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. Fred Cole Inactive
    Fred Cole
    @FredCole

    Annefy: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.

    I understand.  Freedom has consequences, not all of which are awesome all the time.

    However, freedom produces better results than the alternative.

    • #61
  2. Annefy Member
    Annefy
    @Annefy

    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.

    SNIP

    No, you wouldn’t get a collection of stories. I know full well the dangers. I also know that the vast majority of young people who smoke eventually quit.

    I also know that smoking will maybe shorten your life, but it’s certainly not going to ruin your life. It’s not going to threaten a career or being a good spouse or parent.

    I remember the comment I made but I don’t remember the context, so I’m not sure if I was clear. Maybe about self-medication? Point being if my kids are going to self medicate or just pick up a bad habit, I’ve got a lot more destructive things to worry about than smoking a cigarette.

    • #62
  3. Annefy Member
    Annefy
    @Annefy

    Fred Cole:

    Annefy: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.

    I understand. Freedom has consequences, not all of which are awesome all the time.

    However, freedom produces better results than the alternative.

    Agreed. But you should also agree – or at least recognize – that when we are talking about young people, we are dealing with brains that haven’t fully developed. Brains that are at risk of permanent damage, and lives that can be destroyed because they were unable to fully weigh the consequences of their decisions.

    And as mentioned, it’s not just the owner of that brain that pays the price. Families and loved ones. Society loses – who knows the cost of so much lost potential?

    I don’t have the answer.

    • #63
  4. Fred Cole Inactive
    Fred Cole
    @FredCole

    Annefy:

    Fred Cole:

    Annefy: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.

    I understand. Freedom has consequences, not all of which are awesome all the time.

    However, freedom produces better results than the alternative.

    Agreed. But you should also agree – or at least recognize – that when we are talking about young people, we are dealing with brains that haven’t fully developed. Brains that are at risk of permanent damage, and lives that can be destroyed because they were unable to fully weigh the consequences of their decisions.

    I agree with you 100%.  We should have different rules for minor children.  But adults shouldn’t have to be treated like children.  I shouldn’t be forbidden steak because a baby can’t chew it.

    • #64
  5. Fred Cole Inactive
    Fred Cole
    @FredCole

    Annefy:I also know that smoking will maybe shorten your life, but it’s certainly not going to ruin your life. It’s not going to threaten a career or being a good spouse or parent.

    Are you serious?  Every cigarette takes seven minutes off your life.  It can be the difference between dying at 62 and dying at 92.  And it’s a horrible way to go.

    Neither is quitting smoking as easy as you seem to think it is.  No.  You should really be concerned about your kids smoking.  It’s a horrible, disgusting, expensive, and highly addictive.

    As far as ruining your life, cigarettes here cost north of 10 bucks a pack.  If you smoke a pack a day, that’s 300 dollars a month.  That’s a car payment.  Do you know what I could do with $300 a month?

    • #65
  6. J. D. Fitzpatrick Member
    J. D. Fitzpatrick
    @JDFitzpatrick

    What I’m curious about is how, historically, the ruin of lives due to alcohol addiction compares with the ruin of lives nowadays thanks to other forms of addiction.

    IIRC, in the Teaching Company Course The History of the US Economy in the 20th Century), the professor says that Americans drank four times as much in 1900 as they did in 2000. But I noted that other forms of addiction (hard drugs, yes, but also electronic addictions) have developed since then and wondered if we could call the reduction in alcohol consumption much of a triumph.

    What I’m wondering is this: is the rate of lives ruined by addictive behavior relatively constant? In other words, is there little that we as a society can do to save people from their appetites?

    • #66
  7. J. D. Fitzpatrick Member
    J. D. Fitzpatrick
    @JDFitzpatrick

    Fred Cole: As far as ruining your life, cigarettes here cost north of 10 bucks a pack.  If you smoke a pack a day, that’s 300 dollars a month.  That’s a car payment.  Do you know what I could do with $300 a month?

    I bite my tongue, Libertarian. :)

    • #67
  8. Kate Braestrup Member
    Kate Braestrup
    @GrannyDude

    PsychLynne: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?

    I have a young friend who, after making a real mess of himself and his life, finally ended up in the care of the Massachusetts Criminal Justice System. And lo-and-behold, I think this may have saved his life (it’s one of those intensive probation regimens, with swift consequences for screwing up).

    When it came to my own kids, I tried to meet relatively low-level, initial transgressions (of any kind, not just drugs/alcohol) with as big a parental smack-down as I could muster. Not always easy, being a widowed mother of four, but I did my best, and it worked at least to the extent that, knock wood, none of the kids are addicted to anything, and they’re all good citizens. (This can change, I know, hence the wood-knocking).

    So I think my suggestion would be that we have a system that reacts (even over-reacts) early rather than waiting for a “real” problem to manifest itself. Ideally, kids who screw up get caught while they are still kids, and the real-life consequences aren’t quite as severe.

    I would also lower the drinking age. Paradoxically, I think it drives college-age drinking underground without discouraging it much at all. And it forces colleges administrations, police departments, restaurant personnel, bartenders and parents to waste time and energy enforcing (ineptly) a law that many if not most are going to break. Far better to have adults engage in adult behavior openly, where wiser souls can monitor and mentor the young.

    I also think we need long-term mental institutions. These could be designed the way nursing homes now are, with appropriate supervision and care offered for varying levels of disability. (Hey—we institutionalize the elderly don’t we, and people with M.S. and Parkinsons, spinal cord injuries?)

    Some people might have to live in “assisted living” their whole lives, but with help, these could nonetheless be good, happy and reasonably productive, even “free”  lives.

    • #68
  9. Midget Faded Rattlesnake Contributor
    Midget Faded Rattlesnake
    @Midge

    PsychLynne: So… 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?

    I… don’t know. How much do we really understand addiction, anyhow?

    Both Barkha and I have mentioned that you don’t even need to be human to find that a fulfilling life combats addiction – even rats experience the same thing.

    There isn’t a magic way, though, to give someone leading an unfulfilling life a more fulfilling life. Discovering a more fulfilling life takes individual motivation – and sometimes, a whole lotta patience when the first (or second… or hundredth…) self-improvement strategy attempted fails to work as advertised.

    I suspect that correcting dysfunction and self-destruction matters more than stopping use of any particular drug. Whether a person confines himself to his bed all day because he’s high or because he is so depressed (but completely sober!) that he thinks of himself as too worthless to do anything worthwhile, he’s not functioning either way. And if he’s confined to bed all day because of untreated physical pain, he’s also not functioning.

    (And it’s possible to develop very self-destructive habits that involve neither sex nor drugs nor rock’n’roll.)

    How do you get people to see themselves as something better than a useless burden – especially when a series of bad choices or unfortunate events means they’ve effectively become burdens?

    • #69
  10. Annefy Member
    Annefy
    @Annefy

    Fred Cole:

    Annefy:I also know that smoking will maybe shorten your life, but it’s certainly not going to ruin your life. It’s not going to threaten a career or being a good spouse or parent.

    Are you serious? Every cigarette takes seven minutes off your life. It can be the difference between dying at 62 and dying at 92. And it’s a horrible way to go.

    Neither is quitting smoking as easy as you seem to think it is. No. You should really be concerned about your kids smoking. It’s a horrible, disgusting, expensive, and highly addictive.

    As far as ruining your life, cigarettes here cost north of 10 bucks a pack. If you smoke a pack a day, that’s 300 dollars a month. That’s a car payment. Do you know what I could do with $300 a month?

    CAN be the difference.

    As someone who quit smoking, just who do you think you are lecturing about how difficult it is to quit? And as someone who nursed her father through lung cancer, and held his hand while he died, just who in the hell do you think you’re talking to?

    Regarding cost, the same can be said for stamp collecting.

    Horrible? Expensive? Disgusting?

    Our sob stories about drug abuse are met with a shrug from you because liberty. But because of your own sob story I’m told to be very concerned about smoking? Libertarian much, Fred?

    • #70
  11. Merina Smith Inactive
    Merina Smith
    @MerinaSmith

    Fred Cole:

    Annefy: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.

    I understand. Freedom has consequences, not all of which are awesome all the time.

    However, freedom produces better results than the alternative.

    Obviously you are not a parent.

    • #71
  12. Zafar Member
    Zafar
    @Zafar

    There’s this book Chasing the Scream which addresses this very issue.

    And I think it is worth looking at what drives this issue.  It’s not the availability of drugs, it’s the desire to use them.

    What drives that desire?

    Yes, rat-town is a helpful insight, but it’s pretty confronting when what we see as a good environment doesn’t give that to those we love – either we blame the drugs or we face our own failure and do something about it. jmho.

    • #72
  13. Merina Smith Inactive
    Merina Smith
    @MerinaSmith

    anonymous:

    Merina Smith: 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.

    Certainly I oppose them, because I believe in the separation of medicine and state. I believe in the principle of self-ownership, and reject the idea that I require permission from somebody licensed by the state to treat any condition I have in any means I choose, after consultation with resources I wish to consult, in the manner I decide is best. Many people will want to rely upon the advice of a single licensed physician, while others will want to do their own research or explore experimental therapies. We’ll never know how many people have died because FDA approval of therapies was delayed which could have saved them.

    I also reject state licensing of physicians. Let physicians be certified by medical guilds and post their certifications for patients to see. Given that states certify physicians who murder viable babies in the womb, I have no confidence whatsoever in the validity of state certification in the interest of patients.

    I also note that the statistics cited about this “opoid medical crisis” fail, deliberately I believe, to distinguish deaths due to prescribed medication and drugs such as heroin which have been banned. Every time the screw is turned tighter on legitimate use of painkillers, those excluded will be motivated to turn to alternatives which have been prohibited, which vary from batch to batch in potency and increase the risk of a lethal overdose.

    I’d trust you would use medications correctly, John, because you are a smart scientist.  I wouldn’t trust me, though, because I am not a scientist.  I want doctors to help me out in knowing what I should take for what problem.  I like it when dangerous drugs are illegal because that tells me they are dangerous.  Maybe it’s not a completely accurate method, but it helps.  In general, I take as few meds as possible, and rely on doctors to help me know when to take them.  I don’t think that makes me an unfree person–we all rely on other people for all kinds of things.

    I agree that licensing is somewhat over the top. OTOH, there are problems with guilds policing themselves….

    Fred, of course it is a complicated world.  The ways of approving drugs for OTC or not are also complicated and imperfect.  Welcome to life.  Maybe the system needs to be reformed, but humans need guidelines and roadmaps in order to know how to live.  Many of these customs and traditions–law among them–are part of that roadmap. Can it be overdone? Sure.  Is it always bad?  No.  Every individual can’t reinvent the wheel.  You seem to think that unless every person makes every decision for him or her self, we are oppressed by tyranny.

    • #73
  14. Merina Smith Inactive
    Merina Smith
    @MerinaSmith

    Zafar:There’s this book Chasing the Scream which addresses this very issue.

    And I think it is worth looking at what drives this issue. It’s not the availability of drugs, it’s the desire to use them.

    What drives that desire?

    Yes, rat-town is a helpful insight, but it’s pretty confronting when what we see as a good environment doesn’t give that to those we love – either we blame the drugs or we face our own failure and do something about it. jmho.

    I read the blurb about the book, Zafar, and am thinking about buying it, but when I looked at the endorsements–that’s not a bunch of people I trust!!!!!  Might read it still, but I wish there were some names of people whose opinions I value in the list!

    • #74
  15. Zafar Member
    Zafar
    @Zafar

    Merina Smith:

    Zafar:There’s this book Chasing the Scream which addresses this very issue.

    And I think it is worth looking at what drives this issue. It’s not the availability of drugs, it’s the desire to use them.

    What drives that desire?

    Yes, rat-town is a helpful insight, but it’s pretty confronting when what we see as a good environment doesn’t give that to those we love – either we blame the drugs or we face our own failure and do something about it. jmho.

    I read the blurb about the book, Zafar, and am thinking about buying it, but when I looked at the endorsements–that’s not a bunch of people I trust!!!!! Might read it still, but I wish there were some names of people whose opinions I value in the list!

    I know – Elton John, right?  But if you want people who have real experience of addiction themselves, who would really be best placed to comment on this aspect of it, then that limits your options.

    • #75
  16. Fred Cole Inactive
    Fred Cole
    @FredCole

    Merina Smith:I’d trust you would use medications correctly, John, because you are a smart scientist. I wouldn’t trust me, though, because I am not a scientist. I want doctors to help me out in knowing what I should take for what problem.

    A couple of things here:

    First, it’s not freakin’ rocket science.  We’re not talking about operating an MRI machine here.  It’s just popping pills.  There are instructions on the side that tell you how much to take.  And if all else fails: Google.

    Second, nobody’s saying you shouldn’t go to your doctor and discuss things.  Go to your doctor.  The objection isn’t to the doctor or the pharmacist, it’s to a third party getting involved and imposing outside restrictions on people.

    • #76
  17. Fred Cole Inactive
    Fred Cole
    @FredCole

    Merina Smith:Fred, of course it is a complicated world. The ways of approving drugs for OTC or not are also complicated and imperfect. Welcome to life. Maybe the system needs to be reformed, but humans need guidelines and roadmaps in order to know how to live.

    I’m not against roadmaps, whatever you and your doctor decide should be between you.  But I’m against trusting the wisdom of the government.  The government isn’t wise.  It doesn’t make good or even rational decisions.  It’s just whoever manages to win elections jamming their preferences down everyone’s throats.

    There’s no standard for what’s over the counter.  Controlled meds in NY are different from ones in Massachusetts.  If I drive to Canada, I can buy Tylenol with codeine over the counter.  In NY, I need a script.  Alcohol, nicotine, and Tylenol are all very powerful drugs, with serious health consequences if they’re over consumed, yet they’re all available otc.

    It’s all arbitrary.  There’s no rational system.  It’s just whatever statist busybodies can manage to control.

    • #77
  18. Fred Cole Inactive
    Fred Cole
    @FredCole

    Annefy:As someone who quit smoking, just who do you think you are lecturing about how difficult it is to quit? And as someone who nursed her father through lung cancer, and held his hand while he died, just who in the hell do you think you’re talking to?

    You tell me.  You’re the one with the caviler attitude about cigarettes.  We’re talking about something that is expensive, highly addictive, that causes serious health damage.  You were able to handle your addiction and get past it.  Awesome.  I like when people can overcome addiction.

    So what makes nicotine different from other drugs?  Why restrict them and not nicotine?

    By the way, just so everybody’s clear, despite the potential for addiction, and the horrible health consequences associated, I’m not advocating a ban.  Why?  Because I don’t believe in using force to rule other people and I don’t believe in meddling in other people’s affairs.

    • #78
  19. Annefy Member
    Annefy
    @Annefy

    Fred Cole:

    Annefy:As someone who quit smoking, just who do you think you are lecturing about how difficult it is to quit? And as someone who nursed her father through lung cancer, and held his hand while he died, just who in the hell do you think you’re talking to?

    You tell me. You’re the one with the caviler attitude about cigarettes. We’re talking about something that is expensive, highly addictive, that causes serious health damage. You were able to handle your addiction and get past it. Awesome. I like when people can overcome addiction.

    So what makes nicotine different from other drugs? Why restrict them and not nicotine?

    By the way, just so everybody’s clear, despite the potential for addiction, and the horrible health consequences associated, I’m not advocating a ban. Why? Because I don’t believe in using force to rule other people and I don’t believe in meddling in other people’s affairs.

    First of all, no one on this thread has talked about banning drugs, just like you haven’t talked about banning cigarettes.

    Nicotine is indeed highly addictive. So what? As I said in my original comment, smoking will not prevent you from functioning to your God-given ability, nor will it impede in the slightest your ability to be a good friend, a good spouse, a good parent.

    If only we could say that about all addictive substances. And even some non addictive ones.

    • #79
  20. Annefy Member
    Annefy
    @Annefy

    BTW, I’m also very cavalier about my friends who are obese, knowing full well the long-term health consequences.

    I’m also cavalier with my friends who ride motorcycles and engage in dangerous hobbies.

    I stop getting cavalier when I see young people unable to function to their God-given potential because they are smoking pot or dabbling in more dangerous drugs. And seeing the impact it has on their families.

    I’ve said over and over I don’t have an answer. But to choose my nephew smoking a cigarette vs trying to have a conversation with him when he’s high? I’ll take the first every time.

    My daughter getting arrested for pot was probably the best thing that ever happened to her. It was the worst thing for a friend of hers, whose 6 month sentence ended up being a 3 year sentence.

    Notice I am not advocating for anything. It’s a complicated issue with different solutions for everyone. And sometimes, unfortunately, there’s no solution.

    Edit: But I seek no solution for the people in my life who smoke. To some extent I am sure they are self-medicating. Could be worse.

    • #80
  21. Fred Cole Inactive
    Fred Cole
    @FredCole

    Annefy:Nicotine is indeed highly addictive. So what? As I said in my original comment, smoking will not prevent you from functioning to your God-given ability, nor will it impede in the slightest your ability to be a good friend, a good spouse, a good parent.

    A couple of things:

    1. It very much can impede your life.  It’s subtle, but it absolutely can.  The obvious way is its health impacts, but there are social impacts.

    2. Smoking can impact your children depending on whether you smoke in front of them.

    3. I read somewhere above that all addicts are slaves.  Addiction seems to be our standard for controlling things.

    • #81
  22. Annefy Member
    Annefy
    @Annefy

    Fred Cole:

    Annefy:Nicotine is indeed highly addictive. So what? As I said in my original comment, smoking will not prevent you from functioning to your God-given ability, nor will it impede in the slightest your ability to be a good friend, a good spouse, a good parent.

    A couple of things:

    1. It very much can impede your life. It’s subtle, but it absolutely can. The obvious way is its health impacts, but there are social impacts.

    2. Smoking can impact your children depending on whether you smoke in front of them.

    3. I read somewhere above that all addicts are slaves. Addiction seems to be our standard for controlling things.

    1. So you don’t smoke in front of anyone.
    2. ditto
    3. I’ll remember that when I make my second pot of coffee tomorrow.

    Not all addictions are created equal.

    • #82
  23. Larry3435 Member
    Larry3435
    @Larry3435

    Fred Cole:As far as ruining your life, cigarettes here cost north of 10 bucks a pack. If you smoke a pack a day, that’s 300 dollars a month. That’s a car payment. Do you know what I could do with $300 a month?

    Well, I guess you could smoke a pack a day.

    By the way, where is “here”?  Ten dollars a pack?  Really?  Do you live in the White House, or what?

    • #83
  24. Larry3435 Member
    Larry3435
    @Larry3435

    Merina Smith:

    Fred Cole:

    Annefy: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.

    I understand. Freedom has consequences, not all of which are awesome all the time.

    However, freedom produces better results than the alternative.

    Obviously you are not a parent.

    Eventually, parents find themselves to be the parents of adult children.  Adult children.  Who do not benefit from being treated as children.

    • #84
  25. PsychLynne Inactive
    PsychLynne
    @PsychLynne

    Kate Braestrup:

    PsychLynne: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?

    I have a young friend who, after making a real mess of himself and his life, finally ended up in the care of the Massachusetts Criminal Justice System. And lo-and-behold, I think this may have saved his life (it’s one of those intensive probation regimens, with swift consequences for screwing up).

    So I think my suggestion would be that we have a system that reacts (even over-reacts) early rather than waiting for a “real” problem to manifest itself. Ideally, kids who screw up get caught while they are still kids, and the real-life consequences aren’t quite as severe.

    I would also lower the drinking age.

    I also think we need long-term mental institutions.

    Some people might have to live in “assisted living” their whole lives, but with help, these could nonetheless be good, happy and reasonably productive, even “free” lives.

    I think you raise some interesting ideas, Kate.  Especially the last example on “assisted living”  a semi-structured environment, maybe with some link to the legal system?

    • #85
  26. PsychLynne Inactive
    PsychLynne
    @PsychLynne

    Midget Faded Rattlesnake:

    PsychLynne: So… 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?

    I… don’t know.

    Yeah….me either….

    I suspect that correcting dysfunction and self-destruction matters more than stopping use of any particular drug…

    How do you get people to see themselves as something better than a useless burden – especially when a series of bad choices or unfortunate events means they’ve effectively become burdens?

    I really like your last question.  there’s a song from the 90s by Russ Taff (gospel/Christian singer) called Healing Touch, it has a line that says “the loving truth is a painful touch, when guilt is all you feel.”

    I think that guilt of having to help them, not being able to do it themselves, impedes a lot of people when they try to mend bad behaviors that lead to burdening others.

    • #86
  27. Merina Smith Inactive
    Merina Smith
    @MerinaSmith

    Larry3435:

    Merina Smith:

    Fred Cole:

    Annefy: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.

    I understand. Freedom has consequences, not all of which are awesome all the time.

    However, freedom produces better results than the alternative.

    Obviously you are not a parent.

    Eventually, parents find themselves to be the parents of adult children. Adult children. Who do not benefit from being treated as children.

    But before that, they are children.  There are always children in the world, and we need to fashion the world to some degree to deal with this reality.  That means it cannot be a libertarian nirvana.

    • #87
  28. Fred Cole Inactive
    Fred Cole
    @FredCole

    Merina Smith:But before that, they are children. There are always children in the world, and we need to fashion the world to some degree to deal with this reality. That means it cannot be a libertarian nirvana.

    So because children exist, all adults need to be treated like children?

    • #88
  29. Fake John Galt Coolidge
    Fake John Galt
    @FakeJohnJaneGalt

    Fred Cole:

    Merina Smith:But before that, they are children. There are always children in the world, and we need to fashion the world to some degree to deal with this reality. That means it cannot be a libertarian nirvana.

    So because children exist, all adults need to be treated like children?

    Yes and those that need these type of drugs have to be treated like criminals and maybe not be able to get them.  Will definitely cost them more money, time, inconvenience to get the medicines they need.  Just because some people have children that they can not seem to steer clear of these type of drugs.

    • #89
  30. Annefy Member
    Annefy
    @Annefy

    PsychLynne:

    Kate Braestrup:

    PsychLynne: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?

    I have a young friend who, after making a real mess of himself and his life, finally ended up in the care of the Massachusetts Criminal Justice System. And lo-and-behold, I think this may have saved his life (it’s one of those intensive probation regimens, with swift consequences for screwing up).

    -snip –

    I also think we need long-term mental institutions.

    Some people might have to live in “assisted living” their whole lives, but with help, these could nonetheless be good, happy and reasonably productive, even “free” lives.

    I think you raise some interesting ideas, Kate. Especially the last example on “assisted living” a semi-structured environment, maybe with some link to the legal system?

    There are already assisted living accommodations like you describe available. I know two ex-addicts who have lived in such a facility. They were both impaired mentally and physically after years of chronic alcohol and marijuana abuse.

    One has since passed; he died at around the age of 55. The other is probably about 60 and has lived in the facility for 10 years. He was indigent and his family has limited resources, so I assume Medicaid or something like it is picking up the tab.

    • #90
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