7 ms·

This is a yellow journalism headline. Hearst would be proud. As I've remarked before, the war on drugs and getting tough on crime is not working out too well f

by pnathan 10y ago

This is a yellow journalism headline. Hearst would be proud. As I've remarked before, the war on drugs and getting tough on crime is not working out too well for us, so it's time to change our plan. I don't advocate off the shelf heroin or any of the cluster of ideas that suggest that. I do advocate focusing on the funnel that leads to addiction, homelessness, and death. Part of that is significantly amping up mental healthcare spending; part of that is having legally controlled drugs available in pharmacies for reasonable prices; part of that is supporting better schools (giving a window into a better world, and a way to climb through); part of that is supporting jobs programs. All of those relate in one way or another to the problem, some years and years earlier in the funnel. No one is born choosing to be an addict in their later life; a series of choices and pressures put them there. The pressures from society can be changed, which shapes the set of choices visible.

hackermailman 10y ago
From anecdotes of living beside the biggest open air drug market in Canada for a decade, and from watching my own friend's behavior growing up it seems to me the biggest problem is being unable to do anything when somebody you know or a family member becomes an addict. You can't force them into treatment, you can't even get the police to find them if they disappear into the streets, and the cycle in and out of jail just makes them career addicts as any chance of normal life seems over to them at that point. Here if they check into detox, even if you are direct family you can't visit them or bring them anything because detox will deny they are there. You can't ask detox to call when they are released so you can pick them up and they don't end up released back on the streets. Another problem is the waiting times for treatment. Real treatment is a long commitment sometimes living for years in a halfway house being supported by other peers to remain sober. An addict should be able to check into treatment and immediately commit themselves instead of waiting for months for a spot to open. Lack of any facility for police to just dump out of control users and have them treated by doctors and addiction specialists is another issue. Often there are mentally ill with secondary addictions or other problems, and the police don't know what to do with them and money is wasted having them ferry around doctors to look at these addicts in jails or playing catch and release after a weekend in jail. A one stop sober shop and treatment option is always requested by police here but it never materializes. Of course all of this costs money nobody will get elected with this spending platform on junkies until the synthetic opiates problem is so large the political will exists to do this. All the addicts I've talked to including 2 of my friends who had a bad addiction for a few years, they all ended up addicts by becoming successful and partying to celebrate it. Anybody who lives in Vancouver if you go to VANDU and listen to one of their meetings sometime this is the same story you will hear: I was successful, I started drinking and partying, I used drugs to help regulate my sleep, or to get sober (cocaine sobers you up) or stay awake to function, I ended up an addict and lost everything here I am living in the dumpster or flop hotel being enabled by other addicts because I stole from every family member/friend and burned all those bridges.
- Schn1eck7 10y ago
  Started an addiction clinic (outpatient) and I'm pretty convinced it's a great model for large populations. It's not for everyone initially - you may need more attention than weekly/bi-weekly visits to a treatment center, but we've seen more than half remain in treatment. Of that group that stays in treatment, more than half got jobs (almost all without our help, although we're starting to help now). Focusing on rebuilding your life while on Suboxone, while having access to mental health professionals (doctors, counselors, therapists) is working. Open 6 months, we're growing fast and hope to help everyone we can. Only one in our city who accepts insurance without a waiting list, and we do that exclusively (no self pay).
  - hackermailman 10y ago
    They've had success here too with Suboxone but took a long time for regulators to allow it to be prescribed instead preferring methadone which failed as a treatment strategy http://www.theglobeandmail.com/news/british-columbia/a-bc-clinic-is-showing-how-quick-treatment-can-get-patients-offopioids/article33815291/ http://www.theglobeandmail.com/news/british-columbia/a-bc-cl... It's good you have immediate treatment they still can't figure that out here, the "Rapid Access Addiction Clinic" in that story is unfortunately not accessible to all addicts and has temporary funding.
    - Schn1eck7 10y ago
      Methadone is a full opioid agonist, similar to traditional opioids like painkillers and heroin. So the abuse potential is there. And nearly all methadone clinics don't provide additional supports (behavioral health or otherwise). They more or less function as pill mills. I don't need to own the entire system with this stuff, but it's very hard to set up (unfortunately). Hoping more people wake up and are able to do similar things. And we're going to keep expanding access to treatment. We only accept medicaid (for the poor in the US), who otherwise wouldn't have access to free treatment. They pay $300-500 per month for Suboxone at cash clinics, but typically don't get as much behavioral health treatment.
scurvy 10y ago
I live next door to a rich heroin junkie. She has no job. What's left of her family has basically cut her off. She can afford all of the care in the world, but chooses heroin over treatment instead. Why? Heroin don't care. The city of San Francisco took her dog away (twice) and declared her place a health hazard for a while, but ultimately it never forced her to get treatment and is tacitly approving of her heroin use. She hasn't paid her property taxes in years and the police come out about once a month, but the US has no ASBO laws so it's catch and release in hippie dippie SF. She's got the money for the dope, and heroin don't care. PS> She got the dog back both times.
- idiot_stick 10y ago
  >She's got the money for the dope, and heroin don't care. So you what do you propose as a solution for this (likely unrepresentative) anecdote? Lock her up?
  - scurvy 10y ago
    I don't have a solution, but my point was that not all addicts are victims. For some, it's a conscious decision about choosing heroin over life (insert Trainspotting ending here). Unless the US adopts some sort of ASBO laws, there's not much you can do about forced treatment for someone who doesn't choose treatment. Also, you could substitute heroin here with any other equally damaging substance like alcohol and the situation wouldn't change.
    - deleted 10y ago
      [deleted]
    - smokeyj 10y ago
      > Also, you could substitute heroin here with any other equally damaging substance Desk jobs and fast food? As long as we have public healthcare I reserve the right to smack that bag of chips out of your chubby fingers. /end of rant
    - wyager 10y ago

by pnathan 10y ago

hackermailman 10y ago

From anecdotes of living beside the biggest open air drug market in Canada for a decade, and from watching my own friend's behavior growing up it seems to me the biggest problem is being unable to do anything when somebody you know or a family member becomes an addict. You can't force them into treatment, you can't even get the police to find them if they disappear into the streets, and the cycle in and out of jail just makes them career addicts as any chance of normal life seems over to them at that point. Here if they check into detox, even if you are direct family you can't visit them or bring them anything because detox will deny they are there. You can't ask detox to call when they are released so you can pick them up and they don't end up released back on the streets. Another problem is the waiting times for treatment. Real treatment is a long commitment sometimes living for years in a halfway house being supported by other peers to remain sober. An addict should be able to check into treatment and immediately commit themselves instead of waiting for months for a spot to open. Lack of any facility for police to just dump out of control users and have them treated by doctors and addiction specialists is another issue. Often there are mentally ill with secondary addictions or other problems, and the police don't know what to do with them and money is wasted having them ferry around doctors to look at these addicts in jails or playing catch and release after a weekend in jail. A one stop sober shop and treatment option is always requested by police here but it never materializes. Of course all of this costs money nobody will get elected with this spending platform on junkies until the synthetic opiates problem is so large the political will exists to do this. All the addicts I've talked to including 2 of my friends who had a bad addiction for a few years, they all ended up addicts by becoming successful and partying to celebrate it. Anybody who lives in Vancouver if you go to VANDU and listen to one of their meetings sometime this is the same story you will hear: I was successful, I started drinking and partying, I used drugs to help regulate my sleep, or to get sober (cocaine sobers you up) or stay awake to function, I ended up an addict and lost everything here I am living in the dumpster or flop hotel being enabled by other addicts because I stole from every family member/friend and burned all those bridges.

Schn1eck7 10y ago
Started an addiction clinic (outpatient) and I'm pretty convinced it's a great model for large populations. It's not for everyone initially - you may need more attention than weekly/bi-weekly visits to a treatment center, but we've seen more than half remain in treatment. Of that group that stays in treatment, more than half got jobs (almost all without our help, although we're starting to help now). Focusing on rebuilding your life while on Suboxone, while having access to mental health professionals (doctors, counselors, therapists) is working. Open 6 months, we're growing fast and hope to help everyone we can. Only one in our city who accepts insurance without a waiting list, and we do that exclusively (no self pay).
- hackermailman 10y ago
  They've had success here too with Suboxone but took a long time for regulators to allow it to be prescribed instead preferring methadone which failed as a treatment strategy http://www.theglobeandmail.com/news/british-columbia/a-bc-clinic-is-showing-how-quick-treatment-can-get-patients-offopioids/article33815291/ http://www.theglobeandmail.com/news/british-columbia/a-bc-cl... It's good you have immediate treatment they still can't figure that out here, the "Rapid Access Addiction Clinic" in that story is unfortunately not accessible to all addicts and has temporary funding.
  - Schn1eck7 10y ago
    Methadone is a full opioid agonist, similar to traditional opioids like painkillers and heroin. So the abuse potential is there. And nearly all methadone clinics don't provide additional supports (behavioral health or otherwise). They more or less function as pill mills. I don't need to own the entire system with this stuff, but it's very hard to set up (unfortunately). Hoping more people wake up and are able to do similar things. And we're going to keep expanding access to treatment. We only accept medicaid (for the poor in the US), who otherwise wouldn't have access to free treatment. They pay $300-500 per month for Suboxone at cash clinics, but typically don't get as much behavioral health treatment.

scurvy 10y ago

I live next door to a rich heroin junkie. She has no job. What's left of her family has basically cut her off. She can afford all of the care in the world, but chooses heroin over treatment instead. Why? Heroin don't care. The city of San Francisco took her dog away (twice) and declared her place a health hazard for a while, but ultimately it never forced her to get treatment and is tacitly approving of her heroin use. She hasn't paid her property taxes in years and the police come out about once a month, but the US has no ASBO laws so it's catch and release in hippie dippie SF. She's got the money for the dope, and heroin don't care. PS> She got the dog back both times.

idiot_stick 10y ago
>She's got the money for the dope, and heroin don't care. So you what do you propose as a solution for this (likely unrepresentative) anecdote? Lock her up?
- scurvy 10y ago
  I don't have a solution, but my point was that not all addicts are victims. For some, it's a conscious decision about choosing heroin over life (insert Trainspotting ending here). Unless the US adopts some sort of ASBO laws, there's not much you can do about forced treatment for someone who doesn't choose treatment. Also, you could substitute heroin here with any other equally damaging substance like alcohol and the situation wouldn't change.
  - deleted 10y ago
    [deleted]
  - smokeyj 10y ago
    > Also, you could substitute heroin here with any other equally damaging substance Desk jobs and fast food? As long as we have public healthcare I reserve the right to smack that bag of chips out of your chubby fingers. /end of rant
  - wyager 10y ago