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.

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.

Alcohol, Other Drugs and Prison

treatment not jail

Treatment not jail

Our society has not yet come to terms with the failed policy of putting alcoholics, drug addicts and substance abusers in prison. Alcohol, other drugs and prison is a major problem in America. Having an addiction problem doesn’t excuse someone from murder or armed robbery or other violent crimes, but putting addicts in prison for non-violent crimes that are associated with their addiction is futile, wasteful and counter-productive. Here are some statistics from CASA Columbia.

Of the 2.3 million inmates crowding our nations prisons and jails, 1.5 million meet the DSM-IV medical criteria for substance abuse or addiction, and another 458,000, while not meeting the strict DSM-IV criteria, had histories of substance abuse; were under the influence of alcohol or other drugs at the time of their crime; committed their offense to get money to buy drugs; were incarcerated for an alcohol or drug law violation; or shared some combination of these characteristics, according to Behind Bars II: Substance Abuse and America’s Prison Population. Combined these two groups constitute 85% of the U.S. prison population.

Drug Courts and DUI Courts, in which non-violent law-breakers are given a chance to receive long term treatment reveal that treating addiction is better than filling up more prisons and ruining more lives to the point there’s little hope of real change. As Drug/DUI courts become more effective, and if more resources become available to attract quality addiction treatment providers, the results will surely improve. The addiction treatment field has been underfunded. Even private insurance companies don’t cover addiction treatment like they do other medical conditions.

The quality of addiction treatment will remain inconsistent until there’s proper funding. Talented young people leaving college aren’t attracted to the addiction treatment field because other fields of endeavor offer better pay. The idea that people who work in addiction treatment should do it solely out of the goodness of their hearts is a very old and silly idea. Addiction treatment is a healthcare service that can save society billions of dollars if done right, not to mention the lives it can save, and the improvement in the quality of life for millions it can provide. If treatment is effective on only half of the non-violent law-breakers who are now going to prison for what is fundamentally an addiction problem, then that alone is worth is the effort.