Addiction, Homelessness, and Healthcare

 

I’m really tired today after coming off of working three days in a row. That may not seem like a lot to the regular work-a-day folks, but when you’re in healthcare, the hours are often long and arduous. I’ve worked about 40 hours in the past three days, and I work in a busy Emergency Department in Portland, OR. Every day that I worked, the ED was on divert — meaning ambulances were directed to not come to us because we were so busy.

When I left work last night, there were 30 patients in the waiting room. Many had been waiting three to five hours just to be put in a room; the wait time to see a physician after being roomed was even longer. Staff scurried about looking haggard, pulled in a million directions. At one point I counted 17 patients in the department that had been admitted to inpatient services waiting for a bed, but since the hospital was full they continued to board in the ED. Multiple patients were there with mental health crises that had landed them with psych holds.

Over the past week, many of the patients I cared for were in the hospital because of drug abuse — usually heroin and meth — or mental health or some combination thereof. Most of those patients were also homeless. Another nurse’s patient was put up for discharge back to the streets after she faked an illness in order to come in and sleep indoors, and as I walked by the open door of her room I saw her rummage through the cabinets, stuffing her patient belongings bags full of hospital supplies. She asked me for a fourth cup of coffee and a third boxed lunch when I pulled the hospital pillow out of her bag and told her that she can’t steal supplies from the hospital and she needed to leave. “I just need another cup of coffee, man! I spilled my last one. I need coffee with like four sugars and six creamers.” I told her it was time to leave.

Another homeless guy on heroin came in with some respiratory complaint and was kept overnight for observation. When the provider went to discharge him, he claimed he was going to go kill himself once he left. Social workers were called to talk to him about mental health resources in the community — it was pretty clear he did not actually have any suicidal ideation — but he threatened to jump off a bridge if we discharged him. He ended up staying four days in the ED between his stay for observation and the time it took to arrange his admission to the psych hospital.

Earlier last week, a patient came in for treatment of her abscesses due to daily heroin use. She said she really wanted to get clean, and she was worried that she couldn’t get into rehab if she had an infection. This was one of many admissions to our ED. Multiple times she tried to leave the department (IV in place) to “go to the cafeteria” and the “gift shop.” When she was told that wasn’t allowed, she started yelling and swearing at us, as though we were abusing her. Her son and his friend came to visit, bearing a Pop Tarts box. Another nurse noted some suspicious activity, and when she went in to investigate, the patient was drawing up heroin into a syringe her son had brought. She tried to say she had changed her mind and wasn’t going to shoot up after all, but when the nurse said that she would be calling public safety, the patient stuck the needle into her arm, making eye contact with the nurse the whole time. She then ripped out her IV and told her son they needed to get out of there now.

These are just a couple stories from all that I dealt with this weekend. I estimate about 33-40 percent of the patients I see are drug addicts, homeless, and have serious mental health problems. Injection is the most common way of using, which leads to all sorts of health problems that send people running to the ED for help. Many of these patients present to the ED over and over again with the same infections. IVs have to be placed using ultrasound because even the most experienced ED nurses can’t get a line because the patient’s veins are so sclerosed.

After about 24 hours since they last used, they go from cooperative and apathetic to antsy and abusive as they start jonesing for their substance of choice. I am constantly yelled at for not treating their pain, for letting them suffer, thinking that the hospital should be providing enough oxycodone to satisfy their two or three gram a day habit. Often these people have a “family emergency,” leave against medical advice, or just leave while no one is looking. Our social workers work tirelessly to help people get off the streets and into rehab. I cannot tell you how many times I have had patients decline placement in a shelter in favor of being on the streets. Much of transitional housing has high vacancy rates because of the no drugs and no drinking stipulation.

Walking in downtown Portland is not safe. I personally know two people that have been stabbed by homeless guys on the street with no provocation. A man was arrested for a stabbing after he said that his wife, Taylor Swift, told him to kill the guy that happened to walk by. Tent cities are everywhere, and one cannot drive through downtown without seeing shopping cart after shopping cart being pushed by someone mumbling to themselves.

There is a big call for legalization of drugs by the left and the libertarians. But how does that work? If we legalize drugs, making them easy to obtain and removing the stigma, how will that decrease the number of people coming to the ED with MRSA abscesses and endocarditis? While I agree that people have the right to make their own choices in life, how do we handle the stress placed on the country by these addicts? This patient population rarely has health insurance, or if they do it’s Medicaid, and they rack up tremendous hospital bills for their 48-hour stay in the ED to get treatment for their infections. The taxpayer pays for it any which way.

While decriminalizing drugs might save money from the prisons, courts, and police, it does up the cost of healthcare. We cannot turn patients away from treatment. There is no “three strikes and you’re out” policy in the hospital that allows us to tell a patient that we’ve already treated them three times before for injection-related infections so we can’t treat them again. Hospitals, nurses, and doctors would be sued six ways to Sunday if we did.

I’m all for individual freedoms, but I cannot see how legalizing drugs will do anything but hurt our society.

There are 173 comments.

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  1. RightAngles Member

    Good grief. They should have you testify in Congress.

    • #1
    • January 9, 2018, at 2:38 PM PDT
    • 14 likes
  2. C. U. Douglas Thatcher

    Unfortunately this is compounded with Portland’s homeless problem that’s escalated rapidly after two decades of being overly permissive — treating homelessness as a lifestyle choice and not a problem. And another factor is our country’s seriously broken infrastructure for dealing with the seriously mentally ill who tend to self-medicate (as discussed in Insane Consequences by DJ Jaffe).

    I’ve mostly remained ambivalent about the drug legalization: I can see how some methods of enforcement in the War on Drugs leads to abuse, but drugs such as meth and heroin cause more problems for those around the abuser. They won’t just disappear when drugs turn legal, and it won’t solve the problem of addiction.

    • #2
    • January 9, 2018, at 2:41 PM PDT
    • 12 likes
  3. Vicryl Contessa Thatcher
    Vicryl Contessa Post author

    RightAngles (View Comment):
    Good grief. They should have you testify in Congress.

    I feel like that wouldn’t go over well. I’m far less eloquent in real life.

    • #3
    • January 9, 2018, at 2:43 PM PDT
    • 10 likes
  4. Front Seat Cat Member

    I can hardly type through the tears. There are hardly words after what I just read. VC – what is the solution here? I did a post on not legalizing marijuana, but there is a much bigger picture that has gotten much worse during Obama. Was it this bad 9 years ago? I see a mental health crisis, a drug crisis, a homelessness crisis, a healthcare crisis, a health insurance crisis, a healthcare provider crisis, a mental health crisis, rolled into a super-volcanic eruption in American society, that shows a society unable to cope with the Pandora’s Box of problems we have allowed to get worse and worse.

    During Bush’s years, I think it was better – there was encouragement for more faith-based help for broken people – an acknowledgement that the government cannot do it all, and doesn’t do it that well. It doesn’t seem that Obamacare has solved these ills, by allowing illegal drugs and gangs into the country, or demonizing police officers, or not addressing the homeless crisis.

    What kind of changes do you and your fellow healthcare providers need, from the government, society, and locally? I am sad to read that Portland has this problem, because I know it is a snapshot of every town. PS God bless what you have chosen to do for a living.

    • #4
    • January 9, 2018, at 2:50 PM PDT
    • 12 likes
  5. Bryan G. Stephens Thatcher

    You are singing from my playbook VC! The last thing America needs is more addicts. Making all drugs legal will lead to more people trying them and more addicts. I am amazed that the same people that go on about how much damage alcohol causes, “and it’s legal” cannot understand it when I go: Yes. It is legal. Alcohol is not extra bad, it is extra used.

    Homelessness and Mental Illness and Substance Abuse are tied together. We are not addressing any of this today in our society in any serious way. Homelessness is not caused by lack of affordable housing. It is caused because people cannot engage in the behaviors that will keep them housed. Drugs and Mental Illness are the chief reasons for this.

    Libertarians have no real answer for either, because they refuse to acknowledge that addicts and the mentally ill are no longer rational actors. Taking a “that is what they have coming” attitude will not help. They will continue to exist, and we will pay for them. Now, I suppose libertarians would be all for telling and ED that it can turn people away. One more reason that sorry political approach should be shunned. Our society has the resources to address these issues if we choose, but we don’t. Neither party cares. The middle class only cares when it effects them.

    VC, you are on the front lines still, fighting a battle I spent my life on until I was unceremoniously kicked to the curb by a system as dysfunctional as the people I was trying to help. I am going to my first NAMI Cobb Board meeting tonight. I was asked to serve on the board to add some professional expertise to it, so I am still in the fight in a way. God bless the work you are doing.

    And get your hugs from hubby.

    • #5
    • January 9, 2018, at 2:52 PM PDT
    • 22 likes
  6. DocJay Inactive

    Vicryl Contessa (View Comment):

    RightAngles (View Comment):
    Good grief. They should have you testify in Congress.

    I feel like that wouldn’t go over well. I’m far less eloquent in real life.

    Hell, most of our politicians are hepped up on something anyway.

    I don’t know what the answers are for drugs but we can either fill our hospitals or our prisons with the serious abusers.

    I feel for you VC, dealing with the dregs of society is exasperating and heart wrenching. Some days it’s astounding what they make you give.

    • #6
    • January 9, 2018, at 2:53 PM PDT
    • 13 likes
  7. RightAngles Member

    Front Seat Cat (View Comment):
    Was it this bad 9 years ago? I see a mental health crisis, a drug crisis, a homelessness crisis,

    One of the most damaging things the liberals have done is removing the stigma from homelessness (and unwed mothers and on and on) in their misguided “compassion.” When I was little, we called them “bums.” Social stigmas perform a vital function in any society, and removing the stigma from a bad behavior does nobody any favors. When you remove the stigma from it, you get more of it.

    • #7
    • January 9, 2018, at 2:53 PM PDT
    • 21 likes
  8. Vicryl Contessa Thatcher
    Vicryl Contessa Post author

    Front Seat Cat (View Comment):
    I can hardly type through the tears. There are hardly words after what I just read. VC – what is the solution here? I did a post on not legalizing marijuana, but there is a much bigger picture that has gotten much worse during Obama. Was it this bad 9 years ago? I see a mental health crisis, a drug crisis, a homelessness crisis, a healthcare crisis, a health insurance crisis, a healthcare provider crisis, a mental health crisis, rolled into a super-volcanic eruption in American society, that shows a society unable to cope with the Pandora’s Box of problems we have allowed to get worse and worse.

    During Bush’s years, I think it was better – there was encouragement for more faith-based help for broken people – an acknowledgement that the government cannot do it all, and doesn’t do it that well. It doesn’t seem that Obamacare has solved these ills, by allowing illegal drugs and gangs into the country, or demonizing police officers, or not addressing the homeless crisis.

    What kind of changes do you and your fellow healthcare providers need, from the government, society, and locally? I am sad to read that Portland has this problem, because I know it is a snapshot of every town. PS God bless what you have chosen to do for a living.

    I don’t think Portland is a snapshot of every town. I think Portland is way worse. I’ve had several homeless patients tell me they just moved here because Portland has such rich resources.

    • #8
    • January 9, 2018, at 2:57 PM PDT
    • 18 likes
  9. The (apathetic) King Prawn Inactive

    Vicryl Contessa: how do we handle the stress placed on the country by these addicts?

    The heartless conservative in me says let them suffer the consequences of their own choices, but that means death, so it’s a no-go.

    Vicryl Contessa: I’m all about individual freedoms

    I wonder how much of your freedom is countermanded when your skills are conscripted by the state to repeatedly treat the same people.

    • #9
    • January 9, 2018, at 3:01 PM PDT
    • 15 likes
  10. C. U. Douglas Thatcher

    RightAngles (View Comment):

    Front Seat Cat (View Comment):
    Was it this bad 9 years ago? I see a mental health crisis, a drug crisis, a homelessness crisis,

    One of the most damaging things the liberals have done is removing the stigma from homelessness (and unwed mothers and on and on) in their misguided “compassion.” When I was little, we called them “bums.” Social stigmas perform a vital function in any society, and removing the stigma from a bad behavior does nobody any favors. When you remove the stigma from it, you get more of it.

    Portland has “Compassion” in spades from the creation of Dignity Village, where the city gave land to the homeless to camp out at and self-govern. This has only gotten worse and now little homeless camps are all over several public grounds. In our last visit we passed through the city and there were several tent camps along the road I used to take to get to work. They weren’t there three years ago.

    Portland’s overly-permissive attitude towards homelessness is creating more problems on a nigh-exponential basis. If the city reversed itself and tried not to pretend the homeless are just harmless permanent campers — and actually treated their police force with some respect — some of this would be alleviated right there. As it is, Portland is determined to make their city unlivable for just about anyone. I love my home city, but the Left is killing it with misplaced compassion.

    • #10
    • January 9, 2018, at 3:02 PM PDT
    • 12 likes
  11. The (apathetic) King Prawn Inactive

    RightAngles (View Comment):
    Social stigmas perform a vital function in any society

    The only stigmas now are for making wise choices and enjoying steak.

    • #11
    • January 9, 2018, at 3:03 PM PDT
    • 16 likes
  12. Vicryl Contessa Thatcher
    Vicryl Contessa Post author

    C. U. Douglas (View Comment):

    RightAngles (View Comment):

    Front Seat Cat (View Comment):
    Was it this bad 9 years ago? I see a mental health crisis, a drug crisis, a homelessness crisis,

    One of the most damaging things the liberals have done is removing the stigma from homelessness (and unwed mothers and on and on) in their misguided “compassion.” When I was little, we called them “bums.” Social stigmas perform a vital function in any society, and removing the stigma from a bad behavior does nobody any favors. When you remove the stigma from it, you get more of it.

    Portland has “Compassion” in spades from the creation of Dignity Village, where the city gave land to the homeless to camp out at and self-govern. This has only gotten worse and now little homeless camps are all over several public grounds. In our last visit we passed through the city and there were several tent camps along the road I used to take to get to work. They weren’t there three years ago.

    Portland’s overly-permissive attitude towards homelessness is creating more problems on a nigh-exponential basis. If the city reversed itself and tried not to pretend the homeless are just harmless permanent campers — and actually treated their police force with some respect — some of this would be alleviated right there. As it is, Portland is determined to make their city unlivable for just about anyone. I love my home city, but the Left is killing it with misplaced compassion.

    Dignity Village is actually pretty cool. But they have a no drug, no alcohol, no prostitution rule there, and if people violate those rules they’re kicked out. It works because it’s so small. Which I guess might go to show that people who really want to get out of their current poor situation will find a way. The rest will continue to wind up in my ED with their bodies looking like cobblestone streets.

    • #12
    • January 9, 2018, at 3:05 PM PDT
    • 14 likes
  13. Blondie Thatcher

    Vicryl Contessa (View Comment):

    RightAngles (View Comment):
    Good grief. They should have you testify in Congress.

    I feel like that wouldn’t go over well. I’m far less eloquent in real life.

    I agreed with your comment, but you sell yourself short. You can be eloquent when need be.

    • #13
    • January 9, 2018, at 3:06 PM PDT
    • 6 likes
  14. C. U. Douglas Thatcher

    Vicryl Contessa (View Comment):

    C. U. Douglas (View Comment):

    RightAngles (View Comment):

    Front Seat Cat (View Comment):
    Was it this bad 9 years ago? I see a mental health crisis, a drug crisis, a homelessness crisis,

    One of the most damaging things the liberals have done is removing the stigma from homelessness (and unwed mothers and on and on) in their misguided “compassion.” When I was little, we called them “bums.” Social stigmas perform a vital function in any society, and removing the stigma from a bad behavior does nobody any favors. When you remove the stigma from it, you get more of it.

    Portland has “Compassion” in spades from the creation of Dignity Village, where the city gave land to the homeless to camp out at and self-govern. This has only gotten worse and now little homeless camps are all over several public grounds. In our last visit we passed through the city and there were several tent camps along the road I used to take to get to work. They weren’t there three years ago.

    Portland’s overly-permissive attitude towards homelessness is creating more problems on a nigh-exponential basis. If the city reversed itself and tried not to pretend the homeless are just harmless permanent campers — and actually treated their police force with some respect — some of this would be alleviated right there. As it is, Portland is determined to make their city unlivable for just about anyone. I love my home city, but the Left is killing it with misplaced compassion.

    Dignity Village is actually pretty cool. But they have a no drug, no alcohol, no prostitution rule there, and if people violate those rules they’re kicked out. It works because it’s so small. Which I guess might go to show that people who really want to get out of their current poor situation will find a way. The rest will continue to wind up in my ED with their bodies looking like cobblestone streets.

    That’s true, but it’s drawing in the elements that would violate those rules and they’re spreading out. It would be a cool concept if the City would deal with those elements that DV recognizably hasn’t the ability to cope with. But the City won’t and here we are.

    • #14
    • January 9, 2018, at 3:08 PM PDT
    • 8 likes
  15. Bob Thompson Member

    RightAngles (View Comment):
    Social stigmas perform a vital function in any society, and removing the stigma from a bad behavior does nobody any favors. When you remove the stigma from it, you get more of it.

    True. Not only that, can you see the resources unnecessarily consumed by the ‘bums’ that kept @vicrylcontessa so busy. Those filled spaces were clearly keeping those in need of emergency medical care from being treated at that emergency facility. I have no clue how to solve the drug addiction problem we have but the injustice visited on others by these people is unconscionable. Social policies supporting this behavior need to be reversed.

    • #15
    • January 9, 2018, at 3:16 PM PDT
    • 13 likes
  16. Vicryl Contessa Thatcher
    Vicryl Contessa Post author

    It gets better, kids. There’s a measure we just voted on up here about adding a 1.5% “assessment” on health insurance and hospital revenue in order to fund healthcare for the uninsured and Medicaid. I asked @1967mustangman if I my ballot would be counted if I wrote “HELLZ NO!” on it. I just filled in the bubble instead.

    • #16
    • January 9, 2018, at 3:22 PM PDT
    • 18 likes
  17. C. U. Douglas Thatcher

    Vicryl Contessa (View Comment):
    It gets better, kids. There’s a measure we just voted on up here about adding a 1.5% “assessment” on health insurance and hospital revenue in order to fund healthcare for the uninsured and Medicaid. I asked @1967mustangman if I my ballot would be counted if I wrote “HELLZ NO!” on it. I just filled in the bubble instead.

    Oregon’s health plan was bleeding revenue fifteen years ago. I suspect they were hoping Obamacare would save them, even though they blew all their State health exchange money on a failed website and ridiculous advertising.

    • #17
    • January 9, 2018, at 3:27 PM PDT
    • 7 likes
  18. 1967mustangman Inactive

    C. U. Douglas (View Comment):

    Vicryl Contessa (View Comment):
    It gets better, kids. There’s a measure we just voted on up here about adding a 1.5% “assessment” on health insurance and hospital revenue in order to fund healthcare for the uninsured and Medicaid. I asked @1967mustangman if I my ballot would be counted if I wrote “HELLZ NO!” on it. I just filled in the bubble instead.

    Oregon’s health plan was bleeding revenue fifteen years ago. I suspect they were hoping Obamacare would save them, even though they blew all their State health exchange money on a failed website and ridiculous advertising.

    That’s what happens when a “mean tested” medical insurance plan winds up covering a significant percentage of the state population.

    • #18
    • January 9, 2018, at 3:48 PM PDT
    • 6 likes
  19. Midget Faded Rattlesnake Contributor

    The King Prawn (View Comment):

    Vicryl Contessa: how do we handle the stress placed on the country by these addicts?

    The heartless conservative in me says let them suffer the consequences of their own choices, but that means death, so it’s a no-go.

    The heartful conservative in me thinks death might be a welcome relief for them compared to the life they have now. But yeah, that’s a taboo thought.

    There’s hospice for people’s natural illnesses, where we accept death with grace and stop trying to revive, but “hospice” for addicts for their addiction? How would that even work?

    • #19
    • January 9, 2018, at 4:31 PM PDT
    • 6 likes
  20. The (apathetic) King Prawn Inactive

    Midget Faded Rattlesnake (View Comment):
    There’s hospice for people’s natural illnesses, where we accept death with grace and stop trying to revive, but “hospice” for addicts for their addiction? How would that even work?

    I imagine “efficiently” is probably not the right answer…

    • #20
    • January 9, 2018, at 4:47 PM PDT
    • 7 likes
  21. Vicryl Contessa Thatcher
    Vicryl Contessa Post author

    Midget Faded Rattlesnake (View Comment):

    The King Prawn (View Comment):

    Vicryl Contessa: how do we handle the stress placed on the country by these addicts?

    The heartless conservative in me says let them suffer the consequences of their own choices, but that means death, so it’s a no-go.

    The heartful conservative in me thinks death might be a welcome relief for them compared to the life they have now. But yeah, that’s a taboo thought.

    There’s hospice for people’s natural illnesses, where we accept death with grace and stop trying to revive, but “hospice” for addicts for their addiction? How would that even work?

    Empty a bag of needles and heroin out on a table and say “dig in, kids.”

    • #21
    • January 9, 2018, at 5:02 PM PDT
    • 11 likes
  22. Al French, sad sack Member

    Vicryl Contessa (View Comment):

    RightAngles (View Comment):
    Good grief. They should have you testify in Congress.

    I feel like that wouldn’t go over well. I’m far less eloquent in real life.

    I don’t believe it.

    • #22
    • January 9, 2018, at 5:23 PM PDT
    • 3 likes
  23. Annefy Member

    My sister used to Uber and she was shocked at how many homeless she saw off the beaten path here in LA.

    My little town has attracted a group of homeless that live in the park and use the bathroom in the new library. The park is basically useless for intended purposes. A variety of crack pipes, etc have been found in the library bathroom and several couples doing the dirty deed have been walked in on. So no one is using the library for its intended purpose, either. (I’m still paying for the park and the library to the tune of $500 / year; I voted against it and it annoys me so much all the kids and my husband know better than to even drive by it when I’m in the car)

    The last time I walked past the homeless encampment, one person was doing dishes and another was saying, “I’m going for ice. Anyone need anything?” They sounded like my family camping in Yosemite.

    We have a lot of churches in town and several of them are dedicated to keeping them all fed. It’s raining now (yippee!) and I’ve already seen several Facebook posts from locals looking for sleeping bags, tents etc to bring to the park.

    As I told the mayor: if you feed them, they will come.

    Everyone in charge claim the laws are written in such a way that there’s nothing that can be done.

    • #23
    • January 9, 2018, at 5:40 PM PDT
    • 13 likes
  24. Doug Watt Member

    Big sigh, I’ve been there and seen it Portland. Great essay. Carve out a place for you and your husband, cry on his shoulder when you need to. I’m glad I’m out of it now.

    • #24
    • January 9, 2018, at 6:02 PM PDT
    • 10 likes
  25. Jules PA Member

    Vicryl Contessa (View Comment):

    RightAngles (View Comment):
    Good grief. They should have you testify in Congress.

    I feel like that wouldn’t go over well. I’m far less eloquent in real life.

    Just read out loud, this post. You are quite rational, and level headed.

    And, well, call me hard hearted, the three strikes you’re out should be set-up for the abusers to be housed in some other fashion, than on the streets.

    You accost the ER nurse or staff three times, you get a puppy chip implant that sets off a sensor when you cross the threshold.

    Like a reverse shoplifting sensor.

    There is no way a mental illness or addiction should torture our nurses and hospital staff that way.

    I know it can’t ever happen the way I just described, but I feel for you and all the rest of the medical services.

    Bless You Vicryl Contessa for your golden and strong heart.

    • #25
    • January 9, 2018, at 6:26 PM PDT
    • 14 likes
  26. Jules PA Member

    Vicryl Contessa (View Comment):

    Front Seat Cat (View Comment):
    I can hardly type through the tears. There are hardly words after what I just read. VC – what is the solution here? I did a post on not legalizing marijuana, but there is a much bigger picture that has gotten much worse during Obama. Was it this bad 9 years ago? I see a mental health crisis, a drug crisis, a homelessness crisis, a healthcare crisis, a health insurance crisis, a healthcare provider crisis, a mental health crisis, rolled into a super-volcanic eruption in American society, that shows a society unable to cope with the Pandora’s Box of problems we have allowed to get worse and worse.

    During Bush’s years, I think it was better – there was encouragement for more faith-based help for broken people – an acknowledgement that the government cannot do it all, and doesn’t do it that well. It doesn’t seem that Obamacare has solved these ills, by allowing illegal drugs and gangs into the country, or demonizing police officers, or not addressing the homeless crisis.

    What kind of changes do you and your fellow healthcare providers need, from the government, society, and locally? I am sad to read that Portland has this problem, because I know it is a snapshot of every town. PS God bless what you have chosen to do for a living.

    I don’t think Portland is a snapshot of every town. I think Portland is way worse. I’ve had several homeless patients tell me they just moved here because Portland has such rich resources.

    I liked this comment, but the tears were in the emoji I imagined.

    • #26
    • January 9, 2018, at 6:30 PM PDT
    • 3 likes
  27. Jules PA Member

    Midget Faded Rattlesnake (View Comment):

    The King Prawn (View Comment):

    Vicryl Contessa: how do we handle the stress placed on the country by these addicts?

    The heartless conservative in me says let them suffer the consequences of their own choices, but that means death, so it’s a no-go.

    The heartful conservative in me thinks death might be a welcome relief for them compared to the life they have now. But yeah, that’s a taboo thought.

    There’s hospice for people’s natural illnesses, where we accept death with grace and stop trying to revive, but “hospice” for addicts for their addiction? How would that even work?

    Sadly, if those folks could get all the drugs they wanted, they would eventually OD. Because we aren’t actually heartless, we do try to intervene. Because we KNOW there is better for them, if they could just see past their addiction.

    It’s like the parent of a raging toddler that just envelopes them with their body, until the toddler’s rage subsides.

    Kind of hard to do that love-wrap-human-straightjacket with raging adults.

    But that’s probably what they need.

    Tough love tactics are better than dying a cold solitary death on the street.

    The problem is, the tough love tactics can’t be sourced in government.

    Humans love, governments don’t.

    • #27
    • January 9, 2018, at 6:45 PM PDT
    • 7 likes
  28. Jules PA Member

    Humans love, governments don’t.

    • #28
    • January 9, 2018, at 6:48 PM PDT
    • 7 likes
  29. Vicryl Contessa Thatcher
    Vicryl Contessa Post author

    Jules PA (View Comment):

    Midget Faded Rattlesnake (View Comment):

    The King Prawn (View Comment):

    Vicryl Contessa: how do we handle the stress placed on the country by these addicts?

    The heartless conservative in me says let them suffer the consequences of their own choices, but that means death, so it’s a no-go.

    The heartful conservative in me thinks death might be a welcome relief for them compared to the life they have now. But yeah, that’s a taboo thought.

    There’s hospice for people’s natural illnesses, where we accept death with grace and stop trying to revive, but “hospice” for addicts for their addiction? How would that even work?

    Sadly, if those folks could get all the drugs they wanted, they would eventually OD. Because we aren’t actually heartless, we do try to intervene. Because we KNOW there is better for them, if they could just see past their addiction.

    It’s like the parent of a raging toddler that just envelopes them with their body, until the toddler’s rage subsides.

    Kind of hard to do that love-wrap-human-straightjacket with raging adults.

    But that’s probably what they need.

    Tough love tactics are better than dying a cold solitary death on the street.

    The problem is, the tough love tactics can’t be sourced in government.

    Humans love, governments don’t.

    I’m really good at the tough love stuff. I’ve told many a kid to “cut that sh!t out because I don’t want to have to go tell your mom that you died from an overdose.” I don’t know if it’s effective, but at least I’ve done what I can do.

    • #29
    • January 9, 2018, at 6:50 PM PDT
    • 19 likes
  30. LibertyDefender Member

    Vicryl Contessa: There is a big call for legalization of drugs by the left and the libertarians. But how does that work? If we legalize drugs, making them easy to obtain and removing the stigma, how will that decrease the number of people coming to the ED with MRSA abscesses and endocarditis?

    The purest libertarian philosophy regarding drug legalization was championed by the late, great Thomas Szasz. He steadfastly argued that no one – no government, no private actor – has any legitimate authority to tell a healthy adult what he may put in his body. It’s a compelling argument – flawless, even. However, it does open the door to massive unintended consequences, e.g. people coming to the ED with MRSA abscesses and endocarditis.

    The best defense against unintended consequences of drug legalization is education. We’ve screwed the pooch on that score by surrendering education to government.

    No libertarian I know advocates for a welfare state healthcare system, so the ED should be able to deny (or drastically limit) care to those who cannot pay for it. Private charities are far better equipped to help such people than is government. That said, homelessness is a thorny problem to solve, even by the best private charities. Simply providing food and shelter to the homeless exacerbates the problem, it doesn’t reduce the problem at all.

    I doubt you disagree with those of us who argue that the War on Drugs is heinously expensive, with literally nothing to show for it.

    Some problems don’t have solutions. Humans are imperfect.

    • #30
    • January 9, 2018, at 9:58 PM PDT
    • 10 likes
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