Kima: "You motherf***kers kill me. Fighting the drug war one brutality case at a time."
Carver:"Girl, you can't even call this a war."
Kima: "Why not?"
Carver: "Wars end"
Exchange between Detective Kima Greggs and Police Sgt. Carver, "The Wire."
As Sgt. Carver observes, the "Drug War" is an endless endeavor. You do not settle things decisively with one battle, which is, of course, why like the "war on cancer" and the "war on terror," it's not really a war at all but a metaphor of a struggle, a conflict which we would like to win but never will.
So it is with drug addiction.
Alcoholics say, "I'm an alcoholic. I've been sober 30 years," to emphasize that demon is always with them, no matter how long they've kept it at bay.
When the National Institute of Drug Abuse (an institute within the National Institute of Health) defines "success" in treating drug addicted patients it says its goal is returning patients to function, to a viable place in society. The NIDA does not talk about eliminating drug overdose deaths as a measurable outcome, or curing patients of addiction. They talk about managing this disease over time, as you would any chronic disease, like hypertension or diabetes.
When critics say drug rehabilitation programs "don't work" or fail, the NIDA says, well, that depends on what you mean by failure. No the rehab programs don't cure addiction, but they help people manage it.
2/ If we only cared more about these addicts, we would not see all these overdose deaths.
3/ Caring more is expressed as spending more money on:
a/ Drug rehabilitation programs in and out of the hospital
b/ Hiring more people to be "drug rehabilitation certified" experts and advocates.
c/ Funding more programs in schools to "educate" kids not to use drugs or be attracted by the drug culture. Of course programs like "DARE" proved to be an utter failure and when it was examined for results it was such an abject bust, they discontinued it even in affluent counties which could afford it. The drug pundits say that's because it was only for grade school and middle and was not continued into high school. No, actually, that's because kids in an counter culture, bad boy mode are not going to be scolded into acquiescence by adults.
d/ Putting Narcan rescue containers in ambulances, schools, airports, subways, you name it.
e/ Fund needle exchange programs so addicts can get clean needles
It is entirely understandable how frantic parents become when they learn their kids are stealing opioids from them or from others and using them.
To say we are taking the wrong approach to managing drug addiction in this country is not to say we should do nothing, just give up on the addicted.
In the case of intravenous use, you get a whole separate set of diseases: heart valve infections, hepatitis C and HIV. This could be addressed by a functioning health care system which included things like needle exchanges.
But this public health program has never been accepted as a public health problem. Big shots want to jail users and dealers alike.
Portugal has found a solution with measurable results. After legalizing the use and possession of drugs, HIV, hepatitis C and endocarditis rates, once the highest in Europe plummeted to the lowest by far. But that meant drug fiends, as they call themselves, were not jailed or scolded but simply treated in a national health care system.
But in our for profit, commercial health care system, what insurance company wants to take on the expense of drug addiction? Who will pay for these fiends?
There are some ugly truths out there. The fact is, most middle to upper class folk cannot even bring themselves to watch "The Wire" where these problems are most clearly delineated, much less to actually act to make our government develop humane and sensible and cost effective policies.
Carver:"Girl, you can't even call this a war."
Kima: "Why not?"
Carver: "Wars end"
 |
| Sgt. Carver |
 |
| Det. Greggs |
As Sgt. Carver observes, the "Drug War" is an endless endeavor. You do not settle things decisively with one battle, which is, of course, why like the "war on cancer" and the "war on terror," it's not really a war at all but a metaphor of a struggle, a conflict which we would like to win but never will.
So it is with drug addiction.
Alcoholics say, "I'm an alcoholic. I've been sober 30 years," to emphasize that demon is always with them, no matter how long they've kept it at bay.
When the National Institute of Drug Abuse (an institute within the National Institute of Health) defines "success" in treating drug addicted patients it says its goal is returning patients to function, to a viable place in society. The NIDA does not talk about eliminating drug overdose deaths as a measurable outcome, or curing patients of addiction. They talk about managing this disease over time, as you would any chronic disease, like hypertension or diabetes.
 |
| No cures; Relapses as soon as the patient leaves the program |
When critics say drug rehabilitation programs "don't work" or fail, the NIDA says, well, that depends on what you mean by failure. No the rehab programs don't cure addiction, but they help people manage it.
 |
| Van Gogh, Wheat Fields with Cyprus |
The reason America has turned its attention to the "opioid crisis" is that we are seeing more deaths and more deaths among white middle and upper class children. This is really an epiphenomenon. Heroin addiction has always been out there and often among the affluent as well, but dead bodies have a certain insistence; you cannot cover up a death the way you can an admission to the hospital for drug detoxification. Fentanyl, a lethally potent opioid has caused the surge in deaths. That's what's new. The addiction problem is nothing new.
EMT's interviewed on NPR, who are on the front lines, complain they are called back six times to administer Narcan to the same addict who has overdoses yet again. Why are we doing this, they ask? What have we accomplished?
EMT's interviewed on NPR, who are on the front lines, complain they are called back six times to administer Narcan to the same addict who has overdoses yet again. Why are we doing this, they ask? What have we accomplished?
What irritates me is the unexamined assumptions I hear politicians and other pundits use:
1/ If we only cared more about these addicts, we would not see widespread addiction.2/ If we only cared more about these addicts, we would not see all these overdose deaths.
3/ Caring more is expressed as spending more money on:
a/ Drug rehabilitation programs in and out of the hospital
b/ Hiring more people to be "drug rehabilitation certified" experts and advocates.
c/ Funding more programs in schools to "educate" kids not to use drugs or be attracted by the drug culture. Of course programs like "DARE" proved to be an utter failure and when it was examined for results it was such an abject bust, they discontinued it even in affluent counties which could afford it. The drug pundits say that's because it was only for grade school and middle and was not continued into high school. No, actually, that's because kids in an counter culture, bad boy mode are not going to be scolded into acquiescence by adults.
d/ Putting Narcan rescue containers in ambulances, schools, airports, subways, you name it.
e/ Fund needle exchange programs so addicts can get clean needles
It is entirely understandable how frantic parents become when they learn their kids are stealing opioids from them or from others and using them.
To say we are taking the wrong approach to managing drug addiction in this country is not to say we should do nothing, just give up on the addicted.
In the case of intravenous use, you get a whole separate set of diseases: heart valve infections, hepatitis C and HIV. This could be addressed by a functioning health care system which included things like needle exchanges.
But this public health program has never been accepted as a public health problem. Big shots want to jail users and dealers alike.
Portugal has found a solution with measurable results. After legalizing the use and possession of drugs, HIV, hepatitis C and endocarditis rates, once the highest in Europe plummeted to the lowest by far. But that meant drug fiends, as they call themselves, were not jailed or scolded but simply treated in a national health care system.
But in our for profit, commercial health care system, what insurance company wants to take on the expense of drug addiction? Who will pay for these fiends?
There are some ugly truths out there. The fact is, most middle to upper class folk cannot even bring themselves to watch "The Wire" where these problems are most clearly delineated, much less to actually act to make our government develop humane and sensible and cost effective policies.
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