We Must Embrace Harm Reduction – Time to Stop Incarcerating Sick People And Treat Them With Medically Sound Intervention

This past week I was privileged to be a guest on Talk Recovery Radio 100.5 Vancouver.  I hope you will take the time to listen to that interview.  It was streamed live on Talk Recovery’s Facebook as well as available on their podcast.

https://player.fm/series/talk-recovery-radio/june-ariano-jakes-author-of-addiction-a-mothers-story

 

As well,  I have now finished the Third Edition of Addiction: A Mother’s Story.  If you previously read the first or second editions of Addiction: A Mother’s Story you will find a third of the content repeated.  A third revised content and a third completely new content, with a focus on harm reduction.

Below you will find Chapter 66 of the Third Edition – I feel it falls in line with some of the discussion I shared on Talk Recovery Radio  – We Must Embrace Harm Reduction – Time to Stop Incarcerating Sick People And Treat Them With Medically Sound Intervention

I am sure that every one of you who has a loved one struggling with drug addiction and the resulting criminal activities will feel as passionately as I do about this subject.

Do we, as a society, keep doing what we have always done, or do we stop that revolving door and admit that what we have been doing is not working? It is not working now. It never worked in the past. And it won’t work in the future.

Our prisons, worldwide, are overflowing with people whose crimes are related to their drug addiction. Most of those people likely made that first moral choice to try potentially addictive drugs in their teen years or early twenties. And I believe it would be fairly safe to say that none of those who experimented with drugs ever expected to become addicted. Never expected to be that person who would lose everything.

Those are the years when every generation tends to take the biggest risks. In the case of drugs, not any one of our loved ones ever expected to become addicted to the drugs they were experimenting with. It was just supposed to be fun. It was just supposed to be a party.

And for some, it was just a party.

As I have previously said, it wasn’t that they were stronger or more determined. It wasn’t that they had willpower and our child didn’t. It wasn’t because they were born into a certain family or attended a certain school or lived in a certain area. None of that matters. It was simply because they did not have the disease of addiction, and our child did.

Many people will argue that it is a moral choice, not a disease. As you know by now, my feeling about addiction is that the very first time our loved one took a potentially addictive drug, they made a moral choice. They crossed that line. But once addiction raises its ugly head, it is a disease, albeit a disease with a choice. At any time, an addict can stop using their drug of choice, and the disease halts. They will always have that propensity, but they will have stopped their addiction in its tracks. Sounds simple enough.

Well, if it were that simple, we would not have hundreds of millions of people struggling with addictions so severe that they lose everything in life they love. Everything and everyone they care about for that next fix or that next drink.

Addiction is a disease, and as a society, we have to stop treating addicted people with punishment. Worldwide, countries are building more and bigger prisons to house all those people who have committed crimes to feed their addiction.

Now don’t get me wrong, I too believe that people should have to pay for crimes they commit. I am not saying they should not be held accountable. I am only saying that incarceration is not the long-term answer.

Instead of building more and bigger prisons, why are we not turning those resources around and providing places of help for those struggling with addiction.

We will never “punish” our way out of a health crisis. And that is exactly what addiction is. It is a health crisis of monumental proportions. Punishing very sick people for being sick makes about as much sense as spanking a child for hitting their sibling and then telling them “don’t hit.”

If nothing changes, nothing changes. It is as simple as that.

The average cost to incarcerate one person is $115,000 per year. I say the average cost because minimum-security prisons would be less, maximum- security prisons would be more.

What if our governments got smart and admitted what they clearly know: that the status quo is not working?

On average, 90% of imprisoned people are for one reason or another there for drug- or alcohol-related crimes—possession, robberies to support a drug habit, car thefts, home invasions, assaults, spousal abuse, prostitution to support a drug habit, DUIs, vehicular homicide while under the influence of drugs or alcohol, fraud, identity theft, credit-card theft, shoplifting. The list goes on and on. But the common denominator is that 90% of the imprisoned population is in for substance-abuse-related offences, and 70% of them are battling severe addictions.

We need places of help. We need places of hope. Punishing sick people for committing crime, without addressing the root cause does absolutely nothing to address their disease. If we help those struggling with their addiction, they won’t have that need to turn to criminal activity. The revolving door of the criminal justice system must end for those battling addiction.

From my many years of experience in the field of drug addiction, both with Nathan’s devastating addiction and with the work I do with those battling addictions, homelessness and mental illness, on the street, I have come to realize there are only two reasons people use drugs. Curiosity and pain.

People are naturally curious and that may well be what first brought your loved one to try an illegal substance. It may be as simple as that. And that curiosity led them down a path they could never had imagined in their worst nightmare and neither could you.

The second reason and this is more complex, is pain. I say this is more complex because we have many different types of pain. It may be physical pain. Like my son initially prescribed opiates because of a motor vehicle accident. And as he told me years later, “I loved the feeling I got from that medication”. It could be pain from a skiing or sports injury. A ruptured disc from lifting something the wrong way. Something that caused extreme physical pain and needed to be treated with an opiate.

Now I am not saying that everyone who takes an opiate loves it because that is not the case. When I had surgery and was given morphine, I hated the feeling and told the nurse I didn’t want it again. Clearly my physiology is different than Nathan’s. It left me very uncomfortable. It left him initially feeling relaxed, peaceful and warm. And that is the difference being someone with the disease of addiction and another without that disease.

It may be emotional pain, perhaps a sexual assault, maybe domestic violence, the death of a loved one, continuous bullying, seeing a traumatic event. Perhaps PTSD. An emotional pain that leaves you feeling broken or isolated and you found that taking that medication left over in the medicine cabinet when you got your wisdom teeth out, helped. You forgot for a while with its lulling affect. So many people are suffering in silence and we may not even be aware of it.

When addiction takes control of your life, and it does take control, it leaves the person addicted feeling helpless and hopeless. I will repeat it again, look into the eyes of someone struggling so severely with addiction and you will see sadness, pain, hurt and hopelessness.

Repeating the comment Nathan once said to me, after many years in his addiction, “I used to have hope, Mom, but I don’t anymore. I used to believe that things would change, but I don’t believe they will. I accept this is my life. I want it to be different. I just don’t know how to do that anymore”.

They are stuck.   We have to offer every bit of help we can. And help is there. But we need to make it readily and easily available. People struggling cannot go through hoop after hoop. They will give up. We have to meet people where they are at and provide them with the best possible treatment option, individualized care that works for them. Addiction treatment is not a “one size fits all” disease any more than any other chronic or potentially terminal disease is. An individual care plan must be established for people to achieve the best and safest results for themselves.

It is stunning to note that 80% of people struggling with the disease of addiction are not receiving treatment. That is staggering. We are failing people by keeping them isolated, stigmatized and living in shame.

We have to improve a person’s chance of success by normalizing their treatment. And what may be effective treatment for one person will not be effective for another.

Abstinence alone, when dealing with opioid use disorder rarely work long term. Statics are not in their favour. But we have medications available that have proven highly effective treating addiction. Highly effective. Science, not emotions should guide decisions around addiction and harm reduction. We need a continuum of care with evidence based, immediate access to treatment.

We have to make it easier for people struggling to access effective medication. Every doctor should be able and willing to prescribe it and  all pharmacies should have it available to fill those prescriptions. Not just in larger communities but in every community in every town and city everywhere. Because this issue is everywhere. Methadone, Methadose and buprenorphine (Suboxone) are highly effective in the treatment of opioid addiction. I see first hand how it gives those we love their lives back. These are life saving medications.

Far to many people take the attitude that you are just exchanging one drug for another. Or that you should be weaned off it as quickly as possible.

I disagree completely. And so does medical science. The facts are evident. These highly effective medications can stabilize the life of a very sick person. We would never stigmatized a diabetic for taking insulin or a person with arthritis taking anti-inflamatories, or someone with high blood pressure taking medication. Those are all chronic diseases. Then why do we treat those battling the disease of addiction with any less awareness, understanding or compassion. If taking a medication every day to stay healthy is wrong or a sign of weakness, then we are all wrong and we are all weak. Addiction is a disease that no one ever thought they would get. Absolutely no one. But they did. They made a decision at one point in their life and that decision gave birth to the disease of addiction in their life.

By the time a loved one struggling with addiction is ready for help, they may have been through considerable trauma. As I have said before, those people in the illegal drug trade are ruthless.

They may be struggling with the underlying causes as to their initial drug use. We have to, as a society, do everything we can to offer support, counseling, and understanding. This is not a quick fix. And we should not expect it to be. But help is available and should be much more easily assessable.

And what about those individuals that have tried everything available. They have gone through detox. They have gone to treatment facilities. They have been on Methadone and Methadose and Suboxone. But they cannot get on top of their addiction. That grip just will not let them go. Do we forget about them?

Absolutely not. And this is where we have to embrace other means of harm reduction. As I have previously said, this is not a “one size treatment fits all” disease. We have to think outside the box. It may not be popular. It may not be what many want to see happen. But it saves lives for those people who would otherwise never get a handle on their addiction. Specialized clinics that provide prescription heroin or hydro-morphine injections daily. Where a person struggling goes in a few times a day for their medication. They are no longer using toxic illegal drugs sold on the street. They are not overdosing. Crime goes down. They are seen thoughout the day by a nurse and they are able to stabilize their health and stabilize their life. And that is a very good thing. Like I said, many in society will not consider this a popular treatment but it is not them that is struggling every day just to make it through the day. We have to keep our minds open to effective possibilities. Popular or not. For some, this is the only option they have left. And for them it works.

Drug addiction is a chronic and deadly disease. If we keep incarcerating sick people, keep punishing them, without giving them the help and medical intervention they desperately need then the cycle continues. But if we offer treatment then we give each of those people the opportunity to break the chains of addiction holding them hostage.

Everyone wins every time a person struggling with the disease of addiction gets help. We then have another responsible adult in our community—contributing in a healthy manner.

Crime would go down astronomically. The costs of health care, emergency personnel, police, the courts, and all the other services related to substance abuse would decrease if members of our addicted population received the proper treatment.

Addiction is a disease. The status quo doesn’t work. It is time to rewrite some of our laws. Every day that we delay, more very sick people continue in the revolving door. And sadly, many die while our governments world wide are building more prisons.

We will always deal with the naysayers who believe we should simply lock up addicts and throw away the key. And that is absolutely ridiculous. Too often, though, people have stayed silent when their voices could have made a difference. We can’t stay silent any longer. The lives of our sons and daughters are depending on us. We need to speak up and let our politicians know that it’s time to see addiction for what it is: a disease that has far too many of our loved ones in its grip.

Until next time – take care of yourselves – talking care of yourself cannot be seen as a luxury – it is a necessity – remember in all the kayos of addiction, you count.  Be kind to yourselves.

Much love,

June

2 thoughts on “We Must Embrace Harm Reduction – Time to Stop Incarcerating Sick People And Treat Them With Medically Sound Intervention

  1. Tania Smith

    I loved reading your latest post. My daughter is in hospital with a DVT, pneumonia, and sepsis. We got the call last week that every parent doesn’t want. Get yourselves here sooner rather than later! She is making progress, thank God and has now got a place in a proper Rehab. We love her very much but it’s not enough. Hopefully now she will find the mental strength to get her life back.

    1. Thank you so much for taking the time to share your daughter’s very serious health emergency with me Tania. I am truly humbled.

      I am so happy to hear your daughter is ready to go into treatment. Nothing is more important than finding that right place where the care and support fit what it is she needs to feel safe and supported in a therapeutic setting.

      As her Mom, I know the devastation of getting that phone call, brought you to your knees. As parents we would do anything to help our children whom we love so much. Sadly, we realize they need help and support much sooner than they do. By the time our loved one may be ready, as with your girl, consider damage to their health has occurred.

      You, your daughter and your family will remain in my thoughts, that this is the time she is ready to grab that lifeline and accept the help both she and you desperately deserve. Please stay in touch. I truly care.

      Much love,
      June

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