Monday, July 10, 2017

Are Drug Users Victims or Victimizers?

We are told that drug users are victims and that drug addiction is a "health problem not a legal problem" - but is this always the case?  By the way, where are there "how to shoot up" videos on YouTube?


We are in the midst of an opioid epidemic that seems no signs of letting up and is "impossible to stop" even though we know where the vast majority of drugs are coming from - and not some smuggler or drug-dealer, but major US Pharmaceutical Companies.   We could stop this if we wanted to, we chose not to, because a lot of people are making a lot of money at this, and it is all charged to Obamacare.

I mentioned before how a local "pain doctor" offered Mark a prescription for Oxycodone before he even examined Mark's back!  Mark wisely said "No!"   It is a pretty lucrative deal.  The doc writes the 'scripts and bills insurance for his "office visit" and gets a kick-back from the drug company.  The "patients" either use the drugs, or sell them for $20 a pill - after getting a whole bottle for a $20 co-pay.

Even the "re-hab" clinics cash in - many sketchy places opening up to accept "addicts" but in fact are little more than "shooting galleries" themselves.   It is all billed to Obamacare, which picks up the tab and then raises rates for the rest of us.    And people say Obamacare doesn't need to be fixed!  Sadly, the GOP probably won't fix this part, as they all get campaign donations from big Pharma.

But enough of my soapbox.

Addiction has become more than a mere health issue, it has become a political one as well.   We are told that we need to spend yet more money treating addiction, and that the people who take drugs are not villains but victims whose bad actions should be excused on a blanket basis as "they can't help themselves."   Being an addict is sometimes literally a "get out of jail free" card, as you can posit that you are not a criminal, but a victim of drug use - a victim of something you took up willingly.

People on the political side of this argument often don't use science in their discussions.  It is just assumed that once you decide to take drugs, nothing is ever your fault again, and that society has an obligation to cater to your every whim.   But is this the case?  Is this based on real science or pseudo-science?

Some argue that "addiction" of even the hardest drugs - methamphetamine, cocaine, and opioids, is a little overstated.  For example, some note that:
More people quit addictions than maintain them, and they do so on their own. That's not to say it happens overnight. People succeed when they recognize that the addiction interferes with something they value—and when they develop the confidence that they can change.
This is a pretty powerful statement to make, and no doubt unpopular among those in the addiction industry.   The idea that people have a choice in the matter is routinely shouted down by many.

Another fellow, a former "addict" notes that his urge to be a drug addict sort of faded away over time:

When I stopped shooting coke and heroin, I was 23. I had no life outside of my addiction. I was facing serious drug charges and I weighed 85 pounds, after months of injecting, often dozens of times a day.
But although I got treatment, I quit at around the age when, according to large epidemiological studies, most people who have diagnosable addiction problems do so—without treatment. The early to mid-20s is also the period when the prefrontal cortex—the part of the brain responsible for good judgment and self-restraint—finally reaches maturity.
I found this last part fascinating as age 25 was when I stopped using drugs - even alcohol - as I realized it was leading me nowhere.  Why do some people walk away from the drug scene, and yet others stay in it - often until "death do us part"?
Even if we assume that physical addiction makes it difficult to quit a particular drug, what causes addicts who are "clean" for days, weeks, months, or years, to go back to abusing drugs?  Some argue that this is "psychological addiction" and is as compelling as a physical addiction to the drug or maybe even moreso.   Others might argue that it is a matter of choice based on low-self-esteem issues.

And at what point do we discriminate between choice and compulsion?   It is a tricky question.

The problem I see is that when we create a role for people to play, many people will play it.  People stop living their lives and start playing roles, with defined behaviors, attitudes, and even a dress code.  Maybe half the country is doing this at one time or another.   Granted, many of these roles are harmless enough, or arguably have positive social vales - Soccer Mom, Striving Yuppie, Working Stiff.   Others are not as positive, for society or the individual - Social Activist, Slacker, Stoner, Drug Abuser, Crack Whore.

This is not to say that kicking drugs is easy.   But as some note, part of the problem is not merely the physical addiction or the behavior patterns, but the environment and existing psychological problems the person may have.  When someone goes to a 30-day "rehab" and then returns to their drug-infested neighborhood, their drug-addled friends, and their dysfunctional family, odds are, they will return to their old habits in short order.

The problem a lot of Americans have is that it seems we are lavishing at lot of attention on people who refuse to take care of themselves.   And if it was a matter of them just doing drugs, maybe most of us wouldn't be bothered too much by it (although the idea of supporting yet another person on welfare isn't very attractive).   The problem is that often these are the same people stealing our shit, living on the margins of society, and causing trouble, often violence, in our lives.   There reaches a point where compassion fatigue sets in.

A small town in Ohio has caused a furor because the local Sheriff won't let his deputies carry or administer Narcan.   He argues that if he was to do this, then they should also carry epipens, and insulin shots.   A local town councilman, tired of the thousands of ambulance calls for overdoses every year, makes the Swiftian proposal that maybe after your third OD call, you're on your own.  Harsh measures, to be sure, but it illustrates that people are getting sick and tired of this "epidemic" that is caused, at least initially by voluntary behavior.

People just get worn down by all of this.  We are supposed to "feel sorry" for people who won't even take care of themselves and moreover, make our lives a little (or a lot) more miserable.   How come they get a free pass, while we are held accountable for our errors?

Of course, to even suggest this is to be called a Cruel Heartless Bastard (CHB) by the far-left, who thrives on this addiction narrative - because half of them are stoned most of the time (I say this from experience).   "We need to fund more treatment centers!" they cry, not realizing that we can't fund even 1/10 of what we would need to do to treat all the mentally ill and drug-addicted we already have on the streets today.

As the article cited above notes:

The average cocaine addiction lasts four years, the average marijuana addiction lasts six years, and the average alcohol addiction is resolved within 15 years. Heroin addictions tend to last as long as alcoholism, but prescription opioid problems, on average, last five years. In these large samples, which are drawn from the general population, only a quarter of people who recover have ever sought assistance in doing so (including via 12-step programs). This actually makes addictions the psychiatric disorder with the highest odds of recovery.

It is an interesting viewpoint.   And it begs the question as to whether "treatment" is really helping the majority of addicts, or whether it is merely giving them a new role to play in the game.

This is not to say we have no compassion.   But there are people out there with real medical problems.  Folks who have cancers, hereditary disorders, traumatic injuries, or chronic illnesses that are not the result of their own behaviors.  You have to put this shit into perspective.   Saying that someone "can't help themselves" seems a little too pat an answer, particularly when others seem to be able to help themselves or avoid such perils to begin with.

One reason I got out of the drug thing is that I saw my peers going down a dark path.   I made a choice, and that has made all the difference in the world.   It was the early 1980's and the coke boom of the disco era was just wearing off.   A friend of mine got into that, and I stopped being friends with him as a result.  That was the smartest and best thing I could have done.   And no, I had no obligation to "save" him, and even if I had tried, it would have been fruitless and pointless and would have dragged me down with him.   When someone drives their car off a cliff, make sure you are not in the back seat!

Another friend called me one day and said I needed to try this "rock cocaine" they had discovered.  This was before the term "crack" was invented.   I took a pass and waved goodbye to more drug friends.   Another friend started smoking opium, and I realized I really needed to find new friends.

They made shitty choices.  I made better ones.  We need to reward better choices more and discourage shitty choices.   And yes, that sounds "harsh" but it is actually a loving thing.  Indulging people is really a cruelty.   When you say "Yes" to a child's every whim, you are not doing that child a favor, but setting them up for heartbreaking cruelty later in life, when they discover that not everything goes their way.

I guess the point is, it seems we lavish too much attention on drug addicts these days.   No, maybe we aren't providing enough "treatment centers" or whatever.  But that is part of the problem - we posit the problem is not spending enough money on drug users rather than something simple like blowing up the world headquarters of the companies pushing this poison through doctors.  Just Kidding.   Don't want Office of Homeland Security to come a-knocking.

This idea that the dregs of our society should be elevated on a platform as the "noble homeless" or the "sainted poor" or the "helpless drug addict" is, I think, an unhealthy obsession both for our country and for the Democratic Party.   Yes, being poor and homeless sucks - it should.  When we make it comfortable, fewer and fewer people will bother trying to find a better way.  Similarly, when we make being a drug addict a career choice, where you can get high all day long and just dial 911 for your free Narcan shot, maybe fewer and fewer people will find a need to stop shooting up.

As the first article above notes, "People succeed when they recognize that the addiction interferes with something they value—and when they develop the confidence that they can change."   When we make addiction not interfere, then there is no need to not be an addict.

Drugs are a dead-end.   Making them more attractive as a lifestyle isn't the answer to the problem.

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