Front page of The Indiana Gazette on Nov. 10, 2019: “Drug deaths again on rise” and in the first paragraph “… but the reason for the increase is hard to pin down.”
Really? The rest of the world is coming to understand that our treating a drug addict with shame, humiliation and jail time harms both the person with a drug addiction and society.
In 2016, there was a public hearing at the Kovalchick Center concerning “Confronting the Heroin/Opioid Epidemic in PA” during which Sen. Don White said, “This is a huge problem, but no one has been able to come up with a solution.”
I commented that two actions that would immediately benefit both the addicted person and society would be to decriminalize drug use and set up Safe Injection Facilities (SIFs) like Switzerland first did and other countries are now doing.
Instead, the police, the prosecutors, the politicians and the press continue to talk about putting drug dealers behind bars.
I don’t have a problem with putting drug kingpins in jail, but it hasn’t solved the problem in the past and won’t solve the problem in the future.
When addicted low-level dealers bring drugs from Pittsburgh to Indiana, they get arrested and within hours, another is sent in their place. In the rare instance, a kingpin gets arrested, usually to much fanfare and front page news.
There is always someone who takes their spot.
Forced drug rehabilitation unfortunately only works in a small percentage of those undergoing rehab. It doesn’t help those who aren’t ready to go off drugs. And it only helps less than 25 percent of those who enter rehab stay off drugs.
Less than 1 in 4. How about the rest, the vast majority? The ones that make up the increasing numbers of overdose deaths we are seeing?
In 2016 the surgeon general of the United States released “Facing Addiction in America” which refuted abstinence-only philosophies as unscientific and supported MAT (Medication Assisted Treatment). It noted that addiction is not a character flaw or moral failing but is a chronic illness.
Think in America how a person with a drug addiction is viewed versus a person with a different addiction or serious medical problem.
The Indiana Gazette’s “Police Log” frequently reports “___, age ___, of ___, was arrested after a stop for a broken tail light and to be in possession of (marijuana or heroin) and released on $___ bond.”
Or recently “___, 59, of Indiana, was charged with possession with intent to deliver a controlled substance, possession of a small amount of marijuana and drug paraphernalia after she was found to have a marijuana plant at a residence along ___ Street. She was released on $5,000 unsecured bond pending a ___ hearing at 1 p.m.”
If we read reported in the “Police Log” that “A 40-year-old male with nicotine addiction was arrested for having nicotine-laced cigarettes in his car” or “a 30-year-old obese female with a food addiction was arrested when a supersized order from McDonald’s was seen on her passenger seat” we would be outraged.
We don’t label as a criminal — unless they commit a crime — a person with a nicotine, food or alcohol addiction. But it’s OK to humiliate a person with a drug addiction by labeling them a criminal and entering them into the criminal justice system with all the long-term negative consequences.
As Dr. Gabor Mate noted, “If I had to design a system that was intended to keep people addicted, I’d design exactly the system we have now.” The World Health Organization calls for drug decriminalization as a necessary measure for better public health.
Imagine if the government told diabetics they couldn’t take insulin. Imagine if the government told doctors they couldn’t write prescriptions for insulin/needles for diabetics. Imagine then, if insulin was only available illegally and the problems with contamination and not knowing how many units you were actually injecting. Imagine if the police caught someone injecting insulin, and they were labeled a criminal and put in jail. If we did this, everyone would say the government is crazy. But that is exactly how we treat people addicted to drugs.
Do we really want to decrease drug overdose deaths or not? If we do we should adopt actions that actually work:
No. 1: Decriminalize drug use. In the 1990s Portugal had one of the worst heroin problems in the world. In 2001 Portugal decriminalized the possession of small amounts of all drugs because the general feeling among the Portuguese was that a drug addict was a sick person and not a criminal.
At the time, the head of the Portuguese DEA warned about an explosion of drug use, but 10 years later said, “What I was afraid of didn’t happen.” Portugal switched its resources from arresting, prosecuting and jailing drug addicts to treatment. What happened? Addiction decreased. Injecting drug use decreased. Overdose deaths dramatically decreased.
In 2017, Portugal had six drug-induced deaths per million population vs. 185 in the U.S., 31 times higher.
No. 2: In the 1980s, Switzerland had the worst HIV epidemic in Europe. In the mid-1990s, Switzerland was one of the first countries to try SIF’s and heroin-assisted treatment.
The drug addict is encouraged to go to counseling but is not required to do so. What happened? Crime decreased. Street prostitution virtually ended. The transmission of HIV and Hepatitis B and C dramatically decreased. Overdose deaths decreased and have been decreasing since then vs. a continual rise in the U.S. Referendums in 1997 and 2008 to end these new policies in Switzerland were soundly defeated. Why? Switzerland is a democracy and its citizens are pragmatic. The railroad stations, parks and playgrounds previously populated by drug addicts and used needles were once again safe.
The costs for the programs were less than the costs of arresting/prosecuting/jailing drug addicts. SIF’s have now existed for years in Europe, Canada and Australia.
It’s time for a change.
Dr. Kim Hatcher has practiced medicine in
Indiana for 38 years and was a past president of the Indiana County Medical Society.