Pain and Suffering in New England

 

imageHere in New England, it’s hard to get through a news cycle without at least one mention of the region’s opioid epidemic. Every media outlet covers it; governors are creating task forces faster than you can count; and the presidential candidates expect daily questions on the matter, often from parents who lost a child to an overdose. (Notably, Jeb Bush’s daughter has struggled with addiction for years, and Carly Fiorina’s stepdaughter died of an overdose.)

Is the problem worthy of the hype? More so than I had thought. In Massachusetts last year, there were nearly 1,100 confirmed deaths from opioid poisoning, and that number is likely to crawl higher as some investigations are completed. That’s up from 711 deaths in 2012, which constituted very nearly 30 percent of all accidental deaths in the state. Most depressingly, confirmed overdose deaths have increased every year since 2010, when the number was just 555. New Hampshire has only a fifth as many people as Massachusetts, but almost a third as many fatal cases. These rates are significantly higher than national averages.

Now, statistics like this are only a reflection of reality and often a distorted one: It’s wholly possible that the increase in the number of recorded incidents reflects, at least in part, a growing awareness of such causes of death (when you start looking for things, you tend to find them). Still, that’s a staggering number of deaths, both in absolute numbers and as a proportion of preventable deaths. I’m hesitant to use the word “epidemic” to describe things short of the Spanish Flu, but there’s a undoubtedly a very serious problem here.

One of the more interesting aspects of this is that a large and growing percentage of addicts start with prescription opioids and then progress to illegal ones. That is, they get hooked on OxyContin or similar pain killers — dangerous in itself — and then switch to heroin when their prescription runs dry or they can’t afford to refill it. (Like many folks, I know someone who got hooked on prescription narcotics. It was a mess. She’s recovered, but she had a really strong support network).

Indeed, the numbers of legal painkillers prescribed are astonishing (for a really interesting piece on pain treatment, do check out this one we published earlier this week). Via the Boston Globe, consider:

The council also received new data on prescriptions for controlled substances, such as painkillers, derived from the monitoring program. It showed that prescriptions had declined slightly in 2014, returning to 2011 levels. But the numbers remain staggering: In a state with 6.7 million people, 4.4 million opioid prescriptions — including 240 million pills, capsules, or tablets — were dispensed in 2014.

One of the more interesting responses to the crisis has been the distribution of naloxone, a drug that can reverse the effects of an opioid overdose. Though effective, safe, and available to medical professionals for more than three decades, some municipalities have experimented with distributing it widely, including to treatment facilities, police, family of addicts, and — controversially — the addicts themselves. A few years back, the police department in Quincy, Mass. spearheaded a program of training all officers to carry and administer emergency doses; they’ve saved dozens of lives locally in the last few years and have trained other departments in the region. Also controversially, the Gloucester, Mass. PD has unilaterally decided not to arrest addicts who walk in the door, and to divert them to treatment instead.

On the other hand, Massachusetts Governor Charlie Baker is considering a number of responses, including short-term involuntary treatment, restricting the number of pills that can be prescribed at any given time, and requiring pharmacies to do more reporting.

Of course, there’s only so much state and local agencies can do, and the real work is almost certainly best done by private institutions and churches. Laws and regulations might be able to mitigate the damage, but family and religion stand a much better chance of addressing the underlying human crisis.

Published in Culture, Healthcare, Policing
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  1. Titus Techera Contributor
    Titus Techera
    @TitusTechera

    PHenry:

    Manny: One thing I do know, you can’t have a democracy without virtue.

    agree. I just don’t believe for a minute you can create virtue with legislation!

    You do not have to create it. You have to help it along & try to persuade people to take it seriously. The powers of the laws over people reach far beyond the narrow understanding of law in law schools.

    Americans really have spread across the world the democratic habit of voting on anything, political or not, including where to go for dinner.

    Other examples would be less ridiculous, but if you want some more of this sense of humor: Americans have a habit of closing their eyes to their very undemocratic habit of naming one man to get things done, as opposed to deciding what is to be done. Even liberal organizations, even universities have a CEO, although the constitution creates only one for the federal government, leaving the rest of the country free to do otherwise. But the influence spreads…

    • #31
  2. Annefy Member
    Annefy
    @Annefy

    PHenry:

    Manny: One thing I do know, you can’t have a democracy without virtue.

    agree. I just don’t believe for a minute you can create virtue with legislation!

    Well, you might not be able to create virtue, but you can change behavior. My daughter spending two nights in jail on a pot charge certainly changed her behavior.

    And once her behavior changed, and her mind cleared, she became a much more virtuous person.

    • #32
  3. Ontheleftcoast Inactive
    Ontheleftcoast
    @Ontheleftcoast

    It may be worth treating IV drug use as its own category – at least in the initial phases in which there is a social component to using, or learning to use, drugs by injection.

    The historical record has shown that under schemes by which addicts obtain their drugs via prescription, addicts would divert their legally obtained drugs to initiate friends into drug use, thereby essentially being spreading an epidemic of a contagious disease.

    Unfortunately, the record (Sweden in the 1960s) also shows that while forced rehabilitation has worked at least to a degree, it takes many months of incarceration under a strict regime, which would incur its own social and financial costs, not to mention an authoritarian approach not currently acceptable in the US.

    Returning to the theme of epidemics, the draconian approach mentioned above is only useful in the initial stages of an outbreak, so barring the emergence of a technological solution, this is only of academic interest in our era of endemic drug abuse.

    • #33
  4. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Manny:

    PHenry:

    Manny:

    So only when it promotes the common good being served can liberty be allowed?

    Hmm, yes. The constitution guarantees you the freedoms in the bill of rights.

    Well… it wasn’t supposed to be like that at first.

    We were supposed to inherit the common-law rights that every Englishman knew about, rights thought so mundane at the time that there seemed no need to spell them out in the Bill of Rights.

    And we were supposed to have a government of enumerated powers governing a citizenry presumed to have unenumerated rights. Not a government of unenumerated powers governing a citizenry with only a pitiful few enumerated rights.

    Alexander Hamilton expressed his concerns in Federalist Paper No. 84, “[B]ills of rights . . . are not only unnecessary in the proposed Constitution, but would even be dangerous.” Hamilton asks, “For why declare that things shall not be done [by Congress] which there is no power to do? Why, for instance, should it be said that the liberty of the press shall not be restrained, when no power is given [to Congress] by which restrictions may be imposed?”…

    Alexander Hamilton added that a Bill of Rights would “contain various exceptions to powers not granted; and, on this very account, would afford a colorable pretext to claim more [powers] than were granted. . . . [it] would furnish, to men disposed to usurp, a plausible pretense for claiming that power.”

    Hamilton wasn’t right about everything, but maybe he was about this.

    • #34
  5. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Manny:

    Barkha Herman:

    Barkha Herman:The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

    I did not expect this on Ricochet.

    Retained by the people means it’s open for legislative decision. Are you saying legislators don’t have the authority to create laws?

    They were not supposed to have the authority to create any law, no. Especially not at the federal level.

    Each state in the union inherited the police and parliamentary powers from Mother England. That was supposed to be our US tradition, and explains (among other things) why the most obviously criminal crimes are typically prosecuted at the state level – where the police power is supposed to traditionally reside.

    But even state governments were supposed to be constrained by the traditional constraints on police power inherited from England. States were, of course, each going to evolve their law a little differently. But to throw off the yoke of English constitutional heritage entirely and say, “Hey, since we’re states, our legislators can do whatever the [expletive] they feel like as long as it doesn’t violate the explicit wording of the federal costitution,” is not actually traditional at all.

    • #35
  6. Merina Smith Inactive
    Merina Smith
    @MerinaSmith

    Let me ask you libertarians–do you oppose prescription drugs in general?  In other words, many drugs are controlled that aren’t really addicting, but that do have other side effects that non-medical people don’t understand.  For that reason, they can only be prescribed by a doctor after an examination for a particular purpose.  I think that is perfectly reasonable, and I think it is perfectly reasonable to  control substances that are addicting for the same reason.  People might want to take them because they make them feel good temporarily, but they don’t fully understand the properties of the drug, just as with other non-addictive drugs.

    • #36
  7. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    Addicts are not free, they are slaves.

    I advocate using the power of the state to coerce people into treatment for addiction at the point of a gun. I have seen it work time and time again to get people back to lives. They get their family ties back, they enter the community, they are productive.

    Saying “They have a right to be an addict” is saying that we are OK with their slavery to their drug.

    I am not advocating legislating morality. I am advocating forcing help on people who need it, and who have a brain that cannot seek help. I am for restoring their liberty.

    • #37
  8. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Merina Smith:Let me ask you libertarians–do you oppose prescription drugs in general?

    Opposing available-by-prescription-only is not the hill I want to die on.

    That said, I do question many aspects of the existing prescription-drug regime, and would not be surprised if a laxer regime (ranging from marginally less encumbered than our current system to totally unencumbered) would be better.

    …For that reason, they can only be prescribed by a doctor after an examination for a particular purpose. I think that is perfectly reasonable… People might want to take them because they make them feel good temporarily, but they don’t fully understand the properties of the drug…

    It all sounds perfectly reasonable, but how does it work in practice? You describe benefits. What about costs?

    Many drugs available by prescription only aren’t any less dangerous that the OTC drugs available now. The joke goes aspirin wouldn’t even be approved by the FDA if it hadn’t been grandfathered in. Nor does it take much excess dosing on Tylenol to fry your liver. By far the worst drug withdrawal I ever went through came from Benadryl (used at OTC doses). Like something straight out of Trainspotting it was – and no, let’s not go into more details than that!

    I’ve also watched several former prescription drugs (rather predictably) become OTC with wry amusement.

    And doctors still expect to be consulted about OTC drug usage, too, and for their advice to be heeded.

    • #38
  9. danok1 Member
    danok1
    @danok1

    Larry3435: People in agonizing pain, who cannot get the medication they need, go to the streets to get whatever they can. Heroin is a cheap and readily available alternative. The worst possible thing the government could do here is to crack down further on prescription pain killers.

    This is absolutely spot on, though it doesn’t address the needs of folks with chronic pain. The only really effective painkillers are also addictive. I use Tramadol for RA pain. It doesn’t really work very well, especially in a flare. But the alternative is to take something like OxyCotone, which I wil not do. I’d rather try to deal with the pain than to get hooked. Though talk to me again in a couple of years.

    We need to develop effective, non-addictive pain medications. (I think Claire had a thread about this.)

    • #39
  10. Manny Coolidge
    Manny
    @Manny

    Midget Faded Rattlesnake:

    PHenry:

    So only when it promotes the common good being served can liberty be allowed?

    Manny: Hmm, yes. The constitution guarantees you the freedoms in the bill of rights.

    Midget Faded Rattlesnake: Well… it wasn’t supposed to be like that at first.

    Are you saying that the founders did not envision laws being created?  Article 1, Section 1:

    All legislative Powers herein granted shall be vested in a Congress of the United States, which shall consist of a Senate and House of Representatives.

    Of course that requires a definition of legislative powers, but I think that it’s clear there is power to legislate.  The word “power” implies an act of force.  Perhaps my understanding of civics is at a high school level, but we’ve got all sorts of laws that restrict individual freedom.  It wasn’t too long ago we had sodomy laws, of all things.  We had laws of conscription that could pull you out of your current life and draft you to fight a war.

    • #40
  11. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Manny:

    Midget Faded Rattlesnake:

    PHenry:

    So only when it promotes the common good being served can liberty be allowed?

    Manny: Hmm, yes. The constitution guarantees you the freedoms in the bill of rights.

    Midget Faded Rattlesnake: Well… it wasn’t supposed to be like that at first.

    Are you saying that the founders did not envision laws being created? Article 1, Section 1:

    All legislative Powers herein granted shall be vested in a Congress of the United States, which shall consist of a Senate and House of Representatives.

    Of course that requires a definition of legislative powers, but I think that it’s clear there is power to legislate.

    Yes, there is power to legislate federally according to the “Powers herein granted”. Those are the enumerated powers, no?

    Each individual state, by contrast, inherits the parliamentary power, which in England, is sovereign. But even despite the sovereignty of England’s parliament, the Englishman still considered himself to have certain common-law rights. The Parliament might have the power to override those, but not justly.

    • #41
  12. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    danok1:

    Larry3435: People in agonizing pain, who cannot get the medication they need, go to the streets to get whatever they can. Heroin is a cheap and readily available alternative. The worst possible thing the government could do here is to crack down further on prescription pain killers.

    This is absolutely spot on, though it doesn’t address the needs of folks with chronic pain. The only really effective painkillers are also addictive. I use Tramadol for RA pain. It doesn’t really work very well, especially in a flare. But the alternative is to take something like OxyCotone, which I will not do.

    Heh, more fool you! Tramadol’s “abuse potential” now means it’s a controlled substance according to the DEA – Schedule IV as of August 18, 2014. Addict ;-)

    • #42
  13. danok1 Member
    danok1
    @danok1

    Midget Faded Rattlesnake: Heh, more fool you! Tramadol’s “abuse potential” now means it’s a controlled substance according to the DEA – Schedule IV as of August 18, 2014. Addict ;-)

    Yep, I know that. I just wish there were more pain relief for the “new hoops” we have to jump through.

    • #43
  14. Manny Coolidge
    Manny
    @Manny

    Midget Faded Rattlesnake:

    Each individual state, by contrast, inherits the parliamentary power, which in England, is sovereign. But even despite the sovereignty of England’s parliament, the Englishman still considered himself to have certain common-law rights. The Parliament might have the power to override those, but not justly.

    I said above that you have the rights granted under the bill of rights.  And the rest is open for legislation.  Are we saying the same thing?

    • #44
  15. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Manny:

    Midget Faded Rattlesnake:

    Each individual state, by contrast, inherits the parliamentary power, which in England, is sovereign. But even despite the sovereignty of England’s parliament, the Englishman still considered himself to have certain common-law rights. The Parliament might have the power to override those, but not justly.

    I said above that you have the rights granted under the bill of rights. And the rest is open for legislation. Are we saying the same thing?

    Not at the federal level. At the federal level, powers are enumerated, that is, restricted to powers specifically granted in the Constitution, not just “anything that doesn’t violate the Bill of Rights”. Or that was how it was supposed to be. Now, of course, we do have a federal government of unenumerated powers.

    Practically speaking, federal lawmakers no longer bother to think, “Is the power we want granted by the Constitution?” Instead, they proceed as if every power is available to the legislature unless someone can prove that it violates the Bill of Rights or subsequent amendment.

    You and I may be saying the same thing at the level of each state’s government, which is where police and parliamentary powers are supposed to reside. But even then, while the police and parliamentary powers vested in each state grant each individual state government plenty of power, a state legislature using that power however it wants without regard to the Anglo-American heritage of rights is not acting traditionally (or justly).

    • #45
  16. Larry3435 Inactive
    Larry3435
    @Larry3435

    You know Manny, what I have observed about people who make your argument is that they always seem to assume that the people who will be passing the laws will be people who agree with their own ideas of “virtue.”  When the government starts imposing laws that you find morally reprehensible (say, for example, China’s one child policy), maybe you will come to appreciate the value of freedom.  Of course, by then it will be too late…

    • #46
  17. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    danok1:

    Midget Faded Rattlesnake: Heh, more fool you! Tramadol’s “abuse potential” now means it’s a controlled substance according to the DEA – Schedule IV as of August 18, 2014. Addict ;-)

    Yep, I know that. I just wish there were more pain relief for the “new hoops” we have to jump through.

    Understood :-) I hold out some hope for immune-modulating biologics, among others. Understanding pain is not easy.

    • #47
  18. Old Buckeye Inactive
    Old Buckeye
    @OldBuckeye

    This problem is more widespread than the NE. A friend of mine works at a Detroit-area library. The librarians have to patrol the restrooms in order to curtail the heroin users from shooting up there and/or leaving used needles. And a recent obit in my hometown paper (NW Ohio) showed a photo of a beautiful young woman in her 30s with the headline “Mother of 3 dies of heroin overdose.”

    • #48
  19. Front Seat Cat Member
    Front Seat Cat
    @FrontSeatCat

    This makes me so so angry!! 60 Minutes last Sunday featured a segment on drug overdoses and death from the heroin epidemic and said every town in US has been touched – a panel of parents who lost their kids had no idea. One 17 year old in recovery said out of boredom she started with weed (heads up to those proponents of legalizing for recreational purpose), progressed to cocaine and heroin – kids with sports injuries being prescribed opiates – I lived in Boston for over 20 years – beautiful, historic, quaint and now a drug epidemic.  Chef Anthony Bordain went back to his old NE town and did a segment on the heroin addiction there.

    You mentioned churches. There is a battle waging for children, the weak and mentally challenged. It’s physical, mental and spiritual – the Pope even approved an exorcism for Mexico, the whole country! –  since the war against the drug cartels has unleashed a massive wave of violence – their biggest drug customer? The U.S.

    I’m reading Patrick Kennedy’s book A Common Struggle – with drugs and mental illness – so much silent suffering – but he is doing great work in the private sector for it. Worth reading and supporting him….I think he would be a great resource for expanding this outreach to include drug addiction not related to mental illness.

    Too much needless suffering – we need to be vigilant for each other and the most vulnerable.  We can’t wait for gov. intervention and more statistics.

    • #49
  20. Fred Cole Inactive
    Fred Cole
    @FredCole

    Bryan G. Stephens:Addicts are not free, they are slaves.

    I advocate using the power of the state to coerce people into treatment for addiction at the point of a gun. I have seen it work time and time again to get people back to lives. They get their family ties back, they enter the community, they are productive.

    Saying “They have a right to be an addict” is saying that we are OK with their slavery to their drug.

    I am not advocating legislating morality. I am advocating forcing help on people who need it, and who have a brain that cannot seek help. I am for restoring their liberty.

    So what are the limits on this?  Would you use men with guns to lock up nicotine addicts?  What about people who are addicted to Oreos?

    • #50
  21. Fred Cole Inactive
    Fred Cole
    @FredCole

    Front Seat Cat:This makes me so so angry!! 60 Minutes last Sunday featured a segment on drug overdoses and death from the heroin epidemic and said every town in US has been touched – a panel of parents who lost their kids had no idea. One 17 year old in recovery said out of boredom she started with weed (heads up to those proponents of legalizing for recreational purpose), progressed to cocaine and heroin

    Question: Do you think we should make public policy based on sob stories?

    • #51
  22. Front Seat Cat Member
    Front Seat Cat
    @FrontSeatCat

    Fred – sob stories? Oreos? People are voting down legalizing pot in areas –  this is powerful, illegal drugs getting into our country, hooking kids – we’re losing the war on drugs –

    • #52
  23. Annefy Member
    Annefy
    @Annefy

    Fred Cole:

    Front Seat Cat:This makes me so so angry!! 60 Minutes last Sunday featured a segment on drug overdoses and death from the heroin epidemic and said every town in US has been touched – a panel of parents who lost their kids had no idea. One 17 year old in recovery said out of boredom she started with weed (heads up to those proponents of legalizing for recreational purpose), progressed to cocaine and heroin

    Question: Do you think we should make public policy based on sob stories?

    Good Lord Fred. You want public policy changed because of your own sob story.

    • #53
  24. Fred Cole Inactive
    Fred Cole
    @FredCole

    Merina Smith:I think that is perfectly reasonable, and I think it is perfectly reasonable to control substances that are addicting for the same reason.

    Of course that sounds perfectly reasonable.  It sounds like a clean little system where people get safe medicines that they need and dangerous stuff is kept out of their hands.  That’s not at all the system we have, nor is it anything that could be created by a government.

    What we have now is a system where I need a permission slip from someone to get certain chemicals.  But other chemicals, some of which are far more potent and potentially dangerous are sold over the counter.  And which is which is decided by politicians and bureaucrats with little regard to their potency or addictive properties.

    The result is that pain meds for terminal cancer patients are limited (so they don’t get addicted).  The result is that doctors recommend acupuncture for people in need of pain meds, because they don’t want to get branded by the state as pill pushers.  The result is that the privacy of the individual is violated when their prescriptions have to be registered with the state.

    You need and clean system can’t exist.  I hear conservatives talk over and over about how libertarians live in a fantasy land.  Well its the statist who live in a fantasy land where they think they can solve complex problem by using men with guns.

    • #54
  25. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Front Seat Cat:This makes me so so angry!! 60 Minutes last Sunday featured a segment on drug overdoses and death from the heroin epidemic and said every town in US has been touched – a panel of parents who lost their kids had no idea. One 17 year old in recovery said out of boredom

    Yes. Boredom. People do terrible things when they feel their lives are a boring waste. Drug abuse isn’t the only terrible thing. Even rats use narcotics more when they’re bored, apparently, and less when their little ratly lives are more fulfilling:

    [T]o provoke animals to self-administer cocaine (and most other drugs), they must be “trained” to do so. In order to maximize the dose and frequency of use, researchers tether animals to the cage and surgically implant a permanent injection apparatus in their backs. This unreachable catheter injects cocaine intravenously following operant behavior… Many researchers starve the rats before training begins because this increases the likelihood that animals will repeatedly inject cocaine.

    But just as humans are typically distracted from drug use by other pleasures and life commitments, so are animals…

    When animals are allowed to interact socially, their drug consumption also tends to decrease. In one series of studies, rats were trained to drink a morphine solution but then permitted access to an open area populated with other rats and scattered with objects for inspection and play. These opportunities for exercise, play, and socializing markedly decreased their consumption of morphine…

    • #55
  26. Larry3435 Inactive
    Larry3435
    @Larry3435

    Fred Cole:

    Merina Smith:I think that is perfectly reasonable, and I think it is perfectly reasonable to control substances that are addicting for the same reason.

    Of course that sounds perfectly reasonable. It sounds like a clean little system where people get safe medicines that they need and dangerous stuff is kept out of their hands. That’s not at all the system we have, nor is it anything that could be created by a government.

    What we have now is a system where I need a permission slip from someone to get certain chemicals. But other chemicals, some of which are far more potent and potentially dangerous are sold over the counter. And which is which is decided by politicians and bureaucrats with little regard to their potency or addictive properties.

    The result is that pain meds for terminal cancer patients are limited (so they don’t get addicted). The result is that doctors recommend acupuncture for people in need of pain meds, because they don’t want to get branded by the state as pill pushers. The result is that the privacy of the individual is violated when their prescriptions have to be registered with the state.

    You need and clean system can’t exist. I hear conservatives talk over and over about how libertarians live in a fantasy land. Well its the statist who live in a fantasy land where they think they can solve complex problem by using men with guns.

    ^This.

    • #56
  27. Fred Cole Inactive
    Fred Cole
    @FredCole

    Annefy:Good Lord Fred. You want public policy changed because of your own sob story.

    The difference is that I never use sob stories to try to take away someone else’s rights.

    • #57
  28. PsychLynne Inactive
    PsychLynne
    @PsychLynne

    Bryan G. Stephens:Addicts are not free, they are slaves.

    I advocate using the power of the state to coerce people into treatment for addiction at the point of a gun. I have seen it work time and time again to get people back to lives. They get their family ties back, they enter the community, they are productive.

    Saying “They have a right to be an addict” is saying that we are OK with their slavery to their drug.

    I am not advocating legislating morality. I am advocating forcing help on people who need it, and who have a brain that cannot seek help. I am for restoring their liberty

    To Bryan’s excellent point, addicts are slaves, they often do not possess what would be considered legal decision-making capacity.  Yes, some of their decisions are bone-headed and stupid and unwise, but at other times they show clear impairment in decision-making that makes them an imminent danger to themselves or others.  Happy to use my license to commit them for a 72 hours eval when they meet criteria.

    Fred Cole:

    So what are the limits on this?

    There are already a significant number of limits, not the least of which is the need for danger to be “imminent.”  And the limitation of the hold for 72 hours.

    • #58
  29. Annefy Member
    Annefy
    @Annefy

    Fred Cole:

    Annefy:Good Lord Fred. You want public policy changed because of your own sob story.

    The difference is that I never use sob stories to try to take away someone else’s rights.

    And this is where it gets squidgy. Because as a parent I resent mightily having had to do battle daily the attitude that anyone has the right to do anything they want, as long as they’re willing to suffer the consequences.

    Because it’s not just the imbiber who pays the price.

    My right as a parent was constantly under assault. I’ll spare you the sob story.

    • #59
  30. PsychLynne Inactive
    PsychLynne
    @PsychLynne

    Fred Cole:

    Annefy:Good Lord Fred. You want public policy changed because of your own sob story.

    The difference is that I never use sob stories to try to take away someone else’s rights.

    Just to note, everyone has a sob story.  And to pretend it doesn’t affect our views is our tendency, but it does.

    Annefy, earlier you mentioned something about not making a big deal if your kids smoked.  I think the evidence on smoking says yournot only significantly raise your risk of lung cancer, but also other significant diseases of the cardiac and pulmonary systems.  But my guess is, if I asked you about this, I wouldn’t get an epidemiological argument, I get a view supported by a collection of stories.

    Because we’re humans and that’s what we do.  Our brains are wired to over-value evidence that supports our arguments.

    Having said all this, I come back to Bryan’s early comment–there is a rich discussion to be had about options and successes and distilling the argument down to legalization and philosophies deprives us of thinking about ways to minimize the damage and work towards solving the problems of people in pain and in the throes of addiction.

    So, here’s  a question for Bryan and others–if you were designing the kind of addiction services you wanted…what would you do?  where is the biggest bang for the buck? what about first-timers versus long-time addicts?

    • #60
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