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Roadie

Trad climber
moab UT
Topic Author's Original Post - May 15, 2018 - 01:37pm PT
So I was just listening to NPR and there was a discussion with the mayor of, I think, Charlottesville West Virginia. He was complaining about how needle exchanges brought so much crime to his city and bla bla bla. He went on to put all the blame on the drug companies and demand they cover the cost of rehab bla bla bla.

Now, those of you who know me or have read any of my stuff will probably guess that I am a flaming pinko liberal and you are right. That being said, there comes a point when personal responsibility has to come into the equation.

In my mind there is a lot of personal responsibility to go around here. A good deal can and should rest with the drug companies for reasons so well known and documented that I won't bother to go into them here.

A larger portion of responsibility rests with the users themselves. We all make decisions in life and we need to live with them.

If you are starting to get mad at me here just hang on a second. An even larger portion of that responsibility, I believe, rests with policy makers. For years and years we have been given painkillers for minor aches and pains. For more chronic conditions open ended prescriptions were given and opioids were handed out like tic-tacs. For years I climbed with a sub-standard partner in the Sierra, the main reason being that she was the Percocet Princess.
"How many do you want for the decent Steve?"
"Give me three." A questioning look, "Hey, go big or go home, right..."

Then, after a few high profile deaths we descend into this panic/hysteria mode and all those good available drugs get yanked away. As a result many of those habitual users, many of whom have real, chronic and legitimate pain issues turn to the street and begin dropping like flies due to the erratic dosage levels of street drugs. To me at least this was just utterly predictable and painfully obvious.

The largest portion of blame lies with society itself. While drugs have been with us since we came down from the trees, it is only since the industrial revolution that their use, or rather overuse, has reached epidemic proportions. I would hypothesize that what we have today isn't in fact a drug epidemic so much as a hopelessness epidemic.

I grew up near a large eastern city in the 60s and 70s, heroin use was common in the mostly black ghettos. It was then easy for the largely white policy makers to look at it as a moral deficiency of 'those people' and treat it as a criminal issue. Fast forward forty years and spread the problem out into the white rural areas and we have suddenly grown a conscious. Funny how that works, but not really.

The common thread between large, minority, inner city neighborhoods and the rural, white opioid hotspots today is that they are both areas that are rich in hopelessness. Jobs are few and usually low paying. People feel trapped. They see no escape. Drugs, heroin especially, have always offered a cheap, reliable, if temporary and potentially dangerous, escape.

A drug epidemic is an easy thing to rally against. We can blame the drug, the user, the manufacture, whoever. But to face the underlying cause is a lot scarier. It calls into question the values of the society we have built.

{This is a rough draft of an article I have been toying with the past few months. I am throwing it out here in hopes that some may have other input or experience's, if you see flaws in my logic. Please feel free to disagree with me. If you see things I have missed please point them out. Above all lets keep this civil and constructive.}

Thank you
Steve Seats


Norton

climber
The Wastelands
May 15, 2018 - 01:52pm PT
we should have stayed in the trees
Roadie

Trad climber
moab UT
Topic Author's Reply - May 15, 2018 - 01:55pm PT
I've been saying that for years...
Ezra Ellis

Trad climber
North wet, and Da souf
May 15, 2018 - 03:19pm PT
Very thoughtful roadie,
I agree with most all of what you said,
But I am also a liberal lol.

At the same time the drug companies also hid and argued against the known side effects.
Lots of blame to go around,
No easy solutions.
I personally believe that opioids need to be given much less frequently and for short duration only.
Ghost

climber
A long way from where I started
May 15, 2018 - 03:26pm PT
So I was just listening to NPR and there was a discussion with the mayor of, I think, Charlottesville West Virginia. He was complaining about how needle exchanges brought so much crime to his city and bla bla bla.

Steve: I climbed for close to 20 years with a guy who eventually became the senior detective on the Vancouver Police Department Drug Squad.

When the city of Vancouver, the provincial and federal governments, and the VPD began getting serious about the drug problem (far worse than most US cities at the time), he went to Germany and spent some time working with the police in Frankfurt, where a harm-reduction model of dealing with the drug problem had been in place for almost a decade.

When he returned, I helped him prepare his presentation (I had the graphic design skills he lacked), and that presentation ultimately led to the adoption of a similar program in Vancouver.

Vancouver didn't go as far as Frankfurt had (i.e. no safe injection sites), and when the political winds shifted a few years later much of the program was killed, but...

Anyway, somewhere on my hard drive, I have a lot of data about what happens to the frequency of a whole load of drug-related crimes (purse-snatching, smash and grab, muggings, car break-ins etc etc) when a big city goes "soft on drugs." Won't be a surprise to you that there was a huge fall in the rates of all those crimes.

Anyway, if you want to pursue this, let me know, and I can go hunting for the data.

David Harris
aspendougy

Trad climber
Los Angeles, CA
May 15, 2018 - 04:07pm PT
Just some history;

Back around the early 1900's and late 1800's heroin was legal and used by hospitals for patients coming off of morphine, a synthetic analogue of heroin. Believe it or not, heroin was actually considered more mild and slightly less addictive than morphine. Everything changed after heroin got criminalized. One problem with that is once you take it out of the medical profession and put it on the street, you don't know what you are getting, but there are many other problems as well.

On a more personal, psychological level, it is easy to get used to using opioids when you really need them, i.e. coming off of a serious injury or medical procedure. But at some point you need to be weaned off of them. Many people find that these drugs will also dull emotional and psychological pain, and, having a certain amount of both physical and emotional/mental pain, they are not so keen on giving them up. Ultimately it comes down to personal responsibility.

sween345

climber
back east
May 15, 2018 - 06:04pm PT

Loss of hope can be a devastating thing.

Winemaker

Sport climber
Yakima, WA
May 15, 2018 - 06:52pm PT
On a more personal, psychological level, it is easy to get used to using opioids when you really need them, i.e. coming off of a serious injury or medical procedure.
My experience, after surgery for a severed quad tendon, is different. I was given oxycontin for pain. I was in pain and took the drug as prescribed. It did reduce the pain, but it also made it impossible for me to get deep sleep. I couldn't dream and never really fell asleep. It was awful; I was turning into a zombie. The slightest noise and I would be instantly fully awake. I was constipated. After two days I told my wife no more; the pain was better. It took another two days to finally be able to sleep and sh#t. This was unquestionably the worst I have ever felt in my life. I do not understand how taking this drug can be a pleasurable experience and why anyone would use this sh#t. I flushed the rest of the pills down the toilet.
ionlyski

Trad climber
Polebridge, Montana
May 15, 2018 - 07:17pm PT
Back around the early 1900's and late 1800's heroin was legal and used by hospitals for patients coming off of morphine, a synthetic analogue of heroin.


Other way around dude. You are bass ackward:)

Reilly

Mountain climber
The Other Monrovia- CA
May 15, 2018 - 07:19pm PT
I flushed the rest of the pills down the toilet.

Dood, that was not nice. Now you got the brown trout strung out.
Jon Beck

Trad climber
Oceanside
May 16, 2018 - 02:50am PT
What was your dosage winemaker? Friend of mine is staying at my place while he recovers from hip surgery. He was a strong athlete until his hips went out 10 years ago. They gave him oxycontin, 5mg, which is low dosage. Scares me because he is a recovering drinker, 1 year without a drink. Getting his hip fixed has really changed his outlook. He took all the pills and I hope he does not get a refill.

thebravecowboy

climber
The Good Places
May 16, 2018 - 03:57am PT
donini

Trad climber
Ouray, Colorado
May 16, 2018 - 06:25am PT
I agree with your hoplesness premise Steve. Also, consiider that we live in a society that has long condoned highly addictive ,and often harmful, drugs like alcohol and nicotine. Mixed messages rarely produce good results.
Humans will always gravitate to activities that make them feel good....starting with eating all of their Halloween candy.
Consider that the sexual orgasm evolved to ensure the perpetuation of the species.
Jebus H Bomz

climber
Sacramento, CA
May 16, 2018 - 08:33am PT
I think Donini is right that we dont have frank discussions in the first place, so how do we get anywhere?

Id rather come down harder on alcohol (not prohibition) and give IV drug users free, clean needles and discounted, quality yam yam so they dont develop endocarditis that requires $100K of surgery and care to fix and they dont steal sh#t. I bet itd be so much cheaper and less hypocritical.

Pills for everything and insta gratification customer service medical care where Docs can click a box on a chart saying they addressed the problem. Gotta love it.
frostback

Social climber
great white north
May 16, 2018 - 08:41am PT
Yes to accountability across the spectrum, but yes to empathy toward those who for whatever reasons wind up in a position of addiction.
Winemaker

Sport climber
Yakima, WA
May 16, 2018 - 09:41am PT
Hey Jon, can't remember the dosage; pretty sure it was low though. My wife was given a sheet to track usage, so they were concerned about amounts.
Roadie

Trad climber
moab UT
Topic Author's Reply - May 16, 2018 - 10:24am PT
Very thoughtful response's so far. Keep em coming. I should also mention that that mayor yesterday, after annoying the sh#t out of me for five minutes, concluded by saying he thought society should provide free heroin to wean off those wanting to begin rehab. That made me take a second look at what he was saying.

Also, while big-pharma is clearly a cabal of greedy, evil, cash grabbing, soulless, monsters any doctor who didn't realize in pre-med that Vicodin, Percocet.... are all basically heroin with training wheels needs to have his/her medical license revoked. Christ, I knew that at twenty and I am just some fool with a GED.

It has long been my belief that prohibition just doesn't work, be it alcohol, weed, coke, whatever. And as painful as it may be for their loved ones to watch, it is every persons right to self destruct as they see fit, be that drugs, random sex in rest area toilets or free soloing.


Ok, longer than I intended. Keep em coming, S

ps, micronut, you out there, you're an md and we probably disagree on a long list of things. That said, you do seem smart and thoughtful...
ionlyski

Trad climber
Polebridge, Montana
May 16, 2018 - 11:26am PT
One of the biggest lies out there is that there are medical alternatives for the addicts. There is NONE and likely never will be. When you hear people talk about opiate replacement therapy or opioid substitution, they are talking about bupenorphine, one of the most powerful opioid narcotics out there. Mixed with nalaxone is called suboxone (spelling?). This super long half life opiate drug is the hardest sh#t of all to get off of. Some claim you never really can get off it, way harder than heroin with its 3 hour half life.

You can get plenty buzzed on Bupe, keeps you buzzing 24/7. All it is, is a way to get addicts off the street and keep them happy. That way their supply is secure and they are stable. I'm not saying there is not a place for it, but be honest with the public. Ignorance is high on this topic.

Hell in Great Britain they just use heroin for legal opiate replacement therapy. Call it what it is, a spade is a spade.

Arne
Roughster

Sport climber
Vacaville, CA
May 16, 2018 - 12:24pm PT
I have had 3 surgeries where they prescribed me opioids. Total opioids taken? Zero.

I know my personality and I know that sh#t isn't for me. The biggest misconception of all regarding this argument is that pain (for known reasons) is always a bad thing. When pain is associated with healing, it is your body's way of saying "Slow the f*#k down, or stop doing that sh#t knucklehead." There is nothing wrong with a persistent reminder that your doctor told you to sit on the couch with your leg elevated and iced for a very specific reason.

Ibuprofen is actually superbly effective in eliminating debilitating pain. Yeah it doesn't alter your mental state so you can pretend like you're all better when you're actually not, but it meets the need for the VAST majority of pain where things are not life and death.

In that sense, companies that pushed opioids where they were not needed do have some accountability in the current mess.

blahblah

Gym climber
Boulder
May 16, 2018 - 01:28pm PT
It has long been my belief that prohibition just doesn't work, be it alcohol, weed, coke, whatever. And as painful as it may be for their loved ones to watch, it is every persons right to self destruct as they see fit, be that drugs, random sex in rest area toilets or free soloing.

It's a little more complicated than that, and it depends on what you mean by not working.
Prohibition was ended because we live in a democracy (of sorts) and lots of people want to drink. And obviously prohibition caused problems with crime (corruption and gangs).

Alcohol use went way down during prohibition, and that had very real benefits to society. The overall cost/benefits are hard to say and depend on value judgments.
But just saying "prohibition didn't work" overly simplifies things.
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