Opioids

A Chicago Tribune Columnist Thinks Helping Opioid Users Is 'Accommodating' Them

It's time to stop punishing people for their addictions.

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As the bodies of opioid users pile up in morgues across America, one newspaper columnist wonders if we should stop "accommodating" these "cunning" addicts:

Kevin Small, who used Naloxone kit to save a friends life, poses for portrait at his apartment in Manhattan, New York, U.S., April 20, 2018. SHANNON STAPLETON/REUTERS/Newscom

Many years ago, I was in the home of a relative whose husband was a heroin addict, and hanging on a wall in the hallway was a poster that read: "Signs of a drug overdose." It went on to list symptoms such as passing out, disorientation, shallow breathing, vomiting and muscle spasms. It instructed them to call 911 immediately.

I was aghast. It was like saying to the addict and their children that it's OK to use drugs as long as you make sure someone knows how to save your life if you take too much.

Today's version of that poster might read, "Make sure you've got naloxone in your medicine cabinet."…

Placing so much attention on accommodating the drug addict does nothing to address the underlying problem of addiction. The truth is that America doesn't know how to fix this opioid problem and meanwhile, it's getting worse. But we cannot allow Narcan to become a crutch that allows us to shirk our responsibility to figure it out.

Of course, throwing drug users in jail isn't the answer either. But there has to be something between locking addicts up and giving them a license to use drugs freely.

When I see a liberal newspaper columnist like the Chicago Tribune's Dahleen Glanton parroting the arguments of Maine Gov. Paul LePage—who made national headlines in 2016 by vetoing over-the-counter access to naloxone, on the grounds that making the overdose reversal drug widely available would simply enable opioid users to get high again—I wonder how we can move the conversation about drug addiction out of the late 1980s and into what should be a more compassionate present.

One way to do that might be to put opioid addiction in the context of some other conditions that lie at the intersection of psychology and physiology. Consider Type 2 Diabetes. There's evidence that people are genetically predisposed to developing insulin resistance, but we also know it's possible to reverse symptoms with behavioral modifications. Should we stop "accommodating" type 2 diabetics by providing them with access to insulin and metformin? Probably not: Behavior modification "works" in less than two percent of the type-2 diabetic population (and not at all for type-1 diabetics, who require insulin medication to stay alive regardless of what they eat or how much they exercise).

What about hypertension? It's also reversible with dietary changes and exercise! But just as with diabetes patients (and metabolic diseases in general), long-term compliance with lifestyle changes is poor. Increasing cardiovascular exercise can lower cholesterol. Are we excessively accomodating people by giving them statins?

If you have any of those diseases and are offended by the suggestion that your sickness is your fault, or by the idea that providing you with medications allows you to continue living in such a way that makes medication necessary, imagine how you'd feel if I or someone else—your governor, say, or a prominent columnist at your city's most widely read newspaper—suggested that your medicines are a crutch and making them available to you sets a bad example for people who don't already have your condition.

You'd probably be angry, and maybe scared. You might wonder if people know how hard it is to replace deeply entrenched behaviors that started not with a declaration of "I'm going to live in such a way that I am more likely to develop a serious health problem" but more slowly and subtly, over years and under the influence of your environment, your community, your genes, and a thousand small choices that, taken alone, seemed inconsequential when you made them.

Despite everything we know about the neurological aspects of addiction, this is exactly how we talk about opioid users. Safe injection sites "would encourage and normalize heroin use, thereby increasing demand for opiates and, by extension, risk of overdose and overdose deaths," U.S. Attorney Christina E. Nolan complained when local leaders in Burlington, Vermont, called for opening such facilities. "Government-sanctioned shooting galleries won't solve the drug crisis," Glanton wrote in her column just last week.

It is absolutely true that supervised injection facilities make intravenous drug use less risky. That is the entire point. Countries that allow them do so to reduce the danger for people who will die without them. It's why we have seat belts in cars and lifeguards at the beach and condoms at college health centers and those glow-in-the-dark tabs in car trunks. The idea behind all these inventions and policies is that if we can make an activity less dangerous, we should, because helping people stay alive is morally and ethically preferable to the alternative. This is also why we give people statins and Metformin and hypertension medication!

And in all those cases—save unapproved opioid use—we accept the trade-off without even realizing that's what we're doing. Whether it's because we can imagine ourselves benefitting from those forms of insurance, or because we all drive cars and expect to get old and develop cardiovascular disease, we support policies and technologies and social contracts that shield us from the most dire consequences of our own risky behaviors.

But for some awful reason, we have allowed prohibitionists to draw the line at drugs. Tens of thousands of our family members and neighbors die each year because of that concession. As Jacob Sullum wrote in March:

Naloxone indisputably saves people's lives, and it would be unconscionable to block access to it based on speculation about how the availability of that lifesaving option might affect other people's behavior. That is like banning seat belts or HIV treatment because the extra assurance they provide might encourage some people to behave more recklessly.

This is the logic of prohibition, which endangers the lives of drug users to deter people who otherwise might join them. One way it does that is by making drug potency unpredictable, which makes overdoses more likely, thereby increasing the need for naloxone. LePage is not wrong to think that making naloxone hard to get is consistent with this plan. He is wrong to think the plan is morally defensible.

By criminalizing both their behavior and the methods proven to help opioid users live longer—supervised injection facilities, easy access to opioid agonist treatments, clean needle exchanges—lawmakers have marked opioid addicts as lost to their disease, useful only as cautionary tales to people who are not sick with that particular disease. Can you imagine the uproar if officials talked about elderly, hypertensive swing-state voters the same way?

Glanton says we don't know how to tackle this problem, but that's absolutely wrong. France lifted provider restrictions on the opioid treatment buprenorphine, and in just four years reduced opioid overdose deaths by nearly 80 percent. The supervised injection facility in Vancouver, British Columbia, has reduced both opioid overdose deaths and the transmission of HIV in the surrounding area. In the 1970s, New York City's methadone-on-demand program saved countless lives.

These policies keep more people alive longer than prohibition does. As a bonus, they don't require people like Glanton, Nolan, and LePage to forfeit their prejudices against people they see as admonitory, or economically useless, or "cunning." They can keep their contempt so long as they allow opioid users to access the health care their neighbors wish to provide. The real miracle of modern medicine is not that it fixes us; it's that it allows broken people the chance to live normal lives.

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  1. Couldn’t you make the same argument about any other vice or misfortune? Isn’t it time we stopped punishing people for not showing up to work and losing their jobs.

    I am all for decriminalizing drugs. If you want to use them, have fun. But I will be damned if I am going to pay one dime of tax money to help people use drugs. Fuck them. I want drugs to be legal because I am not willing to spend money to try and save people from themselves. That principle applies whether the money is spent on locking them in jail or giving them some kind of government funded treatment.

    1. Isn’t this piece just about legalizing Naxolone?

      We don’t punish people for not showing up to work, last time I checked.

      1. We sure as hell do punish people for showing up to work. They lose their jobs. And the piece wants to legalize, which is fine. But it also seems to want to have supervised dispensaries which I will likely be funded by tax money. That is the problem.

        1. “We” do not punish shit. There is no punishment for not showing up for work. There is for doing drugs.

          Where did they talk about tax money going to dispensaries? Is it even standard for those to be government run, rather than by private charities? If so it’s just an artifact of our prohibitionism, that naxolone, or methadone, or even heroin or whatever, should only be available in government dispensaries. If you could sell them all at CVS next to the animal crackers there would not be any kind of government involvement at all. Why not take the compromise, which is probably better than nothing in terms of expense, as this point?

          1. They’re gov’t-run in countries where things tend to be gov’t-run. In the USA they’re private.

          2. >> It’s time to stop punishing people for their addictions.

            This makes it sound like Joe Stoner is just walking down the street one day, minding his own business when out of the sky ***BOOM*** an addiction falls on him and won’t let go. He’s purely innocent. Had nothing to do with his circumstances. Sort of like the guy who weighs 500 pounds and needs you to pay for his quadruple bypass surgery because cakes and cookies keep flying into his mouth all by themselves.

            Personally, I think drugs should be legalized and not restricted. But people need to be responsible for their own abuse of drugs. So by all means, stop restricting Naloxone. But don’t expect me to pick up the tab for emergency services when your O.D. gets you a near-death experience.

    2. Yeah, government shouldn’t be forcing us all to pay for harm reduction programs. But they shouldn’t get in the way of private people trying to help either. The columnist Riggs is responding to doesn’t seem to make the distinction very well. What’s the family of the heroin addict supposed to do? Let him die to serve as an example for others? It’s not about coddling addicts in cases like that, but keeping people you care about from dying.

      1. I agree zeb. There is really nothing you can do. There is no such thing as “treatment”. The person either decides to stop or they don’t. No one can do anything for them. They have to decide for themselves.

      2. I’ll give Riggs credit that his primary focus is “blocking naloxone use”. That’s wrong, period. In a libertarian world, that should be freely available over the counter.

        What I don’t like is the notion that bodies wouldn’t be piling up if it were made available. Vancouver’s Insite suggests the opposite is true.

        Not to belabor the point, but to belabor the point, people are simply scared that the problem will become worse of people are incentivised to behave poorly. I remember back in the 90s in one of the Scandinavian countries that created liberal drug use policies and safe injection sites, the complaint was that it didn’t really fix anything, it just brought the drug addict “out of the alley on on to your doorstep”.

        The real problem here is the War on Drugs, and since that’s not going away any time soon, people are scared that their neighborhoods will become dangerous hellholes if the behavior is encouraged. And it’s not an entirely unfounded fear.

    3. That is my issue.

      I do not CARE if a junkie wants to shoot heroin all day and kill themselves.

      If i have to PAY for it, then i am markedly less tolerant.

    4. Isn’t it time we stopped punishing people for not showing up to work and losing their jobs.

      Wow, is it illegal to lose your job?

    5. Isn’t it time we stopped punishing people for not showing up to work and losing their jobs.

      Because. . . the State punishing someone for doing drugs by throwing them in prison is exactly the same as an employer punishing someone for not showing up to work by firing them. /smh

      1. ^^This

  2. The idea behind all these inventions and policies is that if we can make an activity less dangerous, we should, because helping people stay alive is morally and ethically preferable to the alternative.

    Really? If we have a moral and ethical duty to keep people alive, then how can you argue against the government taking actions to do so? This statement reads the personal responsibility element right out of freedom. It also denies the eternal truth stopping people from experiencing the consequences of their behavior just encourages more of it.

    1. I suppose if it comes down to a choice between full on War on Drugs and some kind of government program for addicts, I’d pick the latter. I think it would be a lot less expensive and destructive.
      But you are right, taking the personal responsibility part out of the equation is a problem.

      1. I think I might pick the former but both are equally bad.

        1. both are equally bad.

          Empirically, they are not.

    2. Yes, I see what you’re saying. The tone of this piece is weird and not what you’d expect to see in a supposedly libertarian publication.

      Sometimes we pat ourselves on the back for our newly “enlightened” attitudes toward self-destructive behaviors, but when you scratch the surface you see the pattern is away from any old-fashioned concept of individual freedom and responsibility; the “hawk” vs. “dove” debate is increasingly an internal one of those positions within progressivism!

      For instance, as we rapidly close in on tobacco prohibition (yeah, that drug-war mentality sure is on its last legs!) we see nonsmokers increasingly emboldened (as was the plan) to take utter glee in regarding smokers with outspoken disgust, contempt, hatred for their private choices. And the only pushback we see against the excesses of that attitude is, “No, no, no. We must have compassion for them. You see they are addicts; what they do is not voluntary; they are automata enslaved to the demon tobacco.” Or take the looming prog battle between paranoiac antiobesity nannyism and “fat acceptance”–for which I’ll definitely be grabbing the (unbuttered) popcorn. I’m sure the gays have a version of this too; I’m just too lazy to think of it…

      1. …I should note that this is one case where the “salt of the earth” folks that we anti-cosmo types like to (not without cause) think of as infinitely closer to liberty than the weed-and-buttsex progs at the cocktail parties are, are absolutely no good! Try running on a libertarian opioid platform for local office in Red Country. They won’t want to hear that personal responsibility shit! They’ll be all, “Drugs have devistated this community; stop them!” To Jane Six Pack, her brother was an innocent, good man, who she can’t imagine could have ever gotten into this. You must go after the doctors, the pushers, the manufactures, fuck even the chemical itself, who “murdered” him–because she is in pain and can’t deal with the truth. What kind of narrative is this? People should be ashamed of themselves for talking this way; it’s the last thing addicts need to hear. Fuck, if Jane is going to blame anyone else for John’s death it probably should be her enabling ass.

      2. The tone of this piece is weird and not what you’d expect to see in a supposedly libertarian publication.

        But the way in which the tone is weird is in its insistence that “addiction” is a “disorder,” as if it fucking matters. Individuals have a right to use drugs, including heroin, and drug prohibition is a human rights travesty for that reason in addition to reasons like its destruction of the fourth amendment.

        Why not rip this columnist for acting like there is an opioid crisis other than the difficulty users have in accessing the opioids of their choice? The problem isn’t just that we can’t all buy naloxone at Walgreens, but that we also can’t just buy heroin there.

        1. The most obvious way to help these people is, as you say, allowing them to buy the drug in known doses from respectable sources.

        2. +1

          Would more people use heroin if it was legal? Yeah, probably.

          Would people still die from overdoses? Yeah, probably.

          Would there likely be fewer overdoses overall when people could buy precisely manufactured drugs in known strengths? Yeah, probably.

  3. I’m gonna have to agree with John here. This is one of those very few cases where we’re on the same LePage.

  4. Except your logic is faulty in this story. All drugs for hypertension and type 2 diabetes require prescriptions. So make a better analogy.

    1. Moreover they’re not free. At least my town doesn’t have a metformin clinic doling out pills to chubby folks.

    2. It’s a terrible analogy. I used to work in heathcare. Imagine a diabetes patient told his doctor,

      “I’m not really feeling the treatment program, so I’m going to come to your office and eat and drink whatever I want, and if I go into shock or collapse, you’re going to have medical staff standing by to revive me.”

      There’s no doctor or healthcare organization on the planet that would agree to that.

      I’m not against the idea of naloxone use, but but Vancouver’s insite program is a prime example of how creating safe injection sites hasn’t worked, and in fact the problem has become worse. And please, don’t post the 2011 study that showed a drop in overdose deaths. Overdose deaths have increased dramatically and the Insite officials even admit as much, but blame it on other factors.

    3. Here’s an analogy: it’s like arguing that having a first-aid kit in my office is “sending a message” that’s it’s “OK” to be negligent in handling machinery because we have the means to fix you up.

      It’s like arguing that having fire insurance is “sending a message” that it’s “OK” to burn your house down.

      It’s like arguing that having emergency rooms in hospitals is “sending a message” that it’s “OK” to get involved in gun fights because there are doctors who will patch you up.

      Get the point?

      Note: the editorial writer is not raising the question of who should pay for the ameliorative treatment. She is arguing that the mere existence of ameliorative treatment is a bad thing.

      1. It’s like arguing that having fire insurance is “sending a message” that it’s “OK” to burn your house down.

        Careful on that one. It’s been argued in the pages right here that FEMA has encouraged people to build in risky places.

        She is arguing that the mere existence of ameliorative treatment is a bad thing.

        Does Riggs identify as “she”?

        1. No. Riggs was quoting liberal newspaper columnist Dahleen Glanton, who I assumed was a “she.”

          As for FEMA: i see your point but the analogy is flawed. FEMA and flood insurance are taxpayer subsidized, so the homeowner does not bear the full cost of the risk he or she is assuming by building in a risky place. But I don’t think anyone here argued that flood insurance should be outlawed completely, even if it was privatized and properly priced.

        2. The criticism of FEMA is entirely related to the fact that it’s essentially a subsidy for building in dangerous areas and therefore means the owner does not bear the full cost of floods which can cause more people to build in flood prone areas.

          This is not the case with fire insurance where the insured bears the full cost of the insurance.

  5. What’s beginning to occur is a loss of patience. Plus, there’s a certain amount of agency that we as libertarians shouldn’t turn a blind eye to.

    Some cities have IN FACT encouraged illegal drug use which is why bodies are piling up in morgues.

    The City of Seattle has free methadone programs, free drug rehab, free housing, free support, free counseling and the local homeless population rejects these programs entirely. Aggressively rejects them when offered. They were even offered money to pick up their own trash in their illegal encampments and pretty much to a one, arrogantly refused. The reason they’re rejected is because the city encourages that behavior by making it easy to reject those things.

    One doesn’t have to “support the War on Drugs” to know that human beings respond to incentives– and that if you have a bunch of people that are likely to descend into a life of meth (or other drug) addictions, that allowing them to do it anywhere, any time, that bodies are going to start piling up. And on the agency side, I’ve lost my compassion for people who knowingly choose to engage in incredibly risky behavior that has predictable consequences.

    1. Here’s a list of arguably “preventable tragedies” that have occurred due to the behavior the city has encouraged over the last decade. The people who put this report together are not lacking in compassion– they are in fact more compassionate than I am about the situation. Unfortunately, the answer is probably, yes, we’re gonna start forcing people into some programs and force them off the fucking street. PDF Warning.

      Three filthy and neglected children were found alone in a
      homeless camp under the West Seattle bridge by women
      from a neighborhood group. The only adults nearby, who
      were not their parents, were intoxicated on
      methamphetamine.

      1. But Washington has a relatively low rate of ODs. Moreover, the rate has barely increased since 2010, while other states such as West Virginia, Ohio, and New Hampshire have much higher rates and are increasing much faster.

        Data > Anecdote

        1. King County is not Washington. To take Washington statistics is to flatten out what’s happening in King County and in particular Seattle which has its own policies towards drug use and homelessness that aren’t parroted around the state. To wit.

          Miles of tents, human feces, rats and used needles is not anecdotal. It’s a serious problem that’s concentrated in one city in one county of the state. And there’s a reason for it.

          1. King County has 2.1 million people. 379 deaths works out to 18 per 100,000. That is still less than many of the other states listed.

            1. I understand that. However, almost all of those “king county” deaths occurred in Seattle which has ~600,000 people. PDF Warning. The study linked shows a heat map of where those deaths are occurring. You get a pretty clear picture what… or more importatnly… WHO is driving those deaths.

              Also, I think the opioid epidemic looks different in different parts of the country. The midwest and south where the opioid crisis is “raging” has an entirely different profile than it does in left coast cities such as San Francisco and Seattle.

      2. “Some cities have IN FACT encouraged illegal drug use which is why bodies are piling up in morgues.”

        The increase in drug overdose deaths has been much higher in rural than in urban areas. Before 2000, urban areas had drug overdose rates 50% higher than rural areas and today the rural drug overdose rate is higher than the urban drug overdose rate. That’s according to the CDC, but Reason won’t let me post the link because it’s too long

        I highly doubt rural West Virginia is giving out the same types of services to drug addicts that exist in Seattle, so I don’t know how you can blame ‘bodies piling up in morgues’ on specifically urban attempts to deal with drug overdose problems

        1. This is a complicated subject. I believe the Opioid crisis in rural West Virginia (to use your example) is very different than what’s happening in left coast cities like Seattle and San Francisco. I believe that the addicts and circumstances surrounding the addiction are entirely different in both demographics and approach.

          It’s my understanding that most of what’s going on in the rural parts of America is prescription opioid abuse– although I’m not basing that on any researched numbers, just what I’ve gleaned from the news. What’s going on in places like Vancouver, Seattle and San Francisco is injected street heroin while living in rat-infested squalor beneath overpasses that’s literally (not figuratively, but literally) being allowed to proliferate by the very health departments whose mission it is to stop it.

          Again, my primary point isn’t to harp upon death rates per 10,000 due to opioid use. I’m merely trying to articulate why ostensibly “liberal” people might have a hesitation about the easy distribution of Naloxone. Not all of the counter arguments are valid, but in some cases, they come from a perfectly rational place based on the observed results when you allow large segments of your community to be an open air drug market and safe injection site.

  6. But there has to be something between locking addicts up and giving them a license to use drugs freely.

    I have just the answer – unicorn therapy works wonders. Plus, since the unicorns shit gold nuggets, it’s quite profitable. Just issue every addict a therapy unicorn and the problem magically solves itself.

    Or maybe the universe doesn’t work the way you think it does and no matter how much you insist there has to be a way to fix every problem the universe doesn’t give a shit what you think. Maybe some problems are intractable and the best you can do is make trade-offs and maybe some times doing nothing is the best thing you can do.

    See also: any other big government program that seems to create more problems than it solves at a cost of a gazillion dollars and big chunks of your liberty. Libertarians are scoffed at because their laissez faire attitude toward most everything doesn’t suggest any good way to solve all the problems in the world when the whole point of libertarianism is that all the problems in the world can’t be solved and attempting to fix them has a better than even chance of making them worse. It’s like somebody with a plan for a perpetual motion machine who, when you tell him it isn’t going to work even if you can’t say specifically why it isn’t going to work, asserts that until you’ve produced a workable plan for a perpetual motion machine you have no right to criticize his.

    1. You’re the best, Jerry.

    2. I have just the answer – unicorn therapy works wonders. Plus, since the unicorns shit gold nuggets, it’s quite profitable. Just issue every addict a therapy unicorn and the problem magically solves itself.

      Unicorns shitting gold nuggets is a myth! Unicorns poop rainbow ice cream. Totally clean! Totally cool!

  7. San Francisco has a policy of naloxone distribution through Department of Public Health.

    Every naloxone use saves thousands of dollars in emergency response. Until we can reach the libertarian ideal where, if you haven’t bought an OD insurance plan, you are left to die in the street and your corpse will be left to rot, harm reduction will save money as well as lives.

    This is the cheaper option. Not providing harm reduction is like not changing your oil. You save $30 bucks on the oil change, but a year later you pay much more for a valve job.

    1. Isn’t the use of naloxone effectively an emergency response?

      1. Naloxone is distributed throughout the community. Community members perform the response for the cost of one dose of Naloxone, instead of sending an ambulance. San Francisco experiences a fraction of the deaths of other American cities, and it’s obviously not because there aren’t any users.

        Harm reduction saves lives AND saves money.

        1. I’m not an expert on Naloxone, I just find it surprising that you can respond to an overdose and not follow up with an ambulance and trip to the ER.

          1. Addicts will avoid the trip to the ER if at all possible. If the naloxone works they just won’t go.
            Same with other medical issues such as infections which is a big issue with IV drug use. Typically addicts wait until the problem is so severe that there is no other choice.

            All of which adds to the cost the rest of us pay.

            You could deny payment to the hospitals and ambulance but you pay one way or the other as the hospital just passes it on in higher fees.

        2. Also, I should add that even as a libertarian, saving lives AND saving money are not necessarily the primary conditions of a program’s success. Especially when there are potentially dire second order effects.

          1. An ER visit is recommended. However, the severity is less for someone treated immediately versus having to wait for first responders. Also, it’s not necessarily an ambulance trip.

            Nobody’s freedom is being restricted by increasing availability of naloxone. Government spending decreases. Seems like a libertarian solution to me.

            1. Nobody’s freedom is being restricted by increasing availability of naloxone. Government spending decreases. Seems like a libertarian solution to me.

              I’m not arguing against the use and availability of Naloxone (which in Rigg’s defense is what this article is about). I’m arguing about the surrounding policies that many Naloxone proponents also put in place, and in particular put in place right outside my doorstep which sure– may save a life and a few pennies of my taxpayer scratch, but are causing major negative cascading effects which are stressing the living tar out of all the other services here.

  8. Let naloxone be available but early studies show expanding Naloxone access might not in fact reduce mortality. Although the risk of death per opioid use falls, an increase in the number or potency of uses means the expected effect on mortality is ambiguous.
    The moral hazard prevails, when people are protected from the consequences of their risky behavior, they may be more inclined to take risks.

    1. I haven’t seen any data that discusses incidence of overdose compared to lives saved. The data I have seen from insite mainly showed how many overdose victims were saved, but didn’t seem to have any indicators if overdoses had increased. I believe that Inside claimed they had four overdoses a day at the insite location. If those overdoses would have resulted in death, that would be 1400 overdoses a year at that site ALONE. Insite officials also note that a lot of addicts don’t bother to come to the insite location but just remain in the back alleys and sidewalks in the general neighborhood. The response to that was to create patrolling naloxone teams throughout the neighborhood.

      My question, which I don’t have any hard data for is, are we saving lives but increasing the incidence of life-threatening conditions?

      1. How would they measure lives saved?

        I have seen some of the data from the Toronto center. It is hard to draw any conclusions. It is self reported data from one center so that is a limitation. Since they are only reporting what they have there is no control group to compare with.

        It is difficult to come up with any hard data on this whole issue which is part of the problem.

    2. Recall my wife mentioning some literature on this. Can ask her tonight but got a link?

    3. I have high blood pressure. The doc prescribed me a pill I take. It is not expensive, just an old school beta blocker generic with some small dose of diuretic. I just pop one down with my coffee in the morning.

      He also said I should cut down on sodium intake and exercise more.

      The BP and resting heart rate are normal now.

      I have not given up my beloved corned beef sandwiches and kosher dills from the deli and still do not exercise any more than I did.

      I have been protected from the consequences of my actions and risky behavior. For now anyway.

      Mortality rates. We all die eventually. One needs to be specific about those to make any sense out of those numbers.

    4. So it seems to me you are essentially noting that dead drug addicts stop taking drugs, where as ones that don’t die keep living and thus take more drugs at some later point in time.

  9. “Many years ago, I was in the home of a relative whose husband was a heroin addict, and hanging on a wall in the hallway was a poster that read: “Signs of a drug overdose.” It went on to list symptoms such as passing out, disorientation, shallow breathing, vomiting and muscle spasms. It instructed them to call 911 immediately.

    I was aghast. It was like saying to the addict and their children that it’s OK to use drugs as long as you make sure someone knows how to save your life if you take too much.”

    This is an extremely good point. If someone you love has a drug problem, you should make sure that you have absolutely no idea what to do if they overdose

    1. The concern which is often poorly articulated is not so much that we should be saving their lives, but if we do save their lives, do we just high-five them when they come to and hand them another clean syringe full of heroin? Is there perhaps a comprehensive set of policy changes (which include the use and availability of naloxone and life-saving techniques) that might help the individuals and the community avoid exacerbating other problems which tend to spread far beyond the addict?

      1. I understand your argument, I’m just bringing up the fact that it’s absolutely insane to look at an individual’s attempt to keep their husband from dying and be “aghast.”

      2. IMO the moral equivalency to providing safe injection site & narcan to “save lives” and the damage done to families of the addict is wrong think. Imagine teaching your 10 year old to inject mommy or daddy if he/she won’t wake up. There are treatments for opiate addiction other than methadone that work. But you have to want these to work.

        1. How many psychiatrists does it take to change a light bulb?

          Just one but the light bulb has to really want to change.

  10. Oh, and by the way, state law states there’s no smoking within 20′ of the safe injection site– and definitely no plastic straws allowed.

  11. Ya know, this, along with every other socially-invasive piece of legislation, can be gone in the blink of an eye with the abolition of taxation.

  12. Glanton:

    the underlying problem of addiction. The truth is that America doesn’t know how to fix this opioid problem

    Riggs:

    Glanton says we don’t know how to tackle this problem, but that’s absolutely wrong. France lifted provider restrictions on the opioid treatment buprenorphine, and in just four years reduced opioid overdose deaths by nearly 80 percent. The supervised injection facility in Vancouver, British Columbia, has reduced both opioid overdose deaths and the transmission of HIV in the surrounding area. In the 1970s, New York City’s methadone-on-demand program saved countless lives.

    Not the same problem, you see. Glanton’s problem is “addiction”, Riggs’s problem is deaths & illness.

  13. Whew! I was afraid the liberal Trib columnist was Chapman.

  14. “…does nothing to address the underlying problem of addiction. The truth is that America doesn’t know how to fix this opioid problem…”

    Retarded all-or-nothing thinking on display.

    While we’re waiting for all social problems to be solved (and I’m sure people like this guy will figure it out any day now), then let’s talk about ways for addicts to not die, so that once these genius newspaper columnists find their wonderful “fix,” the addicts will be around to be benefit from it.

  15. “Placing so much attention on accommodating the drug addict does nothing to address the underlying problem of addiction. The truth is that America doesn’t know how to fix this opioid problem and meanwhile, it’s getting worse”

    You know what else? Placing so much emphasis on “bathing” does nothing to address the underlying problem of humans getting dirty. The truth is that America doesn’t know how to make dirt-resistant humans who don’t need to sweat, and in the meantime people are just getting stinkier.

  16. I think that addiction is hard-wired into some people and should not be treated as a weakness or moral failure. All this talk about opioids while alcohol continues to be much more widely abused and kills more people

    1. Ya, the majority will eventually grow out of their addictions once they hit rock bottom or find something better to do. Much of addiction treatment is merely harm reduction until that particular light bulb goes off. A lot of it is simply waiting for the young and stupid to become less so. You might as well harangue about teen drivers and how air bags are incentivizing poor driving skills.

      Hinted at by the rural vs. urban death rates is the lack of medical treatment available out in the sticks. With the closing of rural hospitals as a cost cutting measure, distance to get medical treatment has doubled in what wasn’t enviable in the first place.

      Libertarianism, as usual, has very little to offer beyond free to die, darwin awards, move to where the medical professionals are, and wondering why the can’t get elected.

  17. “Accomodating?” Maybe not the right word. “Enabling?” I could see that.

  18. Tsk, tsk. The Libertarian Party has turned into Democratic Socialists, virtue signalling their morally superior humanitarianism, while relying on taxation to pay the bills. Wondered how long the LP leadership would hold out against conflating charity with welfare state taxation, once they noticed that D.C.’s millionaire tax collectors are keeping half the “humanitarian” taxes.

    P.S. Drug addiction is a decision, not a disease. If it were a disease, millions of kids in the sixties copping every drug made, every day, in every park, in every city would be highly observable today as millions of 70 year old addicts.

  19. The progressive communist loves to control you for your own good, man.

    This is all about the Bureaucratic Mind who went to pre-think tanks schools like the Kennedy School of Big Government.

    Now the bureaucratic mind (BM) is a special type of mind.

    According to scholars, the BM, was brought into the modern world by the German egghead Max Weber and introduced to the USA by the egghead Woodrow Wilson.

    Writing as an academic while a professor at Bryn Mawr College, Woodrow Wilson’s essay “The Study of Administration” argued for bureaucracy as a professional cadre.

    When he was elected the 1st democrat progressive socialist president – he was said to remark- “now I can really tax, regulate, and control”

    Wilson, got the USA involved in WWI, a war that had nothing to do with America.

    Few American men wanted to fight in Wilson’s war of choice, so he started a military draft to force men to fight.

    But really gave him wood was how to fund his war of choice.

    Yes – he started a federal income tax.

    Wilson personally wrote the first IRS forms along with the instructions and regulations .

    Do government forms and regulations befuddle you?

    Blame Woodrow Wilson, the socialist god.

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