The Mayor understands addiction better than the media does.He is an inside man at the "Skonk Works" & knows needle exchanges are just feel-good waste of money programs. Legalizing heroin & every other kind of dope is a much better idea that also has.
We will find out some day that this entire opiate epidemic was not accidental.
It has worked much quicker and efficiantly than was planned or expected.
It makes and keeps a lot of different people very wealthy.
2
West Virginia looks and acts more like a territory, more like Puerto Rico than a State. Natural resources extracted by robber barons , population insufficient to supply needed labor so immigration added to supply. Now the people are poorer and less educated, less hopeful, and less likely to recover. The efforts of Robert Byrd to lift West Virginia out of poverty are a distant memory. The current leaders in the state and in Washington are more than pleased with the present state of affairs.The chosen remedy for opioid epidemic? Why death and brimstone. A sad and bitter end in such a beautiful place.
2
Opioid addiction is just the most recent by product of an economy grinding to a halt. It used to be alcoholism or other drugs. W. Virginia, along with other rural states, has been played like a cheap fiddle by Trump, by other republicans and some democrats. COAL IS NOT COMING BACK - GET IT ?
Fuzzy black and white photos of smiling workers carrying lunch pails, after one more heroic and productive day in the mines are fine for blue jean ads.
In addition to never coming back, coal has destroyed much of the natural beauty of W. Virginia and other places so tourism potential is affected.
Other than defense, space, and dot com we have not invested in anything with true potential since the 80's. That is why there are no jobs. Investment means putting money in THE FUTURE. The means we use tax dollars which perhaps do not create any return for 3 or 5 or 20 years.
To do that, we need to collect taxes. That is how the interstate highway system was funded, creating jobs for generations in highway construction, in the auto industry, in the home building industry, for decades.
You don't do it by snapping your fingers.
You don't do it by criminalizing people.
5
Needle programs are a necessary evil.
2
They're victims of inadequate healthcare or weak and immoral - depending on your political sensibility. Either way, drug abusers are over there giving each other HIV. There're not "us." So misleading. The drug problem is increasingly middle/upper middle class phenomenon. Economic dislocation and recessions have knocked people down the economic latter. We feel the effect but don't see it on the corner. Both parties are in denial.
5
It makes me frustratingly sad to realize that America's priorities don't involve solving it's deadly epidemic opioid epidemic. Instead, we seem to believe that if we ignore the problem long enough, it'll all just go away, all by itself.
Solving the problem means too many wealthy people, politicians and business leaders alike, will have to force themselves to admit they really don't care. Heck, after all, it's not their son, daughter, wife, sister, brother causing all the
ruckus. They're all 'model' citizens and 'those people' are 'responsible' for their own misery. Admitting the problem exists would be and is, half the battle.
But it won't happen. There's too many wealthy hands dipping into the pot that exploits the opioid abusers for- profit. There isn't any real upside, or profit for them- in actually getting drug abusers truly clean- for life. Too many drug co's with rabid stockholders looking for that payout. Too many shady drug rehab facilities milking the insurers. Too many private equity firms salivating at the next prison/penal contract handed to them by our bought and sold pols.
Life in America. Ain't it great.
4
Your article on endocarditis focus on drug users but I got it from dental work. Many older Americans that do not abuse drugs get it too.
2
Really disappointed with how easily America abandoned its supposed principles.
2
Practical politics consists in ignoring facts.
1
End the failed drug war and focus on treatment.
3
...and legalization.
Needle exchange programs are similar to every other liberal scheme--where the proposed solution exacerbates the problem.
Want more unemployment? Hand out generous unemployment benefits.
Want more disabled citizens? Create generous disability programs.
Want more folks in poverty? Maker it easier to apply for food stamps, public housing, rent subsidies, free cell phones and heat assistance,
Want more addicts? Decriminalize drug possession, and hand out free needles.
Subsidizing any activity, good or bad, ensures there will be more of it. If we want less dependency, less addiction, fewer property crimes and less bad behavior in our communities...then stop making it easy to engage in undesirable behavior.
You won't read this in the NY Times, or learn about it in any mainstream medial outlet--but the recent experience with welfare reform in Maine is a perfect example of what Conservatives have always known.
In 2014, Maine had 16,000 able-bodied citizens on welfare. They passed a new law mandating recipients find some form of work to continue receiving benefits. Over 90% of them dropped off the program. Today, only about 1,500 remain on welfare--saving over 40 million dollars. This money can now be used to fix roads and bridges, or fund other public works projects--or to better support those who legitimately need the assistance.
Singapore has no needle exchanges--and very few addicts. It executes drug dealers. Sometimes compassion can seem harsh.
3
Maybe you can explain why the more liberal states have the highest per capita income, the longest life expectancy and the lowest rates of obesity? While the opposite ends of those spectra are all filled by the most conservative states?
5
Well, I suppose a return to a Dickensian lack of compassion would effect the desired result: an early, miserable death for many people who lack the fortitude to "legitimately" need assistance. Money saved.
On the other hand, Singaporean compassion is even more effective, clearly: Put them out of their misery. More money saved.
1
Finding a job is a good idea if you have skills, a home, and the jobs are available. How do you feel about investing some money in creating new employment opportunities and educating people so they can take advantage of these opportunities? That would also require tax money.
I wonder how many of the 90% that dropped out of the program are doing.
Do you care ?
7
If there are 3-4 percent of Charleston's residents injecting drugs, the city officials are delusional if they think closing down the the needle exchange program will solve their problems. There is something serious going on there they need to deal with if they don't want their city to self-destruct. I remember driving through West Virginia as a teenager going to visit places my mother lived when she was growing up. The state is beautiful but the cities are depressing. They need leaders who will completely reorient how they think. They need to come to grips with the reality that education is key to adapting to changing circumstances if they want to become successful. This includes better jobs and better health. Instead they vote for Trump and similar politicians who sell them the hogwash that the world has been unfair to them and they can hold on to jobs in dying industries and lifestyles that are killing themselves also.
2
So many other creative solutions could have been used.
Why not provide incentives for people to bring in discarded needles (such as you have with recyclables in many cities)? Why not roving vehicles that make the congregation of addicts in one spot less likely? Or look to what so many other cities have done to creatively help addicts and reduce the burden on the cities themselves.
I think its fear and ignorance. People just don't want to support addicts. Let it be someone else's problem. The fact that evidence shows no one is taking up drug use from needle exchanges and no one is moving INTO a city because needles are available means nothing to these people.
Maybe this is why I just choose not to use drugs. It gets too complicated otherwise. What always impresses me sometimes when reading about many who can’t figure out how to feed themselves yet are always able to get drugs instead. Remarkable adaption skills.
2
If Heather Bresch, Joe Manchin's daughter, had figured out a way to profiteer shamelessly from needle exchanges the same way she did with epi-pend (600% price-gouging), you can bet that W Va would still have the probram.
Money talks...again...especially in one of the most politically and generally corrupt states in the USA. (Think not? Then Google Wally Baron and Arch Moore, along with Bresch, Manchin, and Blankenship.)
4
That preventive programs work, save money, etc., doesn't matter. The Right today wants retribution, not common sense or reconciliation, and they sure as Hades do not want facts to box them in with an unimpeachable argument. They want punishment. They want to see suffering that vindicates their worst prejudices. They're prefer to invite the problem and then punish the people who have it.
1
It's an interesting idea based on shallow compassion, akin to giving incorrigible drunks rubber cars. The problem is every junkie at some point turns on some innocent kid. Misery loves company, dope use is spread by hand-to-hand networking.
Addiction is a multi-level, big $$ business and nothing else. The junkie is the key cog in the machinery of that business. Junkies support via profit & protect via silence the dealer. They support the treatment-clinic scammers as clients on the public/private dime, and they feed an industrial jail business rife with pensions and a vast building program.
To attack the addiction problem you have to address the junkie as a profit hub via a new method. You do not enable them. The first key is: face the fact that addiction is permanent & not treatable while also not clearly criminal. Society must regulate addiction away from the Black Market, by providing the addict with prescribed hard dope in exchange for compliance with strong rules.
1. You lock up (or worse) the dealers.
2. You register and provide safe legally prescribed drugs of varying kind for the addict so they have no relationship with the Black Market.
3. With the money you save on incarceration you create an education system against drugs for kids. You make it so powerful that kids by nature turn in the first person who shows them a little baggie with white powder in it.
Read here, perhaps starting at chpt 10:
http://www.druglibrary.org/schaffer/library/studies/cu/cumenu.htm
Morons.
Injection Drug Users spread disease beyond the boundaries of their community.
Needle exchange programs absolutely work to decrease the spread of blood-borne disease.
Even Indiana, under Governor Mike Pence, created a needle exchange program.
Then again, why should I care?
I'll never be in West Virginia for any reason, so I have no reason to care...unless some of those people immigrate out west.
2
Yes - the research is conclusive: Needle exchange programs do ABSOLUTELY nothing to cut down on the rate of illegal drug use.
They create a concentrated living zone of Dante's Third Circle of hell for the ordinary civil residents who live around them.
They normalize as 'safe' - a practice that kills most of its adherents to kids and young adults.
And if they indeed 'save' $70 million in HIV treatment costs - why was the budget for HIV treatment costs ever lowered by - you know - the claimed $70 million dollars.
2
So tell us what research you're talking about!
One point of needle exchange programs is to promote prevention of infectious disease epidemics. That keeps us all safer.
18-months ago the CDC released a report that encouraged using needle exchange programs.
Vital Signs: Trends in HIV Diagnoses, Risk Behaviors, and Prevention Among Persons Who Inject Drugs — United States / Weekly / December 2, 2016 / 65(47);1336–134 https://www.cdc.gov/mmwr/volumes/65/wr/mm6547e1.htm?s_cid=mm6547e1_w
The report says:
"Implications for public health practice: Access to comprehensive prevention services is essential for all PWID. Syringe services programs reduce syringe sharing and can help PWID access prevention and treatment services for HIV and other bloodborne diseases, such as hepatitis C and hepatitis B."
It also says that white people are now 50% of the new needle users and they are sharing needles and could really raise the rates of HIV infections. Charleston, WV is 80.3% white and the county is 88.6% white (according to 2016 & 2017 U.S. Census estimates). Therefore, I suspect more than 50% of new addicts in Charleston are white.
So...where are your studies and facts that prove ABSOLUTELY that you are correct?
1
Gotta love the South, they do whatever they can to keep themselves down.
2
The truth is the both sides have the truth, as those using drugs, are probably in need of mental health services, using other drugs beside heroin, etc. such as meth or alcohol, and when on all of that have issues like anger, violence, inability to take care of personal hygiene, which presents problems of contagious diseases to the public at large, and the fact that these people have so many needs, as each person with these issues needs care 24-7, and the money to fund the kind of services needed by this population of people is astronomical, as these people addicted to drugs also are homeless. An affluent society breeds more addicted people, more dependency, and more safety, and health issues for society at large. None of it is a win, win for either side.
3
Drug addiction is not a moral failing. It is a physical condition. We are human beings with vulnerable physical bodies that grow and decay. Treat the physical condition, then allow the individual to use the resulting clarity to assess whatever role their psychology, their environment, or their moral compass might have played in developing the substance abuse.
1
West Virginia is the poorest state in the union. West Virginins have poor health as illustrated by obesity and early mortality. It is sad to see that their politicians dont have the courage to make unpolular decisions which can decrease the liability of an AIDS population. I suspect religous fundamentalism which frequently engages in fantassy and moral judgments limits thesee politicians.
5
Why not adopt an obvious and simple solution borrowed from bottle and can recycling programs?
Maybe people could be paid a few cents for each used needle they turn into the exchange.
That way, addicts have an incentive to not discard their used needles, and to clean-up after others.
10
Lol ... this was never the problem. Exchanges work by offering incentive by giving you free clean needles in exchange for your dirty ones.
You get 1 needle for each dirty one you bring in ... understand? That's why it's called an 'exchange'.
There's no need to incentivize a needle exchange with money ... clean, working, sharp needles for free is more than enough incentive.
1
But still the alcohol flows freely and the cigarettes too, and cannabis seen as another devil. Keeping the big wig's glasses full without a thought about the broken dreams of kids who are most hurt by this heroin epidemic. Maybe if we plugged in and paid attention to everyone's reality and supported the mental health of those struggling there wouldn't be a nation of people trying to numb themselves from a sad reality, that unless you're rich and privileged, you're not as important.
4
Give them some credit for at least trying.
2
The title of this article is "Why a City at the Center of the Opioid
Crisis Gave Up a Tool to Fight It", where "It" is opioid use.
However, no evidence is provided that needle exchange significantly
reduces opioid use. It states: "Needle exchanges reduce the spread of
blood borne diseases like hepatitis C and H.I.V. and do not increase
drug use." A tool to fight opioid use would do more than "not
increase" drug use! Thus, the article conflates fighting opioid use
with the benefits of needle exchange.
6
" A tool to fight opioid use would do more than "not
increase" drug use! Thus, the article conflates fighting opioid use
with the benefits of needle exchange."
You are the only one stating that the needle exchange is meant to reduce opioid use. The second sentence of the article clearly statues the intent of the program: "To its supporters, it [the exchange program] was a crucial response to an escalating crisis, and the last bulwark standing between the region and a potential outbreak of hepatitis and H.I.V."
The article goes on to relay the debate between city officials, such as the mayor, and proponents of the needle exchange program. Interestingly, the mayor's resistance to the program seems to stem from your same confusion; namely, that it does not fight use of the drugs in the first place. From your comment and those espoused by city officials, the conflation of issues seems to stem from poor communication of the needle exchange's purpose.
It should be made clear that there is value in the exchange program alongside other measures to reduce first time drug users, and recidivism from users trying to get clean. The supporters make a strong argument that many societal costs are reduced by this program. Perhaps the opponents need to consider allocating some of the cost savings in reduced Hep-C and HIV costs to programs which reduce drug use.
1
By connecting users with the health care profession it increases the chances that they may seek addiction treatment.
3
Needle exchanges fight drug *abuse* by engaging a population with healthcare that wouldn't otherwise be.
Addicts that go in for clean needles are offered medical treatment with methadone, suboxone, etc ...
4
“This is really truly backwards.”
Is that the West Virginia State motto?
6
Sadly whatever the mayor is saying he has a view of the people in these programs that makes them less than human and thus he can strip them of accesss to a program and services that saves lives of both addicts and nonaddicts. Can I assume he keeps his own son out of Charleston?
It’s perverse. Close down a program that is working because it’s working! Yes, that is the new wave of insanity that has infected our Poltics and our culture. It will not end well.
4
How was it working? There was no reduction in opioid use at reduction in infections. And the users were littering their used needles rather than exchanging them.
Prepare yourself for what your parks and public spaces look like without a 1-for-1 exchange.
You do understand the exchange requires you to bring back your dirties right? So for every needle that ends up discarded in a park ... the addict has to spend money to buy one they would otherwise have had for free.
Addicts can still buy needles regardless of what-ever state policy you might have ... even one that prevents them from buying them in pharmacies ... thanks to the power of the US Postal Service.
Only now, they have absolutely no incentive to properly dispose of them ... or maybe even no *way* to dispose of them depending on pharmacy policy.
1
Sure, let's go back to doing without this important public health intervention. What came befre was working so good, right? So good they had to open needle exchanges to deal with the diseases and other health effects that the prohibitionst mindset imposed on the population. A moralistic solution is no solution to a healthcare crisis.
Some will undoubtedly say that whatever happens is god's will. Nonsense. These are man's laws, man's will, god has nothing to do with it other than the fact that I sure would not want to try to defend myself when I voted for something I knew would be sure death for a number of junkies. I suspect god wouldn't be happy here.
Cruel, human rights violating law doesn't help anyone, except the few that are angling this to look good to get reelected. The monsters aren't all in jail. Some are sitting right there in the statehouse drawing a fat government check.
2
We are talking about the rights of addicted individuals. But what about the rights of the city? A city is not just a conglomerate of buildings and sidewalks: it is a living entity, with its own character and destiny. A beautiful, clean and livable city uplifts its inhabitants and creates the sense of community, so sorely lacking in American life. I lived and visited in cities where you don’t risk stepping on needles or confronting some twitching, filthy and dangerous wreck of a human being when you take a walk or sit in a cafe. Most Americans who only know the trashed-up ghettoes or the soulless suburbia have no idea what city life can be like. So I applaud the Mayor who is trying to prevent his city from falling apart. Yes, we are bound by the social contract to support those in need. But a junkie shooting up in the view of children; a stinking homeless person accosting passers-by; or somebody urinating in the middle of a sidewalk; have they fulfilled their side of the social contract? And if not, by what right can they demand that we fulfill ours?
10
And there are no other solutions that would enable support of addicts and harm reduction AND resolving the side effects?
As someone mentioned, for a tiny price, one could give back 5 cents to returned needles (just as it works for recycling). One could create a roving needle exchange that isn't housed in the fancy civic center. One could look at all kinds of solutions that work in all kinds of other cities that are both fighting this issue and preserving quality of life. It isn't and shouldn't be an either/or decision.
3
Spoken like a true child of privilege...
2
Needle *EXCHANGE* ... how does no one even understand the concept when it's spelled out so clearly in the name?!
1
I've actually been there, It's just West Virginia.
4
The worst thing about this isn't that the opponents are flat wrong in believing needle exchanges increase drug use.
The worst thing is that they think letting people get HIV is better than people trying drugs. That is a very, very sick set of priorities.
5
Whenever a huge oil spill occurs, "Big Oil" responds with billions of dollars and clean-up operations. Settle down liberals, I know "Big Oil" is evil .. but at least they try to contain their mess...
"Big Pharma" on the other hand sits back and says, "Don't look at me.."
4
Not really. Big Oil does all it can to permit, ignore, and deny spills that don't meet the standard for "huge". Those small spills are common and endemic. In the aggregate those spills are colossal and thanks to the perps, they aren't news.
1
In the 2 years or so that it took Mike Pence to come around on a needle exchange program, thousands and thousand of people got infected with AIDS.
Conservatives are not concerned with what works, they are concerned with what proselytizes.
They have no problem with a war of convenience that slaughters hundreds of thousands of innocents, but, they do have a problem with transgender bathrooms.
Their morality begins and ends with hubris.
They vote for a racist, but condemn a jay-walker.
Such is the morality of the shallow. The people who cannot separate the frame from the message. Christians who quote the bible, yet, have zero understanding of it message.
If Christianity can be reduced to a single word, it's "empathy". And compassion is it's child.
Put yourself in someone else's shoes, and the world is yours. And pontification without emapthy is the hallmark of a fool.
Empathy is a practical profession. Condescension is the art of vacuousness presented as virtue.
5
Star locking up junkies and throwing away the keys and then number of people using illicit drugs will drop dramatically. The junkies know they can get away with the drug use. Needle exchanges just encourage more people to play with drugs.
2
Unfortunately, research (as the article points out) solidly shows exactly the opposite of what you just said.
3
It's always a problem when facts get in the way of so-called common sense. Facts don't usually win, but they don't go away either.
Stretching support points when making an argument undermines the argument. The assertion that the lack of free needles will cause addicts to rob and steal is rather silly. I guess I'm presuming they don't have an alternative source of funds for the heroin.
3
Your argument doesn't make sense. If an addict with a $200/day habit can get that money, he could also get $1/day for a sterile needle. If, while high, he shares his drugs with a fellow addict, or has sex with someone infected, he's going to get infected anyway. And while in a drug stupor, judgement vanishes.
One of the defects in most progressive programs is that anything that sounds good, they are prepared to throw money at.
At its peak, the needle exchange under discussion was distributing needles to 400 people per week and creating a health hazard to the neighborhood by discarding their used needles in public rather than exchanging them. [This decreased public support for the program.] Meanwhile 20 patients per week availed themselves of the resources of the health department, to be tested for hepatitis and HIV, and five of them were brought into the system to get help for their addiction.]
Since the end of the needle exchange, only 12 people are visiting the health department. Do you have any basis for your belief that resources are not now being better utilized and that eight of the 12 are getting help compared to the five out of 400 under the needle exchange program?
It's not clear to me...are there needles everywhere in town? or just at the exchange site? If they are just at the exchange site, why aren't they just cleaned up? If they are everywhere, what does the needle exchange program have to do with that aspect of the problem? Or is this just the age old problem of no one wanting "undesieables" whether homeless, mentally ill, convicts, or addicts near them or visible to the general population?
1
Studies say it reduces infections. But it didn't say BY HOW MUCH?
Saying it saves money is questionable. Once a druggy is dead, they consume no more resources and commit no more crimes. Certainly that saves money.
I detect bias in the reporting.
2
The article states:
"One recent study estimated that $10 million spent on needle exchanges might save more than $70 million in averted H.I.V. treatment costs alone."
Here's a link to the study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4211599/
I highly recommend reading the study, because it estimates the reductions in infections, and cites at least 5 other studies attempting to determine the same thing.
3
"I detect bias in the reporting" because it doesn't match up with your presumption that high rates of HIV and hepatitis infection are a net tax benefit, a conclusion which you have come to based on no experience, no research and no data.
I detect bias in your reasoning. You just like the thought of drug users getting sick and dying.
1
If we had few people in the world, and needed every one of them, we might actually begin to take care of each other. Now we don’t invest in people because there are too many of us. What is the right number of people? When will the time come that we find out?
1
what's happening to good old empathy?
[someone mentioned the trait before me.]
and who benefits from it disappearing?
1
I don't understand why people struggle with straightforward social benefits like wanting to live in a less disease-ridden society and to have your city prosper, rather than sitting back and watching everything crumble out of spite and moral superiority.
1
I was struck by the comments about runining the neighborhood, as apparently Charleston has happily got a neighborhood right next to its new civic center.
Also enjoyed the bit from the mayor about moving the whole program out of downtown to some idyllic country location, as though those folks are dying to have junkies bussed in regularly.
They shut down a working program that was starting to save them money. I hope they're planning to enjoy the consequences.
3
They hypothesized that it would someday save money. It was in fact costing money. They didn't have any evidence that it was saving money. They believed that fewer people would become infected with hepatitis and HIV and that would ultimately save money in treating them. They did not produce a reduction in infection but in fact identifies that they had an epidemic, which is why they show up on the map as a hotbed of infection.
It wasn't starting to save money.
i do not work in this field, etc, but i suspect many taxpayers do not feel that they should be forced to pay for others to possess and use illegal and harmful drugs. do the police look the other way when a person goes to the taxpayer suuported place to use the needles and throw away facilities? are these users special? the users apparently can pay for their drugs, then why do taxpayers have to pay for the neddles?
2
Says anyone that does not understand the power of addiction, and how its not a choice, how 'tough on drugs' does nothing to reduce its occurrence or harm, and how turning a blind eye to harm reduction just costs everyone a whole lot more.
No one chooses to become an addict. And almost no one can stop on their own without professional help and doing so would risk their life. And yet access to addiction treatment is scarce (after all which taxpayers want to pay for it).
This isn't like quitting smoking or consuming transfat. Think of it more like being told you can't drink liquids anymore or consume food.
A civil and humane society takes care of its people. But I'm not surprised by this response: Americans even balk at helping each other with healthcare costs or education. its just every man for himself.
2
It's not a choice? Users didn't choose to shoot up the first time or the first ten times until addiction took hold? Who is forcing people to inject drugs?
Actually, tobacco is quite hard to kick. Even the Times reports that it's harder to quit smoking than to quit heroin.
And it's not entirely true that 'get tough' programs don't reduce drug use. The incidence of tobacco use has declined significantly over the years, and surely part of the explanation for that is that we introduced more regulation and made it more expensive. People were told they couldn't smoke on airplanes, in bars, and in office buildings. We didn't say 'oh poor dears you are addicted so we have to accommodate you.' We said 'this is not acceptable in public.'
"Health experts say the programs create relationships between deeply addicted people and the health care system, an essential step if they are to be reintegrated into society. "
That's just the point, they have no intention of reintegrating into society. If they did they wouldn't be looking for a needle to inject their drugs.
2
if it were as simple as that ...
[at some point, addiction is no longer
just a matter of willpower or its lack.]
1
There are far more drug users around than you know about. They are already integrated into society. Chances are they mostly conceal their drug use from you and so you have no idea.
1
They think they are integrated and hiding their addiction but they aren't. Their drug addiction is more apparent to those around them than you or the addicts want to admit. Drug addicts are always in denial and failing to take personal responsibility.
The main problem is that needle "exchanges" often are giveaways instead of exchanges. In SF one program SFAIDS alone gives away 2.7 Million needles each year. The result is millions of needles with biohazardous material in trash cans, on the street, and in playground sand boxes.
1
I'm sure that the families of the addicts were happy that someone was doing something. I would. They can take care of the addicts someplace else, but knee capping the program is pure malevolence. See Pence in Indiana.
3
I found this article frustrating. Instead of closing the exchange center could they not try to move it to a more suitable location?
4
The utter lack of understanding on people's part of heroin addiction, plus the current PC dilution of clear thinking into a morass of easy-solution preference is stifling progress on the issue. Before making conclusions misled by the unrealistic vagaries of political correctness, interested people need to read this whole book, and the sections on addiction (chpt 10 forward) 3-4 times until it sinks in:
http://www.druglibrary.org/schaffer/library/studies/cu/cumenu.htm
1. Heroin addiction is a permanent condition that destroys the ethics and morals of otherwise good people, turning them into a lower form of human.
2. The junkie is not the victim in the profit-driven addiction cycle, they are a participant and an enabler of the innocent, and protector of dealers.
3. The victim is the non-user led to use by junkies.
1
Let's stop pretending that these poor addicts became addicted from a legitimate prescription. Most are simple people who claim they are impoverished but have or steal enough money to buy drugs because they choose to. In the olden days, they were referred to by their proper name; lowlife drug addicts.
Society should not have to spend any money to aid and abet them in their activities, nor supply free medical care when they contract diseases from their habits. There is another article in the paper today about uninsured addicts receiving heart valve replacement surgery because of their activities with drugs and them coming back with the same problem a few months later expecting more free surgery. Instead of wasting money giving needles to addicts, use that money to give needles to insulin-dependent diabetics who can't afford all the supplies necessary to control their disease and surgery for the many uninsured who actually need it through no fault of their own.
2
While you play the morality police, stomping on anybody who you deem to be undeserving of public assistance, the simple result of your simplistic approach is a degraded society with worsening problems.
1
Needle exchange programs are ridiculous. Junkies are all around us. They should be able to walk into Walgreens or any other drug store and buy syringes. If they were able to do that, we wouldn't be shutting down these so-called magnets for the addicted that happen to save lives. Of course they are magnets, and that's because we have so many addicted people with so few places to go to just get through a day.
Walgreens, HD Smith, Purdue and too many physicians to mention caused the opioid crisis. Needle exchanges, if we are to have them, should be in the driveways of executives of every one of these companies, not to mention doctors who pleaded stupidity to the addiction potential of Oxycodone (a drug that's been around since the 1920s) while accepting vacations and cash from drug companies. You don't want to have needle exchanges in the town square or in drug stores? Fine. We'll have them in the front yards of pharmaceutical profiteers.
I know it sounds harsh, but I have no sympathy for people who lack the fortitude to not get addicted to pain medications, and particularly those who, instead of getting medical help, move on to heroin. I've done the cycle of opiate pain meds several times, and on my mind every hour was getting off as soon as I could, even if it meant using smaller doses and enduring the pain.
6
@Mtnman1963
Then here is an even better idea for you -- the next time you need surgery just bite on a stick for pain control, that way fortitude and pain endurance can lead the way without opportunity for addiction. Could work for pain control in cancer patients as well.
So glib without asking what my pain treatment was for. If you are talking about terminal cancer, why are you worried about addiction?
1
I am extremely disappointed in my hometown Mayor Danny Jones. I understand that he doesn't want the health department and concomitant syringes next to his baby, the Civic Center revitalization, but there are other ways to handle this. Can't he move the needle exchange program to another location? Think a little outside the box, and avoid the risk of a full-scale Hepatitis or HIV epidemic.
We forget that drug users are still humans who deserve care and hope. For if family and community do not provide these, then they will continue to rely on the one antidote and cause of their problems: opioids.
5
If in fact $10M spent on a needle exchange saves $70M in treatment costs, then take some of that $60M savings and invest it in the community that accepts the "burden" of the exchange. Spend some of the money on policing, community development, and education. The community sees tangible benefits, the drug afflicted are helped, and there is still room for profits to be made.
This country (maybe all countries) have a difficult time understanding, managing, and appreciating "cash-flow" in investments that require up large front payments but reap much greater rewards down the road. It's a moral and fiscal conundrum.
9
Very interesting that the mayor - an addict with a heroin-addicted son, would want to shut down the program.
I wonder what the incidence of endocarditis is in Charleston, WVa -- and the surrounding area? (Re the Oak Ridge TN report.)
Medicine is big business -- as the 150K (seems low) cost for cardiac surgery indicates.
I don't know why the opioid crisis continues... and of course I know that many have switched to heroin. We would seem to need to catch people before the first hit -- and I am sure some of it is recreational, not medicinal. And we need research to understand why some people do have a propensity towards certain kinds of addiction.
That said, there seems to be lots of mistrust. Asking for identification would seem to be a small thing, yet health dept. workers refused this modification? The numbers are also astonishing. By all means, we need to stop the spread of ancillary diseases.
2
Asking for ID seems like a small thing to those of us who are not addicts, but to addicts who live in the shadows, doing something that can get them arrested and about which they must lie, it can be a very big deal.
1
The needle exchange program proves so popular that there is a concern that people from outside Charleston are using it. If I was the mayor of Charleston, I'd be upset too. But he has the response completely backward - he should be continuing his program and pressuring those in surrounding communities to start and fund their own needle exchange programs to address what is clearly an unmet regional need.
11
Agree. I'm baffled why they don't just open a second site so the first one isn't so crowded, and maybe move the first one?
4
" mitigating the risks from drug use — means enabling drug use.".. The problem, really, is that there is a broad cultural undercurrent in America that views any sort of "sin" without consequence as anathema. We see this in the opposition to abortion and birth control too. Despite documentation that the increased costs, increased rates of infection of HIV and Hepatitis come from forcing people to share needles, the opponents press on. The ratio of nearly 7 to 1 for costs without a needle exchange in medical care should be enough to get people to wake up. I suspect though that the public nature of the exchange, it's visibility was it's fatal flaw.
12
Nobody is "forcing people to share needles" or forcing they to use drugs. The junkies knowingly decide to break the law and use illegal drugs.
1
It seems to me that one of the defining differences between left-wingers and right-wingers is that left-wingers are worried about innocent people being unjustly punished and right-wingers are worried about guilty people being unjustly unpunished.
There's also another perspective. There are almost 16.1 million alcoholics in the United States, There are about 1 million injectable drug users who's addictive state would compel them to share needles. The sheer cost to society isn't from "drug" abusers, it's the alcoholics.
"Needle exchanges — also called NSPs (Needle Syringe Providers) — have struggled to gain public acceptance in the United States, which still lags far behind many countries in their adoption. According to the North American Syringe Exchange Network, 333 such programs operate across the country, up from 204 in 2013. In Australia, a country with less than a tenth as many people, there are more than 3,000."
"Meanwhile, in the US, drug law enforcement is often responsible for hindering access to NSPs, even where these are legally sanctioned. Five years ago, a national survey revealed that nearly 50% of NSPs reported
that their clients experienced police harassment on at least a monthly basis. A recent study on police encounters among NSP clients in Baltimore confirms that this harmful practice continues today. The study found that even under a favorable policy and legal regime, police continue to unlawfully confiscate injecting equipment and interfere with the functioning of NSPs,
with non-white clients more likely to report confiscation of injecting equipment or arrest. Adversely affecting both the behavior and health of people who inject drugs, drug law enforcement is evidently an important determinant of health for this population, and particularly for marginalized groups."
https://www.hri.global/contents/1739
America' wretched puritanical-police-prosecutorial-prison-industrial complex works it destructive magic once again.
"We're #1 !"...... in cultured stupidity.
51
Giving someone a clean syringe so they can use it to inject themselves with drugs of uncertain potency, with impure adulterants, makes no sense to me. Its like giving a person drowning in 200 feet of water a three foot tall ladder to stand on.
For a lesson, we need to go back to the days of prohibition, where alcohol was made and sold outside the law, and illegal fortunes were made, financing other illegal activities. Legal distribution of alcohol ended that. Drug users health would be better protected if they had access to pharmacy grade drugs of known potency and purity. This would take revenue out of the pockets of the illegal drug industry, and like bootlegging in 1933, would largely disappear.
No, heroin should not be an over the counter drug. But bona fide addicts willing to register as such, and submitting to efforts at treatment, should be able to buy their drugs from safe and legal sources. It would also reduce criminal behavior by addicts trying to raise money to support their habits.
20
As the article points out, needle exchange programs substantially reduce the public burden of the costs of AIDS and Hepatitis treatment, which can be astronomical. These exchanges don't, on their own, solve to all the problems associated with addiction, but they a point at which addicts can be reached and recruited for treatment options, without incurring the costs of arrest, jail, and court.
4
If your argument is that needle exchanges make no sense when we should just be ending prohibition, fine, but we aren't ending prohibition any time soon and in the world as it exists today needle exchanges at least go some way to mitigate the harms of prohibition.
If you cannot help others, how can you help yourselves if you, by your fears, prejudice and selfishness ensure a Society more full of desperate, homeless, drug addicted, poor and criminal victims of both themselves and the circumstances created and/or made much worse with the policies or lack thereof that reflect so many people's lack of charity, help and concern for others but continue because of them as well as the fear and prejudice that make them worse.
Then EVERYBODY to an extent (as they do) will find that they will , in many ways, reap what they sow or fail to do to, help perpetuate and make the failing or dark Society they fear/hate/despair of the reality it is.
Many of the solutions are there to be seen but so many of the problems and the reasons they are not applied lies in the hearts and minds of those that can solve them but don't.
9
What a shame that opinion outweighed facts in Charleston. Needle exchange programs are not new. New Haven had one at least 30 years ago, if memory serves me correctly. Not only do they prevent diseases like hepatitis and HIV, but they are a way to gain trust among addicts, who may decide to ask for help from people they have come to know. In other words, they fight addiction itself in the long run. Charleston made a mistake in closing its needle exchange program.
38
Suspicion, blame, and stereotypes block the value of a simple procedure, but this a hidden moral component: the new morality continually suggests doing good has bad consequences--that every effort at help, in fact, makes things worse.
It is a cynical view, a debased view of humans, even addicts, but one we hear repeated from local and national leaders, including the President. I suggest the review is true! Greed persists, deflected by blame. Indifference spreads, enabled by narratives that help is hopeless and wasted. These attitudes narrow the path to death, which seems to be the unspoken outcome in these narratives of help-doesn't-work, a corruption of the theory of tough love.
So the sickness among us are left without support, out of fear and a falsely justified cruelty. It is these attitudes that drive addiction, not the desire to help!
9
(Corrected copy; my blood sugar was spiking; I proof my thoughts, not the text! Mea culpa!)
Suspicion, blame, and stereotypes block the value of a simple procedure, needle exchanges, but there is also a hidden moral component: a new morality that continually suggests doing good has bad consequences--that every effort at help, in fact, makes things worse!
It is a cynic's view, a debased view of humans, even addicts, but one we hear repeated from local and national leaders, including the President. I suggest the reverse is true! Cynics are hiding their greed, deflecting by blame. As indifference spreads, enabled by narratives that help is hopeless and wasted, these attitudes narrow the path to death--which seems to be the unspoken outcome of these narratives of help-doesn't-work, that corrupt the theory of tough love.
So the sickest among us are left without support, out of fear and a falsely justified cruelty. It is these attitudes that drive and support addiction, not the desire to help!
21
"The research is unambiguous: Needle exchanges reduce the spread of bloodborne diseases like hepatitis C and H.I.V. and do not increase drug use. They’ve been shown to reduce overdose deaths, decrease the number of needles discarded in public places and make it more likely that drug users enter treatment. They also save money: One recent study estimated that $10 million spent on needle exchanges might save more than $70 million in averted H.I.V. treatment costs alone." It seems as though the premise is faulty. It's either needle exchange or nothing. So Miami doesn't have a program and San Fransisco does as if only if you exchange a needle can it be properly disposed of. What about the prevalence of "sharps boxes?" Are they readily available in both cities? The study doesn't address that.
3
do we need a wall around these needle exchange places? do we want to keep the illegal users within the walls(called prisons) or keep others out?
why do the taxpaers have to pay for someone else to break the law by using illegal drugs? does this make the taxpayers an accomplice?
1
Why does the taxpayer have to pay? Easy answer: because it's a public good, which as the commentator above indicates, saves the taxpayer more than $7 for each $1 spent, just in averted HIV treatment alone. As a bonus, the taxpayer gets to live in a community with less HIV. And that's just one of the advantages.
Does this make the taxpayers an accomplice in illegal drug use? Even easier answer: no, of course not.
1
I was surprised to not see Barnstable County, (Cape Cod) on the CDC map.
As well as the southern New Hampshire region. Both areas are very hard hit with drugs. The tourists that visit are oblivious to it, until they step on a discarded needle on the beach. The Chambers of Commerce keeps this bad secret tightly under wraps and well unknown for good reason.
20
A $100 million civic center? Why wasn't that money invested in the people of West Virginia struggling with drug addition or the children of drug addicts or drug rehab centers or solving the problem with the needle exchange? Who are the people making these decisions?
52
ExactlY! Thank You.
2
WHO are they?
People voting for Trump and Big Coal's Joe Manchin! (And father to Mylan's Heather Bresch, who jacked up the price of epi-pens by 600%) And thinking of voting for Massey Energy's Donald Blankenship, merely convicted of criminal charges in the death of 29 miners. That's WHO they are!
2
Who are the people making these decisions?
white middle age male republicans.
3
There is something a bit pathetic about needle exchanges--and safe injection sites (SIFs)--as the forefront of U.S. handling of the opioid crisis. The user still gets the heroin from an illegal source--suppliers perhaps connected to some cartel, and having every incentive to cut the product with cheaper substances such as Fentanyl in order to increase profits, or "up-sell" the user to even stronger products. The user still spends time scrounging for the next fix, and maybe committing crimes in order to finance it.
We need to look at the larger picture: the entirely predictable consequences of illegality. (Remember Prohibition of Alcohol?) That is what we should be addressing, not just tinkering at the margins with needle exchanges and SIFs. That which is illegal cannot be regulated. Legalize in order to regulate.
Check out https://lawenforcementactionpartnership.org/. An organization of current and former law enforcement personnel committed to stopping the War on Drugs.
29
I like that you brought up prohibition. It is well documented that this brought more strength and power to organized crime. There is also proof of those in power that still enjoyed their alcohol while the general public were prosecuted for it. Took 13 years before it was repealed. A bit late to stop the violence of it.
"They were once a largely urban phenomenon. But the opioid crisis is changing the landscape." This is the real reason for all of the attempted changes in the decades long drug problem. Once it became the soccer moms, average to upper middle class and beyond problem, it is a crisis. Every state is effected. Legalization has been kicked around for so long. But surely you know there are too many is power that prevent it because they probably have some stake in rehab, private prisons and so on that they rely on the illegal drugs for their wealth. I will check out the web site you provided. It makes sense there is a group of those that are on the front line of this "crisis".
7
And, punishment doesn't work.
Let's not forget that the U.S.'s "War on Drugs" has had international consequences. Just look south to Mexico, Guatemala, Peru or Columbia. Even Afghanistan where the poppy fields fund the Taliban. Instead of just having organized crime impact us, it's now destroying entire countries like Mexico. We are sure winning this war.
1
As long as Americans persist in their belief that substance abuse is only caused by “Moral-Failure” any attempts to deal with substance abuse as a public health issue will be resisted. Of course, the Moral-Failure argument is older than the nation and has been part of the human belief/social system. Addiction, unlike other diseases, has not yet made the transition from Moral-Failure to disease largely because we have not done enough research into the root-causes of addiction. Since we generally think of addiction as a Moral-Failure we are not inclined to fund research into discovering the root-causes. On top of that we have a Recovery Industry that has a vested interest in maintaining the Moral-Failure diagnosis.
Statistics show that not everyone who takes a drug or drinks alcohol becomes addicted. In fact, the percentage of the population that is addicted tends to hover around 10%. While the Recovery Industry points to their successes they have not brought us any closer to identifying the root-cause of the problem.
23
This is a very disingenuous comment, prompted more by beliefs than facts. First of all to group alcohol (my father was an alcoholic) and the other drugs together and come out with an addiction rate of 10% is incredibly misleading. The prevalence of addiction in different drugs varies drastically.
The other misleading statements are that choice and morality have absolutely nothing to do with addiction. There are people who have innocently become addicted to opiates, for example, because of careless prescriptions for real pain without the physician supervision that should have been required. But plenty of addicts simply tried the drugs for a good time and wound up addicted. To pretend that there is never any fault or choice in any addiction is simply lying.
Addiction is a complex problem, and will not be solved by either simplistic statements that it is simply a moral issue and that any addict could cure themselves by doing a 12 step program or by sufficient will power OR by a simplistic statement that it is simply a disease and that behavior has absolutely nothing to do with those afflicted. Behavior is often, not always, but often the source of the affliction and the costs imposed on society by a group of feckless careless people who put their own gratification before responsible behavior.
13
Good points. Like with cigarette smoking not everyone that smokes ends up with a cancer diagnosis. You bring up root-causes. From some I know that addicts~drug and alcohol~their root-cause is deep. In that they resort to use that leads to addiction because the life they live is toxic, unhappy, turning to self medication through alcohol and of course getting prescription drugs then some seek street drugs as well. Yes the recovery industry is a big profit maker for those that invest in it. Especially now with the "crisis" of wealthier people being addicts.
I have been on high doses of narcotics for chronic/degenerative disease pain. I did not become dependent/addicted on them. All it did for me was limited relief with side effects that were not worth continuing it. Due to the nature of those drugs I did have to be weaned off slowly. But once stopped I was done. I have learned to live with the pain using less powerful drugs as needed when the pain becomes incapacitating. What makes me not become addicted? I smoke cigarettes so I am addicted to nicotine. So I know what that is like. Obviously it is our genetics/DNA that sets us up for addiction. Trying to figure out just what you mean about moral failure. Isn't that a biblical thing?
6
Breaking the law is a moral failure. Esp. when buying illegal drugs funds criminals and their other illegal enterprises.
1
Stigma is the issue here. Nobody wants to acknowledge that their community has as many people struggling with addiction(or homelessness). The perception that "these people aren't our own people" is deep and wide, as it is easier to be angry at the evidence of the magnitude of the problem of active addictions in our country.
20
@Mary, You're not kidding. Many communities also decided years ago to just stick their heads in the sand and pretend drug use did not exist in their towns. Then of course it got way worse and now it's almost too late to stop the scourge.
Been down the Methadone Mile in Boston lately? It's right out of a horror, apocalyptic movie. And it's located right next to some of the largest hospitals in the city.
2
It is a fine line between things that work and don't work.
In general (not this specific story), you research something, try is out, if it works continue it, if not stop it.
Two examples of this on either end are affordable, universal, quality health care that all our peer countries have except us and is the gold standard for medicine.
On the other end, Finland dropped its' policy of giving money to unemployed people to spend as they wished because it did not work.
10
Finland has NOT dropped the UBI experiment. The experiment is ongoing. What they have done is stopped an expansion of the experiment. They want to first collect the data from the ongoing experiment and THEN decide what to do.
43
Okay...thank you, I stand corrected but the bottom line is to follow the rules history has set up for us in my original post..
7
This was not a UBI (not Universal) since it went to only
a sample of the unemployed.
3