As you know, a significant part of the battle is just getting people to acknowledge that addiction isn't a choice and the people who have addiction problems don't deserve the hardships that addiction has caused. We could fix a lot of problems if only there were some way to dial up our collective empathy meter.
Substance abuse disorders are a subset of mental health disorders. We don't treat schizophrenics any better than we do addicts. It's all scandalous. But unless there's money to be made, investors aren't interested and the indigent mentally ill have no money. Unless government taxes the rich, neither do we.
Harmful effects from our foolish response to addiction spread their tentacles through our whole society. I follow a Twitter thread of chronic pain patients (CPPs) who have done well on opioids for chronic non cancer pain. Thousands are being abandoned, involuntarily tapered, or simply unable to find another prescriber after their doctor retires or is forced out by prosecution. They are horrified because their doctors say (or don't say) they fear or are being threatened with prosecution if they continue prescribing.
The well-meant CDC Guidelines on opioid therapy have been weaponized by legislatures and prosecutors to attack doctors who are prescribing to merely relieve suffering.
This all comes back to the Controlled Substances Act of 1970, enacted out of puritanism, racism and Nixon's scheme to destroy his enemies. The US imprisons over 2 million people, mostly on drug charges, mostly people of color.
To what end? The US death rate from OD is 50 times Portugal's which famously decriminalized all drug use in 2001.
Case and Deaton, and since them, many others have linked our epidemic of deaths of despair to Federal policy favoring massive transfer of wealth from the middle class to the insanely rich.
All this stems indirectly from the growth of fascism in the US, which we're just realizing now has been fostered and fed by Russian disinformation propaganda for at least 30 years. The Ukraine war has brought this into focus, and I hope the US will have a feverish convulsion of revulsion and a new birth of democracy as we realize how we've been manipulated.
Thus I hope for a simple repeal of the CSA, with drug regulation placed under HHS instead of DOJ, and more tax policy like Biden's recent proposal to tax the rich enacted. And I hope Democrats in Pennsylvania will register 100,000 new voters and get them to the polls in November.
Hi Mr. Kristiof, First of all, I was an early contributor to your campaign for Governor and I am deeply disappointed that Fagan stepped in to disallow your candidacy. One of my main reasons for supporting you was your focus on addiction and homelessness, both extremely intertwined. I lost my oldest son to OxyContin at the age of 33 (Bright, talented software engineer with amazing other gifts). My other son is in recovery with 15 years of sobriety. Both of my parents , alcoholic. This issue is obviously core to me. I suggest you reach out to Brent Canode, the executive director of the Alano Club in Portland. The work Brent is leading is recognized nationally as some of the most innovative and effective , community based recovery programs. And the services are free to all who seek it! My vision is to see the Alano Club model replicated throughout the state. I pitched the concept to Wyden’s office but it went nowhere. It is a low cost to serve model. I am convinced the public funding is available, either federally, through the OxyContin settlements or through OHA funding. This issue needs a champion and you can be that champion! As I assume you know, we have the second highest rate of addiction within the 50 states and the lowest level of treatment available. If you want to dialogue, call me at 503/680-5566. Liz Eiting
I should have been dead over 30 years ago from the disease of addiction - I happen to be one of the very fortunate ones who managed to sober up, stay sober, and enjoy a life that is beyond my wildest dreams. So I am well aware that recovery is possible - I'm living proof. And this column is another reminder to me to do more to reach out to others who need help.
Unfortunately, the groups and programs that deal with addictions still have to have "Anonymous" as their second name. As you & others have mentioned, society stubbornly refuses to accept addiction as a disease, or to release its iron grip on those antediluvian drug laws and attitudes that produce effects completely opposite their stated purpose. When I discussed Portugal's phenomenal successes with an older American, the reply was, "So, you advocate doing something wrong to produce good results?" The notion that helping addicts was "wrong" was so deeply embedded in this person's thinking that there was absolutely no room for compassion or open-mindedness.
So my goal - and evidently yours as well - is to not allow ourselves to fall prey to the same sort of hopelessness that leads to these "deaths of despair." We have to hold on to the hope that these seemingly bedrock attitudes can indeed be changed. And we have examples from recent history: at the height of the AIDS epidemic many Americans - including the president of the US - chose to ignore the disease, calling it "gay cancer." Religious leaders called it God's punishment for gay men. These attitudes seemed to be unshakable as well, since they were a part of our religious doctrines and societal beliefs for centuries.
But there has been enormous change in the way Americans view LGBTQ citizens, and this gives me hope that these same Americans will find a way to begin changing their attitudes about addiction as well. So thanks for the column, and for your efforts to help people just like me, who haven't yet found their way.
I think some of the problems start with our lack of good quality early childhood education followed by good education thru high school preparing people for meaningful employment, healthy relationships and good self esteem. Obviously that is a very long term solution but we need to start at the bottom and work up generation by generation
If society accepts its collective responsibility for addiction, we’re going to have to accept our collective responsibility for poverty too. And if we do that, people may realize that being rich does not make you Horacio Alger. And that realization is threatening to a lot of people “who were born on 3rd base and thought they’d hit a triple.”
A huge factor that drives addiction in our country is Prenatal Alcohol Exposure (PAE), which manifests in Fetal Alcohol Spectrum Disorders (FASD). In the 50 years since researchers identified alcohol as the most dangerous toxin that a mother can ingest while pregnant, we have seen little validation of this truth due to the legal nature of this substance and the deep pockets of the alcohol industry which has targeted women of childbearing age for the last 40 years. A 2018 study estimates that 1 in 20 first graders in the US have FASD, making it nearly 3x as prevalent as Austism Spectrum Disorders. PAE is the single leading cause of ADHD and intellectual and developmental disabilities in our country. Combine a lack of government funded programs for prevention, screening, diagnostics, and interventions of FASD and you have the majority of this population continuing the cycle of addiction, homelessness and incarceration. The etiology of so much addiction is prenatal alcohol exposure. It's time to validate it!
I think the danger of addiction needs to be taught in the lower grades so kids know how bad it is. it is too late when they are in early teens... they are already experimenting with drugs... and sadly, sex.
Deaths of despair from drug use absolutely deserve attention and effective action. We appear to be living through a period in which reality is in disregard: e.g., alternative facts, anti-science, book bans. Back in the 60's there was enthusiasm -- albeit misguided -- for seeking higher consciousness from ingesting hallucinogenic or mind-altering substances. "Doors of Perception." "Tune in, turn on, drop out." Was the urge to get stoned a half century ago a legitimate protest against a disappointing experience with real life? And glorifying drug use as a rebellion against traditional values? Putting aside the physiological, destructive effects of potent addictive chemicals, in what sense is the crisis of despair a reflection on existential dissatisfaction and lament over real life and long-standing traditions? Across urban, suburban and rural communities one can measure alienation by the self-destructive behavior and catastrophic effect on emotional, mental and physical health. Hope and change? Can the modern world make new traditions?
Agreed. Even when people receive treatment for their substance abuse illness it is rarely good quality, rarely long enough to work, and rarely reinforced across their environments for the time necessary to last. Putin and Xi's role in this is rarely taken into account. Perhaps if we consider it the huge national security risk it truly is, we can get the dedicated policy changes needed to intervene in ALL cases and make prevention a #1 priority. Of course all families, all communities, and all fiscal budgets will benefit from such policies if we are determined to make them effective. Nicholas, since you are no longer running for Governor, would you and your wife please take on this challenge today?
I am a retired addiction and mental health counselor who developed and managed several treatment programs to address both diseases. They are often intertwined. Not only must we make treatment more available to anyone who wants it, we need to reduce overdose deaths by providing clean needles to drug users and a safe place to use drugs. Yes, this is a controversial idea, but it's been done successfully in other countries, where information on treatment is available along with safety. And we must start with children, providing the stability and services they need so that they don't turn to drugs to self-medicate mental illness or despair and other problems. Until we do these things, nothing will change. I am hopeful and I also know that alcoholics and drug addicts are also considered the dregs of society, people who chose their fate. Therefore, society sees little reason to offer them the help they need. But this is wrong, of course. Addiction is an illness and, as such, deserves the same attention as cancer, diabetes, heart disease and other chronic disorders.
A large portion of the population suffering from substance use disorder are also suffering from severe mental and emotional illness and could benefit from dual diagnosis treatment approaches to treatment.
As you know, a significant part of the battle is just getting people to acknowledge that addiction isn't a choice and the people who have addiction problems don't deserve the hardships that addiction has caused. We could fix a lot of problems if only there were some way to dial up our collective empathy meter.
Substance abuse disorders are a subset of mental health disorders. We don't treat schizophrenics any better than we do addicts. It's all scandalous. But unless there's money to be made, investors aren't interested and the indigent mentally ill have no money. Unless government taxes the rich, neither do we.
Harmful effects from our foolish response to addiction spread their tentacles through our whole society. I follow a Twitter thread of chronic pain patients (CPPs) who have done well on opioids for chronic non cancer pain. Thousands are being abandoned, involuntarily tapered, or simply unable to find another prescriber after their doctor retires or is forced out by prosecution. They are horrified because their doctors say (or don't say) they fear or are being threatened with prosecution if they continue prescribing.
The well-meant CDC Guidelines on opioid therapy have been weaponized by legislatures and prosecutors to attack doctors who are prescribing to merely relieve suffering.
This all comes back to the Controlled Substances Act of 1970, enacted out of puritanism, racism and Nixon's scheme to destroy his enemies. The US imprisons over 2 million people, mostly on drug charges, mostly people of color.
To what end? The US death rate from OD is 50 times Portugal's which famously decriminalized all drug use in 2001.
Case and Deaton, and since them, many others have linked our epidemic of deaths of despair to Federal policy favoring massive transfer of wealth from the middle class to the insanely rich.
All this stems indirectly from the growth of fascism in the US, which we're just realizing now has been fostered and fed by Russian disinformation propaganda for at least 30 years. The Ukraine war has brought this into focus, and I hope the US will have a feverish convulsion of revulsion and a new birth of democracy as we realize how we've been manipulated.
Thus I hope for a simple repeal of the CSA, with drug regulation placed under HHS instead of DOJ, and more tax policy like Biden's recent proposal to tax the rich enacted. And I hope Democrats in Pennsylvania will register 100,000 new voters and get them to the polls in November.
I can dream, can't I?
Hi Mr. Kristiof, First of all, I was an early contributor to your campaign for Governor and I am deeply disappointed that Fagan stepped in to disallow your candidacy. One of my main reasons for supporting you was your focus on addiction and homelessness, both extremely intertwined. I lost my oldest son to OxyContin at the age of 33 (Bright, talented software engineer with amazing other gifts). My other son is in recovery with 15 years of sobriety. Both of my parents , alcoholic. This issue is obviously core to me. I suggest you reach out to Brent Canode, the executive director of the Alano Club in Portland. The work Brent is leading is recognized nationally as some of the most innovative and effective , community based recovery programs. And the services are free to all who seek it! My vision is to see the Alano Club model replicated throughout the state. I pitched the concept to Wyden’s office but it went nowhere. It is a low cost to serve model. I am convinced the public funding is available, either federally, through the OxyContin settlements or through OHA funding. This issue needs a champion and you can be that champion! As I assume you know, we have the second highest rate of addiction within the 50 states and the lowest level of treatment available. If you want to dialogue, call me at 503/680-5566. Liz Eiting
I should have been dead over 30 years ago from the disease of addiction - I happen to be one of the very fortunate ones who managed to sober up, stay sober, and enjoy a life that is beyond my wildest dreams. So I am well aware that recovery is possible - I'm living proof. And this column is another reminder to me to do more to reach out to others who need help.
Unfortunately, the groups and programs that deal with addictions still have to have "Anonymous" as their second name. As you & others have mentioned, society stubbornly refuses to accept addiction as a disease, or to release its iron grip on those antediluvian drug laws and attitudes that produce effects completely opposite their stated purpose. When I discussed Portugal's phenomenal successes with an older American, the reply was, "So, you advocate doing something wrong to produce good results?" The notion that helping addicts was "wrong" was so deeply embedded in this person's thinking that there was absolutely no room for compassion or open-mindedness.
So my goal - and evidently yours as well - is to not allow ourselves to fall prey to the same sort of hopelessness that leads to these "deaths of despair." We have to hold on to the hope that these seemingly bedrock attitudes can indeed be changed. And we have examples from recent history: at the height of the AIDS epidemic many Americans - including the president of the US - chose to ignore the disease, calling it "gay cancer." Religious leaders called it God's punishment for gay men. These attitudes seemed to be unshakable as well, since they were a part of our religious doctrines and societal beliefs for centuries.
But there has been enormous change in the way Americans view LGBTQ citizens, and this gives me hope that these same Americans will find a way to begin changing their attitudes about addiction as well. So thanks for the column, and for your efforts to help people just like me, who haven't yet found their way.
I think some of the problems start with our lack of good quality early childhood education followed by good education thru high school preparing people for meaningful employment, healthy relationships and good self esteem. Obviously that is a very long term solution but we need to start at the bottom and work up generation by generation
If society accepts its collective responsibility for addiction, we’re going to have to accept our collective responsibility for poverty too. And if we do that, people may realize that being rich does not make you Horacio Alger. And that realization is threatening to a lot of people “who were born on 3rd base and thought they’d hit a triple.”
And to ignore deaths by guns as though it was an acceptable daily occurrence
A huge factor that drives addiction in our country is Prenatal Alcohol Exposure (PAE), which manifests in Fetal Alcohol Spectrum Disorders (FASD). In the 50 years since researchers identified alcohol as the most dangerous toxin that a mother can ingest while pregnant, we have seen little validation of this truth due to the legal nature of this substance and the deep pockets of the alcohol industry which has targeted women of childbearing age for the last 40 years. A 2018 study estimates that 1 in 20 first graders in the US have FASD, making it nearly 3x as prevalent as Austism Spectrum Disorders. PAE is the single leading cause of ADHD and intellectual and developmental disabilities in our country. Combine a lack of government funded programs for prevention, screening, diagnostics, and interventions of FASD and you have the majority of this population continuing the cycle of addiction, homelessness and incarceration. The etiology of so much addiction is prenatal alcohol exposure. It's time to validate it!
I think the danger of addiction needs to be taught in the lower grades so kids know how bad it is. it is too late when they are in early teens... they are already experimenting with drugs... and sadly, sex.
Thank you for shining the light on this dreadful problem. Here in TN it affects so many youth.
Deaths of despair from drug use absolutely deserve attention and effective action. We appear to be living through a period in which reality is in disregard: e.g., alternative facts, anti-science, book bans. Back in the 60's there was enthusiasm -- albeit misguided -- for seeking higher consciousness from ingesting hallucinogenic or mind-altering substances. "Doors of Perception." "Tune in, turn on, drop out." Was the urge to get stoned a half century ago a legitimate protest against a disappointing experience with real life? And glorifying drug use as a rebellion against traditional values? Putting aside the physiological, destructive effects of potent addictive chemicals, in what sense is the crisis of despair a reflection on existential dissatisfaction and lament over real life and long-standing traditions? Across urban, suburban and rural communities one can measure alienation by the self-destructive behavior and catastrophic effect on emotional, mental and physical health. Hope and change? Can the modern world make new traditions?
Agreed. Even when people receive treatment for their substance abuse illness it is rarely good quality, rarely long enough to work, and rarely reinforced across their environments for the time necessary to last. Putin and Xi's role in this is rarely taken into account. Perhaps if we consider it the huge national security risk it truly is, we can get the dedicated policy changes needed to intervene in ALL cases and make prevention a #1 priority. Of course all families, all communities, and all fiscal budgets will benefit from such policies if we are determined to make them effective. Nicholas, since you are no longer running for Governor, would you and your wife please take on this challenge today?
Your voice needs to be amplified so any political "soap box" you choose I will support.
I am a retired addiction and mental health counselor who developed and managed several treatment programs to address both diseases. They are often intertwined. Not only must we make treatment more available to anyone who wants it, we need to reduce overdose deaths by providing clean needles to drug users and a safe place to use drugs. Yes, this is a controversial idea, but it's been done successfully in other countries, where information on treatment is available along with safety. And we must start with children, providing the stability and services they need so that they don't turn to drugs to self-medicate mental illness or despair and other problems. Until we do these things, nothing will change. I am hopeful and I also know that alcoholics and drug addicts are also considered the dregs of society, people who chose their fate. Therefore, society sees little reason to offer them the help they need. But this is wrong, of course. Addiction is an illness and, as such, deserves the same attention as cancer, diabetes, heart disease and other chronic disorders.
A large portion of the population suffering from substance use disorder are also suffering from severe mental and emotional illness and could benefit from dual diagnosis treatment approaches to treatment.