Why Do We Treat Heroin Addicts Like They Deserve to Die?


Alternet, Eric Sterling
April 5, 2013 |

In the 1980s, Hilary Rosen was lobbying for the City of San Francisco's programs of health care for gays and lesbians (and drug users) with HIV and AIDS, she writes in the Washington Post Friday, March 29, 2013. Sen Orrin Hatch (R-Utah) warned her that she should not be lobbying to help "those kind of people," meaning gays and lesbians, she wrote.

I recall a similar situation in those days. I was counsel to the House Judiciary Committee's Crime Subcommittee and attending a hearing of the House Select Committee on Narcotics Abuse and Control regarding heroin use. A Member of Congress said encouragingly at one point,"We don't have to worry about heroin anymore. They're all going to die of AIDS."

That chillingly indifferent phrase epitomized the ability of some people to dehumanize the un-favored "others:" gays, lesbians, drug users. In their eyes, if "those people" die, not only is their death not a tragedy, it is a good thing.

This is the powerful belief system that underlies outbreaks of genocide - there are amongst us "others" who endanger us, and we would be better off without them. This belief system is alive today.

On Thursday, March 28, 2013, I testified before the Judiciary Committee of the Maryland House of Delegates which was considering a bill, S.B. 297 [4], to reduce the penalty for possession of 10 grams or less of marijuana to a $100 civil fine. The bill already had overwhelmingly passed the Maryland State Senate. One Delegate, in arguing against the legislation, said that no one in his experience in Maryland is being sentenced to jail for a first offense of simple possession of marijuana. He was adamant in opposing this bill which would reduce the penalty from a misdemeanor (a crime) to a civil offense because that would not be enough of a penalty. "What's the penalty ... if it is not going to keep me from getting a job, if it is not going to keep me from getting a college scholarship, it means nothing!" Because, 'I want people to not use dope!" he shouted, we should have laws that would result in marijuana users losing their jobs and being excluded from getting college scholarships. What would be more harmful to that young person -- using marijuana or being excluded from the job market and excluded from continuing their education?

This is yet another instance of well-meaning people blind to the humanity and dignity of people who aren't straight - in this case, those not abstinent from marijuana use.

Blindness to the humanity in "the other" is also blind to the destructive forces that laws based on dehumanization unleash. "Good Germans" in the 1930s, for example, failed to see the destruction of all of Germany that would ultimately result from believing their society suffered from a "Jewish problem" that needed a "solution."

For thirty years, various anti-narcotics officials and politicians have focused on the "drug problem" as a "demand problem" that needs solutions such as "zero tolerance" and exclusion from education, housing, employment, health care, even nutrition programs.

The Maryland Delegate's preference to use the collateral consequences of criminal laws (because there is no longer a moral consensus that harsh penalties are just) to eliminate the "demand problem" for marijuana and other drugs fails to see the consequences for the whole society. Tens of millions of Americans now have criminal convictions, many of them for drug offenses. Their criminal records prevent them from bringing home a paycheck means. They suffer, but, four years after the 2008 Great Recession, companies like Wal-Mart are still facing flat profits, and every investor suffers, and Wal-Mart doesn't hire more workers.

Imagine how many more customers companies like Wal-Mart, McDonalds, General Motors, Amazon.com, Ford, Foot Locker, H & M, or Ben & Jerry's might have if the tens of millions of people with convictions could get jobs and not have to live on food stamps! Imagine how many more employees they would have hired if they had millions of additional customers. The "war on drugs' increases unemployment among people who have never used drugs and never committed a crime!

Imagine where the Dow Jones Industrial Average or S&P 500 Index could be with that increased productivity. Imagine how many pension funds would not be underfunded, or how many senior citizens could to retire (and have their jobs replaced by younger people) if we weren't deny drug users jobs and education.


continued: http://www.alternet.org/why-do-we-treat-heroin-addicts-they-deserve-die

Links:
[1] http://www.alternet.org
[2] http://www.alternet.org/authors/eric-sterling
[3] http://www.washingtonpost.com/blogs/post-partisan/wp/2013/03/26/the-insiders-same-sex-marriage-its-personal/
[4] http://mgaleg.maryland.gov/webmga/frmMain.aspx?id=sb0297&stab=01&pid=billpage&tab=subject3&ys=2013RS
[5] http://mgahouse.maryland.gov/House/Play/17bdf185b5f6452cb6fcafe71ffce7ad1d?catalog=03e481c7-8a42-4438-a7da-93ff74bdaa4c
[6] http://www.business-council.org/11ways
[7] http://www.alternet.org/tags/drug-policy
[8] http://www.alternet.org/tags/marginalization
[9] http://www.alternet.org/tags/drug-war
[10] http://www.alternet.org/tags/other-2
[11] http://www.alternet.org/tags/drug-users
[12] http://www.alternet.org/tags/heroin
[13] http://www.alternet.org/tags/aids-0
[14] http://www.alternet.org/+new_src+[/quote]
 

Comments

yeah very good article basically sums up why some humans are such pieces of shit to others. What's there to do about this though when it is intentionally set up this way by others? The drug trade, Law enforcement, big pharma, prison industry, government all have a hand in the same setup (The drug war), along with greed and capitalism, these people have tremendous power, global influence and i imagine will not be easily swayed by appeals to humanity. I'm sure some people in earnest believe in the drug war but i bet the large majority know why we keep this charade up. If those people in power have to identify with heroin addicts as human beings equal to themselves then there's no way they could keep this drug war up, of course they don't give a fuck in the first place which is the real problem IMO.

it's not going to be like Germany's destruction, this drug war can play out forever unless enough actual people put a stop to it as in some sort of revolution.
 
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Why do we treat addicts like they deserve to die? The Birth of Heroin and Demonization of the Dope Fiend and Ceremonial Chemistry do a great job in summing the answers up. IMHO the question is rather stupid, naive, even rhetorical - then again, I've already read the books :)

That being said, I don't mean to belittle it in any way. After all, this is a very important question. Not only because it leads to a multitude of other rather pressing concerns, which in themselves are no less important, but also and primarily because, without any attempt at answering it, one of the most draconian pogroms the world has ever seen will continue, thanks at least in part to good, well intentioned cheery eyed, stuffy nosed boys and girls like you and me (well, no me ;)).

Anyways, that pogrom I speak of? That's right, you got it: The War on Drugs.

Plus such an exercise might even begin to transform the Recovery Industrial Complex into something else, perhaps something more compassionate, humane or effective. Current recidivism rates, whether they're for our criminal justice system in the USA or recovery program(s), are more than pathetic.

Oh yea, you should also read Are Prisons Obsolete, not that I've really segued into Angela Davis territory ;)
 
Because habitual heroin use has a not-unfounded reputation for robbing its users of their integrity. As if that weren't damning enough, heroin also has a reputation for changing a person permanently, such that many users can never stop missing the drug and can never take pleasure in really anything the way they used to, even if they manage to quit all opiates for good. Stories abound in areas of heavy heroin use of users who've had all the love and support the community could muster extended to them, and still managed to burn every bridge, break every trust, and die tragically and young.

All of us here, of course, know people who've used heroin, sometimes heavily and for long periods of time, who never forgot what really matters in life and never put these things in jeopardy for the sake of a fix. But in my experience, my readings, and my conversations with other people, heroin carries an unusually high risk of becoming, for those who try it, the only thing that will ever really matter in life from that point on.

Remember the lab rat with an electrode implanted in its pleasure centers, that pressed a lever until it died, foregoing all other life necessities? If this experiment were done with an animal much more social than the rat, I would hypothesize that the other animals would fear and reject this experimental animal soundly, even if the experiment was stopped before the animal died. I hypothesize that in most runs of such an [unethical!] experiment, the test subject would never fully reintegrate itself into the community, because it would never be able to find the same rewards in the same stimuli as those who'd never had their pleasure centers artificially hyperstimulated for long periods of time.

Heroin scares me. Its users do not necessarily scare me, but I find them impossible to fully trust or open up to, not only because I've been conned, lied to, and stolen from, but because I've studied the neuropharamacology and pathophysiological changes that habitual use of this drug bestows upon the CNS. I try very hard to be a compassionate person who sees individuals as individuals, not statistics or stereotypes. That said, I find that heroin and the deeds it leads its habitual users to do to other people really test my ability to "hate the game, not the player". When a drug has such potential to change a person so fundamentally, and ostensibly the person chose to use it in the first place, "blaming the victim" doesn't seem like the outrage it usually is.

This is the one drug I hope my children never every try, under any circumstances.

What this world badly needs is a pharmacotherapy for heroin addicts that actually restores the opiate receptor density in the brain's pleasure centers to opiate-naive levels, and undoes other chronic changes to this neural pathway that result from artificial hyperstimulation and oversaturation. I think ibogaine may hold some answers as far as this is concerned, and definitely deserves more research.

But until then, I'm afraid most communities around the world, especially the majority whose material and human resources are limited and must be budgeted thriftily, will continue to treat recalcitrant heroin addicts as simply a scourge to protect the rest of the population from.

This post will probably hit a nerve here on BL. I know. I've lost a good deal of face in this community over the year for expressing my fearful views on heroin (and to a lesser extent pharmaceutical painkillers), and my inability to relate to those who've struggled with this uniquely difficult addiction. In spite of this, I agree wholeheartedly that there need to be more places in this world where present and former heroin addicts can be accepted as fully dignified human beings, and bond with others who relate, though.
 
Interesting, MDAO. As one of my (a clean heroin addict) favourite posters on BL, you've challenged me to think with your post. I will have to sleep on it before writing a reply (if I can, this is the hardest topic in the drug debate). I agree with you about Ibogaine. More research needs to be done on Ibogaine and if anything similar could be made that might be easier on public opinion.
 
Thank you for your kind words, RedLeader. In my experience, it is extremely hard for a person who has struggled with heroin and someone who has never touched it to truly relate deeply to the way each other see the world. This includes heroin-virgins who have used all sorts of other drugs. It reminds me of the wide chasm of understanding that stands between people of markedly different cultural and religious upbringings.

I had a fairly disillusioning moment sometime back in '07 here on BL. When I first came here in the site's early days, I saw a community of mostly MDMA and psychedelic users who were looking to share ways to connect back with the larger world under the power of this drug. But when I took a hard look again years later, I saw a community of mostly heroin users (many of them formerly idealistic MDMA and psychedelic users), who wanted community and refuge from a larger world that had rejected them, and that they had by this point largely rejected also. And I didn't relate. How much of this is my own twisted perception, rather than statistical reality? Probably a lot. I'm sure both types of people existed here both in BL's early days and now. The key was maturing and accepting that a community full of people just like me is neither possible nor desirable.
 
MyDoorsAreOpen;11536894 said:
Heroin scares me.
That's why your opinion (on heroin) is worth nothing. How can you try and talk about something objectively if you admit to being "scared" of it, like it's some kind of demon?
 
opi8;11537084 said:
That's why your opinion (on heroin) is worth nothing. How can you try and talk about something objectively if you admit to being "scared" of it, like it's some kind of demon?
I never claimed objectivity. On the contrary, I'm rather biased on the subject.

My bias comes from:
* Working as a primary care physician and having my trust broken and my good nature abused by heroin addicts more than any other population
* Seeing friends who I used to use other drugs with graduate to heroin, and cease to be good friend material shortly thereafter. Even the ones who didn't try to use me soon decided they didn't relate to me anymore.
* Seeing most of the BL shrine consist of heroin overdoses
* Seeing folks on BL who used to be so idealistic and life-loving turn very cynical and world-weary after moving on to heroin, even after they quit.
* Having recreated with the leftovers from the opiate painkillers I've been prescribed for legitimate purposes, and scaring myself by thinking "Wow, I could get used to this!"

Lest anyone think that my stance on heroin stems from a knee-jerk acceptance of the conservative party line.

But then again, I bet my condemnation of heroin is even more upsetting to a lot of BLers than that of your garden variety clean-living upstanding citizen, who broadly condemns all drug use and knows not what (s)he condemns. For my condemnation comes from personal experience and deep reflection upon it, in the setting of a broad acceptance of psychoactive drug use. People call my stance on heroin hypocritical. When I hear that logically-preposterous charge, I see, more often than not, someone who's jealous that I haven't [yet??] slid all the way down the slippery slope of recreational drug use, the bottom of which is... heroin.
 
Is heroin really so different than cigarettes? Junkie life would be perfectly normal if dope were as accessible as cigarettes. Most of the ugliness of the lifestyle comes from having to buy it on the black market at usurious prices.

I do think it's human for us to reject people who are unlike us. But I think the pursuit of chemical pleasure is intractably human as well.

I'm in agreement with Jeffrey Miron the economist: sell heroin in supermarkets and encourage people to smoke it instead of injecting:

http://www.bluelight.ru/vb/threads/666927-Harvard-Economist-Legalizing-Drugs-Suits-Ideal-of-American-Freedom
 
23536;11537570 said:
Is heroin really so different than cigarettes? Junkie life would be perfectly normal if dope were as accessible as cigarettes. Most of the ugliness of the lifestyle comes from having to buy it on the black market at usurious prices.
That's it in a nutshell. No, the Reagan's, church, law enforcement, my parents, the news, or any other propoganda has scared me of heroin. In fact I consider it a soft drug. Unlike alcohol, where a 14 dollar bottle of tequila will take down a lumberjack. There is no such thing as "alcohol maintenence" like there is opiate maintenence. In fact people maintaining on opiates legally do not lose integrity or have to steal to "eat". The availability is heroin's biggest problem. If someone could have a bag dropped off every 6 hours most people wouldn't know if someone was addicted. It's the illegal aspect that makes it hard to get and has people going through great lengths to get, similar to food if that was needed.

Besides the one fact that injecting a drug takes that drug to a whole different level and makes it more dangerous, if there were a heroin pill or even heroin cigarette it would be no different than cigarettes. I remember before the Reagans came into office nobody freaked out over a line of cocaine or heroin. In fact it was somewhat prestigious to snort a line of coke even in public. It was all over publically in the 70's early 80's. Wow, so we come through the 80's with the "just say no" mentality and now these two plants, coca and poppy have been demonized. Even people that would try other drugs and feel that "some" drugs are ok, look at these two things as "bad".

Yeah yeah, I did time because of heroin. I know the problems associated. It was the availability that caused me to do stupid things to get it. That created bad karma and a lot of clean up. Poppy tea did not do that because it was around and easier at the time to get. So I didn't have to hustle. Same drug, different availability means, and different set of problems. No one knew.
 
slimvictor;11536052 said:
I blame religion.
Outlaw religion, and these things will right themselves.
I don't think outlawing religion would fix many problems to be perfectly honest. You don't have to be religiously minded to be indifferent to groups of people (whether they be Jews, homosexuals, drug users, etc.)
 
I
Of course, in this day and age, there have been, are, and will continue to be those who can use heroin without falling into the pit described so well by MDAO. That said, isn't it kinda naive to put heroin in a class all its own, when there are legal pharms out there like oxymorphone (etc) that are just as strong and can do just as much damage? Albeit, I guess for most of us they're a tad harder to get and more expensive than street dope (heroin), but still...
 
I think that people in power are oblivious to the fact that the oscillating prescribing patterns of pain doctors turn people onto heroin a lot more than just prescribing a lot of pain meds in the first place. Restrictions, reformulations, switching drugs, and so on, well it tends to take place when policymakers fear that people are abusing addictive drugs (wow...who would have thought!!). But these corrective measures often interfere with patients' schedules to the point where heroin enters the picture to "bridge a gap." And of course there is no turning back. So the efforts made to curb opiate addiction often just lead to worse opiate addiction.

Sometimes I wonder what percent of the population knows that heroin is an opiate at all, or how close it is to what hospitals use. Saying "opiates, including heroin," instead of "opiates and heroin" would be a good first step. Doctors and policy makers working together to keep treatment plans consistent would also be good.
 
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RedLeader;11538038 said:
I think that people in power are oblivious to the fact that the oscillating prescribing patterns of pain doctors turns people onto heroin a lot more than just prescribing a lot of pain meds in the first place. Restrictions, reformulations, switching drugs, and so on, well it tends to take place when policymakers fear that people are abusing addictive drugs (wow...who would have thought!!). But these corrective measures often interfere with patients' schedules to the point where heroin enters the picture to "bridge a gap." And of course there is no turning back. So the efforts made to curb opiate addiction often just lead to worse opiate addiction.

Sometimes I wonder what percent of the population knows that heroin is an opiate at all, or how close it is to what hospitals use. Saying "opiates, including heroin," instead of "opiates and heroin" would be a good first step. Doctors and policy makers working together to keep treatment plans consistent would also he good.
Very, very good points RL! And well said too ;)
 
^ It's a fine, fine balancing act, compadre. *sigh*

Both undertreating genuine pain and prescribing scheduled substances that aren't medically warranted break the Hippocratic Oath. Any healthcare professional's greatest protection against either of these pitfalls is a very knowledgeable and well-established professional-to-client (or patient, in this case) relationship. If I go into private practice, I'll tell new patients right upfront that I don't script scheduled substances of any sort until at least the third visit, by which time I'll have done a really thorough history and physical exam, gotten all your old records faxed to me, and had a chat with your old doctor. Ain't got that? Then it'll be as long as it takes me to have some hard evidence in the form of exam findings and test results that strongly support the scripting of the scheduled substance. I'm not against using any Schedule II~V drug for a purpose that I deem medically warranted to the best of my knowledge. But surely it's not unreasonable to ask for some hard proof of this, plus at least the start of a relationship of trust. And complicated chronic pain, psych, or substance abuse recovery patients -- I'm referring them to somebody who does nothing but that all day, because these patients have little margin for error when dosing and adjusting their meds.

The public is not naive when it comes to prescription opiates (or benzos or stimulants, for that matter), IME, but does not put them in quite the same category as heroin. I was taught in school that the diacetylation of the morphine molecule gives it an especially tenacious affinity for the mu opiate receptor, peerless in the opioid class of drugs in this regard. This means that the neurons which sport these receptors are more likely to produce many more of them over time, such that even after the heroin habit is ceased, most patients will need some opioid replacement therapy (like methadone) because they cannot possibly produce enough endogenous endorphins to stimulate the fraction of them needed to signal pleasure.
 
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MyDoorsAreOpen;11538559 said:
The public is not naive when it comes to prescription opiates (or benzos or stimulants, for that matter), IME, but does not put them in quite the same category as heroin. I was taught in school that the diacetylation of the morphine molecule gives it an especially tenacious affinity for the mu opiate receptor, peerless in the opioid class of drugs in this regard. This means that the neurons which sport these receptors are more likely to produce many more of them over time, such that even after the heroin habit is ceased, most patients will need some opioid replacement therapy (like methadone) because they cannot possibly produce enough endogenous endorphins to stimulate the fraction of them needed to signal pleasure.
When were you in school? I do not mean to belittle or question you as regard to your training and background. I'm just curious, because I've had some classes where teachers, as well as our text, didn't exactly portray things accurately (at best generalizing). Although I know of not case study or whatnot to the contrary (or in support of it for that matter), I find it hard to believe heroin stands in a class all its own as you describe, especially when compared to the more potent opioids out there. But I'm no expert here...
 
I definitely feel like there is a unique psychological component to heroin withdrawal, compared to any other opiate withdrawal - that hollow despair feeling. It still SUCKS quitting other opiates, physically and mentally it is hell. But it tends to be more of an emotional sadness whereas heroin is just raw hollow apathy. Perhaps this is due to the unique happenings via the diacetylation? But I must be lucky, because no matter how bad the habit, I seem to bounce back really quickly and still have just as much passion for life. Perhaps it is my use of psychedelics? In any case, I do know that the hollow emptiness I described is suicide-esque, so if it really stays that bad for months, years, etc for some people, then ya, I am lucky.
 
^i've never withdrawed from heroin but hydromorphone and oxycodone withdrawal is pretty fucking terrible, not just sucks, it's soul shattering, even poppy seed tea withdrawals gave me that sense of absolute dread, doom and despair (in fact i found them to be the worst). I couldn't imagine a thing more awful except for benzo withdrawals, i found both benzos and opiates had nasty acute withdrawals and a long recovery time for both, just different symptoms. Opiate PAWS last for months for me, i'd definitely say you are lucky. I don't think heroin is particularly special. i remember reading about a chemist who was synthing super potent opioids and managed to get himself massively addicted and killed himself, while those opioids aren't out there really, things like oxymorphone and fentanyl, even hydromorphone are extremely strong and just as likely to cause damage whether it be social issues from drug related crime or personal issues from addiction.
 
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