is executed.

Article 4 - Clean Needle, Clean Life Program

4.1 - Approve and roll out the Needle and Syringe program (NSP), to renamed Clean Needle, Clean Life (CNCL), a social service to be staffed with paid volunteers that allows injecting drug users to obtain clean and unused hypodermic needles and associated paraphernalia for free.

4.2 - It is based on the philosophy of harm reduction that attempts to reduce the risk factors for blood-borne diseases such as HIV/AIDS and hepatitis that will spread through infected needles.

4.3 - Oblige the volunteers to hand out pamphlets issued by the Ministry of Health and Education encouraging them to join the rehabilitation programs.

4.4 - Allocates 20 million florins per quarter for this program.

Written by Health and Education Minister Jocelyn Jones, Member of the Kodiak Workers' Party.