Substitution therapy for heroin addiction

Substitution treatment for heroin addiction, defined here as maintenance prescribing of opioid agonist drugs to opioid dependent subjects, has increased in the last decade. The recent history of substitution treatment in five countries--Canada, the U.K., Australia, Israel, and France--is reviewed. In all five countries, the critical issues around substitution treatment are similar. The first key issue concerns the balance between making treatment accessible and attractive, and minimizing diversion to the black market. The second issue concerns the role of primary health care in delivering MMT. In general, there has been increasing involvement of primary health care, with training and support for practitioners. However, there remains uncertainty and official ambivalence over whether treatment should be restricted to specialist clinics and practitioners, or available through primary care. Most importantly, underlying these issues is the problem of stigma being associated with both addiction, and with substitution treatment. The underlying problem that treatment is often at odds with community values places enormous strains on substitution treatment, and makes the treatment system vulnerable to shifting community support and abrupt, politically-driven changes in policy

Can Internalism and Externalism be Reconciled in a Biological Epistemology of Language?

This paper is an attempt at exploring the possibility of reconciling the two interpretations of biolinguistics which have been recently projected by Koster(Biolinguistics 3(1):61–92, 2009). The two interpretations—trivial and nontrivial—can be roughly construed as non-internalist and internalist conceptions of biolinguistics respectively. The internalist approach boils down to a conception of language where language as a mental grammar in the form of I-language grows and functions like a biological organ. On the other hand, under such a construal consistent with Koster’s (Biolinguistics 3(1):61-92, 2009), the non-internalist version does not necessarily have to be externalist in nature; rather it is a matter of mutual reinforcement of biology and culture under the rubric of a co-evolutionary dynamics. Here it will be argued that the apparent dichotomy between these two conceptions of biolinguistics can perhaps be resolved if we have a richer synthesis that accounts for both internalism and non-internalism