Opiates and Politics

Opiates and politicsIn the last decade opiate use has risen significantly. Overdoses and deaths from opiate use are increasing at a frightening rate. Whether it’s opiates like heroin or morphine or synthetic opioids like Percocet or Oxycodone, there’s no difference when considering the consequences of addiction and misuse and possible solutions. When a person develops tolerance and addiction, the body doesn’t know the difference from heroin bought off the street or Oxycodone that comes from a pharmacy.

I’ll just use the term opiate for the sake of simplicity. Opiates like heroin and morphine are nothing new. This is from Wikipedia:

The Mediterranean region contains the earliest archeological evidence of human use; the oldest known seeds date back to more than 5000 BCE in the Neolithic age[8] with purposes such as food, anaesthetics, and ritual. Evidence from ancient Greece indicate that opium was consumed in several ways, including inhalation of vapors, suppositories, medical poultices, and as a combination with hemlock for suicide.[9] The Sumerian, Assyrian, Egyptian, Indian, Minoan, Greek, Roman, Persian and Arab Empires all made widespread use of opium, which was the most potent form of pain relief then available, allowing ancient surgeons to perform prolonged surgical procedures.[citation needed] Opium is mentioned in the most important medical texts of the ancient world, including the Ebers Papyrus and the writings of Dioscorides, Galen, and Avicenna. Widespread medical use of unprocessed opium continued through the American Civil War before giving way to morphine and its successors, which could be injected at a precisely controlled dosage.

Countries like China have had wars over opium, and the U.S. declared a War on Drugs in the 60s, when opiates were referred to mostly as narcotics. Opiate and politics are a big concern now, although the mindset of making war against opiates still prevails. All attempts to eradicate opiates have failed. Just recently government ordered a reduction in the production of synthetic opioids. Government, to its favor, has also called for treatment of opiate addiction, and government supports the use of Buprenorphine as a regulated replacement drug that allows addicts to get into treatment without overwhelming withdrawal symptoms — however, treatment resources and access to resources are sadly insufficient.

Our society seems to favor  symptomatic law and order solutions over long term, fundamental solutions like education, prevention,  treatment and ongoing support. Waging war against drugs has created drug cartels and deadly battles for domination. Addiction, drug misuse and the demand for illicit drugs are the fundamental problems. All efforts so far to change minds and hearts about drug use have come up short. As a society we’re confused about drugs. Thinking clearly and objectively about drugs would be a great first step. If we can remove the fear and stigma, maybe we’ll find fundamental solutions.

If all the resources wasted on waging war against drugs were channeled into education, prevention, treatment and ongoing support, we’d gradually experience a change. Fearing drugs and fighting drugs with weapons have not changed our relationship with drugs. I know it’s a huge problem with no easy solutions, but I have to believe that understanding the problem through real, comprehensive education and prevention efforts will lead us in the right direction.

The Presidential Election and Addiction

Presidential election and addictionI would like to think that whoever becomes our next President will have a good understanding of our nation’s problem with addiction, but I haven’t heard much at all about the subject from the candidates — they appear to have lots of other things on their minds. I’m not convinced the solution to addiction problems, such as the nation’s heroin epidemic, must necessarily come from government, and I tend to think that local communities might find better solutions than top down federal government solutions, but it’d be good if representatives making all the funding decisions in DC really understood addiction.

So much could be done to save lives if only government officials would handle fundamental problems with fundamental solutions rather than wasting money applying symptomatic solutions to symptomatic problems. It appears that most efforts to deal with addiction have created unintended consequences, like the War on Drugs. After decades of treating drug addiction as if it’s a part of an enemy plot to destroy America, the problem is arguably worse than when the “war” started. Locking up drug users along with drug dealers has only ruined the lives of many good people who could have received treatment and gone on to live productive lives. The money it costs to house drug users in prison where they learn criminal behavior is mind-blowing.

I don’t have much hope that the next President will do much that’s different from what other Presidents have done, but it doesn’t hurt to hope. Drug court programs are successful government efforts, although it’s more of a local solution. As middle class and upper class mothers and fathers lose children to heroin overdose, maybe the nation will wake up and pay attention to addiction in general, thus creating a path to apply fundamental solutions. We’ve wasted enough time, money, effort and lives battling drugs as if we can make an imaginary Drug Invader surrender. As along as the demand for drugs grows, the supply will follow. We need innovation, creativity and perseverance to find true, lasting solutions

Drug Courts: National Results

the treatment alternative

Treatment not Jail

Drug Courts have been around for a long time and the results have been very good. Most of us who’ve worked in the treatment field have known for a long time that jail has always exacerbated addiction, and that treatment of addiction is better for individuals and society. Drug Court as an alternation to jail is not a slam against the law and order position, it’s a practical position that has to do with the reality of addiction. In treatment, addicts aren’t escaping responsibility for their actions, they’re treated for a chronic brain disease for which they have to take responsibility. Addicts in Drug Court are held accountable – they’re expected to follow the rules and achieve the goals set for them by the treatment team.

In jail, the addict would be around other addicts and criminals and would not receive treatment for the condition that will likely keep the person in and out the court systems until something really bad happens. Below are facts about Drug Courts:

+ Drug Courts Reduce Crime

  • FACT: Nationwide, 75% of Drug Court graduates remain arrest-free at least two years after leaving the program.
  • FACT: Rigorous studies examining long-term outcomes of individual Drug Courts have found that reductions in crime last at least 3 years and can endure for over 14 years.
  • FACT: The most rigorous and conservative scientific “meta-analyses” have all concluded that Drug Courts significantly reduce crime as much as 45 percent more than other sentencing options.

+ Drug Courts Save Money

  • FACT: Nationwide, for every $1.00 invested in Drug Court, taxpayers save as much as $3.36 in avoided criminal justice costs alone.
  • FACT: When considering other cost offsets such as savings from reduced victimization and healthcare service utilization, studies have shown benefits range up to $27 for every $1 invested.
  • FACT: Drug Courts produce cost savings ranging from $3,000 to $13,000 per client. These cost savings reflect reduced prison costs, reduced revolving-door arrests and trials, and reduced victimization.
  • FACT: In 2007, for every Federal dollar invested in Drug Court, $9.00 was leveraged in state funding.

+ Drug Courts Ensure Compliance

  • FACT: Unless substance abusing/addicted offenders are regularly supervised by a judge and held accountable, 70% drop out of treatment prematurely.
  • FACT: Drug Courts provide more comprehensive and closer supervision than other community-based supervision programs.
  • FACT: Drug Courts are six times more likely to keep offenders in treatment long enough for them to get better.

+ Drug Courts Combat meth addiction

  • FACT: For methamphetamine-addicted people, Drug Courts increase treatment program graduation rates by nearly 80%.
  • FACT: When compared to eight other programs, Drug Courts quadrupled the length of abstinence from methamphetamine.
  • FACT: Drug Courts reduce methamphetamine use by more than 50% compared to outpatient treatment alone.

+ Drug Courts Restore Families

  • FACT: Parents in Family Drug Court are twice as likely to go to treatment and complete it.

  • FACT: Children of Family Drug Court participants spend significantly less time in out-of-home placements such as foster care.

  • FACT: Family re-unification rates are 50% higher for Family Drug Court participants.

There’s no question that Drug Courts provide long term solutions and that jail simply prolongs and complicates the problem of addiction.