Wednesday, June 10, 2015

MENDACITY AND SERENDIPITY

Try this one on for size. The junior Senator from Texas (Republican Ted Cruz) signed himself and his family up for Obamacare, saying that it “was a good deal” for them. This coming from the person who led the effort in Congress to shut down the government (and cost the U.S. economy $25 billion) in an attempt to force a repeal of the very same program! And if you really want to get me started, how about the politicians who get plastered at fund-raising cocktail parties and devise ways for the government to get tough on drugs?

Quite randomly, the last five books I’ve read have all (to a greater or lesser extent) employed this theme of hypocrisy. Forty-six years out of high school, and I re-visited J.D. Salinger’s CATCHER IN THE RYE, Tennessee Williams’ CAT ON A HOT TIN ROOF, Billy Shakespeare’s ROMEO AND JULIET,  and Dr. Seuss’ YERTLE THE TURTLE. Salinger’s Holden Caulfield rails throughout the opus of his contempt for “phonies.” Both Brick and Big Daddy in CAT complain of being “surrounded by lies and liars.” The tragedy of R and J is assured by the self-deluded Montagues and Capulets who opaquely conceal their petty vindictiveness behind a veneer of respectable civic leadership. Finally, it was Dr. Seuss’s genius to create Yertle who, while fancying himself a benevolent king of the pond, actually used his compliant subjects as expedient objects to satiate his outsized ego needs.  

All of this leads me to the fifth literary work, CHASING THE SCREAM (subtitled THE FIRST AND LAST DAYS OF THE WAR ON DRUGS) by British journalist Johann Hari. Jaded and world-weary as I am, when I first spotted the book at the Strand in NYC, my reaction was that no one could tell me anything  I didn’t already know about the War on Drugs. After all, it struck me as a bad idea back when the drug and alcohol-addled Richard Nixon announced it, and it has turned out to be even worse than imagined in its implementation. What Mr. Hari clearly shows, is that by traveling back to the Drug War’s Big Bang in the 1930s with the creation of the Federal Bureau of Narcotics, the War on Drugs always exhibited the characteristics of a lovechild conceived from a chance encounter between racism and political ambition.

The villain in this piece is Harry Anslinger who served as the founder and Director of the Bureau until the 1960s. Anslinger was responsible for the torment and death of countless thousands of people, including the singer Billie Holiday,  whose demise owes not a little to the harassment and cruelty he visited on her. Harry wrote memos to his colleagues in which he referred to Ms. Holiday as a “niggress” who had to be destroyed. When he wanted to expand his office’s budget, he testified to Congress about the need to stop Mexican men, whose marijuana use was whipping them in to a sexual frenzy, from crossing the Rio Grande and raping our white women. Later during the Red Scare of the late 40s and early 50’s, Harry would get his blank checks from Congress by claiming that drugs were being sent into our nation by the Kremlin. If there was a Mt. Rushmore for ignominy, Harry Anslinger’s face would surely be carved in to that hillside. His drug war was first and foremost a contrivance.

CHASING THE SCREAM is a work that examines much more than the vulgarities of the aforementioned Mr. Anslinger. The author gives us the experiences and perspectives of drug gang members, people suffering in the grip of addictions, law enforcement and treatment providers. I thought I knew all that was needed about the War on Drugs before picking up this work; but I was wrong. Yes, the War is stupid and destructive; however it is so much more. Every page turned in CHASING THE SCREAM is like Humphrey Bogart slapping Elisha Cook, Jr. in THE MALTESE FALCON, right up to the explosive last few pages. If you enjoy a book that grabs you by the lapels and gives you a deeper insight into something you thought you understood – then CHASING THE SCREAM is just what the doctor ordered.

Ed Martone
Policy Analyst


Monday, June 01, 2015

Make Naloxone a Bridge to Treatment

Last year, with New Jersey in the midst of a worsening heroin and prescription drug problem that daily left overdose deaths in its wake, policy-makers reacted with a harm reduction effort that has since kept many from perishing. The response provides police and first-responders with the drug naloxone, which reverses the effects of an opiate overdose. Yet this measure stops just at the point when it could set many on a path away from the drug use that nearly killed them.

The National Council on Alcoholism and Drug Dependence-NJ (NCADD-NJ) is pressing law-makers to take the next, vital step, namely to refer to treatment anyone who been resuscitated with naloxone, and do so as soon as possible following the overdose. Failing to make such a treatment referral only returns the person to the stranglehold of addiction. The possibility of another overdose is not small, and the next time EMTs may not arrive in time to revive the individual.

Local officials close to the opiate problem have been struck by the shortsightedness of squandering the chance to use naloxone cases as a springboard to treatment. One of these, Howell Mayor William Gotto (R), whose town and county (Monmouth) have suffered a great many opiate overdoses, said the current system amounts to a “revolving door” in emergency rooms.

A new study from Yale University offers insight into a treatment model that can put an end to having people with an addiction cycle through the ER and back into opiate use. Outcomes from the study indicate that of three options, the best course is a treatment regimen including buprenorphine, a medication that eases cravings for heroin and helps prevent relapse. Because buprenorphine quiets the withdrawal pangs an opiate-addicted person experiences after receiving naloxone, it is particularly well- suited to such patients.

New Jersey has a precedent in translating a harm reduction outreach into an opportunity of guiding people into treatment. The state introduced a syringe access initiative, now known as the Medication Assisted Treatment Initiative (MATI), which operates in five cities, offers a template for making treatment through a program whose first aim is keeping participants safe in the near-term.

The MATI arose from the goal of providing opiate-addicted individuals with clean syringes to prevent the spread of HIV. Supporters of this measure recognized early on that it presented an ideal opportunity to introduce treatment to many of those who came to one of the program’s mobile units for a clean syringe. When a participant approaches one of the program’s mobile units for a syringe, MATI staff provide them with treatment information and, if they agree, referrals to treatment.

As the MATI demonstrates, many addicted to opiates will consider treatment if it is presented under the right set of circumstances. The worst-case scenario in the MATI saw one in two embracing the chance for treatment; the best, nine in ten. One would expect people revived from an overdose with naloxone to respond at least as well. As a result, people referred to treatment will enter recovery and in time build families and careers. In itself, Naloxone fends off death; as a conduit to addiction treatment, however, its potential is to allow many to begin lives in which they will fulfill theirs.

Dan Meara
Public Information Manager
NCADD-NJ