I've never tried heroin because I'd get addicted and I don't know that I'd be able to get clean on my own. If i were a heroin addict looking to get clean, I'd need a person with me 24/7 for months, if not longer. Like most people, if I want to do something, I'll find a way to do it. That drive would need to be contained and managed, and I'd need someone to help me (constantly) redirect it. If I were propped up for a couple hours a day by counselors, then let loose back to my normal life, it wouldn't be enough. For me, an organization like NA would only be useful to maintain sobriety, not to achieve it.
3
Herion is the underlying problem to our overflowing jail population, crime and homelessness. Yet it will tell you that everything is ok. Jails don't have the resources to treat addicts so when they come out they go back to the same thing. No politician wants to touch the problem becuse there is no money in it for them, Correction officers allow it to flow becuase it keeps the prisoners happy and in condtrol and i susspect makes them some easy money. the world is a sad place today and no one cares.
4
Just read 'Chasing the Scream' by Johhann Hari, which was exceptionally thought-provoking and eye-opening- it describes the history of legislation on drug consumption and explains how countries such as the US, Switzerland, and Portugal formulated their policies. As many commenters have already pointed out, politicking, social stigma, and lack of knowledge are likely to be the prime culprits for the tragic situation we witness in the majority of zero-tolerance anti-drug countries around the world.
7
There are strains of marijuana that relieve pain with no 'high'. I know several people who grow it legally. No one has died of a marijuana overdose. People in pain who take opioids do so because it works, but with addictive side effects if one increases the amount taken. Oregon, along with many other states have legalized medical marijuana. There is excellent research finally being done on medical uses of pot.
5
Life is sometimes just too hard and if you are not well adjusted to failure and frustration and you do not live in a supportive community, then life can be impossible. Mr. Kristof I hear your compassion,
3
I don’t know what “reducing the STIGMA of addiction so that more people seek medical help,’ means in this article. Shame is a pretty good inhibitor of bad behavior and people should feel shame if they are taking heroin. They are losers. A scourge on society. Why hide it. If Mr. Morris is any indication its sounds like even recovering heroin addicts are pretty much just a day away from breaking into my house.
7
So is it true, as I read that users are now purposely overdosing to get higher than having a friend bring them back with naloxone. That should sell more drugs.
1
Please be aware that Nalaxone wears off quickly. It does not last as long in the blood as the heroin does. If it is given to someone with a heroin overdose, the vicitm will suddenly revive, and then a short while later, will be back into the overdose. After giving Nalaxone a visit to the ER is a really good idea.
11
For the life of me, with all of these stories, WHY? If somebody said to me, try this, it will make you feel good; I would just decline. If drug users want to overdose, then let them go right ahead because frankly they aren't worth saving. Life is too difficult to make it more so. If you're a drug user, then you're weak. Strong people survive.
6
>
I'm not sure why everyone has got it out for heroin these days. Surely it has it good side too.
It has a rather revealing etymology. In 1890s the German's trademarked it, from Ancient Greek ἥρως (hḗrōs, “hero”) (due to the feelings of power and exaltation while under the influence of the drug). Anybody who has ever been in pain knows of its benefit.
Heine also saw the beauty in it.
Death and his Brother Sleep (‘Morphine’)
There’s a mirror likeness between those two
shining, youthfully-fledged figures,
though one seems paler than the other and more austere,
I might even say more perfect, more distinguished,
than he, who would take me confidingly in his arms –
how soft then and loving his smile, how blessed his glance!
Then, it might well have been that his wreath
of white poppies gently touched my forehead, at times,
and drove the pain from my mind with its strange scent.
But that is transient. I can only, now, be well,
when the other one, so serious and pale,
the older brother, lowers his dark torch. –
Sleep is so good, Death is better,
yet surely never to have been born is best.
Heinrich Heine, The great 19th Century poet.
I'm not sure why everyone has got it out for heroin these days. Surely it has it good side too.
It has a rather revealing etymology. In 1890s the German's trademarked it, from Ancient Greek ἥρως (hḗrōs, “hero”) (due to the feelings of power and exaltation while under the influence of the drug). Anybody who has ever been in pain knows of its benefit.
Heine also saw the beauty in it.
Death and his Brother Sleep (‘Morphine’)
There’s a mirror likeness between those two
shining, youthfully-fledged figures,
though one seems paler than the other and more austere,
I might even say more perfect, more distinguished,
than he, who would take me confidingly in his arms –
how soft then and loving his smile, how blessed his glance!
Then, it might well have been that his wreath
of white poppies gently touched my forehead, at times,
and drove the pain from my mind with its strange scent.
But that is transient. I can only, now, be well,
when the other one, so serious and pale,
the older brother, lowers his dark torch. –
Sleep is so good, Death is better,
yet surely never to have been born is best.
Heinrich Heine, The great 19th Century poet.
6
I don't understand this horror of withdrawal from prescription opiates at all. The worst that ever happened to me was the return of the original pain, and if I took moderately strong stuff, a speeded-up metabolism. Horrors! I forgot to take a dose. I never even even
suffered from the urge to get a tattoo, which seems to be a side effect of addiction. Some here are definitely off-base in generalizing that pharmaceutical companies are producing, and doctors are prescribing opiates simply to make money.
suffered from the urge to get a tattoo, which seems to be a side effect of addiction. Some here are definitely off-base in generalizing that pharmaceutical companies are producing, and doctors are prescribing opiates simply to make money.
9
Why not make a society that can fulfil its members with the promise of meaningful and gainful employment? One that offers intellectual stimulation as well as profound emotional context to one's life? Instead we get the cartels and this stuff called smack...
7
As William S. Burroughs, the gentleman junkie of the Beat Generation, wrote decades ago in the sixties, heroin is the type of drug in which the dealer sells the addict to the addiction. His radical solution was legalization. It sunk faster than a submarine with screen windows. Having served as a medical corpsman in Vietnam, a few of the guys who I smoked dope with back at the hooch in the enlisted mens' compound became heroin addicts. That's why there was a spike in Vietnam veterans incarcerated in prison when they came back to the world. But drug addiction is one of the oldest stories since the dawn of recorded history. The Sumerians had a specific word for opium etched on their codex tablets; they called opium "the happy plant." Kristof is right. Heroin doesn't have to be a killer, if we would just legalize it as we have alcohol and cigarettes and if the federal government controlled the quality of the heroin and registered the addicts. Just google the latest statistics of how many Americans die each year due to the abuse of alcohol or smoking cigarettes Then google how many die due to heroin addiction. But American view addiction not as a disease but as a moral failing. I haven't had a toke in about two decades. I support the state-rights movement in the legalization of grass. Americans are casting off the shackles of Puritan prejudices. And so they should with the epidemic of heroin addiction. People will always want to get high whatever the drug of choice is for them.
19
Legalize all individual drug use. Addicts (addiction is a medical condition, not a crime) may take it under doctor's control, manufactured legally as a controlled substance. Crime will fall, because the price will come down, and there is no incentive to market it and smuggle it. Take the money spent on drug law enforcement (zillions) and prisons and put it into rehab programs. Treat addicts as patients, not criminals.
21
Because of rampant addiction issues in my family, I have been beaten to a pulp. The damage I have experienced, witnessed, the endless lies, the thieving, the disregard -- frankly, I don't have it in me to care about addicts any longer. Are they worth all the pain, trouble, efforts, expense? I guess that's an individual equation, but I'll say, for me, the answer tilts towards no.
9
If heroin was legal, would any of that have happened?
7
It is ironic that people who have intractable pain have a horrible time trying to find a MD who will prescribe sufficient opioids. My friend was bed ridden, screaming and moaning in pain after her Pain Specialist died. It took over a year to find someone willing to treat her. The constant pain of RSD/CRPS is rated ( McGill pain scale) as worse than childbirth and only with what some would consider large doses of oxycodone. The new formulation of Oxycontin is not as effective for pain in 90% of patients. In our concern over over prescribing we ignore those who need these medicines to survive. The suicide rate among chronic pain patients is sky high. Not much wonder in that. A pain patient who cannot take the agony is just as dead as an overdose.
18
We have to make an American fair moral choice between treating illegal drug users and those in possession or addiction as either a medical health care socioeconomic political educational problem worthy of careful compassionate consistent care. Or a criminal justice problem worthy of prosecution and incarceration.
Right now white European Americans who misuse and use illegal drugs get an empathetic humane individual human pass while black African Americans are given an inhumane group imprisonment persecution. That is not right nor moral nor just. But it is legal.
Bill Clinton, George W. Bush and Barack Obama rode illegal drug use right into the Oval Office of the White House. Heath Ledger and Phillip Seymour Hoffman followed illegal drugs to their graves. Rush Limbaugh and Glenn
Beck got an illegal drug abuse pass to media fame and fortune.
Either send everyone to rehab or to prison. Alcohol and tobacco are far more damaging to national health and socioeconomic welfare problems than are illegal drugs. Only illegal drug dealers and the prison-industrial complex profit from the status quo ante "war on drugs." Legalization, regulation, education and taxation are much better realistic alternative options.
Right now white European Americans who misuse and use illegal drugs get an empathetic humane individual human pass while black African Americans are given an inhumane group imprisonment persecution. That is not right nor moral nor just. But it is legal.
Bill Clinton, George W. Bush and Barack Obama rode illegal drug use right into the Oval Office of the White House. Heath Ledger and Phillip Seymour Hoffman followed illegal drugs to their graves. Rush Limbaugh and Glenn
Beck got an illegal drug abuse pass to media fame and fortune.
Either send everyone to rehab or to prison. Alcohol and tobacco are far more damaging to national health and socioeconomic welfare problems than are illegal drugs. Only illegal drug dealers and the prison-industrial complex profit from the status quo ante "war on drugs." Legalization, regulation, education and taxation are much better realistic alternative options.
8
Don't blame this completely on corporations. You miss the point entirely then. Only physicians and dentists can prescribe these drugs. Only their names are on the prescriptions. Not hospitals, not clinics, not corporations, and not governments.
We would save money and lives if we "medicalized" all drugs (except pot which should be sold and taxed as they do in Colorado). GIVE them away in a medical setting ..the addicts would not have to steal, drug cartels would lose their power. The purity of the drug and the cleanliness of the needles would be assured and at the same clinic there could be medical guidance available to help people who wish to get off drugs. We'd SAVE money..when you think of what we spend in the drug war. And no, not everybody would run out and become an addict. Because of the money make in our damaging "drug war" this will not happen until we get the money out of politics.
7
Thank you Mr. Kristof for your sensitive op-ed on this horrific problem. Heroin addiction strikes every person regardless of color, SES, gender or political persuasion the same. It is a highly addictive drug that becomes impossible to shake off for many who want to come clean. I'm glad you mentioned Suboxone as well as Methadone as treatments for users who are tired of sticking a needle into their veins. I have seen the damage that this drug can to people including collapsed veins, loss of teeth, malnutrition & serious infections of the lungs & heart. Most users will overdose several times before seriously seeking treatment which is why Naloxone is a God's send. The damage that is done to families & friends ripped apart from the manipulation,lying & cheating behaviors of heroin addicts as they chase the dragon with little regard for the people they hurt & use along the way is devastating. Not to mention the property crimes, mugging & theft that threaten the safety of neighborhoods, the elderly & small children.
What is not mentioned in your op-ed is the scourge of black tar heroin which moves freely across the US-Mexican border by a band of Xalisco couriers. These entrepreneurial drug dealing hustlers disguise themselves to blend in & delivery by car & use aggressive marketing which targets vulnerable HS kids, hip clubs & affluent clientele creating demand for heroin where there once was little or none. Users don't have to travel into unsafe neighborhoods, they just text.
What is not mentioned in your op-ed is the scourge of black tar heroin which moves freely across the US-Mexican border by a band of Xalisco couriers. These entrepreneurial drug dealing hustlers disguise themselves to blend in & delivery by car & use aggressive marketing which targets vulnerable HS kids, hip clubs & affluent clientele creating demand for heroin where there once was little or none. Users don't have to travel into unsafe neighborhoods, they just text.
2
It takes a really stupid country to prohibit a minamally addictive recreational drug with no record of causing death by overdose. Holland has demonstrated that legal cannabis dries up demand for more dangerous drugs.
5
Why do you need a big picture of a person injecting? Will readers ignore it if no pics? Why do both show dark skinned people?!? Drug use among whites is huge.
Vermont has the highest rate of illicit drug in US. I read they’re enhancing treatment services with law enforcement.....“addressing it on all fronts.”
But for millions of minorities over decades there was only one front addressed on drug ----mass incarceration, extreme sentencing, ruined lives and families.
See NYT on Staten Island NY’s big heroin problem. Is mass incarceration happening there?
See “Tough Texas gets results by going softer on crime”, Washington Post.
“... instead of building new prisons..they built a treatment system. To counter the huge number of former inmates who returned to jail after violating parole, they created hundreds of new beds in drug treatment programs with names like the In-Prison Therapeutic Treatment and Substance Abuse Felony Punishment Facilities.”
Pre-trial diversion programs for those suffering from mental illnesses, overseen by officers who specialize in mental health and drug treatment helped more people avoid jail.”
There was a “deliberate decision,” he said, to have a range of programs to reduce return trips to prison.”
"The state’s crime rate has fallen dramatically. Recidivism is down, 28 % to 22.6. ...multiple reforms created a stable system –and saved the state $3 BILLION...they funded programs rather than prisons. “
Nothing like a positive model.
Vermont has the highest rate of illicit drug in US. I read they’re enhancing treatment services with law enforcement.....“addressing it on all fronts.”
But for millions of minorities over decades there was only one front addressed on drug ----mass incarceration, extreme sentencing, ruined lives and families.
See NYT on Staten Island NY’s big heroin problem. Is mass incarceration happening there?
See “Tough Texas gets results by going softer on crime”, Washington Post.
“... instead of building new prisons..they built a treatment system. To counter the huge number of former inmates who returned to jail after violating parole, they created hundreds of new beds in drug treatment programs with names like the In-Prison Therapeutic Treatment and Substance Abuse Felony Punishment Facilities.”
Pre-trial diversion programs for those suffering from mental illnesses, overseen by officers who specialize in mental health and drug treatment helped more people avoid jail.”
There was a “deliberate decision,” he said, to have a range of programs to reduce return trips to prison.”
"The state’s crime rate has fallen dramatically. Recidivism is down, 28 % to 22.6. ...multiple reforms created a stable system –and saved the state $3 BILLION...they funded programs rather than prisons. “
Nothing like a positive model.
5
I'm sorry- free-needles, methadone, suboxone, naloxone... These are all deadends. We still end up with a bunch of walking junkies. Who honestly thinks these are "solutions" to the problem? I think we don't have the guts, the political will, to really do what it takes to address this problem.
2
What is that? You have to be pretty young not to remember how almost all the current problems are a result of Nixon's idea to stop all growing of opium poppies in Turkey. He succeeded, making MExican, SOuth American and Asian poppies profitable by destroying the established smugglers routes. Heroin addiction has exploded all over the world since the Nixononian push to stop all poppy farming-and thanks to him we also paid for it in cash to the farmers.
1
Heroin and prescription drugs are an epidemic in the Pioneer Valley. It has gotten worse over the past decade with no solutions in sight. Until Anthony Bourdain did a searing expose on his "Parts Unknown" series.
After that, new Massachusetts Governor Charlie Baker and local leaders have laser focus on the scourge of this problem on everyday life in New England cities and towns. Finally.
After that, new Massachusetts Governor Charlie Baker and local leaders have laser focus on the scourge of this problem on everyday life in New England cities and towns. Finally.
2
Using Methadone and Suboxone are NOT cures or even good treatment for addiction - they are legalized forms of addiction. The addict is then dependent on the state and or prescribing doctor to get their "fix". The withdrawal from both Methadone and Suboxone are worse (by far) than that of Oxy or heroin. I have watched my husband go through the gamut with these drugs. The Methadone made him a zombie. The environment was seedy and full of addicts selling their methadone to other addicts. Suboxone (Buprionorphin + Naltrexone) on the other hand is a hyped up nightmare - now killing our teens who are getting it and abusing it. It gave my husband intense muscle cramps and nightmares. When wanting to come off the Suboxone the local drug dextox center wouldn't admit you if you were on Methadone or Suboxone - too dangerous and difficult - they said my husband could only come in and get help if he was on heroin or prescription pills. WHAT? Really. What has worked? Vivitrol - 16 months of monthly injections of strong naltrexone - followed by daily oral low dose naltrexone. Non-addictive. We need to wake up and help addicts become non addicted - not keep their minds and bodies dependent on opiates. It takes years to heal the brain from addiction that healing can't begin until they are opiate free. Methadone and Suboxone just make addiction acceptable it and treats nothing.
1
Sure. After you cure heroin and opium addiction then you can start with all the meth, coke users and then the real big one-cure the alcoholics-anyone for a new prohibition law?
Let's not overlook the role the VA has played in the explosion of prescription pain medication use, associated heroin use and addiction.
It's a lot easier and cheaper to simply give vets these pills to deal with their issues rather than the expensive medical and psychological treatment they actually need. Many become addicts and, if the VA eventually stops their meds, they look elsewhere. This has been going on since the war in Southeast Asia and has gone back into overdrive as the vets of our last two disasters return. A lot of this isn't new. Very discouraging.
It's a lot easier and cheaper to simply give vets these pills to deal with their issues rather than the expensive medical and psychological treatment they actually need. Many become addicts and, if the VA eventually stops their meds, they look elsewhere. This has been going on since the war in Southeast Asia and has gone back into overdrive as the vets of our last two disasters return. A lot of this isn't new. Very discouraging.
1
How do you know that pain is not one of the veterans prime problems? There is not always a treatable under lying problem. Demonizing pain medicine creates a class of people, intractable pain patients, who have no rights.
1
The VA system in general has perverse incentives not to get well. It needs to be reformed while preserving and strengthening the safety net for our vets. It is a valid observation that there are too many meds and not enough health supervision, not for lack of money so much as lack of will to do the job right.
1
Addiction is a chronic brain disease and even though poverty, lack of future and despair can lead to seek an escape, the amount of privileged young kids, with brilliant futures and happy families is also reaching epidemic proportions. Heroin is highly addictive, but just about 30% of the people who use it get hooked. There's a predisposition, a certain wiring of the brain and something triggers it. Just like diabetes, it's donrmant until triggered. I believe we need more brain research to understand addiction at a neurological level and with all the advances in neuroplasticity, electrical stimulation, etc., go to the root of it: the brain and fiigurre out a way to fix it there instead of trying to stop the bleeding with band-aids.
9
There is no proof whatsoever of your contention that addiction is a brain disease. Your "just like diabetes" stuff is wrong. And destructive.
And the numbers I've read indicate that around 80% of heroin users do not become addicted.
And the numbers I've read indicate that around 80% of heroin users do not become addicted.
3
We are a drug culture. If people get hooked on drugs why are we surprised< Drugs are touted as the end all and be all. We can act any destructive way we want and they will "cure" us. So what is the resistance to using them to "cure" the people who use drugs we have deemed illegal for really no good reason except to salve the consciences of those who are addicted to legal drugs. It gives respectability to those addicted to legal pharmaceuticals thought they differ very little.
So use the methadone and naloxone to "cure" and save the lives of those who are hooked on our drug culture and stop the stupid murderous hypocrisy.
So use the methadone and naloxone to "cure" and save the lives of those who are hooked on our drug culture and stop the stupid murderous hypocrisy.
1
When Mr. Kristof notes that doctors overprescribe pain killers, he means for the treatment of non malignant chronic pain using morphine derivatives [opiates or narcotics].
The common, so far legal, use of opiates for permanent management of chronic pain is ineffective and tragic given the known science of opiates and habituation.
As a physician who has seen numerous such cases let me explain the dirty secret of opiates which will be denied by all those who hit the cash register hard selling opiates.
The pain killing effect is temporary, powerful in the first few weeks and months, but then declining steadily over time, leaving patients with their original pain.
BUT the withdrawal sickness when the drug is stopped grows over time and dosage and is brutal, consuming the mind and life of the victim.
Therefore, after some months, patients seek opiates to beat withdrawal, as much or more than their pain.
From then on, it is just as Mr. Morris, the human face of this article describes withdrawing, "he was so sick that he promptly began searching for a hit".
Patients I saw were running for their lives from withdrawal, often more than their chronic pain for which they were originally prescribed opiates. Most had long ago forgotten their chronic pain.
Now they live in fear that somehow they might lose their drug source and face withdrawal. Loss of insurance, doctor on vacation, retiring, moving, talk of reducing their dose etc., haunt their every thought.
The common, so far legal, use of opiates for permanent management of chronic pain is ineffective and tragic given the known science of opiates and habituation.
As a physician who has seen numerous such cases let me explain the dirty secret of opiates which will be denied by all those who hit the cash register hard selling opiates.
The pain killing effect is temporary, powerful in the first few weeks and months, but then declining steadily over time, leaving patients with their original pain.
BUT the withdrawal sickness when the drug is stopped grows over time and dosage and is brutal, consuming the mind and life of the victim.
Therefore, after some months, patients seek opiates to beat withdrawal, as much or more than their pain.
From then on, it is just as Mr. Morris, the human face of this article describes withdrawing, "he was so sick that he promptly began searching for a hit".
Patients I saw were running for their lives from withdrawal, often more than their chronic pain for which they were originally prescribed opiates. Most had long ago forgotten their chronic pain.
Now they live in fear that somehow they might lose their drug source and face withdrawal. Loss of insurance, doctor on vacation, retiring, moving, talk of reducing their dose etc., haunt their every thought.
7
Perhaps the patients live in fear of losing their drug source, because this is the reality of criminalization. It is an over-generalization to say that opiates cannot be used effectively for chronic pain. Many people do just that.
There are few who are truly "cashing in" on opiates apart from the heroin traffickers. Prescribing opiates is a whole lot harder than flat-out refusing to do so, the latter being increasingly common among doctors in the wake of the recent DEA crackdown. Prescriptions are down, heroin use is up. It's that simple.
There are few who are truly "cashing in" on opiates apart from the heroin traffickers. Prescribing opiates is a whole lot harder than flat-out refusing to do so, the latter being increasingly common among doctors in the wake of the recent DEA crackdown. Prescriptions are down, heroin use is up. It's that simple.
2
One would think that physicians of all people would understand that the great majority of those who use opioids for pain do not become addicted. Even when they become physically dependent due to more than short-term use, most users are able to stop. Period.
Your anecdotes cannot be allowed to carry the day. Let's make sure to publicize statistics and truth.
Your anecdotes cannot be allowed to carry the day. Let's make sure to publicize statistics and truth.
4
Wrong. My friend has RSD/CRPS and can live a normal life if prescribed what some might call large doses of opioids. This works for years without increase in tolerance. When her pain specialist died she had to go on a drug starvation regimen. She was in agony for over a year. If she was merely addicted, or having a rebound reaction to over prescribing her pain would have lessened over the year. It got worse. Once she found an MD it took months to find the right dose, far higher than the MD was comfortable with. Now my friend is active and enjoys gardening and being mobile. The most recent definition of addiction looks at function. Some intractable pain patients function better over the long term with opioids and generalizations about all pain patients just make their lives worse. Nobody has fewer rights than a pain patient who responds well to medical treatment. Oh, RSD is rated higher on the McGill pain scale than childbirth, so the distinction between malignant and non malignant pain is stupid. The late great Dr Joel Hochman said 'the brain doesn't care why pain is, only how intense it is,'
4
I'm amazed how the author of this piece is advocating a safer form of drug addiction. Heroin addiction is a vexing problem but the solution starts with having the personal fortitude of saying no or getting the help one's need to quit before the drug quits you.
2
You're "amazed" because you may not have read and absorbed the tenets of a harm-reduction approach to drug use. Easy to find with a simple internet search.
2
Lets get rid of airbags in cars. It was better when people had person al responsibility to not get in accidents. Seatbelts too...
1
Seems like there's always a fairly simple solution to a problem, but our politicians, and their supporters, will not open their minds, even to save these lives. Decriminalize, stop the prejudice, and offer the proper kind of assistance.
4
Don't forget- there is individual responsibility at play with addiction as well as over marketing and over prescribing. No one forces anyone to take oxycontin, and "consumers" demand it.. My husband was on dilaudid after a serious ski accident and went through withdrawal at home, weaning off of the opiate. He didn't demand more meds when told to stop. Too many people do.
5
And your solution to this public health problem is?
That's because your husband was not addicted. He was physically dependent. His experience was the common one, the one the great majority of such users have.
1
News Flash! Heroin, Cocaine, and Cannabis all have legitimate medical uses. We need to scrap 'Schedule 1' and follow Portugal's lead. We could keep the DEA busy fixing highways, bridges, and rail lines.
5
But, but ... that would be socially useful, and looks way too much like work.
1
In 2013, 8,257 overdose deaths were due to heroin, 16,235 to prescription painkillers, and all the rest were due to other drugs. Misinforming the public will only lead us to ignore other deadly drugs besides heroin--which are the majority
3
The other misinformation here--and in my opinion much worse--is the use of "overdose." Somewhere in the range of 75% of these drug "overdoses" are no such thing. They are deaths caused by combining opioids with other central nervous system depressants, especially alcohol and benzodiazepines.
The facts say that habituated opioid users have a high tolerance--and that it is very unlikely for them to overdose.
The facts say that habituated opioid users have a high tolerance--and that it is very unlikely for them to overdose.
1
Naloxone reverses overdoses of opiates--that would include both heroin and prescription painkillers.
The article says that drug overdoses claim more lives than suicide.
But how does anyone distinguish an accidental drug overdose from a suicide via an intentional drug overdose?
But how does anyone distinguish an accidental drug overdose from a suicide via an intentional drug overdose?
3
Heroin doesn't have to be a killer? Nothing new here. Keith Richards has been proving that for ages.
Now that something worthy of "gateway drug" status.
The Swiss have for years provided their heroin addicts with heroin, clean needles, healthcare and counseling all in one place.
As a result they have less HIV, less Hepatitis B and C, less overdoses, less property crime to support an addiction and fewer heroin addicts per capita than the US.
Sadly, the for profit prison profiteers do less well than their always exceptional American counterparts.
As a result they have less HIV, less Hepatitis B and C, less overdoses, less property crime to support an addiction and fewer heroin addicts per capita than the US.
Sadly, the for profit prison profiteers do less well than their always exceptional American counterparts.
3
Or we can look at Portugal: http://www.independent.co.uk/news/world/europe/portugal-decriminalised-d...
2
All you have to do to solve the drug problem is look at the Dutch model. They have the most intelligent response in the world and should be copied. I quote
"Why has the Netherlands—a country sometimes viewed as having a permissive approach to drugs—had better results than so many governments with much more strict policies? A new report by the Open Society Global Drug Policy Program shows how the Netherlands maintained low rates of HIV among people who use drugs and comparatively low cannabis use among young people, all while avoiding the enforcement-heavy measures of its neighbors.
"Why has the Netherlands—a country sometimes viewed as having a permissive approach to drugs—had better results than so many governments with much more strict policies? A new report by the Open Society Global Drug Policy Program shows how the Netherlands maintained low rates of HIV among people who use drugs and comparatively low cannabis use among young people, all while avoiding the enforcement-heavy measures of its neighbors.
4
I know people personally who suffer chronic pain and yeah they are addicted to pharmaceutical drugs and guess what my own mother has been able to live a decent life for 20 odd years free of pain thanks to her compassionate Dr. God bless her for it and so what my Mom is addicted, big deal!
10
Is she addicted? Maybe not. She is certainly physically dependent. But the distinction is of critical importance. Addiction has a definition. The Three Cs is an easy version to learn:
Compulsion to use. Lack of Control while using. Continuing despite adverse consequences.
Physical dependence may be involved; it may not. Addiction need not involve drugs at all since we can become addicted to most any activity, as well.
Compulsion to use. Lack of Control while using. Continuing despite adverse consequences.
Physical dependence may be involved; it may not. Addiction need not involve drugs at all since we can become addicted to most any activity, as well.
1
According to current models of addiction intractable pain patients have better lives with sufficient medication so it is almost the opposite of being addicted. Thank you for pointing out dependence is different than addiction.
3
Thank you for yheinsight.
1
Just like the military industry complex continue to push for more weapon systems, there is a justice/law enforcement industry that receives billions in government funding and from property seizures every year and they will do anything to stop decriminalization of drugs and continue the war on drugs. They are just as much part of the problem as the drug cartels.
Drug addiction is a health problem not a criminal problem.
Drug addiction is a health problem not a criminal problem.
3
important sharing . thank you
Jason Cherkis published an exceptional article titled “Dying to be Free” in the Huffington Post. Cherkis quotes our nation’s foremost expert on opioids, Dr. Mary Jeanne Kreek of Rockefeller University.
“The brain changes, and it doesn’t recover when you just stop the drug because the brain has been actually changed,” Kreek explained. “The brain may get OK with time in some persons. But it’s hard to find a person who has completely normal brain function after a long cycle of opiate addiction, not without specific medication treatment.”
This persistent derangement of the brain’s opioid receptors results in the highest relapse rate of any drug of choice: research shows that 90% of people dependent on opioids who attempt sustained abstinence relapse to active use. Those who don’t resume active opioid use often turn to addictive use of other substances, especially alcohol, benzodiazepenes, or other sedative drugs.
The research is clear: medication assisted treatment with methadone or suboxone is the treatment of choice for opioid dependence. The public needs to know that these are essential lifesaving medications, that many people take indefinitely to sustain a productive quality of life, not drugs that are used to get a legal high.
“The brain changes, and it doesn’t recover when you just stop the drug because the brain has been actually changed,” Kreek explained. “The brain may get OK with time in some persons. But it’s hard to find a person who has completely normal brain function after a long cycle of opiate addiction, not without specific medication treatment.”
This persistent derangement of the brain’s opioid receptors results in the highest relapse rate of any drug of choice: research shows that 90% of people dependent on opioids who attempt sustained abstinence relapse to active use. Those who don’t resume active opioid use often turn to addictive use of other substances, especially alcohol, benzodiazepenes, or other sedative drugs.
The research is clear: medication assisted treatment with methadone or suboxone is the treatment of choice for opioid dependence. The public needs to know that these are essential lifesaving medications, that many people take indefinitely to sustain a productive quality of life, not drugs that are used to get a legal high.
3
Wow. We must assume you believe what you have written here, dead wrong though it is. 90% of Vietnam veterans who were addicted to heroin stopped upon returning home. Did they all use methadone or suboxone? Did they all turn to other drugs?
Of course not. Their circumstances changed--so they changed their behavior. More drug dependence is not the answer to drug dependence. This narrative of drug addiction is destructive.
Of course not. Their circumstances changed--so they changed their behavior. More drug dependence is not the answer to drug dependence. This narrative of drug addiction is destructive.
2
How about some equal time for his robbery victims? Was violence involved? Was A knife, a gun or a of brick used? Any of his victims wake up in an ICU or just scared to leave their apartment thinking next time it might not only be money they take?
I remember the heroin addicts nodding out in filth. Superman, sex all night? What a crock.
I remember the heroin addicts nodding out in filth. Superman, sex all night? What a crock.
1
So should we try to solve the problem -- or not?
1
Decriminalizing drug use and abuse and declaring it a public health issue would go a long way towards lowering the stigma...
2
The Swiss, for years, have been giving their junkies pharmaceutical grade heroin, clean needles, counseling and healthcare all in one place.
As a result they have less drug mortality, less HIV, less Hepatitis B and C, less property crime to support drug habits and fewer junkies per capita.
Sadly, for profit prison profiteers are not doing nearly so well as their American counterparts.
As a result they have less drug mortality, less HIV, less Hepatitis B and C, less property crime to support drug habits and fewer junkies per capita.
Sadly, for profit prison profiteers are not doing nearly so well as their American counterparts.
6
There is a tension between community response and individual responsibility in addressing addiction. Extreme positions which deny either are ineffective. The approaches by Europeans that are working could reduce violent crime, reduce prison populations and save lives. But that wouldn't be holding individuals responsible for their own behavior. We couldn't possibly do that.
1
Drug addiction is a disease.
We had "Mexican mud" making its appearance during the 1970's in Detroit. No matter how hard you try to blame others, it is up to the user to quit.
2
It will probably be because of heroin, not marijuana that we finally end the drug war and treat it as the medical problem it has always been.
I say that because heroin addiction is skyrocketing in middle class white America, and we certainly aren't going to lock up every third white male as we do black males.
That may sound cynical, but it's true. Once the face of rampant drug addiction looks like our faces, we are going to be a lot more reticent to send for SWAT teams.
I say that because heroin addiction is skyrocketing in middle class white America, and we certainly aren't going to lock up every third white male as we do black males.
That may sound cynical, but it's true. Once the face of rampant drug addiction looks like our faces, we are going to be a lot more reticent to send for SWAT teams.
9
You underestimate the zeal to marginalize people, especially based on *class.*
2
“Heroin is actually the underlying problem behind so many issues in Baltimore,” Dr. Wen told me. “It’s why people can’t find employment, why people go to jail, why people don’t get educated. People lose their whole families because of heroin.”
Dr Wen is wrong. Drug abuse, unemployment, jail are the results of 50+ years of failed social policy - welfare, food stamps, housing vouchers, de-stigmatizing unwed motherhood and reward poor uneducated women to breed, etc . All these liberal policies has created a dependent underclass feeding off of law abiding productive citizens. The Great Society and war on poverty have been disasters. End the giveaways now and stop creating more generations of the underclass.
Dr Wen is wrong. Drug abuse, unemployment, jail are the results of 50+ years of failed social policy - welfare, food stamps, housing vouchers, de-stigmatizing unwed motherhood and reward poor uneducated women to breed, etc . All these liberal policies has created a dependent underclass feeding off of law abiding productive citizens. The Great Society and war on poverty have been disasters. End the giveaways now and stop creating more generations of the underclass.
6
Thanks for this. Heroin causes exactly nothing. In a decent society, there would be little serious drug addiction. This is not to say people shouldn't take personal responsibility for their behavior. Indeed they should.
But if we're compassionate, if we understand the terrible consequences of a lack of social integration, we'll be forgiving about drug addiction. And a whole lot more. And we'll advocate harm reduction for those who use drugs.
Part of a harm reduction approach is to cut out sensational, misleading pieces like this one from the obviously well-meaning Nicholas Kristof. Mr. Kristof can easily do research that will smash his wrongheaded notions. Why has he not done so?
Perpetuating misconceptions about drugs and drug users is destructive. Users and non-users need to know the facts.
But if we're compassionate, if we understand the terrible consequences of a lack of social integration, we'll be forgiving about drug addiction. And a whole lot more. And we'll advocate harm reduction for those who use drugs.
Part of a harm reduction approach is to cut out sensational, misleading pieces like this one from the obviously well-meaning Nicholas Kristof. Mr. Kristof can easily do research that will smash his wrongheaded notions. Why has he not done so?
Perpetuating misconceptions about drugs and drug users is destructive. Users and non-users need to know the facts.
3
They were not "liberal"policies.
They were put in place by humanists who were trying to alleviate the poverty and injustices that were products of slavery, a 2 tiered educational system and a government that was only concerned with the problems of the 1%!
Sound familiar?
They were put in place by humanists who were trying to alleviate the poverty and injustices that were products of slavery, a 2 tiered educational system and a government that was only concerned with the problems of the 1%!
Sound familiar?
1
There was an article just yesterday entitled Why Hardly Anyone Dies Of A Drug Overdose in Portugal. You can guess the answer. Also, contrary to Mr. Kristoff's assertion, it is the recent draconian crackdown on popular prescription opiates, particularly the less-potent codeine and hydrocodone (which are available without prescription in many countries), that has caused desperate people to try heroin.
6
I guess I just don't get it. When I was all busted up I took opiates until they warmed me and I fell asleep, or passed out if you prefer, and when I woke I took more. There seemed no sense to lay there feeling that pain. Before that I used heroin intravenously recreationally for a brief period, though I shudder now to think of it. I like opioids. If you were to offer me some I would probably thank you, I hurt everywhere, all the time, but I don't crave them and I'm old. If I could grow some poppys and bleed the sap for the opium and ease the pain, I would like that, but if there isn't any, and there usually isn't,that's okay too, I'll just hurt. Left to my own devices I'll be okay, why do you all have such problems with it? Just be kind.
4
I like to point out that in the 1930's, marijuana became illegal in the US and alcohol became legal. I ask a simple question : Given the fact that both drugs have associated problems, compare how we handle those problems with alcohol as opposed to how we handle those with marijuana. We handle alcohol related problems as health issues, we have virtually taken the violence out of its commerce, and we spend little on jailing offenders. With marijuana, it is just the opposite. The same approach could be applied to other drugs, even those as addictive as heroine. It is a choice about efficacy and best use of resources. It is our choice.
35
We did all that stuff with alcohol -- and though legal, it is STILL a terrible scourge on society and the catalyst behind so much violence, family breakdown, automobile accidents and so on.
And that is WITH treating it as a health problem, and offering numerous options for treatment, and of course, it is 100% legal.
So I guess we should triple and quadruple the problem, by legalizing all drugs?
And that is WITH treating it as a health problem, and offering numerous options for treatment, and of course, it is 100% legal.
So I guess we should triple and quadruple the problem, by legalizing all drugs?
1. America invades Afghanistan.
2. Opium production in Afghanistan rises to record levels.
3. Heroin sales in the lucrative American market rise to record levels.
The profit trail will show that these facts are not random coincidences.
2. Opium production in Afghanistan rises to record levels.
3. Heroin sales in the lucrative American market rise to record levels.
The profit trail will show that these facts are not random coincidences.
5
4. And the CIA financed some of its unattractive under-the-wire operations in Afghanistan through poppy and heroin deals.
Unfortunately, you can substitute Heroin for any drug. Human beings have an unlimited capacity for self-destruction. I remember growing up that Cocaine was thought to be the "perfect high". It seems ridiculous today but it was thought to have no side effects and was not considered particularly addictive. Fortunately, my father is a research physician and warned me off those beliefs. BTW - similar statements are today thrown around about Ecstasy (which can permanently affect neurotransmitter levels) and the "absolutely safe" Marijuana which has an addition level lower than that of other drugs and alcohol but is estimated at 9%. Current fascination Synthetics like Bath Salts, Synthetic marijuana, K2, etc is a horror as is the cheaply manufactured and highly destructive Meth.
People's desire to alter their reality, young people's disregard for their lives and belief in their own immortality coupled with not fully developed brains leads to patterns of highly destructive behavior.
Unfortunately, the whack-a-mole nature of the problem leaves little more than public education and truly changing the perception of the drug culture as the solutions. Hollywood and the media do not help. I am struck these days by the collective message of pot is cool that pervades the culture and media and wonder the downstream affects on young people
People's desire to alter their reality, young people's disregard for their lives and belief in their own immortality coupled with not fully developed brains leads to patterns of highly destructive behavior.
Unfortunately, the whack-a-mole nature of the problem leaves little more than public education and truly changing the perception of the drug culture as the solutions. Hollywood and the media do not help. I am struck these days by the collective message of pot is cool that pervades the culture and media and wonder the downstream affects on young people
1
Cannabis is the recreational drug of choice for people who don't want to find themselves waking up in a gutter.
Pot is not the problem.
The great majority of people who use any illicit drug never "find themselves waking up in the gutter." So say the facts.
1
I grew up in Baltimore and saw the devastation heroin caused in the epidemic that hit the late 60's. My best friend - white and upper middle class - was caught up in it, addicted by age 19, and died at 49 from the effects of methadone and anything else he could put in his body to avoid the pain of life.
Here we are almost 50 years later and nothing much has changed. We spent billions on interdiction which has clearly not worked and left generations of young men and women in prison. Yet we keep on the same stupid path.
Look at Portugal for the solution. Stop criminalizing drugs and make this the medical problem it is. The results have been amazing. Less addiction, fewer overdose deaths, and prisons not bursting at the seams. But empirical solutions to problems in this country are not possible given the toxic ideological driven politics we live with.
Such a shame.
Here we are almost 50 years later and nothing much has changed. We spent billions on interdiction which has clearly not worked and left generations of young men and women in prison. Yet we keep on the same stupid path.
Look at Portugal for the solution. Stop criminalizing drugs and make this the medical problem it is. The results have been amazing. Less addiction, fewer overdose deaths, and prisons not bursting at the seams. But empirical solutions to problems in this country are not possible given the toxic ideological driven politics we live with.
Such a shame.
9
Pharmaceutical distribution of opioids and other dangerous drugs-for-profit is criminal. I wish people could be taught to prepare for a life in which some pain occurs. Chronic pain needs treatment -- whatever it takes -- but, temporary pain does not always need to alleviated. Millions of babies are delivered without the aid of anesthetics; it is one of the most intense pains imaginable. Relieving pain completely when it will go away by itself and thereby risking addiction is just stupid. It is so "today" -- instant gratification, long-term payment.
3
Obviously you have never broken your leg, had surgery for a torn rotator cuff, or endured any of the other common causes of intense pain that, with time, will "go away by itself." And had you endured it, you would have discovered, as have almost all of us who have broken bones, blown out joints, or been in car accidents, that opiods relieve disabling pain but do not lead to addiction. Yes, there is a risk of addiction, but don't confuse the real few hours of childbirth pain with six weeks of trauma induced hell.
1
Remove the stigma by decriminalizing drug use and treat it as the health/mental health problem it is. On the economic side, cartels will go out of business when they can't get profit percentages in the thousands and make millions/billions due to constrained supply.
2
Legal US cannabis is already drying up the markets for Mexican drug cartels.
While I'm all in favor of helping to prevent substance abuse by addressing underlying social issues, I find it very telling that the epicenter of the heroin epidemic here in New York is Staten Island, the whitest and most middle class of all the boroughs. I personally know of plenty of relatively privileged young people who have become addicted, and a number of whom have died. Addiction crosses all lines of race, socioeconomic status and culture. Seeing it as a disease of the poor is, I feel, a form of denial.
9
Downer drugs are most popular with people who find thinking painful.
The energy used by drug addicts in supporting their addiction is at least as much as the energy I use to get up, go to work, do my job, run errands, do chores, cook dinner, watch TV, read the paper, shower, brush my teeth, and go to bed. I see and speak in detail to addicts probably 3 or 4 times a week, on legal issues. Now, it's mainly heroin or methadone. They don't want to be addicts. It's an exhausting life, not conducive to the stability or safety that children need (and custody is my game). If one parent is a user, odds are the other is, too. if one is clean, odds are a relapse is in the cards. Often, their families, their traditional support systems, are struggling, too. The grief that a child experiences in losing a parent to prison or addiction, it's a bereavement as real as death. Our society's criminalization of everything has not worked. I don't know what the solution is, but we need a kinder (but not stupid) approach. My aim is to keep the children safe, but not shatter their bonds with their families. It's very draining work.
7
I appreciate that people are becoming more aware of the horrors of opiate addiction. However, the answer to the severe problem continues to be based on rather simple constructs. We need to consider the prevention of substance use via highlighting at risk youth and endorsing protective factors to them long before the complex aspects of addiction can take hold. We must regulate the process of medicine and debunking the myth that only physicians understand how to prescribe medication. The obvious need to stem the inappropriate use of medications is essential and can be done while also helping those in severe pain. None the less, prescribing medication without an understanding of addiction(which is often the case) leads to the pills----stronger pills-----heroin trajectory. We must not be naïve to the pharmaceutical industry which has profits equivalent to the GNP of small nations. Their drug replacement therapy is equivalent to asking the fox to keep an eye on the chicken coop and is not an effective treatment process. Lastly we need to provide treatment on demand as effective outcome measured treatment is only available to a small fraction of those that need it. These constructs can save lives and for those who worry about the bottom line in the end they will save money.
2
Heroin doesn't have to be a killer. Here's how.
Methadone is a synthetic opioid or more to the point, a synthetic heroin. The only reason people don't regularly overdose on it is because its dosage is known and medicaly supervised.
Like Methadone, heroin was once used as a maintenance drug for Morphine addicts. You now have Methadone addicts and a black market.
To end the epidemic of heroin overdoses, provide medically supervised heroin maintenance as some enlightened European countries do today.
Methadone is a synthetic opioid or more to the point, a synthetic heroin. The only reason people don't regularly overdose on it is because its dosage is known and medicaly supervised.
Like Methadone, heroin was once used as a maintenance drug for Morphine addicts. You now have Methadone addicts and a black market.
To end the epidemic of heroin overdoses, provide medically supervised heroin maintenance as some enlightened European countries do today.
12
Corporate irresponsibility strikes yet once again. The profit motive among corporate executives seems to trump human decency -- of deliberately ignoring the negative consequences of one's actions on our fellow human beings and the natural world in general when it happens to conflict with the "bottom line"...Now this clearly is a problem that has reached epoch proportion.
Our increasingly polluted chemical world is beginning to sap the life out of all of us, including our planet, whether we realize it or not. How anyone can be in support of "deregulation" when you factor in the rich history of abuse when it comes to corporate irresponsibility is a depressing mystery to me.
Our increasingly polluted chemical world is beginning to sap the life out of all of us, including our planet, whether we realize it or not. How anyone can be in support of "deregulation" when you factor in the rich history of abuse when it comes to corporate irresponsibility is a depressing mystery to me.
2
I would like more citations for this notion. It's used a lot, but I've never seen any facts behind it. Also the statement about the vets. I am in favor of legalizing drugs even though I've seen areas that have been awfully blighted by this policy (Amsterdam for one). I think it would be better than the prohibition that we have now with police and jail. However, if we are going to legalize, I think prescriptions opiods should be easier to get. Right now all the laws simply punish the law abiding, but do nothing for the problem at large.
2
"small business owner" -- did you mean to reply to someone else's comment? With respect to the irresponsible drug company executives, the specific example referenced in Mr. Kristof's editorial is what I had in mind. Specifically, their deliberate effort to hide the strongly addictive nature of "Oxycontin" on the unsuspecting public. And their motivation for this omission was corporate profits of course.
And as far as corporate irresponsibility with respect to the environment in general is concerned, it's pretty obvious don't you think? Corporate profits once again takes precedence over environmental and public health concerns.
You want citations? Just take a look at what is happening to our climate and the natural world all around us. The industrialized world is polluting at a pace never before experienced on the face of the planet. And this industrialization produces a great deal of pollution that impacts our natural environment in ways that threaten the future of "life as we know it".
And on the immediate human side, the combination of synthetic drugs and contaminates of all types make it difficult for our bodies to deal with these artificially produced stresses as well.
Are you arguing with these points?
And as far as corporate irresponsibility with respect to the environment in general is concerned, it's pretty obvious don't you think? Corporate profits once again takes precedence over environmental and public health concerns.
You want citations? Just take a look at what is happening to our climate and the natural world all around us. The industrialized world is polluting at a pace never before experienced on the face of the planet. And this industrialization produces a great deal of pollution that impacts our natural environment in ways that threaten the future of "life as we know it".
And on the immediate human side, the combination of synthetic drugs and contaminates of all types make it difficult for our bodies to deal with these artificially produced stresses as well.
Are you arguing with these points?
The Long Form of the St. Michael the Archangel Prayer (found at www.johnleary.com) when prayed for the person who is drug dependent has been found to UNbind the negative spirits attached to the drug dependent person and this explains relapse in people who have worked very hard to get and stay clean.
The negative spirit or demon binds the person to the drug and sabotages the person's hard working efforts to stay clean and sustain sobriety.
Yes, there is spiritual evil and it manifests as binding attachments to that which destroys or kills, in this case drug-using behavior. The Long Form of the St. Michael the Archangel Prayer is very powerful. When you pray it for the person, put drops of Holy Water on the person's picture as the prayer is being prayed.
Yes, the roots of drug use and drug addiction are myriad: genetic vulnerability, neurotransmitter deficits, and the list goes on and on. For example, studies continue to show that 7 out of 10 substance abusing or substance dependent people have a co-existing mental health disorder. But one root not commonly known nor immediately believed is that in some cases a negative spirit or demon binds the person to using or to relapsing!
The unbelief in the reality that is spiritual evil results in the tragic deaths of many who cannot get clean or in those who got clean but cannot sustain their abstinence.
Some may choose to disbelieve that of which I speak, but that free will choice does not obviate this spiritual reality.
The negative spirit or demon binds the person to the drug and sabotages the person's hard working efforts to stay clean and sustain sobriety.
Yes, there is spiritual evil and it manifests as binding attachments to that which destroys or kills, in this case drug-using behavior. The Long Form of the St. Michael the Archangel Prayer is very powerful. When you pray it for the person, put drops of Holy Water on the person's picture as the prayer is being prayed.
Yes, the roots of drug use and drug addiction are myriad: genetic vulnerability, neurotransmitter deficits, and the list goes on and on. For example, studies continue to show that 7 out of 10 substance abusing or substance dependent people have a co-existing mental health disorder. But one root not commonly known nor immediately believed is that in some cases a negative spirit or demon binds the person to using or to relapsing!
The unbelief in the reality that is spiritual evil results in the tragic deaths of many who cannot get clean or in those who got clean but cannot sustain their abstinence.
Some may choose to disbelieve that of which I speak, but that free will choice does not obviate this spiritual reality.
1
In the USA and four other countries, a natural plant medicine that literally cures -- and yes, cures is the right word -- heroin addiction is available. In one grueling treatment, it ends even the lengthiest heroin habits within 45 minutes, though it does subject the user to about 12 hours of a grueling, thoughtful journey. It is called ibogaine, and because it was classified (improperly) as a hallucinogenic in the early days of the War on Drugs, it is too illegal even for research. Dr. Deborah Mash, the Miami neuroscientist, had to move her research out of the country. Ibogaine works. It ends the habit almost instantly, without the withdrawals addicts fear, and then, for an extended period eliminates cravings.
It is a tragedy that the United States is not permitting research into this miraculous medicine. Its rough edges and its risks could surely be improved by scientific testing and professional administration. America's illegalization of it is is an odious effect of the WOD. The best book on the topic I've read is "Rehab Doesn't Work - Ibogaine Does.
http://www.amazon.com/Rehab-Doesnt-Work-overnight-withdrawal/dp/06158264...
It is a tragedy that the United States is not permitting research into this miraculous medicine. Its rough edges and its risks could surely be improved by scientific testing and professional administration. America's illegalization of it is is an odious effect of the WOD. The best book on the topic I've read is "Rehab Doesn't Work - Ibogaine Does.
http://www.amazon.com/Rehab-Doesnt-Work-overnight-withdrawal/dp/06158264...
7
Correction: NOT available in US and four other countries. Available everywhere else, including Canada and Mexico, where US addicts have to go for treatment.
Ibogaine appears to work for some individuals, but not for all. And it is not without risk. I agree it shouldn't be criminalized, but proponents of it also need to be honest and open about the mixed results it has shown, and not sell it as a miracle cure-all that works for everyone with zero risk, because it doesn't work for everyone and it does carry risks (up to and including death in a few cases).
1
The New York Academy of Medicine has just released a report (of which I'm the lead author) that examines the role of harm reduction programs, i.e., syringe exchange, in improving the health of drug users. More broadly, the report and accompanying case study demonstrate what harm reduction programs can teach the health care system in improving the health of many low-income marginalized people. As Medicaid reforms attempt to move the health care system from incentivizing medical procedures to incentivizing improved health outcomes, the frontline experiences of harm reduction providers and their health care provider partners offer many lessons.
http://www.nyam.org/news/press-releases/2015/2015-06-04.html
http://www.nyam.org/news/press-releases/2015/2015-06-04.html
2
Thanks for writing about addiction. Hope to see more articles about the root cause, i.e. why people turn to drugs in the first place, and what can be done about that. Even if heroin were free, most of us would be terrified to try it. So what's the real cause of the problem?
We also need a national conversation about ending the war on drugs, ending the incarceration of drug users and using those resources to better serve people.
We also need a national conversation about ending the war on drugs, ending the incarceration of drug users and using those resources to better serve people.
9
I found the most resonance within this article to come from Ricky Morris' statement that heroin "...does make you feel good."
We ought to ask ourselves why people like Ricky don't feel good. What prevents them from achieving a happy life? If we're honest we know the answer - its the poverty and lack of opportunity they face as they mature, and begin to recognize the limitations that their lives place on them. Today, we also know that young, white Americans in Vermont are taking the same way out of their own hopelessness, as the statistics on heroin use in that state begin to alarm even the governor of the state.
And we don't even have a plan in place to address this growing dynamic -mainly due to the Conservative attitudes toward poverty: the blaming and shaming of those who have not achieved societal success.
And here, right before us in this column is evidence that planned, focused effort on individual achievement works. The revelation that Baltimore's health commissioner is a "graduate" of the Kristoff program of rewarding youthful aspiration and achievement is what I refer to by this.
Just imagine if we had a nationwide program in place to begin to arouse the intellectual curiosity of poor American youth nationwide. And to reward those who work at it - to make them "feel good" about themselves and about their futures.
How hard would it really be to do that?
We ought to ask ourselves why people like Ricky don't feel good. What prevents them from achieving a happy life? If we're honest we know the answer - its the poverty and lack of opportunity they face as they mature, and begin to recognize the limitations that their lives place on them. Today, we also know that young, white Americans in Vermont are taking the same way out of their own hopelessness, as the statistics on heroin use in that state begin to alarm even the governor of the state.
And we don't even have a plan in place to address this growing dynamic -mainly due to the Conservative attitudes toward poverty: the blaming and shaming of those who have not achieved societal success.
And here, right before us in this column is evidence that planned, focused effort on individual achievement works. The revelation that Baltimore's health commissioner is a "graduate" of the Kristoff program of rewarding youthful aspiration and achievement is what I refer to by this.
Just imagine if we had a nationwide program in place to begin to arouse the intellectual curiosity of poor American youth nationwide. And to reward those who work at it - to make them "feel good" about themselves and about their futures.
How hard would it really be to do that?
64
I think you are over simplifying the matter here. Many people start to use drugs to medicate feelings of trauma or tragedy when they are young like divorce, broken relationships, failure in school. The nationwide program to arouse intellectual curiosity is the public school education system which is supposed to provide music, art, theater, dance and humanities education in high school along with sports, science, math, and community service organizations. This nation wide epidemic of drug and prescription pain killers beg many questions about our lives and our choices as humans. Prevention education, free methadone programs, free needle exchange programs, free drug treatment and better options to connect with one self internally with yoga, meditation, pilates, exercise rehabilitation and counseling must be on our "health plate" and made available to all communities, after all haven't we had enough of meth addiction to heroin addition to prescription pain killers, 44,000 overdose deaths a year? Why aren't we "screaming" for the massive interventions necessary in our communities?
52
Well said, and I agree. For instance, with lack of activity - which can be the result of believing one leads a relatively 'normal' lifestyle (sedentary job, etc.) - can come not just aches and pains of getting older, but some serious aches and pains which people consider unreasonable or otherwise unfair, so they turn to pharmaceuticals and perhaps worse. Then there are children 'athletes' on the other side of the coin, who continue on to college and perhaps further, only to burn out on a sport (or sports), and likely due to common training methods, are injured to the point of life-long pains. Big Pharma to the rescue again.
Education is the key as it preventative measures and, honestly, a massive shift in attitudes and future focus. More conveniences is not necessarily a good thing, particularly when such conveniences give us more time to sit about and do little; traditional work and manufacturing roles should be examined, e.g., can the 9-hour work day be shifted forward or backward to leave actual day time for outdoor activity?; why are there not health clinics on every corner to help with preventative medicines/lifestyles?.
As you say, why do we not scream for better lives and opportunities for growth? Why do we scream for cheaper drug prices?
Education is the key as it preventative measures and, honestly, a massive shift in attitudes and future focus. More conveniences is not necessarily a good thing, particularly when such conveniences give us more time to sit about and do little; traditional work and manufacturing roles should be examined, e.g., can the 9-hour work day be shifted forward or backward to leave actual day time for outdoor activity?; why are there not health clinics on every corner to help with preventative medicines/lifestyles?.
As you say, why do we not scream for better lives and opportunities for growth? Why do we scream for cheaper drug prices?
I have never met a conservative that shames poor people. Ever.
1
Nowhere in this article do you mention that Mexican cartels stopped growing marijuana and started growing poppies when legalization of marijuana in some states lowered the value of the product.
And that the dealers deliberately keep the price low to get and keep people hooked, especially those who can't afford or have trouble getting prescription pain killers. To the point where they hang out in front of pain clinics to find new "clients."
Yes, the American pharmaceutical industry played a huge role in getting and keeping people hooked on pain killers. But it took an entire other half--the growers and dealers--to spread this scourge.
And that the dealers deliberately keep the price low to get and keep people hooked, especially those who can't afford or have trouble getting prescription pain killers. To the point where they hang out in front of pain clinics to find new "clients."
Yes, the American pharmaceutical industry played a huge role in getting and keeping people hooked on pain killers. But it took an entire other half--the growers and dealers--to spread this scourge.
12
They have always grown poppies. They increased their poppy production when poppies temporarily came under attack as part of the Afghan war and occupation, because the US military decided it was impossible to stabilize the country without allowing poppy production. Shortly after that, the Feds started to crack down on what they called over-prescription of legal opiates, dumping thousands, if not millions, of legal users into a state of no prescriptions, leaving many thousands of them to seek out the main non-prescription opiate, heroin. In other words, the fact that Mexican cartels are now big in the heroin business is nearly entirely due to decisions by our Federal government.
The Feds seem to make decisions as though they were in vacuum and fail to plan for consequences that should have been plainly obvious to anyone. So obvious, in fact, one has to wonder if those making the decisions aren't on the payroll of the cartels.
The Feds seem to make decisions as though they were in vacuum and fail to plan for consequences that should have been plainly obvious to anyone. So obvious, in fact, one has to wonder if those making the decisions aren't on the payroll of the cartels.
2
I'd like to see some citations about the pharmaceutical companies. Better pain medication isn't something that isn't necessary to millions of people in this country and elsewhere. I'm in pain every single day. It's been relieved somewhat with new medications (not opioids), but to discount the relief to many people is just more than annoying. Right now there are so many restrictions on people to get pain relief and even OTC sinus relief because other people choose to abuse it. We are punishing the people who follow the law!
2
Siobhan, you are right on the mark. Sam Quinones's "Dreamland" tells this story very well (link to a review below).
After the pill mill doc's got a lot of folks outside the cities hooked on opiates, the Xalisco 'boys' from Nayarit Mexico sold them black tar heroin for much cheaper than the pills. They delivered doses like pizza, driving around in old cars with balloons containing doses of heroin in their mouths so they could swallow the evidence if caught and recover it later.
They also solicited new 'customers' from their contacts at methadone clinics and teased back those trying to kick with really 'good' cheap black tar. They'd work a while, then go home and spread the wealth around their villages, then go back north to make more money and spread more drug destruction. They seemed to have little problem crossing the border north or south.
One thing that particularly impressed me was how easily these 'boys' were replaced when some or a whole cell of them got caught - rarely more than a day or 2 before they were replaced. They were just Mexican unskilled workers who came to the US for no other reason than to make big bucks (in their eyes) selling black tar heroin - not working the fields, not mowing yards, etc - and their numbers seemed legion.
An excellent and eye-opening read. Wonder how many are eligible for Obama's DACA/DAPA programs.
http://www.wsj.com/articles/the-great-opiate-boom-1433531938
After the pill mill doc's got a lot of folks outside the cities hooked on opiates, the Xalisco 'boys' from Nayarit Mexico sold them black tar heroin for much cheaper than the pills. They delivered doses like pizza, driving around in old cars with balloons containing doses of heroin in their mouths so they could swallow the evidence if caught and recover it later.
They also solicited new 'customers' from their contacts at methadone clinics and teased back those trying to kick with really 'good' cheap black tar. They'd work a while, then go home and spread the wealth around their villages, then go back north to make more money and spread more drug destruction. They seemed to have little problem crossing the border north or south.
One thing that particularly impressed me was how easily these 'boys' were replaced when some or a whole cell of them got caught - rarely more than a day or 2 before they were replaced. They were just Mexican unskilled workers who came to the US for no other reason than to make big bucks (in their eyes) selling black tar heroin - not working the fields, not mowing yards, etc - and their numbers seemed legion.
An excellent and eye-opening read. Wonder how many are eligible for Obama's DACA/DAPA programs.
http://www.wsj.com/articles/the-great-opiate-boom-1433531938
SAVING LIVES The notion that drug users deserve to suffer and die because of their failure to maintain self-control is yet another in the unending saga of the tsunami of the blame-the-victim attitude that has come to plague our country. Typically, those who oppose needle exchanges and condoms to prevent the spread of deadly diseases, are the first to throw public tantrums about the exorbitant cost of medical care and spending too much on social programs. So it becomes inevitable that we taxpayers, the ultimate chumps, will be spending huge sums for medical care that could be prevented with scientifically proven, safe interventions. Portugal is a case in point. Their death rate from heroin has plummeted because they would rather prevent suffering and save money than moralize. I say, put the drug cartels out of business by decriminalizing all drugs and providing medical care. While we're at it, we should do the same for tobacco, alcohol and coffee, three legal drugs!
20
If we really wanted to use evidence based public policy, we could look to Portugal where they legalized drug use and have seen a precipitous decline in deaths due to overdoses and an increase in treatment. But that would require the application of scientific thinking in the political realm and we see how that's played out in the climate change debate.
56
There is a simple strategy to solving the heroin problem in the U.S. Mao Zedong eliminated a similar level of opiate addiction in China nearly overnight. Unfortunately there isn't the stomach for such a strategy here.
Also, as others point out (but the MD cited doesn't seem to grasp), heroin is escapism at its best--getting rid of heroin doesn't get rid of socioeconomic and cultural problems that lead to its use.
Also, as others point out (but the MD cited doesn't seem to grasp), heroin is escapism at its best--getting rid of heroin doesn't get rid of socioeconomic and cultural problems that lead to its use.
6
I agree with the assertion that pharma is complicit for pushing opioids, but every person is responsible for the doctors they engage, and dupe, to secure prescriptions. Another explanation cloaked as victimization is hard to read. Are there any things out there that do no qualify for "out of our control" status?
The heroin epidemic, at times, seems better compared to a fever which must be allowed to break. For instance, we are distributing narcan to first responders to "save" addicts. Really? It is cruel, and I would feel differently if it were me or a loved one, but why should this be our focus.
Heroine addiction, like so many public policy issues, becomes perverted when we think "what if that were us or our kid". However, that same generous impulse causes all of us to relax behaviors that ultimately put the entire culture on a downward glide.
The best guard against heroine and any other addictive or destructive behavior is human self-control. If we cannot rebuild that within our society, and it looks dicey, putting up enormous guardrails around all of our behavior snubs but does not eliminate the core problem.
We need to take a long gaze at that which we are becoming, and every human life needs to reclaim something better. Until then, we cannot medicate or therapize our way to health.
The heroin epidemic, at times, seems better compared to a fever which must be allowed to break. For instance, we are distributing narcan to first responders to "save" addicts. Really? It is cruel, and I would feel differently if it were me or a loved one, but why should this be our focus.
Heroine addiction, like so many public policy issues, becomes perverted when we think "what if that were us or our kid". However, that same generous impulse causes all of us to relax behaviors that ultimately put the entire culture on a downward glide.
The best guard against heroine and any other addictive or destructive behavior is human self-control. If we cannot rebuild that within our society, and it looks dicey, putting up enormous guardrails around all of our behavior snubs but does not eliminate the core problem.
We need to take a long gaze at that which we are becoming, and every human life needs to reclaim something better. Until then, we cannot medicate or therapize our way to health.
10
In other words, "Just say no!"
That smug, moralistic, do-nothing approach to drug addiction has never worked, anywhere. It hides from reality behind a shield of shaming addicts and gets us nowhere.
It is long past time the US dropped the counter-productive War on Drugs and moved to sane policies such as Portugal's.
That smug, moralistic, do-nothing approach to drug addiction has never worked, anywhere. It hides from reality behind a shield of shaming addicts and gets us nowhere.
It is long past time the US dropped the counter-productive War on Drugs and moved to sane policies such as Portugal's.
38
Smug? Okay. It is your post.
Our spiritual, mental, and physical needs are societal liabilities that ultimately require a health care system so vast and costly that it will be overwhelmed by the demands placed on it. At that point, the same people who "shamed" the "moralizers" will turn into steely-eyed economists and get to work deciding who gets the treatments, first.
Placing this responsibility in the hands of a bureaucracy is one answer. But not a single Progressive can write a word about the personal responsibility each human being has to him/herself or to his family member or neighbor. We pass the problem on to a governmental agency that we fund and stand up to deal with the things we can no longer contain, rarely considering the long-term commitments we are making and none of which will be rescinded.
Until they are rationed, because we will not have the heart to admit we couldn't afford to start the programs or procedures in the first place.
I am smug? You will eventually become an accountant. The old and infirm will be the first victims, just as sure as I am sitting here. It is math, pure and simple.
Our spiritual, mental, and physical needs are societal liabilities that ultimately require a health care system so vast and costly that it will be overwhelmed by the demands placed on it. At that point, the same people who "shamed" the "moralizers" will turn into steely-eyed economists and get to work deciding who gets the treatments, first.
Placing this responsibility in the hands of a bureaucracy is one answer. But not a single Progressive can write a word about the personal responsibility each human being has to him/herself or to his family member or neighbor. We pass the problem on to a governmental agency that we fund and stand up to deal with the things we can no longer contain, rarely considering the long-term commitments we are making and none of which will be rescinded.
Until they are rationed, because we will not have the heart to admit we couldn't afford to start the programs or procedures in the first place.
I am smug? You will eventually become an accountant. The old and infirm will be the first victims, just as sure as I am sitting here. It is math, pure and simple.
3
Piffle.
Your premise assumes vast costs when actually money can be saved by dropping the outlandishly costly War on Drugs campaign, with its huge economic tail of incarcerations. Further costs can be saved by removing addicts from the ranks of criminal predators on society.
Lecturing, shaming and punishing have obviously failed. Treatment and education would be far cheaper and more effective than the drug war nightmare we are currently inflicting upon ourselves.
Your premise assumes vast costs when actually money can be saved by dropping the outlandishly costly War on Drugs campaign, with its huge economic tail of incarcerations. Further costs can be saved by removing addicts from the ranks of criminal predators on society.
Lecturing, shaming and punishing have obviously failed. Treatment and education would be far cheaper and more effective than the drug war nightmare we are currently inflicting upon ourselves.
3
A standard right-wing theme is that addicts made "bad choices" and thus should suffer rather than receive help on My Taxpayer Dollar. To support this, they argue that methadone is "addictive" and naloxone should not be readily available because it saves the lives of worthless people. If drug addicts don't have the Personal Responsibility to get clean cold turkey, tough luck.
Well, addiction is defined as compulsive drug seeking and use, despite harmful consequences. The responsible use of prescription methadone to treat heroin addiction is not in itself an addiction because its consequences are overall good, not harmful. Yes, it must be used for years to help addicts whose CNS have been damaged by street drugs. And it must be tapered slowly if/when it is no longer needed to stave off heroin cravings. And sure, some people will try to get high from it--heck, alcohol treatment units must keep alcohol-containing antiseptics away from patients, but that doesn't mean antiseptics are "addictive," just that desperate people will try to misuse them.
Conservative divide-and-conquer tactics are working very well in the US. They trick ordinary Americans into viewing one another as enemies so we won't notice the rapacious 1%ers who are briskly turning us into a third world country for their own profit. But if you avoid helping heroin addicts, you just wind up with untreated heroin addicts (though you might enhance your sense of self-righteousness).
Well, addiction is defined as compulsive drug seeking and use, despite harmful consequences. The responsible use of prescription methadone to treat heroin addiction is not in itself an addiction because its consequences are overall good, not harmful. Yes, it must be used for years to help addicts whose CNS have been damaged by street drugs. And it must be tapered slowly if/when it is no longer needed to stave off heroin cravings. And sure, some people will try to get high from it--heck, alcohol treatment units must keep alcohol-containing antiseptics away from patients, but that doesn't mean antiseptics are "addictive," just that desperate people will try to misuse them.
Conservative divide-and-conquer tactics are working very well in the US. They trick ordinary Americans into viewing one another as enemies so we won't notice the rapacious 1%ers who are briskly turning us into a third world country for their own profit. But if you avoid helping heroin addicts, you just wind up with untreated heroin addicts (though you might enhance your sense of self-righteousness).
31
@Chadwick
My hope is that in the very near and real future, we will use objective data and more rigorous fact patterns to decide which policies to pursue. Such studies, if their efficacy is broadly shared, will be the arbiter for Left and Right.
Calling each other names is therapeutic but not effective.
Some people believe in standing up large agencies to tackle societal breakdown and others are opposed to those approaches. I know many people who have become ensnared by drugs and alcohol, and it is heart-breaking. I think we are all trying to determine the best way to deal with this situation.
My hope is that in the very near and real future, we will use objective data and more rigorous fact patterns to decide which policies to pursue. Such studies, if their efficacy is broadly shared, will be the arbiter for Left and Right.
Calling each other names is therapeutic but not effective.
Some people believe in standing up large agencies to tackle societal breakdown and others are opposed to those approaches. I know many people who have become ensnared by drugs and alcohol, and it is heart-breaking. I think we are all trying to determine the best way to deal with this situation.
Since when to government officials do what is best for society? In the US, the majority of our Congressmen are interested in getting reelected - and so they do what they think will get them the most votes. In most cases, this means 1) pleasing corporate donors in order to receive as much campaign cash as possible, and 2) using that cash to flood the airwaves with whatever message they think a majority of likely voters will approve of. "Tough on drugs" sells, so that's what is promoted.
Unfortunately, few Americans are familiar enough with the disease of addiction to understand that the highest incarceration rate in the world, combined with billions spent attempting to cut of supplies, is a strategy that has been overwhelmingly unsuccessful and a huge waste of human lives & capital.
Until American citizens make a greater attempt to educate themselves on the deadly disease of addiction, stop treating addicts like vermin, and vote for legislators who will work for drastic changes in our attitude toward drug use, I'm afraid we cannot expect much in the way of change.
As other comments have noted, we have known for years what works and what doesn't. What is lacking is the political will to do the right thing.
Unfortunately, few Americans are familiar enough with the disease of addiction to understand that the highest incarceration rate in the world, combined with billions spent attempting to cut of supplies, is a strategy that has been overwhelmingly unsuccessful and a huge waste of human lives & capital.
Until American citizens make a greater attempt to educate themselves on the deadly disease of addiction, stop treating addicts like vermin, and vote for legislators who will work for drastic changes in our attitude toward drug use, I'm afraid we cannot expect much in the way of change.
As other comments have noted, we have known for years what works and what doesn't. What is lacking is the political will to do the right thing.
19
Lets start by giving Heroin an even worse reputation by using it as the drug of choice to execute those who have been sentenced to death. It works every time by stopping respiration, it is painless, and there is tons of it available in police evidence rooms.
Judging by my very limited experience of how you feel on Heroin, it is not like being high. You have no feeling at all. No friends, no enemies, no plans, no regrets, no nothing. That is why it appeals to people in pain of all kinds, both physical and mental.
Try to understand that the person on heroin is not planning to rob the liquor store, or mug the next person that walks by. It is the addict who comes down and needs more dope who will do anything to get the money.
The solution, in my opinion, is to give the dope away to any adult who wants it. They are going to get it anyway. Anyone who wants the drug used to execute people can have it.
Judging by my very limited experience of how you feel on Heroin, it is not like being high. You have no feeling at all. No friends, no enemies, no plans, no regrets, no nothing. That is why it appeals to people in pain of all kinds, both physical and mental.
Try to understand that the person on heroin is not planning to rob the liquor store, or mug the next person that walks by. It is the addict who comes down and needs more dope who will do anything to get the money.
The solution, in my opinion, is to give the dope away to any adult who wants it. They are going to get it anyway. Anyone who wants the drug used to execute people can have it.
15
There is literature from the 1940s about medical people using heroin regular and as long as they fed, watered and exercised themselves and didn't have to worry about cops, they would function just fine. Could Heroin, properly administrated become our coffee? We need to examine the potential for good coming from substances before we criminalize them.
8
There is other literature about physicians who were dependent on heroin. Their lives were otherwise normal. Constipation seems to be the main unwanted effect.
This history is detailed in the classic 1972 book, Licit and Illicit Drugs: The Consumers Union Report on Narcotics, Stimulants, Depressants, Inhalants, Hallucinogens, and Marijuana - Including Caffeine, Nicotine, and Alcohol - by Edward M. Brecher and the Editors of Consumer Reports. One can learn quite a bit from reading this sober report.
This history is detailed in the classic 1972 book, Licit and Illicit Drugs: The Consumers Union Report on Narcotics, Stimulants, Depressants, Inhalants, Hallucinogens, and Marijuana - Including Caffeine, Nicotine, and Alcohol - by Edward M. Brecher and the Editors of Consumer Reports. One can learn quite a bit from reading this sober report.
As a citizen who is actively involved in the politics of my state and my nation, I have made a firm promise for the upcoming election cycle. I will not cast a vote for any candidate who is not committed to putting an end to the utterly ridiculous and harmful "war on drugs." No comment on this issue? Then expect no vote from me.
41
As a former addict/alcoholic with 37 years of abstinence, I understand the power of the drug. The issues are complex, but my friends who have similar stretches of sobriety pretty much agree with me that it should be legalized and prescribed by doctors. The war on drugs makes the situation a hundred times worse for the addicts and the rest of society.
My biggest worry is that the flurry of anti-heroin articles will further restrict the ability of physicians to stop pain. Their tools are limited, and while the use of opioids for terminal cancer patients is now uncontested, other severely painful conditions are sometimes unrelieved.
My biggest worry is that the flurry of anti-heroin articles will further restrict the ability of physicians to stop pain. Their tools are limited, and while the use of opioids for terminal cancer patients is now uncontested, other severely painful conditions are sometimes unrelieved.
75
I agree--the war on drugs has become a war on everyone who uses drugs, including those who use prescription drugs as directed.
I've had to take methadone for years as the medication of last resort for a neurological disorder. I'd had trials of every other medication commonly used for this disorder; none worked well, and two augmented my symptoms to the point where I considered suicide.
There are many drawbacks to methadone (severe constipation and fatigue bother me the most). I accept that if a new miracle medication is created for my disorder I will have to withdraw from methadone very slowly; no big deal.
Social stigma is the most difficult challenge of my medication regime. Methadone is associated with heroin addicts, so mentioning it gets me classed as one. I must get a new prescription every 30 days--my cost-saving mail-order pharmacy can't be used. When my specialist goes on vacation, sometimes the MD covering for him doesn't bother to mail my prescription despite desperate phone calls--so I suffer neurological symptoms while I wait. Methadone patients now have only a two-day window in which to pick up the new bottle of medication. Thus, if a blizzard or ice storm occurs, I must either brave a 60-mile round trip to the pharmacy or try to drive while fully symptomatic from the neurological disorder, which includes severe pain.
In what way does my suffering fight other people's drug addiction?
I've had to take methadone for years as the medication of last resort for a neurological disorder. I'd had trials of every other medication commonly used for this disorder; none worked well, and two augmented my symptoms to the point where I considered suicide.
There are many drawbacks to methadone (severe constipation and fatigue bother me the most). I accept that if a new miracle medication is created for my disorder I will have to withdraw from methadone very slowly; no big deal.
Social stigma is the most difficult challenge of my medication regime. Methadone is associated with heroin addicts, so mentioning it gets me classed as one. I must get a new prescription every 30 days--my cost-saving mail-order pharmacy can't be used. When my specialist goes on vacation, sometimes the MD covering for him doesn't bother to mail my prescription despite desperate phone calls--so I suffer neurological symptoms while I wait. Methadone patients now have only a two-day window in which to pick up the new bottle of medication. Thus, if a blizzard or ice storm occurs, I must either brave a 60-mile round trip to the pharmacy or try to drive while fully symptomatic from the neurological disorder, which includes severe pain.
In what way does my suffering fight other people's drug addiction?
38
A close relative of mine also reached methadone as a last resort for neuropathic pain. The instant, permanent relief it gave her seemed nothing short of miraculous, and she has now been using it for seven years.
A normal life has been restored to her by this often maligned drug.
Normal, that is, except for the continuing difficulty obtaining it, which has been marked by episodes of pain and withdrawal due to pharmacies' and doctors' sudden attacks of cold feet in their prescribing and dispensing of methadone, "that drug for addicts." Those qualms are due to ignorance and fear generated by this nation's failed drug policies. That's another reason we are long overdue for a change.
A normal life has been restored to her by this often maligned drug.
Normal, that is, except for the continuing difficulty obtaining it, which has been marked by episodes of pain and withdrawal due to pharmacies' and doctors' sudden attacks of cold feet in their prescribing and dispensing of methadone, "that drug for addicts." Those qualms are due to ignorance and fear generated by this nation's failed drug policies. That's another reason we are long overdue for a change.
20
Thank you, ML. Same problem, different medicine. New drug restrictions entangle legitimate pain prescriptions with abused drugs. When people use pain medicine as it is meant to be used, extreme limitations on getting this medicine create painful problems. Like you, I've tried just about everything. I take as little as I can in order to function normally. How does making me see my doctor every 30 days for a new script help drug addiction? Why is there no way to store information at my pharmacy? Is this an attempt to shame people with chronic pain?
3
Heroin was the trade name that Bayer gave diamorphine in 1895, and is now merely the common name for diamorphine that usually has been adulterated. Globally, diamorphine is used in the medical treatment of severe pain, especially in terminally ill patients [1]. Heroin or diamorphine is an important and valuable pharmacological drug.
1) http://www.patient.co.uk/medicine/diamorphine
1) http://www.patient.co.uk/medicine/diamorphine
21
As the founder of one of New York Cities first comprehensive multi-service needle syringe programs Positive Health Project, I can say having these programs does work. However only when adequately funded and when such programs have the dedicated staff to deal with HCV and overdose issues. More importantly having funds to purchase and distribute Naloxone and the ample supply of needles including all the sterile injection equipment needed to prepare drugs for injection in order to prevent HCV. SEPs or NSPs with the proper infrastructure and funding can offer on-site medical care, HIV/HCV testing and interventions to support reducing and or eliminating high risk behaviours. Naloxone distribution was started in the late 90s, when in Chicago and New York we trained drug injectors on how to save their fellow peers lives. Today some 15 - 20 years later after numerous attempts to convince government officials to launch wide scale Naloxone program, and the number of deaths that could have been prevented now open their eyes. Examples of New York and other states can be a model to follow. Its about time!
12
I have naloxone in my home because I know opiate users closely and after one nearly died on the street from an overdose I sought out the local naloxone program just in case that ever happened during a visit. I saw naloxone in person administered to my friend in the hospital and watched as he went from a dreamy, sleepy haze to a state of extreme, if agitated, alertness in seconds. Amazing effect it has.
I just looked up the current statistics on our departments of health websites and they don't quite make his case and indeed point out that the statistics are not actually gathered in any inclusive or reliable fashion:
http://www.drugabuse.gov/related-topics/trends-statistics/overdose-death.... So I wonder where he gets his info and what his agenda is.
Meanwhile, even if his numbers pan out, which seems dubious, I find absolutely no discussion here about why more people might be turning toward the escapism that drugs can bring. Could it be a sense of hopelessness spawned by a bad economy? Could it be that there are more sufferers of chronic pain now than there used to be? Or something else? We certainly gain no illumination from this article. Too bad as it's probably important.
http://www.drugabuse.gov/related-topics/trends-statistics/overdose-death.... So I wonder where he gets his info and what his agenda is.
Meanwhile, even if his numbers pan out, which seems dubious, I find absolutely no discussion here about why more people might be turning toward the escapism that drugs can bring. Could it be a sense of hopelessness spawned by a bad economy? Could it be that there are more sufferers of chronic pain now than there used to be? Or something else? We certainly gain no illumination from this article. Too bad as it's probably important.
15
The database you link above counts only deaths due to overdose of prescription drugs, Sue. I believe that Kristof is writing about overdose deaths involving both prescription and non-prescription drugs.
If anything, Kristof's numbers are conservative. The CDC's WONDER database provides data on 80,000 overdose deaths in the US for 2010 (most recent numbers I can find). See here:
http://www.popsci.com/science/article/2013-04/which-drugs-actually-kill-...
That analysis includes alcohol overdose, but even stripping out the alcohol-related numbers, we're still left with 70,000+ overdose deaths from drugs of all sorts every year.
I can't explain the very low number (44,000) used in this article. But it seems very clear to me transparent reporting at the national level would make it easier to understand the magnitude of this problem.
If anything, Kristof's numbers are conservative. The CDC's WONDER database provides data on 80,000 overdose deaths in the US for 2010 (most recent numbers I can find). See here:
http://www.popsci.com/science/article/2013-04/which-drugs-actually-kill-...
That analysis includes alcohol overdose, but even stripping out the alcohol-related numbers, we're still left with 70,000+ overdose deaths from drugs of all sorts every year.
I can't explain the very low number (44,000) used in this article. But it seems very clear to me transparent reporting at the national level would make it easier to understand the magnitude of this problem.
3
Overdoses increase when user's supply gets disrupted. Addicts with a regular supply are actually very unlikely to overdose partly because they know what they need but, more importantly, because they build up such a strong tolerance that it would take pretty much an intentional overdose to surpass their tolerance.
But when their supply gets disrupted, especially if they go completely through physical withdrawal before they find a new source, they lose their tolerance, they don't know the strength of what they find if it's heroin, and the risk over overdose goes way, way up. So anytime opiates are cracked down on, you can expect to see a surge in overdose deaths, at least in the short term.
But when their supply gets disrupted, especially if they go completely through physical withdrawal before they find a new source, they lose their tolerance, they don't know the strength of what they find if it's heroin, and the risk over overdose goes way, way up. So anytime opiates are cracked down on, you can expect to see a surge in overdose deaths, at least in the short term.
2
"Some conservative politicians oppose needle exchanges fearing that they legitimize drug use."
This would seem to mirror their opposition to dispensing condoms because such might encourage pre-marital sex among teenagers.
So, we have means to address two major ways in which Hepatitis, HIV, and other STDs spread, but some folks who would oppose these means in hopes of enforcing quaint notions of morality through fear (of illness, insanity, pain, sterility, or even death as possible results of contracting such a disease by reusing needles or having unprotected sex).
In the toxic environment of current state and Congressional politics they might be getting away with obstructing these means, but we shouldn't let people who play politics with public health policy and, therefore, with people's lives, get away with calling themselves "conservative."
This would seem to mirror their opposition to dispensing condoms because such might encourage pre-marital sex among teenagers.
So, we have means to address two major ways in which Hepatitis, HIV, and other STDs spread, but some folks who would oppose these means in hopes of enforcing quaint notions of morality through fear (of illness, insanity, pain, sterility, or even death as possible results of contracting such a disease by reusing needles or having unprotected sex).
In the toxic environment of current state and Congressional politics they might be getting away with obstructing these means, but we shouldn't let people who play politics with public health policy and, therefore, with people's lives, get away with calling themselves "conservative."
34
Heroine was once hailed the new wonder drug which was going to save tens of thousands of wounded Civil War Veterans from the depredations of Morphine addiction. Well it got them off of morphine, but the medical success of heroin was pheric as we all now know.
Drug addiction, true drug addiction that is: with tolerance and physical withdrawal, always ends up with the need of the addict to not get sick by upping the dose as the tolerance builds, until relief is found by a hotshot and sudden death. Cause of death is usually related to the manner in which the drug is regulated, which is by criminals, and they have little concern for the pharmaceutical quality or lack of quality of the heroin, which they sell.
In that sense the purchase of heroin is "like a box of chocolates." The addict never knows what he will get, and if its purity is greater than the user's tolerance he simply dies quickly...another casualty in the War on Self Prescription by the Government, which has a completely failed and dysfunctional policy of Drug Prohibition, with regulation left to drug cartels by default.
The signal accomplishment of Drug Prohibition is that it enabled Organized Crime to transcend the Moustache Pete chump change crimes of extortion, prostitution, and gambling and segue from the lucrative days of Alcohol Prohibition into the brave new world of nearly risk free drug distribution, and the mega money which projected them to Wall Street and monied legitimacy. It needs to end.
Drug addiction, true drug addiction that is: with tolerance and physical withdrawal, always ends up with the need of the addict to not get sick by upping the dose as the tolerance builds, until relief is found by a hotshot and sudden death. Cause of death is usually related to the manner in which the drug is regulated, which is by criminals, and they have little concern for the pharmaceutical quality or lack of quality of the heroin, which they sell.
In that sense the purchase of heroin is "like a box of chocolates." The addict never knows what he will get, and if its purity is greater than the user's tolerance he simply dies quickly...another casualty in the War on Self Prescription by the Government, which has a completely failed and dysfunctional policy of Drug Prohibition, with regulation left to drug cartels by default.
The signal accomplishment of Drug Prohibition is that it enabled Organized Crime to transcend the Moustache Pete chump change crimes of extortion, prostitution, and gambling and segue from the lucrative days of Alcohol Prohibition into the brave new world of nearly risk free drug distribution, and the mega money which projected them to Wall Street and monied legitimacy. It needs to end.
28
I was with you until the end. Then you veered off into tinfoil hat country.
Stephen, I agree. It's difficult to take seriously the drug policies of a country that has banned federally the manufacture of diamorphine since 1924, and which is guided in its drug policies not by careful science but by public hysteria and by politics.
If palliative care patients in the UK can be safely prescribed diamorphine, which is the pharmacological name for 100% pure heroin, then this shows that diamorphine per se is not the issue [1].
The USA could learn from the experience of the NHS in the UK. But oh no, I forget. The USA is exceptional. The USA cannot and must not follow anyone else's example. Americans are not like other human beings. Their physiologies are completely different.
1) Gossop, Michael, and Francis Keaney. 'Research Note—Prescribing Diamorphine for Medical Conditions: A Very British Practice.' Journal of Drug Issues 34.2 (2004): 441-450. Full text available at http://the-medical-dictionary.com/levomepromazine_article_1.htm
If palliative care patients in the UK can be safely prescribed diamorphine, which is the pharmacological name for 100% pure heroin, then this shows that diamorphine per se is not the issue [1].
The USA could learn from the experience of the NHS in the UK. But oh no, I forget. The USA is exceptional. The USA cannot and must not follow anyone else's example. Americans are not like other human beings. Their physiologies are completely different.
1) Gossop, Michael, and Francis Keaney. 'Research Note—Prescribing Diamorphine for Medical Conditions: A Very British Practice.' Journal of Drug Issues 34.2 (2004): 441-450. Full text available at http://the-medical-dictionary.com/levomepromazine_article_1.htm
4
Attending to heroin addiction after the fact is a myth. There is no such process. You can use methadone, but methadone completely messes a person up, they are practically dysfunctional so it's a trade-off rather than a saving grace.
The only useful attack on heroin is prevention of it's use, by informing people before they are of the age to have druggie friends who can enable them that; heroin is a very bad, perfectly addicting, no-solution chemical addiction that will ruin your life. That it can kill you is almost a side issue to the living death, betrayed relationships, crime, and wasted futures it creates.
I won't get into how we could possibly spend what we have in Afghanistan and not have eradicated their opium crop. I will offer a link to the book that I read decades ago when it was published, that was so impressively forthright in explaining just how serious heroin abuse is to any individual, that I new better upon finishing it to never go near the stuff. The complete large volume is online, this is a link to one very important chapter on heroin, the whole book is a very educational read on drugs:
http://www.druglibrary.org/schaffer/library/studies/cu/CU10.html
The only useful attack on heroin is prevention of it's use, by informing people before they are of the age to have druggie friends who can enable them that; heroin is a very bad, perfectly addicting, no-solution chemical addiction that will ruin your life. That it can kill you is almost a side issue to the living death, betrayed relationships, crime, and wasted futures it creates.
I won't get into how we could possibly spend what we have in Afghanistan and not have eradicated their opium crop. I will offer a link to the book that I read decades ago when it was published, that was so impressively forthright in explaining just how serious heroin abuse is to any individual, that I new better upon finishing it to never go near the stuff. The complete large volume is online, this is a link to one very important chapter on heroin, the whole book is a very educational read on drugs:
http://www.druglibrary.org/schaffer/library/studies/cu/CU10.html
5
Prevention is preferred to drug abuse although sometimes people disregard advice & hunger for thrills & excitement. Why would people choose to fight in a war if they knew that staying home would prevent them from being killed, maimed or susceptible to PTSD? People become addicted to all kinds of things that they know, in their heart of hearts, are terrible bad choices including sugary or carcinogenic foods, TV, pornography, workaholics, alcohol, promiscuity, shopping, exercise addiction, plastic surgery, adultery, weight control obsession, etc., and know that their behaviors are wreckless although are powerless to gain control over their impulses. This doesn't mean that they are terrible people, only that they are fallible to temptation even with the best of preventative intentions. Methadone clinics use very careful measuring techniques when dosing their patients which includes stabilizing, tapering & eventually weaning people completely off the drug as people come clean & free of their heroin addiction. It is a reliable method of unchaining the shackles of heroin addiction if the addict has the courage, strength & determination to overcome their drug & free themselves of the social, emotional, psychological & physical stigma. Only the needle tracks on their arms & legs serve as a reminder of their power to overcome the burden of this disease.
2
" You can use methadone, but methadone completely messes a person up, "
Is that from personal experience? I know someone who has been on it for years: it hasn't "messed her up." It has freed her from pain and allowed her to lead a life which would be normal except for the constant fear that foolish prejudices about the drug may interrupt her supply.
Is that from personal experience? I know someone who has been on it for years: it hasn't "messed her up." It has freed her from pain and allowed her to lead a life which would be normal except for the constant fear that foolish prejudices about the drug may interrupt her supply.
1
One size never has fit all. The end of life is inescapable and we all seek our own path to peace and pleasure whether through family, religion, drugs, sex etc.
The only rule that should apply is respect for another's person. Difficult as it may be to accept, if one wishes to destroy him or herself by whatever means and it brings no physical harm to other life on the planet that path should be open and unchallenged.
I think while we all understand this many if not most of us don't want to accept it and erect all sorts of barriers to a path through life that doesn't match the one others might choose to follow.
The only rule that should apply is respect for another's person. Difficult as it may be to accept, if one wishes to destroy him or herself by whatever means and it brings no physical harm to other life on the planet that path should be open and unchallenged.
I think while we all understand this many if not most of us don't want to accept it and erect all sorts of barriers to a path through life that doesn't match the one others might choose to follow.
23
Yeah everything is the same, nothing matters, all is equal, moral equivalence, blah blah blah. You speak nonsense. Drug addiction is not a path, it's a dead end.
Oh, please. "A path through life that doesn't match the one others choose to follow"?!?! "If one wishes to destroy himself...that path should be open and unchallenged"?!?! Really? You actually think these are paths people CHOOSE to walk down? How very ignorant you are of addiction.
So, a silly kid, perhaps influenced by peer pressure, makes poor choices (and remember that kids by definition don't have the brain development to always make good decisions) and takes a few hits of a highly addictive drug, with few thoughts of the future (as is the nature of kids) and with a short-sighted focus only on the immediate pleasure of the drug. The kid then becomes addicted, after which point, he or she has little choice other than to keep using. Have you ever experienced addiction? It is usually far more powerful than anything else within a person.
And that's a "path" that someone apparently chose to follow? Dear me, what an utterly ridiculous comment.
So, a silly kid, perhaps influenced by peer pressure, makes poor choices (and remember that kids by definition don't have the brain development to always make good decisions) and takes a few hits of a highly addictive drug, with few thoughts of the future (as is the nature of kids) and with a short-sighted focus only on the immediate pleasure of the drug. The kid then becomes addicted, after which point, he or she has little choice other than to keep using. Have you ever experienced addiction? It is usually far more powerful than anything else within a person.
And that's a "path" that someone apparently chose to follow? Dear me, what an utterly ridiculous comment.
Ian I cannot agree with you.
If I am a 16 year old and I chose to destroy myself by using heroin, a gun a speeding locomotive etc... my parents have been subject to, as you say, no ''physical harm" But they go to their graves with the lament 'Oh God what did I do wrong.'
For myself I firmly believe I am my brother's keeper.
As I see it we are all in the life boat of humanity together. And each of should help to keep that boat afloat.
If I am a 16 year old and I chose to destroy myself by using heroin, a gun a speeding locomotive etc... my parents have been subject to, as you say, no ''physical harm" But they go to their graves with the lament 'Oh God what did I do wrong.'
For myself I firmly believe I am my brother's keeper.
As I see it we are all in the life boat of humanity together. And each of should help to keep that boat afloat.
1
I have been on the frontline for over 20 years dealing with my sons addiction. Two years ago he died of an overdose. I have concluded that addiction is a terminal disease. Methadone, suboxone, rehab all help, but in the end it's terminal for most. Some escape, but most eventually succumb. The only effective treatment is prevention. We need to teach our children at a very early age not to do drugs....we are doing it with tobacco...we can do it for drugs. The 5 year old needs to realize he can never touch drugs. We also need to come out of the closet and face drug addiction like we faced cancer, tobacco addiction and Hiv. We are losing too many of our children to drug addiction.
It
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Thanks for saying this. I am so sorry about your son; I give you my deepest sympathies. Some of those arguing for legalization seem to presume that those people who become addicted are somehow expendable. True there will alwAys be addiction. But prevention does work. We need multiple models and strategies.
And, yes, addiction is terminal. Heroin is a monster. I have been told it is the hardest drug to stop. Thankfully, though, I have met people in AA who were on the needle but stay clean. As hard as it was for me to stop drinking, I know they have a much harder row to hoe.
And, yes, addiction is terminal. Heroin is a monster. I have been told it is the hardest drug to stop. Thankfully, though, I have met people in AA who were on the needle but stay clean. As hard as it was for me to stop drinking, I know they have a much harder row to hoe.
2
So sorry for your loss, Mike. The availability of antidotes, as described in the article, will not work in the same direction as discouraging use of dangerous drugs in the first place.
1
I am so very sorry to hear about your son. Yes, addiction is a terrible disease indeed--not a moral failing, and certainly not a chosen "path," as another commenter on this site has claimed. You are absolutely right in that we need as a society to educate people about the risks and effects of drug addiction. The need is urgent indeed.
1
You can prevent deaths and have the people working light shifts by giving them methadone and maybe even heroin for the bad cases (see programs in Europe, most successfully Switzerland). The drugs and Naloxane at least could be financed by a tax on opiates (after all, these pills are the main reason for the resurgence of heroin addiction at this moment). Yeast strains that cheaply produce heroin will be available soon, if you believe Nature magazine http://www.nature.com/news/drugs-regulate-home-brew-opiates-1.17563 , which should get rid of most health problems associated with heroin. However, that won't get the people out of their propensity for escapism. That, I am afraid, is something the family of the addict and his/her old friends are responsible (needed) for. The addicts normally can't do it by themselves. Got to put that rat into a playground (e.g. http://scicurious.scientopia.org/2011/01/05/drug-abuse-and-rat-playgroun.... My cuz (5 years on heroin) for one is still an unbearable escapist, but he's alive and gets a little better every year.
1
I need more citations before I see a taX on needed pain relief to fund addict policies. Pain relief is a necessity for so many people and now law abiding citizens have to jump through hoops to attain it all because of addicts. I can't even get sinus medication for fear of meth production and they just switched chemicals and still the rule applies. Legalize drugs and bring down the barriers to patients who need them. I am all for helping addicts, but not at the cost to regular citizens.
An excellent and most informative article.
As I understand it, the only reasonable solution in the foreseeable future is the use, sometimes enforced, of anti-addiction drugs. Well, this may be the only workable way, but one can already hear the voices of the opponents of any additional measures of public health.
As I understand it, the only reasonable solution in the foreseeable future is the use, sometimes enforced, of anti-addiction drugs. Well, this may be the only workable way, but one can already hear the voices of the opponents of any additional measures of public health.
5
Interesting, this claimed reason for the explosion of heroin use being the increased prescription of opioids as painkillers. I thought the primary reason was that heroin has become so cheap to use that a few hours begging can cadge enough for a fix, rather than the riskier and greater effort associated with robbing to support a more expensive addiction.
I can understand the draw if one first becomes addicted to opioids, such as OxyContin, an addiction that is far more expensive than heroin to maintain, then on to heroin as the cheaper but effective replacement.
Sounds like we need a crash program for very effective pain relievers that don’t addict, then the banning of ALL substances that DO addict, which again would put their cost beyond what large numbers could afford, legally or otherwise. You’d think there would be a role for government in incentivizing investment in programs to develop such replacements, such as dramatically reduced taxes on them.
In any event, naloxone is merely a treatment for overdose, not a cure for addiction. By all means, evangelize its availability and use, lowering the number of fatal overdoses; but the actual problem is addiction.
I can understand the draw if one first becomes addicted to opioids, such as OxyContin, an addiction that is far more expensive than heroin to maintain, then on to heroin as the cheaper but effective replacement.
Sounds like we need a crash program for very effective pain relievers that don’t addict, then the banning of ALL substances that DO addict, which again would put their cost beyond what large numbers could afford, legally or otherwise. You’d think there would be a role for government in incentivizing investment in programs to develop such replacements, such as dramatically reduced taxes on them.
In any event, naloxone is merely a treatment for overdose, not a cure for addiction. By all means, evangelize its availability and use, lowering the number of fatal overdoses; but the actual problem is addiction.
3
Heroin is cheaper and more available than marijuana, which is not addictive.
2
Uh, Richard? Haven't we tried "the banning of ALL substances that DO addict", and the result has been the opposite of what you propose (unaffordability)?
Wow, the simple-fixers are out early tonight.
Wow, the simple-fixers are out early tonight.
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I agree, but it's so much more fashionable to blame 'big pharma'. I disagree about banning all drugs that are habit forming. Many are lifesavers for people. Why should they suffer because a few may abuse them?
10
Heroin is everywhere: working class communities, suburbs, inner-city tough neighborhoods, jails, rural areas,etc. I don't like calling heroin a drug..it is a compound infested with additives by dealers. A drug should be able to heal. Heroin destroys.
There are no silver bullets to fight addiction and it is never a one size fits all approach that works. Life can be very painful and heroin makes it worse.
Alcholics and drug addicts can be anchors around a family's life raft.
There are no silver bullets to fight addiction and it is never a one size fits all approach that works. Life can be very painful and heroin makes it worse.
Alcholics and drug addicts can be anchors around a family's life raft.
17
Alcohol is everywhere, not heroin, but booze is our legal gateway drug, the one that says, you can't have fun without it. We toast with alcohol, acknowledging birth, marriage, graduations, secret-service retirements, death, and softball victories. That demonstrated, the well-worn path to altering brain chemistry is given to our children as a right of passage to adulthood. And maybe it is part of the human condition, fermenting everything to make us feel, if not good, maybe better. Alcohol production is regulated like other foodstuffs. Legalize mind-altering drugs and reduce crime, premature death and wasted lives. Seems like a no-brainer.
1
It is possible to have a drink or two and not become intoxicated, which makes it different from heroin.
I have known heroin addicts (rehab in a prison) who have stayed clean after rehab programs with N.A. or A.A. I do not consider someone on methadone clean and sober. Functioning better, maybe. How about us everyone's (liberals and conservatives) addressing the real reason for drug use? Every heroin addict I have worked with in rehab wants -- really wants -- to live in la, la land, to escape from reality. Heroin, unlike alcohol, is not a 'social' drug. It is true escapism. I'd like to escape too, but I have chosen A.A. instead, built some emotional resilience through painful crises, and surrounded my life with truly sober people - that excluded exotic dancers and others with a life-style that is less than.
14
Wow! I am sober, too--and actually never had an illegal drug in my life. I do agree that methadone can get people high. Over 27 pharmacies plus a methadone clinics were ransacked in Baltimore-- for the opioids and methadone--which has hit the streets. Pills and methadone have street value. But methadone helps some people.
And you know what? Exotic dancers have a chance at sobriety, formerly homeless people in transitional housing have a chance at sobriety, formerly incarcerated people have a chance at sobriety. Homeless people have a chance. Along with those working, middle and upper class people who almost, or did, destroy families, friends, careers and themselves.
Heroin is a curse and pill use can segue into herion use. And it is an escape but so is alcohol, whether it is considered a "social drug" or not. Plenty of drinkers drink alone.
The right "people, places, and things" are essential to sobriety but I am not going to begrudge a place in AA or presume someone cannot be sober aS an exotic dancer any more than I'd presume that for a cop or doc.
And you know what? Exotic dancers have a chance at sobriety, formerly homeless people in transitional housing have a chance at sobriety, formerly incarcerated people have a chance at sobriety. Homeless people have a chance. Along with those working, middle and upper class people who almost, or did, destroy families, friends, careers and themselves.
Heroin is a curse and pill use can segue into herion use. And it is an escape but so is alcohol, whether it is considered a "social drug" or not. Plenty of drinkers drink alone.
The right "people, places, and things" are essential to sobriety but I am not going to begrudge a place in AA or presume someone cannot be sober aS an exotic dancer any more than I'd presume that for a cop or doc.
1
Escapism can take many forms including prolonged NetFlix binges, trips to the local Casino to gamble for hours at a time, manic shopping trips at the local mall for another pair of shoes which they don't need, obsessive trips to the gym for hours at a time in an obsessive need to have the perfect body, business trips that include forays into strip clubs & lap dances with strippers, food addictions including binging & purging while secretly stashing candybar wrappers in the closet hidden among the designer athletic clothes as well as the dirty grimy addiction of heroin or crack cocaine. These are all coping mechanisms that people try to hide from a perfectly polite society that they imagine in their heads among suburban cookie cutter houses where individuality is dulled in an effort to conform to some monotonous sameness. Just as people in the ghetto look for cheap thrills to transport them out of their hopelessness, bored people in the suburbs look to escape the lack of purpose or meaning in their lives. AA & NA may work for some, although most people dealing with crippling addiction need a medical intervention like Methadone to help them overcome their serious physical, psychological & medical addiction to the drug. Licensed methadone clinics for drug dependence are designed as treatment facilities to wean addicts off of drugs in tandem with NA, not as a permanent alternative to heroin addiction.
3
As a recovering addict of over 8 years (I was addicted to opiate pills) and someone who worked in drug treatment facilities for over 2 years, I can appreciate some of the points you make. However, you fail to make an important one: Methadone and buprenorphine (the active ingredient in Suboxone) may be helpful for some addicts, but they are every bit as addictive as all the other opiates (and, yes, they are opiates) and are more difficult to stop because they are longer-acting. The medical community and Big Pharma may say you can't get high on them, but I've met many addicts who took them specifically to get high. While making naloxone more widely available is a great idea, what's more important is to provide more money for public drug treatment facilities.
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How about Vivitrol, which is adminsitered as a monthly injection ? A young woman called me a couple of weeks ago, telling me how it had changed her life, after she had gone through numerous previous attempts at staying clean and sober. And I've heard negative things from some people about side effects from suboxone. So my impression is that trying to address heroin addiction requires all the tools we can find, that perhaps no single approach will be a silver bullet for all. It's also my sense that people newly clean and sober also need secondary services, such as help finding jobs and housing, so that they are more likely to take their lives in a new direction and not just go back to the same "people, places, and things" for lack of an alternative.
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I guess I shouldn't be surprised that Mr. Kristof takes a gratuitous slap at Big Pharma as being responsible for the epidemic of heroin deaths. Here in Ohio, the problem has been pill mills - unethical doctors teamed with conspiring pharmacies to make money off of those addicted to pain killers.
Most of these pill mills have been shut down and less easily abused forms of pain killers are in the pipeline. That's why heroin use has exploded. First responders in a rural county north of Columbus ran out of naloxone last month due to the number of overdoses - including two deaths.
But it's nice to see a liberal columnist focus a huge and growing problem like heroin, rather than the much smaller problem of assault rifles.
Most of these pill mills have been shut down and less easily abused forms of pain killers are in the pipeline. That's why heroin use has exploded. First responders in a rural county north of Columbus ran out of naloxone last month due to the number of overdoses - including two deaths.
But it's nice to see a liberal columnist focus a huge and growing problem like heroin, rather than the much smaller problem of assault rifles.
3
Liberals and conservatives should be working together for solutions to both problems.
I am not sure how gratuitous it is to call out Big Pharma on the over-development and manufacture of a vast array of drugs. When you couple saturating advertising campaigns with the lobbying they do in places from the halls of Congress to the offices of doctors to get their products out there, for them to walk away (or you to excuse them) as if they share none of the blame for our culture of "a pill for any problem" is disingenuous. Big P is certainly not any part of the solution at this point.
2
They've always got to blame somebody.
Public health efforts need to be depoliticized when it comes to drug addiction. I can think of no other area where outreach is so heavily dictated by the attitudes of politicians and public hysteria.
It's obvious that much of what has been done (massive incarceration and vilification of addicts) has not worked and some things have helped (needle exchanges, suboxone). It's time to let healthcare workers call the shots not impeded by public opinion or politicians.
The people who work with addicts in the health care and social services should be making the decisions. They're the ones that know what works and what doesn't.
It's obvious that much of what has been done (massive incarceration and vilification of addicts) has not worked and some things have helped (needle exchanges, suboxone). It's time to let healthcare workers call the shots not impeded by public opinion or politicians.
The people who work with addicts in the health care and social services should be making the decisions. They're the ones that know what works and what doesn't.
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http://www.nytimes.com/2015/05/31/nyregion/three-quarter-housing-a-choic...
Last week this article pointed out abuses in the drug treatment support system. Think again about having the organizations that profit from drug addiction being the ones deciding the appropriateness of care.
There are no simple solutions to complex problems. Recasting drug addicts as victims hasn't worked.
Last week this article pointed out abuses in the drug treatment support system. Think again about having the organizations that profit from drug addiction being the ones deciding the appropriateness of care.
There are no simple solutions to complex problems. Recasting drug addicts as victims hasn't worked.
1
I applaud Nicholas Kristoff for calling attention to this problem, and I like the essay written by Austin. But with all due respect, Nicholas Kristoff:
1) blames doctors for narcotic abuse,
2) blames pharmaceutical companies for narcotic abuse,
3) blames republicans for narcotic overdoses.
I work in an ER of a public hospital, and let me counter those statements by saying that a lot of people turn to drugs because they want to escape reality. They want to live the free sex, easy drug lifestyle the liberals advocate.
You want to know why heroin is highest in large cities? Because liberals embrace drug use and escapism over everything else. You want to solve the problem? Do the following:
1) anti-drug education and enforcement, including public repudiation of the celebrities who glamorize drug abuse,
2) needle exchanges to reduce transmission of disease,
3) methadone program tied to work and education programs,
4) institutionalize people who repeated violate the drug laws.
Treating drug addicts like victims has not worked. They need help, and sometimes that means "tough love" and reducing their freedom. Harsh medicine, but there is no alternative.
1) blames doctors for narcotic abuse,
2) blames pharmaceutical companies for narcotic abuse,
3) blames republicans for narcotic overdoses.
I work in an ER of a public hospital, and let me counter those statements by saying that a lot of people turn to drugs because they want to escape reality. They want to live the free sex, easy drug lifestyle the liberals advocate.
You want to know why heroin is highest in large cities? Because liberals embrace drug use and escapism over everything else. You want to solve the problem? Do the following:
1) anti-drug education and enforcement, including public repudiation of the celebrities who glamorize drug abuse,
2) needle exchanges to reduce transmission of disease,
3) methadone program tied to work and education programs,
4) institutionalize people who repeated violate the drug laws.
Treating drug addicts like victims has not worked. They need help, and sometimes that means "tough love" and reducing their freedom. Harsh medicine, but there is no alternative.
24
This is facile permissiveness drivel. Many of the worst drug-abuse pockets are in blood-red states and regions. It's not a "liberal" weakness problem; it's a public health problem.
This kind of comment really annoys me. You take a complex issue fraught with nuance and reduce it to liberal-bashing with an unhealthy dose of Calvinist judgmentalism, then smugly walk away dusting your hands of the whole matter. I am not moved or persuaded.
It must be swell to be so superior and know all the answers...
This kind of comment really annoys me. You take a complex issue fraught with nuance and reduce it to liberal-bashing with an unhealthy dose of Calvinist judgmentalism, then smugly walk away dusting your hands of the whole matter. I am not moved or persuaded.
It must be swell to be so superior and know all the answers...
90
It's interesting that you believe free sex and drug addiction is embraced by liberals. I personally know and am friends with people you would consider "liberals" and not one of them condone or encourage a lifestyle of free sex and drug addiction. Well, if you can't blame heroin addiction on liberals it must be Obama's fault.
14
Yeah sure. Only the children of liberals become heroin addicts. Richard Nixon -- a Republican, remember? -- advocated drug treatment for all addicts. Treatment is what the addict needs, not imprisonment. Nixon would never be a Republican candidate today.
BTW, what celebrities glamorize drug use?
BTW, what celebrities glamorize drug use?
11