Tag: Heroin

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Welcome, once again, to the Cesspool that Seattle (formerly the Emerald City) has become. On the “Homeless” front, we have two stories today. First: Seattle to set up homeless shelters in Downtown and Belltown hotels. Seattle is spending their taxpayers’ money to house their increasingly large homeless population in hotels. I wonder whether that will […]

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Several years ago, Vancouver BC created safe injection sites, supervised by medical personnel, so IV drug users could come out of the alleys, and prevent public drug use and overdoses. Two years ago, Seattle authorized two sites, one in Seattle and one in a suburban area. As of today, no sites have been approved or […]

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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.

Dreamland – A Review


Billed as “the true tale of America’s Opiate epidemic,” Sam Quinones’s Dreamland is a pretty quick read considering it’s about 350 pages. The blurbs on the back promise “expert storytelling,” and I suppose it is. The storytelling is good enough to make me wonder how heavily Quinones selected for stuff that would make a good story, while other stuff, equally true and relevant, but less dramatic, got discarded along the way. Quinones focuses on the marketing of OxyContin as a safe prescription drug, its subsequent abuse, the spread of a new means of dealing black tar heroin, and the connection between these, telling the tale of several colorful characters along the way.

To Quinones, the spread of opiate use to white America – not just to impoverished “rust belt” regions, but also to the offspring of the wealthy, managerial class – is fraught with moral meaning, though perhaps contradictory moral meaning. Heroin tempts us when we’re too wealthy, when we’re too poor, because we feel entitled to pain relief, because we don’t feel entitled to stop when it hurts but instead succumb to pressure to tough it out by any means necessary; it tempts us when we’re underwhelmed by life, it tempts us when we’re overwhelmed… Opiates are both the new party drug and the new drug of social isolation… Addiction is simultaneously a moral indictment of American consumerist excess during the pre-crash boom, a testament to post-crash misery, and an illness which deserves less moral stigma than it gets. Forgive me for suspecting at times that, to Quinones, opiates serve mostly as a random moral generator.

Which isn’t to say Dreamland is a bad book. There seems to be plenty of impressive journalism in here, crime journalism especially, although the science journalism falls rather short: there are multiple errors in describing how drugs are metabolized; in describing the drugs derived from the opium poppy (in particular, using “the morphine molecule” as shorthand for all of them); and sometimes there’s just illiterate wording, like calling what’s not statistical mechanics “statistical mechanics” or calling a lumbar sprain “a sprained lumbar” (a sprained lumbar… what?). Still, for someone like me – someone who uses opioids conservatively as part of a pain-management regimen, considering them a not-very-fun occasional treatment reserved for pain that inhibits productivity even more than being doped up would – Dreamland is a tour of a world Quinones, if his story is to be believed, claims I could easily have become a part of, yet haven’t.

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.

What is the Problem with Heroin?


OLYMPUS DIGITAL CAMERAIn his post “Bringing Conservatives and Libertarians Together” about marijuana legalization, Fred Cole wrote:

I think it’s the situation with marijuana that it’s already so widely accepted and widely available, that most people who want to smoke already do. Whatever society costs it imposes are already there.

So marijuana prohibition means we get all of the downsides of legalization and all of the downsides of prohibition, but none of the upsides that come with legalization.  It’s the worst of both worlds.