Duped or doped?

Heroin addicts: criminals or victims?

By Sarah Sidlow

Here’s an interesting bit of trivia courtesy of Cleveland.com: If all the opioid addicts in Ohio lived in one place, it would be roughly the size of Akron, the fifth largest city in the state. Those 200,000 statewide addicts are the face of a startling national reality: According to the Centers for Disease Control, overdoses from heroin, prescription drugs, and opioid pain relievers edged out car accidents as the leading cause of injury-related death in America in 2015. Heroin overdoses alone have more than tripled in the last five years.

Let’s not forget something – these statistics represent actual people. The question is are those actual people criminals, or are they simply victims of a flawed justice and pharmaceutical system?

Many view opioid addicts as victims and argue the system requires a significant re-evaluation. Consider this: someone is admitted to the hospital due to an injury and is prescribed an opioid to manage their pain. Over time, their nerve cells grow accustomed to this outside source of pain treatment. Then, their prescription period ends, or the patient realizes they can no longer afford expensive prescription opioids. But their nerve cells still crave what they’ve grown used to and cry out for help by triggering some really nasty withdrawal symptoms. So, the patient finds another source. Either they find a way to score prescription opioids on the streets, or they experiment with heroin, which boasts a lot of the same pain-relieving effects but with a much smaller price tag. This basic occurrence has become so common that several members of the Ohio judiciary and law enforcement quip that the U.S. Food and Drug Administration’s acronym, FDA, really stands for “Fostering Drug Addiction.”

Ohio Senator Rob Portman thinks it’s time to give addicts a bit of sympathy. He is a co-author of the Comprehensive Addiction and Recovery Act, which passed the Senate 94-1 earlier this year and now awaits analysis by the House of Representatives. The legislation would do a number of things to aid opioid addicts, such as expanding the availability of naloxone (which can counter the effects of an overdose) to law enforcement and first responders, improving prescription drug monitoring programs to help states monitor prescription drug diversion, eliminating questions about illegal drug-related convictions on the Free Application for Federal Student Aid (FAFSA) financial aid form, and diverting resources toward identifying and treating incarcerated people who are suffering from addiction, “rather than just punishment as is often the case,” as the act reads.

But to some, the issue of opioid addiction is black and white: Illegal drugs are illegal; taking prescription drugs without a prescription is illegal; people who do illegal things should be punished.

The opioid issue seems to have potential bipartisan support. The epidemic sits at the junction of criminal justice reform and mental health legislation – two of the three policy areas House Speaker Paul Ryan predicted could pass both the Republican Congress and the Democratic president this year. That is, assuming anyone is willing to be definitive about anything in an election year. (Senate Majority Leader Mitch McConnell recently announced that he might not be interested in taking any substantial cracks at legislation in 2016 – TBD on how that affects basically everything.)

Reach Dayton City Paper forum moderator Sarah Sidlow at SarahSidlow@DaytonCityPaper.com

Passing on judgment

By Ben Tomkins

Heroin is a drug that very few people associate with the word victim because it’s one of the premier stereotypes of an idiot screwing up their life. However, that’s not the be-all and end-all of the argument until we define what a victim is. Here’s an easy example: A college sophomore gets involved with the wrong crowd, engages in high-risk behavior, and becomes addicted to heroin.

A victim? Probably not in most people’s eyes.

However, what about a single mother of four who is under a great deal of financial and personal stress, ends up addicted to pain killers after a doctor over-prescribes them to treat a back injury she got from being rear-ended, and when they cut her off cold turkey, she turns to heroin to stave off withdrawal?

Victim? I think you’d have to be one cynical asshole not to extend her at least part of an olive branch.

There are many middle grounds between those two narratives, but the great misreading of the argument before us is that it is primarily about heroin. This is entirely incorrect. This is about victimization, and heroin happens to be the context. You could replace those examples with a car accident from speeding and the question remains the same. More importantly, if I add in a bit of information you maybe didn’t know—maybe the college kid suffers from severe undiagnosed depression—the entire picture changes because now he is a victim of the unfortunate presence of heroin when he was in a bad state, not a pernicious decision maker.

Therefore, the first principle of victimhood is suffering from circumstances beyond your control—that which elicits sympathy. This can be either the product of another’s bad behavior or an unfortunate event like a tsunami. The second principle of victimhood is suffering from circumstances that could have been avoided but an individual made the best choice they could—that which elicits empathy. One easily leads to the other.

Very often the second principle is the governing factor in drug abuse, and with heroin one use can be plenty to get you hooked. Many people get involved with drugs because of tragedy, mental illness, and all sorts of other reasons that are worthy of our compassion. Heroin is a crime by law and an abuser may have to answer for that, but that doesn’t mean they are a criminal in spirit or irresponsible and self-destructive by nature or choice. If someone is not in a position to make a sound decision, are they not a victim of unfortunate circumstances when bad options come into their sphere? Because of nothing more than chance, one messed up person could become addicted to heroin and another squeaks over a rough patch.

Furthermore, what do we make of the unlucky person then unable to summon the funds for medical help to break the addiction? You can’t exactly sit around the house with 50 boxes of Oreos and dry out. Heroin detox is horrible, and without medical supervision and medication, you can quite literally die. Go ahead and get your copy of “Atlas Shrugged” ready, but I guarantee it’ll be different when it’s your child. Unfortunately, being unable to clean up your life for a lack of money when someone else can by mere luck of the birth lottery—see, affluenza—is being a victim in the first principle sense.

Without question, poverty stricken populations and those suffering from abuse are at higher risk for addiction. A child whose single mother is working three jobs to pay rent in the ghetto and put food on the table is going to have far more stress and instability than many other children. I’ve worked with many extremely poor families, and if you’ve ever had trouble concentrating on a crossword puzzle without a latte, try six hours of school on no dinner or breakfast when you’re eight years old. Also, they are liable to have less guidance in their lives, and suffer from a lack of information. Worse, they may have parents who abuse heroin. I’d go into physical and sexual abuse, but if you can’t put together how that can lead to heroin use you couldn’t have read this far down the page.

The complexities of the heroin epidemic must not be pigeonholed as bad choices. I recommend you take a look back at your life and think about all the choices you made that could have gone one way or another but for sheer luck. Even a single mistake in an otherwise flawless life—perhaps because of a major life trauma—can be the difference between being HIV positive or addicted to powerful drugs like heroin. If you are then crippled by social stigmatization, it’s a thousand times harder to cope.

Almost nobody ever knows the specifics of the things in your life that are screwed up.  However, when we start levying judgment about why someone is, say, addicted to heroin rather than concentrating on helping them get off of it, we fail them in terms of both reason and compassion. The most important thing when someone is desperately reaching out for help is not to judge; it’s to help. Questioning them before extending a hand over the first hurdle is to make them a victim most worthy of pity: a victim of our indifference to their humanity.

Ben Tomkins is a violinist, teacher, journalist and critically acclaimed composer currently living in Denver, Colorado. He hates stupidity and generally believes that the volume of one’s voice is inversely proportional to one’s knowledge of an issue. Reach Ben Tomkins at BenTomkins@DaytonCityPaper.com.

It’s simple supply and demand

By Victor DeLaine

Don’t decriminalize heroin.  If you do, then – duh! – more people will use it.

If you don’t think that would be a bad thing, an awful thing, a tragic thing, then get out of your cocoon, visit a rehab clinic, and take a hard look at the wreckage heroin has wrought in too many lives.  Or visit an addict’s funeral.  Last year, you would have had 30,000 funerals to pick from.

More use means more addiction and more funerals.  Criminal sanctions, by depressing the supply, raising the price, and making users think twice, mean less use, less addiction, and fewer funerals, a fact no decent citizen can ignore.

Should we offer users a medical path away from addiction?  Of course we should.  But don’t assume, as our debate question does, that criminal sanctions and medical care are either / or alternatives.  Think of them instead as both / and.  The epidemic of addiction cries out for compassionate medical care.  But it demands criminal sanctions, too.

Those who argue against such sanctions will inevitably liken heroin, just as they habitually liken all drugs, to alcohol.  Their argument, however, is horribly double-edged.  Alcohol, whose ill effects we treat as medical problems only, not as criminal ones, has far more addicts in its thrall than heroin does.  Alcohol has ruined more careers, relationships, and lives than any illegal drug ever will.  If you lift the criminal sanctions that apply to heroin, then heroin will emerge as alcohol’s competitor.  Five out of 10 adults use alcohol, according to Julie Holland, M.D., as do a distressing number of teenagers. One or two out of a 100, by contrast, use heroin.  Do you really want heroin to be free to rack up the same numbers as alcohol?

Many bad things can rightly be said about our drug laws, but the threat of criminal punishment at least keeps the number of users lower than it would otherwise be.  As high as the numbers already are, decriminalization would make them higher.  Consider the relatively benign example of marihuana.  During its flirtation with libertarianism in the 1970s, Alaska lightened the penalties for marihuana, prompting young people in that state to start using marijuana at twice the rate of the rest of the country, as cited by the Department of Justice Drug Enforcement Administration.

That shows the difference that criminal sanctions make.  The Netherlands, whose laxity about drugs is well known, sees higher rates of use and abuse of almost all drugs.  It is simple economics.  When criminal sanctions depress the supply and constrict the outlets by which that supply reaches end-users, the price is higher and the demand, therefore, lower.

But libertarian ideologues are not moved by such facts.  Their devotion to decriminalization is a matter of principle.  Their position used to be confined to pimple-faced sophomores who read Ayn Rand novels.  In recent decades, however, you hear it from some grown-ups, too.  In their uncomplicated world of simple answers, all the government should ever do is stop people from hitting each other on the head.  Beyond that, we are told, you should be free to snort, smoke, or inject anything, even substances that everyone, including the user himself, knows to be harmful.

But somewhere between the nanny-state socialist view that people are bees in a beehive or ants in an anthill, and the libertarian view that every individual should be a free-floating atom left to fend for itself in the indifferent ether, there is a realm of common sense.  In that realm, the colors are not easy, obvious blacks and whites but, instead, subtle, real-world grays whose different shadings are hard to discern.  Those who inhabit that realm aspire to a government whose role is determined not by push-button formulas, but by humane, alert, intelligent pragmatism, by the demanding but necessary tedium of trial and error, as honest citizens do their level best to coax legislatures to enact laws that have good results and to discard laws that have bad results.

Laws prohibiting heroin are laws that have good results.  They are laws that have withstood the pragmatic test of trial and error.  As soon as the advance of science, transportation, and trade confronted the world with ready, available heroin, every civilized legislature made heroin illegal.  They did not do it to be cruel or to have an excuse to fill jails.  Rather, they did it, with the benediction of thoughtful citizens everywhere, because they knew it would be bad to let the heartless greed of an unregulated market peddle yet another addictive vice into the lives of the weakest, most temptable citizens.

And laws that would lighten or remove those sanctions, thereby easing the path to the very addiction that the legalizers profess to bemoan, are laws that would have bad results.  There are too many addicts already.  No good person should want to see more.

Reach special guest writer Victor DeLaine at VictorDeLaine@daytoncitypaper.com.

 

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Sarah Sidlow
Reach DCP editor Sarah Sidlow at SarahSidlow@DaytonCityPaper.com.

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