“Spend a dollar on drug treatment…” A powerful, dramatic title. As is today’s UPSHOT series.Empowered numbers, graphics, expert’s quotes and loaded, misleading terms:plague, epidemic. Consider the following numbers: 1.Excessive alcohol use led to approximately 88,000 deaths in the US, 2006 – 2010. CDC Fact Sheet. 2. 7 million premature deaths annually linked to air pollution. WHO
3. 440,000 yearly deaths (10% of all US deaths)due to medical errors.
http://www.hopkinsmedicine.org/news/media/releases/study_suggests_medica...
4.Cigarette smoking is estimated to cause more than 480,000 deaths annually in the USA. CDC Fact Sheet. 5.Interestingly the CDC doesn't list obesity as a cause of death. More than 1/3 of adults age 20+ are considered to be obese; 6.3% are extremely obese. Consider: There is no unique treatment technique for drug use, which isn’t also used to treat other conditions/diseases, at a given place and time. Words. Medicines. Etc. Ideologies ( abstinence, harm reduction, quality of life), and not facts, are the underpinnings for “treating” a diverse range of users. Politics, and agenda-stakeholders, not existing health needs, continue to determine what is done, and not done, considered and not considered, in this complex area, deserving of an UPSHOT.
3. 440,000 yearly deaths (10% of all US deaths)due to medical errors.
http://www.hopkinsmedicine.org/news/media/releases/study_suggests_medica...
4.Cigarette smoking is estimated to cause more than 480,000 deaths annually in the USA. CDC Fact Sheet. 5.Interestingly the CDC doesn't list obesity as a cause of death. More than 1/3 of adults age 20+ are considered to be obese; 6.3% are extremely obese. Consider: There is no unique treatment technique for drug use, which isn’t also used to treat other conditions/diseases, at a given place and time. Words. Medicines. Etc. Ideologies ( abstinence, harm reduction, quality of life), and not facts, are the underpinnings for “treating” a diverse range of users. Politics, and agenda-stakeholders, not existing health needs, continue to determine what is done, and not done, considered and not considered, in this complex area, deserving of an UPSHOT.
Spending more to prevent future costs isn't going to happen with the Republicans. Their politics of hate-morals and self-serving interpretations of right and wrong will always result in giving money to rich and depriving the poor and emotionally/mentally ill from getting even a dime. The politics of hate is destroying our country now that it has subverted the entire GOP.
2
I'm off on a tangent here, fair warning.
I've done some reading on ADHD, and it seems to me that making sure that everyone who has it is properly diagnosed and treated would also reduce crime far more than the costs incurred. ADHD is not simply a problem with attention, but also with controlling impulses. If it isn't treated, people with it are more likely to try drugs (feeding the addiction problem this article is about), have car accidents, eating disorders (also expensive), and problems with academic and job performance. It would make great public health sense to make sure that everyone has the chance to be diagnosed and treated.
I've done some reading on ADHD, and it seems to me that making sure that everyone who has it is properly diagnosed and treated would also reduce crime far more than the costs incurred. ADHD is not simply a problem with attention, but also with controlling impulses. If it isn't treated, people with it are more likely to try drugs (feeding the addiction problem this article is about), have car accidents, eating disorders (also expensive), and problems with academic and job performance. It would make great public health sense to make sure that everyone has the chance to be diagnosed and treated.
It's common sense that drug addiction treatment saves society a ton of money in costs related to health care and crime to name but two areas. I don't think Republicans give a hoot about drug addiction treatment. They are the folks who deny drugs among whites are a problem at all and the ones who prefer to ignore drugs among blacks because that feeds the for profit prison system. Wealthy people can afford the lawyers needed to get their kids off criminal sentences, and the medical bills associated from overdoses. Living in isolated enclaves, they are also so narrow minded they don't see the effects on society at large. Nothing will get done under a Trump presidency.
2
Author Austin Frakt ended tjhis excellent, thought-provoking opinion piece by quoting Harold Pollack of the University of Chicago Crime Lab: “Addiction treatment may be the one area of health policy right now in which Democrats and Republicans want to work together to meet an important public health challenge,” Mr. Pollack said. If only this were the case. I fear that many, if not most, Republicans might look at the cost of such programs without looking at the benefits. Furthermore, I suspect that many Republicans might look at treatment as just another way in which government has grown when they (Republicans) want to shrink government. They are likely to see this as "another government handout" without considering the benefits. How very short-sighted.
1
The research in this area is uncertain. Pleas like this are, more than anything, full-employment tactics for psychologists.
We need to legalize drugs. Uncertain claims that counseling can alleviate the mess can only serve to delay what is obviously needed.
We need to legalize drugs. Uncertain claims that counseling can alleviate the mess can only serve to delay what is obviously needed.
1
The idea that this is some ploy to give further employment to psychologists might seem to have sense to it to a lay person. I do not work nor have any monetary interest in pyschology as a profession but I can state with 100% certainty that both the fields of pyschology and psychiatry have historically never been able to assist addicts with their medical disorder. The success rates are abysmal at best.
While I do not have a concrete number for the current database of rehab centers, a very small percentage focus on psychiatric nor pychological remedies, the far-vast majority employing spiritual 12-step programs based on the 80+ year-old program of Alcoholics Anonymous.
My guess is that you are one of the Republicans who does not like the idea that addiction is actually a disease and is not and has never been a problem of morality nor in any way a failure of discipline but simply a medical condition which affects about 4-5% of those who drink and have tried drugs... Normal people with less discipline and moral fiber are not affected.
While I do not have a concrete number for the current database of rehab centers, a very small percentage focus on psychiatric nor pychological remedies, the far-vast majority employing spiritual 12-step programs based on the 80+ year-old program of Alcoholics Anonymous.
My guess is that you are one of the Republicans who does not like the idea that addiction is actually a disease and is not and has never been a problem of morality nor in any way a failure of discipline but simply a medical condition which affects about 4-5% of those who drink and have tried drugs... Normal people with less discipline and moral fiber are not affected.
As soon as our country initiated a "War on Drugs", so began a decades long struggle between addicts and their friends/families/communities, and our awfully expensive and expensively awful healthcare system and the dysfunctional and inequitable criminal justice system. On the one hand, treating addiction successfully requires an expensive, long term investment, often starting with an inpatient detox followed by partial hospitalization and outpatient treatment for opioid/heroin addition and other harder drugs like meth and crack/cocaine. Private insurance and medicaid alike cannot meet their bottom lines giving treatment to all the people who need it to the extent that each individual requires. Then there is our private, for profit prison system that is paid per prisoner and therefore has incentive to lobby to legislators who are tough on crime and don't believe in treatment or rehabilitation, just long sentences. The families who have a few bucks will go broke paying for lawyers to prevent their kids from being stuck with a public defender when they get caught with drugs or committing petty crimes to pay for drugs. Money that would be better used for rehab.
3
Don't forget one stepping stone to addiction: taking pain killers to get back to work so you don't lose your job instead of a sick policy that allows you to heal your body with minimal use of pain killers. Workers Comp is not about helping injured workers. It's about getting people to return to work at the lowest possible cost to the insurer. Physical therapy is expensive. Pain killers are more cost effective. We as a nation need to rethink sick leave as a real need.
11
How convenient now that the drug problem is centered in the upstanding white community. Opioids a crisis, crack a criminal identifier for our inner cities.
When Nancy Reagan said 'Just Say No' there was no interest in helping the inner cities that were being targeted with the super-potent & new version of cocaine, crack. 'No' was a perfect compliment to the 3 strikes and your out legislation. Young black men filled our prisons.
Now, ask yourself this, have you heard of any arrests or drug busts for opioids? Any crime task forces? Presidential or Attorney General going after the drug law breakers? Rural whites opioid addicts filling our prisons?
Used to be said by drug dealers, 'The first one is free....' Today, a Fortune 500 company says, 'The first one is legal...'
This is the subtle undertone of our brand of American racism. It never changes and it is shameful.
When Nancy Reagan said 'Just Say No' there was no interest in helping the inner cities that were being targeted with the super-potent & new version of cocaine, crack. 'No' was a perfect compliment to the 3 strikes and your out legislation. Young black men filled our prisons.
Now, ask yourself this, have you heard of any arrests or drug busts for opioids? Any crime task forces? Presidential or Attorney General going after the drug law breakers? Rural whites opioid addicts filling our prisons?
Used to be said by drug dealers, 'The first one is free....' Today, a Fortune 500 company says, 'The first one is legal...'
This is the subtle undertone of our brand of American racism. It never changes and it is shameful.
8
Most of us either Republican, Democrat or Independent do not do the math. We care because virtually everyone has someone in their circle of family and friends who has a substance abuse problem. We care about them. We applaud the Affordable Care Act for making treatment reimbursable.
What we fail to comprehend is how difficult the process is, and how hard it is to find quality care. Perhaps it takes someone in the family to open our eyes and hearts.
What we fail to comprehend is how difficult the process is, and how hard it is to find quality care. Perhaps it takes someone in the family to open our eyes and hearts.
3
Here's where those dollars for drug treatment should come from, the Sackler Family.
The Opioid Epidemic began with a corporate crime. Nobody seemed to care when it was just Appalachia. Well, the chickens have come home to roost. It is time for us to get angry and to get mobilized. There is a great crime behind this opiate epidemic. It is a corporate crime which rivals "big tobacco" and it needs to be exposed. The perpetrators of this crime, The Sackler Family of Perdue Pharmaceuticals and others, need to be fully disgorged of their blood money and the funds should be set up to aid those in recovery, to support educational efforts and to aid the families and communities so devastated. It is time to report on the role the "philanthropic" Sackler Family has played in this epidemic which is now responsible for the deaths of over 50,000 young people per year.
"Behind every great fortune there is a great crime"-Balzac
The Opioid Epidemic began with a corporate crime. Nobody seemed to care when it was just Appalachia. Well, the chickens have come home to roost. It is time for us to get angry and to get mobilized. There is a great crime behind this opiate epidemic. It is a corporate crime which rivals "big tobacco" and it needs to be exposed. The perpetrators of this crime, The Sackler Family of Perdue Pharmaceuticals and others, need to be fully disgorged of their blood money and the funds should be set up to aid those in recovery, to support educational efforts and to aid the families and communities so devastated. It is time to report on the role the "philanthropic" Sackler Family has played in this epidemic which is now responsible for the deaths of over 50,000 young people per year.
"Behind every great fortune there is a great crime"-Balzac
9
In an address to a service club in Dallas, the head of the Dallas Country program that supplies medications to the indigent explained a challenge to success of her unit: some generic drugs cause side effects in the patients, yet the county rules call for purchasing only generic drugs when available.
She stated that many of the homeless wandering the streets of downtown Dallas were there solely because they refused to take their medications.
Those medications cause side effects, and the indigents chose to act weird
rather than suffer the side effects.
Sometimes providing the name brand drugs would save society money.
She stated that many of the homeless wandering the streets of downtown Dallas were there solely because they refused to take their medications.
Those medications cause side effects, and the indigents chose to act weird
rather than suffer the side effects.
Sometimes providing the name brand drugs would save society money.
3
Glad to see that science has arrived at the same conclusion that a horseback observation has. If junkies steal to support their habit why not treat their addiction? It is way cheaper than jail and yields better results. I am heartened to see it in print in a responsible newspaper. Getting them off drugs will help keep them out of jail and allow them to find employment and pay taxes. It is kind of like a GI Bill for junkies. And another very good idea.
5
Every analysis I have done for the past 35 years shows that money spent on evidence-based substance abuse treatment (and all Behavioral Health treatment, for that matter) shows a positive return on investment for insurers. That's not even taking into account the positive effects on the society, the family members and the person being treated. I wish all investments could be this much of a no-brainer. But there are still those in high policy making places who will not be deterred by facts (or maybe they have contributors in the private corrections industry). If we ever get to block granting Medicaid to the states, or giving the states discretion about which of the 10 Essential Benefits to cover, substance abuse treatment will be one of the first to fall by the wayside. In addition to all of this, we still spend next to nothing on evidence-based prevention. If we were truly a capitalist system, this would be considered malfeasance. This investment works at an astonishing degree of effectiveness.
3
First, beware of economic forecasts that show that a particular program is going to save money in the long run. Economists have political and personal agenda like everyone else. Second, drug addiction treatment programs are notoriously ineffective: although good data are not available, it appears that somewhere between 70 to 80% of people who enter these programs either fail to complete them or return to drug use within 2 years of completing the programs. Third, psychological counseling/ therapy means a lot of different things. Unfortunately there is no good scientific support for the effectiveness of any of these approaches. Oddly, the only intervention that seems to work is to give addicts "legal" drugs that substitutes for street drugs. This might be a good approach for a variety of reasons but the it does not cure addiction although it is good for the drug industry.
1
I am an addiction medicine physician and I find this article very accurate and helpful. We have recently had regulatory relief that allows us to rapidly expand treatment availability. Credit SAMHSA's Center for Substance Abuse Treatment and the NYS Department of Health and the Office of Alcoholism and Substance Abuse Services for this.
It has been most frustrating to do waiting list management rather than actual clinical medicine, especially when we all know the community need is great. I am pledged to a rapid entry into treatment for those who are needing it. I want to see addiction treatment better integrated into primary care medicine, and work for this too.
Also credit the Medicaid expansion which brings the reimbursement to make these service improvements possible. Need I point out that all of this was put in motion during the Obama Administration and comes as part of the Affordable Care Act? Remember that addiction treatment is now an essential component of all insurance sold because of the ACA. That could change.
It has been most frustrating to do waiting list management rather than actual clinical medicine, especially when we all know the community need is great. I am pledged to a rapid entry into treatment for those who are needing it. I want to see addiction treatment better integrated into primary care medicine, and work for this too.
Also credit the Medicaid expansion which brings the reimbursement to make these service improvements possible. Need I point out that all of this was put in motion during the Obama Administration and comes as part of the Affordable Care Act? Remember that addiction treatment is now an essential component of all insurance sold because of the ACA. That could change.
7
I've always wondered if among severe opioid addicts they weren't suffering an a chemical imbalance analogous to depression, caused by a congenital imbalance in some neurotransmitter or low levels of endogenous opioids. They get most easily and stubbornly addicted to opioids because it works as a crude "treatment" for their condition.
If that was the case, why not consider treatment with buprenorphine to be really no different than treating serotonin imbalance with an anti-depressant? I've always found it strange that we're eager to treat depression with low levels of psychotropic drugs, but treatment of addiction the same is looked down upon, as if no treatment that wasn't total sobriety was a success.
If that was the case, why not consider treatment with buprenorphine to be really no different than treating serotonin imbalance with an anti-depressant? I've always found it strange that we're eager to treat depression with low levels of psychotropic drugs, but treatment of addiction the same is looked down upon, as if no treatment that wasn't total sobriety was a success.
7
Addiction is a brain disease. It can be progressive and fatal. Treatment of opioid addiction is difficult because when the person gets clean they do not feel good. Most people feel really depressed for a long time and eventually relapse. The Depression may have been there before the drug use started. That is why people seek support in 12 Step Programs combined with Mental Health Treatment. Trying to beat this disease on your own is almost impossible. But will Republicans support Social Programs which can treat addiction ? I doubt it.
2
Thank you for providing an overview of (and links to) the research on the effectiveness of treatment for substance use disorders. I lost a husband to alcohol addiction in the pre-ACA era of exclusions for pre-existing conditions and no behavioral health parity, when the intensive treatment he desperately needed was unattainable due to its cost. Nothing angers me more than partisan proposals to undermine these central tenets of the ACA.
27
"The researchers found that the opening of an additional treatment facility in a county is associated with lower drug-related mortality in that county, as well as lower crime. The effect of crime reduction alone would save an ..."
Maybe the researchers could take a tour of some wealthy progressive towns in Westchester County, NY . They fight tooth and nails against affordable housing. The village of Irvington turned down a proposal for expansion of Monte Nido, which is, mind you, a facility for eating disorders, not a drug rehab.
Liberals march until they are blue, but NIMBY reigns in their "territories"
Maybe the researchers could take a tour of some wealthy progressive towns in Westchester County, NY . They fight tooth and nails against affordable housing. The village of Irvington turned down a proposal for expansion of Monte Nido, which is, mind you, a facility for eating disorders, not a drug rehab.
Liberals march until they are blue, but NIMBY reigns in their "territories"
5
If the generalities splashed through this article were true the massive drug treatment industry that already exists and has existed would have some demonstrable results to show for their work.
4
The problem with the "treatment" industry is that it is focused on an abstinence philosophy which is successful for a very low percentage of patients.
3
As an ex-junkie, living in a halfway house and getting a job in the community was a vital part of my recovery. I want to urge anyone who feels NIMBY about addiction treatment programs to realize that no matter how nice your neighborhood, there are already addicts living among you, addicts who are actively using as well as addicts in recovery. Addicts who are actively chemically dependent are the ones who will commit crimes to support their habits, not recovering addicts who are trying to stay clean and rebuild their lives. Please don't fear recovery centers and halfway houses. They often help produce upstanding citizens who make great neighbors.
46
80% of painkillers in the world are used in the US. The powers that be are likely to not be moved for any change - drug industry, corrections industry, rehab industry. Purdue Pharmacy/Sackler family (makers of oxycontin and new constipation drug to treat side effects of oxy) are not giving up their art donations to the Smithsonian or their place on the Forbes list. The use of oxy is often followed by the cheaper use of heroin distributed by the Sinaloa Cartel - an odd partnership, but with a shared profit motive.
The city of Everett, Washington sued Purdue Pharmacy/Sackler family in Jan. 2017 reminiscent of the 90's tobacco suit, following a Purdue suit in 2007 of similar content. Purdue knew the addictive side-effects of oxycontin yet marketed relentlessly - first suit. Everett, WA. had a fake clinic set up with greedy doctors, staff to round up homeless folks as fake patients, then sold the pills throughout Everett. The higher than usual numbers of pills did not cause alarm for Purdue who chose not to contact DEA - second suit. Everett wants to recoup the costs to the city - no way to recoup the costs to families and individuals lives who have been destroyed by this 'legal' cartel who keeps doing business based on lobbyists and spin.
I do not see change on the horizon, despite the facts being blatantly clear. Only in America!
http://www.nbcnews.com/storyline/americas-heroin-epidemic/oxycontin-make...
The city of Everett, Washington sued Purdue Pharmacy/Sackler family in Jan. 2017 reminiscent of the 90's tobacco suit, following a Purdue suit in 2007 of similar content. Purdue knew the addictive side-effects of oxycontin yet marketed relentlessly - first suit. Everett, WA. had a fake clinic set up with greedy doctors, staff to round up homeless folks as fake patients, then sold the pills throughout Everett. The higher than usual numbers of pills did not cause alarm for Purdue who chose not to contact DEA - second suit. Everett wants to recoup the costs to the city - no way to recoup the costs to families and individuals lives who have been destroyed by this 'legal' cartel who keeps doing business based on lobbyists and spin.
I do not see change on the horizon, despite the facts being blatantly clear. Only in America!
http://www.nbcnews.com/storyline/americas-heroin-epidemic/oxycontin-make...
14
As my old Kansas grandmother used to say An ounce of prevention is worth a pound of cure.
8
With marijuana now legal the owners of privatized prisons and the bankers assembling the deals always need a new bogey man. Prescription drugs are the latest to be vilified ,when used properly they benefit those who need them, like all drugs with alcohol at the top of the list they destroy lives when improperly used. The first step to ending drug abuse is legalizing everything and spending the trillions spent on drug enforcement, and prisons on education and a national single payer health care system that benefits our citizens not the ceos of big pharma, insurance and private prison. The great hypocrisy is how the laws have been applied over the years to the wealthy as opposed to the poor. Do you know any bankers in prison for drug abuse when cocaine use on Wall Street was and probably remains rampant, didn't think so.
9
Yes...all well and good...Unfortunately: Fire and brimstone Law & Order is the Jeff Session way, having already made his opinion known on this issue, and he's the AG running the Justice Dept.
The proven efficacy and economies of prescription over persecution will just have to wait for a more...eschewing using 'enlightened outlook,' let's go with 'amenable viewpoint'...obviously emanating from a different White House and AG.
The proven efficacy and economies of prescription over persecution will just have to wait for a more...eschewing using 'enlightened outlook,' let's go with 'amenable viewpoint'...obviously emanating from a different White House and AG.
1
But why stop at methadone treatment, free heroin and other things cynically referred to in Canada as "harm reduction"? The inconvenient truth is that drugs still kill, they still destroy brains, minds, internal organs, and we, as a society, lose these people. Are they not worthy of being healed completely? As John Donne writes, "Each man's death diminishes me". Simply "treating" the problem really betrays our own failure, as a society, to provide an alternative to drugs -- namely hope. And why does it take a monetary arguent to make it suddenly worthwhile to treat people who are addicted?
7
A perfectly logical, coherent, virtually indisputable exposition.
Therefore, I'm against it. I don't want MY tax dollars going to a bunch of junkies.
Therefore, I'm against it. I don't want MY tax dollars going to a bunch of junkies.
2
Hope addiction doesn't occur in one of your friends or family members.
1
it's about time we started treating the disease instead of its symptoms. Our incarceration "system" seems to be caught in a positive feedback loop where it only promotes the problem instead of solving it.
4
Hear, Hear! Big pharma has railroaded the U.S. into an opioid epidemic. Alcohol and pot also play huge roles; nothing's changed there.... Treatment works; just look at European prison systems where they treat addiction, provide counseling and get even murderers incorporated back into society. One more point: 12-Step programs work, too! When combined with medical treatment, therapy, 12-Step programs give the gift of sobriety for a lifetime.
1
Speaking of treatment of medical problems preventing crime, if more doctors recognized temporal lobe seizures resulting from head trauma which are often characterized by poor impulse control resulting in violent behavior and treated them properly, we'd put a major dent in violent crimes.
But it's easier simply to call people evil rather than sick and toss them in prison where they end up getting more head trauma which exacerbates their seizures and increases the likelihood for more violence instead of treating them with inexpensive anti-seizure medications.
But it's easier simply to call people evil rather than sick and toss them in prison where they end up getting more head trauma which exacerbates their seizures and increases the likelihood for more violence instead of treating them with inexpensive anti-seizure medications.
2
We're trying to do drug treatment on the cheap in this country and that's why it's not working. Addiction requires, in many cases, long-term residential treatment. Once people get out of treatment, they can't go back to their old neighborhoods and lives without serious risk of relapse. Although it would be extremely costly, I support the concept of gated communities/controlled environments where people recovering from addictions can live and work with fewer temptations and more hope than what they have now. Until we transcend the concept of people with addictions as moral failures deserving of punishment and damnation, we'll never turn the corner on this problem.
9
Funny. The party that wants to run the government more like a business does not seem to be able to find someone capable of performing the most basic cost/benefit analysis of public policies or someone capable of distinguishing between an expense versus an investment that will yield dividends in the long run.
4
It is about time addiction and more broadly, mental health, is recognized as a legitimate healthcare issue deserving of coverage by the insurance industry. Many recovering from addiction and other forms of mental illness require ongoing individual therapy long after they are released from treatment facilities but often wind up in group therapy because their insurance will not cover individual counseling.
Clearly the number of clients who have had multiple stints in rehabilitation would suggest there is more to be done during their stays and after.
Clearly the number of clients who have had multiple stints in rehabilitation would suggest there is more to be done during their stays and after.
7
Behavioral and mental health were added to the ACA under Obama as part of the essential health benefits package - the basic package to be considered health insurance. There is a risk that the opioid epidemic will no longer be covered if the decisions go to the states about what is 'essential'.
2
The same can be said for making mental health benefits comparable to medical health benefits. Some substance abusers are self medicating because of mental illness. These same people could become productive members of society or, at the very least, have better lives if we decided that being treated for mental illness was a worthwhile thing to do. Yet with mental illness, just as with drug abuse, obesity, and the complications that result from these problems, we don't want to help people with what are viewed as "lifestyle" problems. Maybe we're confusing lifestyle problems with what has come before them: the problems associated with obesity, with mental illness, with drug abuse. Most people do not decide to have an illness or problem that is so stigmatized by society.
6
Alcohol IS A DRUG. Writing “alcohol & OTHER drugs” would be an improvement. It’s not a trivial matter. Alcohol is the only drug that frequently leads those taking it to violence. It wouldn’t be a surprise if 50% of violent crimes took place under its influence FULL STOP. It also causes other impairments both physical & cognitive that are unique to alcohol. Each of the common psychoactive drugs including alcohol is unique in its effects & each has potential to be very damaging. Nonetheless, each including alcohol, produces effects many people consider desirable/beneficial. Otherwise no one would take them. Harm reduction can often be achieved through moderating consumption and avoiding altogether when consumption would present additional threats to safety. Opioid dependence & alcohol dependence stand apart from many others because people can become physically dependent on them & in such cases become physically sick if the drug is suddenly removed. Alcohol is relatively cheap so few must steal to obtain money for it. Opioids, excepting those prescribed to actual end users, are expensive due to legal prohibition but they are cheap to manufacture. If legalized & regulated like alcohol they’d be much cheaper & few would need to steal to afford them. Standardized heroin would be free of fentanyl & users could accurately know dosage so overdoses would plummet. Heroin like alcohol has an addiction rate of about 15% of those who try it; not the popular misconception of nearly all.
4
As usual progressives insist that everything is a one or another thing, and back it up with basically phony numbers. Sure if treatment worked and eliminated abuse in those treated I would support it with charity. It generally does not. So how about we eliminate criminals and then if it works treat them, mostly through cutting them off from their drugs. I would support a bill that allows people to have access to such if they are willing to pay the price, same with other so called "essential services". Many will never need such services and forcing them into the system increases prices for insurance.
"Progressives insist", use "generally phoney numbers" and treatment "generally does not" work. Like being progressive is a bad thing. In an article that detailed research, you provide no evidence and support the methods currently used that aren't working as a solution. It's as if anti-logic and counterintuitive waving of a pixie-wand will show those airy progressives how usesless it is to spend money on research and then, God forgive, actually try to make things better.
2
OK, so back up your assertions with some non-phony numbers so we can see if the foundation of your reasoning is fact or fantasy.
2
The right to addiction treatment (with medication) is part of the right to health care. There is no excuse for waiting lists. Imagine such lists for cancer treatment.
12
The problem is that drug use is an expensive habit to support and so almost inevitably leads to crime.
my my. blacks with drug problems are criminal predators. whites with drug problems are sick victims. the depths of white hypocrisy and racism are still unplotted
15
Sadly, people are able to blind themselves to their hypocrisy & racist/biased tendencies to an alarming degree. If we tried limiting our condemnation to racist thoughts, ideas and actions while avoiding labeling people themselves as "racists" then people could and would be much more likely to recognize their own biases when they surfaced and then try to eliminate them. But we label people racists (or sexists or homophobes, etc.) as if that label is the summation of who they are instead of pointing out the action, belief, statement as racist, sexist, homophobic, etc. People are much more than the least admirable action they take, thought they have or believe they hold. Anger and disgust make it easy to give in to the temptation to condemn the whole person but if we want these behaviors to end we need to be much smarter about avoiding slapping such labels directly on people. Labeling people is the surest way to cause those people to go into denial that they ever did or said anything that was racist, sexist, homophobic, etc. because "Everyone knows that racists, sexists & homophobes are bad people". Faced with essentially being labeled a "bad person" of course they seek refuge in complete denial and how can anyone work on a non-existent flaw in thinking? There are few "bad people" in the world but most all of us have traits and habits at least some of the time that could be improved. Let's keep our eyes on the ball and act in ways most likely to improve the world & ourselves.
2
How many crimes are committed to get money to buy drugs, especially if the definition of crime includes prostitution? The "cure" for the drug problem, namely the war on drugs, is worse than the disease.
6
In a society driven by profit instead of compassion, law enforcement, the courts, and prisons win. The result is destroyed families and communities. Until we realize that addiction is a societal problem instead of a personal problem we will spend vast sums of money in the process of destroying lives.
7
"Spend a Dollar on Drug Treatment, and Save More on Crime Reduction"
But - let me guess - you don't actually mean cut actual resources used for managing crime. You really mean cut the theoretical savings that never seem to materialize.
But - let me guess - you don't actually mean cut actual resources used for managing crime. You really mean cut the theoretical savings that never seem to materialize.
3
Incarceration is much easier than mental health therapy and rehab hospitals.
In the US we prefer severe punishment over hospitalization. It's who we are.
In the US we prefer severe punishment over hospitalization. It's who we are.
2
I hope you're using the royal "we". I believe its now the minority of Americans that are still so uninformed that they do not see this as a health crisis.
2
How about the impact on the children of their parents' opioid use disorders, and of their parents being prosecuted for them?
2
Besides the money advantage of a punishment-based system, that kind of system also feeds the emotional dynamic of conservatives' blaming "others" for supposedly being less than themselves.
6
This article makes a lot of sense and is backed up by authoritative studies. But it's an ominous sign that the agencies that conducted the studies are underfunded and under attack by Republicans. I see little evidence that our current federal government has the will, let alone the intelligence to implement public policy based on rigorous data.
I would be encouraged seeing Mr. Frakt's article endorsed by say, the National Review or The Weekly Standard.
I would be encouraged seeing Mr. Frakt's article endorsed by say, the National Review or The Weekly Standard.
8
All good arguments which would be acted upon in Germany, but not in the USA which has a different short term mindset. The same mindset that reckons 16% of GDP spent on medical is OK when Australia spends 9% and insures the entire country. Poles and wires around the USA are routinely blown down and require constant attention over long periods of time costing huge amounts of money. Spending the money to bury them (as in Europe) costs more upfront but much less long term (and looks better). Same issue. We waste so much money.
3
We knee-jerk liberals have know this for decades. Same goes for early childhood education. And, news flash -- cheap birth control reduces abortion rates and also saves money. Oh, and let's not forget the average cost of a year of incarceration -- $30K-$100K per inmate per year!
FISCAL CONSERVATIVES are hypocrites. REPUBLICANS are far more eager to spend $10 later vs. $1 now, running up the deficit and wasting millions on the pounds of cure vs. the ounces of prevention.
Why is it that no one can believe it's Democrats, not Republicans, who are the ones who actually want to save taxpayer dollars? This question has puzzled me since I was 20...and I'm about to turn 60!
FISCAL CONSERVATIVES are hypocrites. REPUBLICANS are far more eager to spend $10 later vs. $1 now, running up the deficit and wasting millions on the pounds of cure vs. the ounces of prevention.
Why is it that no one can believe it's Democrats, not Republicans, who are the ones who actually want to save taxpayer dollars? This question has puzzled me since I was 20...and I'm about to turn 60!
60
In the United States alone, legalizing drugs would have saved $41 BILLION a year currently spent on arresting, trying, and jailing users and sellers, according to a detailed study by the Cato Institute. If the drugs were then taxed at a similar rate to alcohol and tobacco, they would raise an additional $46.7 BILLION a year, according to calculations by Professor Jeffrey Miron of the Department of Economics at Harvard University. That’s $87.8 BILLION next year, and every year. With that money you could provide treatment and social re-connection for every drug addict in America.
17
The biggest obstacle to increasing availability of treatment is the widespread preference for punishment over rehabilitation. Many people would rather hire more police officers and prison guards than more drug counselors and vocational rehabilitation counselors. And many people would rather work as a uniformed, armed, tough law enforcement officer than as a gentle social worker.
This is even hinted at in the NYT article we've just read. Methadone is referred to as a "craving relieving" drug, a clever way of avoiding the simple truth that it is a form of agonist therapy. Methadone is a powerful opioid in its own right, which has a lot to do with it success. Of course, if it succeeds in helping a [person to transform from a street criminal to a working citizen, it makes sense to use it! But many folks dislike the very idea of "catering to" addictive behaviors.
This is even hinted at in the NYT article we've just read. Methadone is referred to as a "craving relieving" drug, a clever way of avoiding the simple truth that it is a form of agonist therapy. Methadone is a powerful opioid in its own right, which has a lot to do with it success. Of course, if it succeeds in helping a [person to transform from a street criminal to a working citizen, it makes sense to use it! But many folks dislike the very idea of "catering to" addictive behaviors.
20
Mr. Trump, please listen.
1/ decriminalize drugs and stop the prosecution for profit
2/ eliminate the DEA. period. Know when to walk away from a failed "war on drugs".
3/ pressure the doctors and drug companies to stop the over-prescription of opioids.
4/ direct health insurers to cover substance abuse treatment 100%
1/ decriminalize drugs and stop the prosecution for profit
2/ eliminate the DEA. period. Know when to walk away from a failed "war on drugs".
3/ pressure the doctors and drug companies to stop the over-prescription of opioids.
4/ direct health insurers to cover substance abuse treatment 100%
16
"For at least two decades, we’ve known substance use and crime go hand in hand. More than half of violent offenders and one-third of property offenders say they committed crimes while under the influence of alcohol or drugs."
The most used "substance" in the US, after alcohol, is marijuana. Numerous studies show that marijuana use decreases the likelihood of violent and property crime. Let's stop publishing alternative facts that reinforce the disastrous war on weed that Jeff Sessions is about to unleash.
The most used "substance" in the US, after alcohol, is marijuana. Numerous studies show that marijuana use decreases the likelihood of violent and property crime. Let's stop publishing alternative facts that reinforce the disastrous war on weed that Jeff Sessions is about to unleash.
29
Please look into methadone monopolies in states like Missouri where doctor groups get paid $10k per patient and have incentives to keep patients on the drug instead of weaning them off. Another win for corporate America but not so much for Americans. Not all "solutions" to the drug epidemic are actually solutions - just profit making machines at the expense of human lives. "Golden handcuffs".
12
There is no one in the biz of rehab (vivitrol, methadone, suboxone), residential treatment centers, spas) that knows anything about weaning off their product. That would be contrary to business practices and shareholders profits.
2
Portugal's experience is most telling. After serious heroin epidemic they legalized possession (but not dealing) and made treatment a medical issue. Numbers of addicts decreased by over 90%.
In the US we look at addiction as a moral failing. Just look at our attorney general. He wants to restart "the war on drugs" which has been nothing but a failure from every measure. People who smoke pot are "bad people" and should be in jail despite overwhelming evidence that marijuana is safe and effective as a treatment for many people and is nowhere as dangerous as alcohol.
In the US we look at addiction as a moral failing. Just look at our attorney general. He wants to restart "the war on drugs" which has been nothing but a failure from every measure. People who smoke pot are "bad people" and should be in jail despite overwhelming evidence that marijuana is safe and effective as a treatment for many people and is nowhere as dangerous as alcohol.
20
This is not news. Alfred Lindesmith informed Americans opiate addiction was a disease and was more efficiently treated than prosecuted beginning in 1938. The pertinent fact is that the US Government has ignored the science and pursued a narcotics policy for 70 years that ruined millions of lives and cost 100x more than "treatment."
31
Punishment makes voters feel safer than treatment.
Maybe that will change. Empathy and faith are needed too.
Maybe that will change. Empathy and faith are needed too.
4
Treating drug offences as a social problem rather than a criminal problem saves money and saves lives and families. The cost of police and prisons is much greater than the cost of rehab. The war on drugs ignores the data.
26
Helping people who are in a bad place works, who'd have thought.
As far as I know, pretty much all programs that allow drug use in a restricted and controlled manner lead to improvements in society as a whole and specifically to improvements of the lives of users. The decriminalization of drugs in Portugal and the various controlled heroin usage clinics in Belgium and The Netherlands spring to mind.
Additionally, ponder that substance abuse is a much bigger problem for poor people. Yes, rich people also mess up their lives and those of their families once they get into a serious drug addiction, but it generally does not involve stealing, robbing and roaming the streets. I'd wager that most rich addicts at some point walk into an intervention, go to rehab, kick the habit and just be done with it.
As far as I know, pretty much all programs that allow drug use in a restricted and controlled manner lead to improvements in society as a whole and specifically to improvements of the lives of users. The decriminalization of drugs in Portugal and the various controlled heroin usage clinics in Belgium and The Netherlands spring to mind.
Additionally, ponder that substance abuse is a much bigger problem for poor people. Yes, rich people also mess up their lives and those of their families once they get into a serious drug addiction, but it generally does not involve stealing, robbing and roaming the streets. I'd wager that most rich addicts at some point walk into an intervention, go to rehab, kick the habit and just be done with it.
7
A lot of people think that other's drug addictions don't affect them nor is it their problem. But it does affect us all if we live in communities. Therefore this must be recognized and fought by all members at all levels of society. The quality of life issue is greatly diminished when there are too many drug users in our parks, schools, courts, hospitals, jails, driving on our roads, etc. Plus property crimes and personal safety factors must also be weighed. Rampant drug use negatively affects us all. Putting people in prison doesn't help for where do they return after they are released? Back into your neighborhoods and towns. An ounce of prevention is prudent.
17
As a criminal defense lawyer, I agree 100%, however, because all of the municipal police departments and a percentage of the state government budgets are addicted to the fines and assessments related to drug crime prosecutions, those political entities are loath to get rid of their 'war on drugs'. The bloated police and criminal justice systems have been addicted to the fines related to drug prosecutions which are used to pay for more officers, more pensions, more healthcare benefits, more cars and bigger budgets to engage the enemy! The war on drugs has been an abject failure!!! This article should be on every police force and municipal government's mayor's desk today so they can save our children and not their budgets....
47
Jobs with not unattractive wages also can bring down crime, along with substance abuse.
Low minimum wage makes the available jobs too unattractive. Youths with a propensity to violence feel like robbing whoever next to them to have a better life thus the crime rate goes up. Then businesses leave along with available jobs & the vicious cycle continues. Providing jobs one way or another with better wages, with subsidies as necessary, is the solution for this predicament.
As for healthcare, it’s sufficiently clear to most who have read & thought about it, the most cost-effective way to have healthcare for people at large is to have a single payer system. But REPUBLICANS as a HABIT continue to RESIST it. But it is inevitable to have a single payer plan, whether all its ingredients are employees of the state, or only certain parts of them are.
One legitimate concern for it's that it creates a huge, unpalatable bureaucracy. With modern technology, without ASSAULTING people's privacies mechanisms to overcome bureaucratic inefficiencies could be created & put in place a lot easier than before. There have also been effective bureaucracies in the US military, in NASA, in the Manhattan project; they have been phenomenally successful.