My kid isn't a junkie
October 30, 2015 11:49 AM Subscribe

As Heroin Use by Whites Soars, Parents Urge Gentler Drug War Noting that “junkies” is a word he would never use now, he said that these days, “they’re working right next to you and you don’t even know it. They’re in my daughter’s bedroom — they are my daughter.”

When the nation’s long-running war against drugs was defined by the crack epidemic and based in poor, predominantly black urban areas, the public response was defined by zero tolerance and stiff prison sentences. But today’s heroin crisis is different. While heroin use has climbed among all demographic groups, it has skyrocketed among whites; nearly 90 percent of those who tried heroin for the first time in the last decade were white.

And the growing army of families of those lost to heroin — many of them in the suburbs and small towns — are now using their influence, anger and grief to cushion the country’s approach to drugs, from altering the language around addiction to prodding government to treat it not as a crime, but as a disease.

posted by futz (125 comments total) 34 users marked this as a favorite

Continuing the trend of people only caring about things when it affects them. Poor blacks? Fuck em. My child? Soooo precious, it's clearly just a mistake.
posted by Carillon at 11:51 AM on October 30, 2015 [107 favorites]

Here's some data on the epidemic.

Any ideas for the unicorn spike in 2006?
posted by notyou at 11:59 AM on October 30, 2015 [3 favorites]

It's nauseating how deeply entwined into every filament of American society racism is.
posted by nikoniko at 11:59 AM on October 30, 2015 [71 favorites]

The tone of this essay is very odd. In a way it's like the tone of climate change reporting now, where we went very quickly from "climate change is controversial and probably not happening" to "climate change is the new normal, everyone knows this". The tone in this piece is "of course people are sympathetic now that it's white people, we all know that racism is a thing" instead of "racism is a thing and now these hypocrites want their kids off the hook", and we've moved on from "racist? of course the drug war isn't racist". It's like we've all decided that racism is as locked-in as climate change, so we can use it as a talking point in news reporting like it's just a fact of life.
posted by Frowner at 12:02 PM on October 30, 2015 [37 favorites]

notyou My understanding is that the Taliban in Afghanistan had been suppressing opium poppy cultivation, but after the US invasion production began to increase dramatically.
posted by nikoniko at 12:02 PM on October 30, 2015 [19 favorites]

Didn't this start much earlier with the states decriminalizing and legalizing pot?
posted by I-baLL at 12:04 PM on October 30, 2015 [5 favorites]

This article is pretty accurate, and it's a challenging thing to work around. The stigma of drug use is connected to racism in very deep ways and the war on drugs is racist in origin and intent. There is little about our drug laws and how we enforce them that is not steeped in race and structural racism.

And. I am so honored and grateful to get to work with some of these parents. Their power is something to watch. The tiny blond mom from Palm Springs who can make Republican legislators cry? She's a rock star in my book. I will take any weapon and resource that I can to end this thing and these parents are new to the movement but wield a lot of influence. They got to this movement through loss and grief, as a lot of us did, and I wish we didn't need them, but we do, and I'm grateful for their work.
posted by gingerbeer at 12:07 PM on October 30, 2015 [95 favorites]

It's just frustrating. How fucking hard is it to have empathy; try and be a better person BEFORE it actually intrudes on your day to day life?

Good on them for changing their opinion I guess, I hope that will reduce harm and help people of all sorts get the help they need before they too lose their life. But I'm not sure it lets you off the hook. "oh i'd never call people junkies now" well why were you dismissing them before? Is there any thought that goes into your judgements or are you so tribal that you can't see the the problem is saying oh NYC, full of junkies I saw THEM.
posted by Carillon at 12:07 PM on October 30, 2015 [14 favorites]

I have trouble getting as mad about this as some of my friends are. This feels like an enemy of my enemy is my friend thing?

Just because they're doing the right thing for the wrong reasons doesn't mean that the end result isn't a net positive. I get the racism angle, but i can't quite get to "fuck these fucking people they deserve it to be as shitty as possible". I mean they do, but the people historically effected by this don't. And if this helps minorities who are primarily prosecuted for this kind of stuff i just... can't rage out that hard?
posted by emptythought at 12:09 PM on October 30, 2015 [19 favorites]

The tone in this piece is "of course people are sympathetic now that it's white people, we all know that racism is a thing" instead of "racism is a thing and now these hypocrites want their kids off the hook"

Also, Yea, frowner, i think that's getting at what bugs me about this. The tone/presentation of it is somehow really weird and kind of loaded in a way that's sort of jarring to see.
posted by emptythought at 12:10 PM on October 30, 2015

Yeah, obviously these people are crap at empathy, but most people are (myself definitely not excluded). However, I'm with gingerbeer. Use any weapon you can get your hands on.
posted by Steely-eyed Missile Man at 12:10 PM on October 30, 2015 [9 favorites]

I'm not sure I understand the gist of this article. Prescription drug abuse has been massive during the past decade or so. Steps taken to limit access to drugs like oxycontin have resulted in a shift to non-prescription opiates, the most common of which is heroin.

Why they decided to bring race into this boggles me. Heroin and morphine abuse has always been generally linked to whites. In black communities, on the other hand, crack was the problem.

What changed is that instead of rifling through their parents' drug cabinets, you have suburban kids with serious opiate habits turning to heroin because it's now cheaper and easier to get.

The problem was always there. Most of these kids opiate addictions previously. The reason the Drug War aspect wasn't there earlier, was that these were mainly prescription drugs that were getting abused.
posted by enamon at 12:17 PM on October 30, 2015 [15 favorites]

Ok but how are these people going to vote from now on? Are they still gonna vote for the candidate who's "tough on crime" because they know that translates to getting black people out of their neighborhoods?

The racism hasn't changed a bit, just the stance on non-violent drug crime. So will it come with a NEW crime to arrest blacks for or are these people finally going to vote for actual progressive candidates?
posted by shmegegge at 12:17 PM on October 30, 2015 [9 favorites]

It's terrible that it took what it took to get these parents to a place of empathy, but it's also terrible that that isn't all that unusual. Most of us have these kinds of failures about something until the stone comes hucking through our own windows. At least they are now exercising the empathy they have come by so horribly.
posted by rtha at 12:18 PM on October 30, 2015 [15 favorites]

It's just frustrating. How fucking hard is it to have empathy; try and be a better person BEFORE it actually intrudes on your day to day life?

Really, really, hard.

I challenge all of us to look around our world and not be complicit in some sort of oppression or racism. The car you drive? Responsible for climate change that will disproportionately affect the third world. The computer you typed that comment on? Made in a factory in a country that very likely has little to no labor laws. The clothes you wear, the food you eat, the roads you drive on, all are feeding a machine that on some level is screwing someone over.

And we all know this of course, and most of us try to mitigate our behaviors whenever possible and however we can... as long as our lives and jobs and families aren't too disrupted by that mitigation.

These aren't bad people, they are people and hopefully reading this will motivate more people to say "Hey, maybe I should add this to the list of things I should try to change with my behavior, buying habits and political engagement."
posted by Jacks Dented Yugo at 12:18 PM on October 30, 2015 [82 favorites]

The article, and pretty much every commenter so far, is assuming causation where only correlation has been demonstrated.
posted by rocket88 at 12:20 PM on October 30, 2015 [1 favorite]

google isn't fetching me anything better than this but I recall seeing the drug lords have been hiring plain vanilla plant scientists to massively upgrade the poppy breeds.

BBC has Afghanistan opium crop at all time high in measure of acreage. (The dip on that graph is of course when the Taliban was in power in Kabul.)
posted by bukvich at 12:20 PM on October 30, 2015

“These dealers aren’t just selling it,” she said. “They’re murdering people.”

Yup, definitely the dealers' fault. Not the legislators that passed laws that make it hard to find help with addiction. Not the police who are largely more interested in arrest numbers than helping people.

Not that "legalize it, regulate it, and tax it" is the solution to any and all drugs, but we've seen repeatedly that making "immoral" substances and activities illegal doesn't curb the behavior, it only endangers those involved. Statements like this just pass the buck.
posted by explosion at 12:21 PM on October 30, 2015 [26 favorites]

I challenge all of us to look around our world and not be complicit in some sort of oppression or racism. The car you drive? Responsible for climate change that will disproportionately affect the third world. The computer you typed that comment on? Made in a factory in a country that very likely has little to no labor laws. The clothes you wear, the food you eat, the roads you drive on, all are feeding a machine that on some level is screwing someone over.

Dude, seriously, there is a world of difference between "I can't find a job without a forty mile commute so I need a car, also I can't afford bespoke American-made fashions for my entire family so I shop at Old Navy" and "Yeah, we need three strikes laws to put those crackheads in jail". The push factors that make us participate in unjust economic systems are really different from the psychological satisfactions of seeking punishment for others rather than understanding.
posted by Frowner at 12:22 PM on October 30, 2015 [68 favorites]

The article, and pretty much every commenter so far, is assuming causation where only correlation has been demonstrated.

Eh?

"Because the demographic of people affected are more white, more middle class, these are parents who are empowered," said Michael Botticelli, director of the White House Office of National Drug Control Policy, better known as the nation's drug czar. "They know how to call a legislator, they know how to get angry with their insurance company, they know how to advocate. They have been so instrumental in changing the conversation."

Or are you saying that the director of the White House Office of National Drug Control Policy is just assuming causation, too?
posted by divined by radio at 12:23 PM on October 30, 2015 [1 favorite]

Why they decided to bring race into this boggles me.

The fact that crack abuse is prosecuted way more harshly than prescription drug abuse has EVERYTHING to do with race.
posted by showbiz_liz at 12:23 PM on October 30, 2015 [64 favorites]

"Step one to becoming a small-town drug dealer: Develop a medically prescribed, and thus completely legal, addiction to opiates."
The Corporate Drug Cartel: On Sam Quinones’s ‘Dreamland’
Tragedy of the American Dreamland
posted by the man of twists and turns at 12:27 PM on October 30, 2015 [6 favorites]

The article, and pretty much every commenter so far, is assuming causation where only correlation has been demonstrated.

Yeah, it's probably just a sudden wave of sympathy for totally unrelated people that's causing parents of drug addicts, including three Republican presidental candidates, to suddenly rethink the war on drugs.
posted by Etrigan at 12:29 PM on October 30, 2015 [6 favorites]

Ms. Jordan, one of the more recent involuntary members of this club of shattered parents, said that someday, when she is better able to function, she “absolutely” wants to work with the Griffins to “help New Hampshire realize there’s a huge problem.” Right now she just wants to hunt down the person who sold Chris his fatal dose. “These dealers aren’t just selling it,” she said. “They’re murdering people.”

How do you draw the line between dealer and addict? This is how it is: the white people are the addicts, the victims of circumstance with a tragic disease. The PoC are the evil pushers. Treatment and understanding and tears and hugs for white people, ever harsher prison sentences for non-whites.

As for why now, aside from the recent crackdown on diverted pharmaceutical opioids, a big part of it is just the consequences of war. It happened after Vietnam, and it's happening again now especially because we devastated a country full of farmers now left no option but to grow poppies. Add this to people who end up opioid addicts while trying to deal with missing limbs or PTSD or CTE or all of the above.
posted by [expletive deleted] at 12:30 PM on October 30, 2015 [6 favorites]

The push factors that make us participate in unjust economic systems are really different from the psychological satisfactions of seeking punishment for others rather than understanding.

I guess my point is that people think about them just as much.

15 years ago no one gave a thought to climate change. They bought SUVs because, why not? 15 years on through behavioral and policy change, the cars on the road and their impact is very different.

Right now no one thinks about punishment in a structured, big picture way. They think "I don't want trouble in my neighborhood" because, why would someone want trouble? Hopefully this motivates behavioral and policy change to make people think about punishment the way they now think about climate change. Which is to say, hopefully it makes them think about it at all.
posted by Jacks Dented Yugo at 12:31 PM on October 30, 2015 [2 favorites]

Well, I work at a mental health care non-profit that does rehab and methadone, and, I must say 99.9 of the clientele I see there is white/predominately white. Truthfully, in my head, I always kind of though of heroin abuse as being a white thing anyway. Not sure why, but I do.
posted by Samizdata at 12:31 PM on October 30, 2015 [2 favorites]

When Blacks were using crack, whites were using cocaine...when white kids began using heroin, whites elsewhere were using crystal meth, etc
the huge jump in heroine use stems it seems from whites going from oxycondin (stolen from home) to the cheaper drug heroin.
yes. racism can be found in this but rehab, insurance for rehab, and help of any kind has been there for some time for whites and for minorities but not nearly as much as is needed.
The white drug of choice is left out of this. Why? booze is legal. Does that mean it is not a drug?
posted by Postroad at 12:35 PM on October 30, 2015

Interesting thing about the perception of drugs. I used to have a crystal meth problem. If I ever try to talk to anybody about it, I have to spend time convincing them I did. Why? I'm relatively nice? No tats? I still have the vast majority of my teeth? I haven't robbed you?

But no one can ever answer.
posted by Samizdata at 12:43 PM on October 30, 2015 [21 favorites]

"Because the demographic of people affected are more white, more middle class, these are parents who are empowered," said Michael Botticelli, director of the White House Office of National Drug Control Policy, better known as the nation's drug czar. "They know how to call a legislator, they know how to get angry with their insurance company, they know how to advocate. They have been so instrumental in changing the conversation."

Or you know, call it privilege. Seems like a pretty clear example. Plus because they're middle class white people, the legislators and insurance companies listen!!
posted by Carillon at 12:44 PM on October 30, 2015 [6 favorites]

“Because the demographic of people affected are more white, more middle class, these are parents who are empowered,” said Michael Botticelli, director of the White House Office of National Drug Control Policy, better known as the nation’s drug czar. “They know how to call a legislator, they know how to get angry with their insurance company, they know how to advocate. They have been so instrumental in changing the conversation.”

They know how?

You mean that people of color were just too dumb to try these things? You mean that white people can do these things and not be ignored.
posted by ignignokt at 12:46 PM on October 30, 2015 [67 favorites]

They know how?

Step 1: Be white, preferably middle- or upper-class.
posted by Etrigan at 12:47 PM on October 30, 2015 [4 favorites]

Heroin is primarily affecting white communities because the Jalisco cartel, run by rural Mexicans with their own media-driven prejudices about African Americans, has by policy avoided dealing with or in black areas.

And the shift in public opinion towards decriminalization is probably due to that.

But you know what?

Fuck it.

The shift towards decriminaiization is a good thing, for everyone, including the black community, and this is one gift horse I am not going to look in the mouth.
posted by ocschwar at 12:49 PM on October 30, 2015 [14 favorites]

Heroin and morphine abuse has always been generally linked to whites.

If by "always" you mean since the 1980s and 1990s, when opiate use underwent demographic changes.

15 years ago no one gave a thought to climate change.

The year Al Gore was running for President?
posted by zombieflanders at 12:50 PM on October 30, 2015 [11 favorites]

Already mentioned by the man of twists and turns, but it deserves repeating: Sam Quinones's Dreamland was a great read and is highly relevant.
posted by giraffe at 12:54 PM on October 30, 2015 [1 favorite]

While it's definitely true that many whites are only now starting to notice how unfair these stigmas are, and that absolutely reeks of privilege, it's not the case that white users haven't been horribly stigmatized and hounded, too, historically. My mom was an addict (German, not American like my dad) and the social stigma around drug addiction in the US made it a simple summary matter for courts here to dismiss her claims to any right to custody or access to me my entire pre-adult life, even though she already had a demonstrated record of being in recovery by the time the custody dispute came to court, and despite the fact my grandparents had kidnapped me when she still had full legal custody of me under a previous U.S. consulate ruling. In my case, even though my grandparents violated the law, they were able to work actively with the FBI to monitor my mother's entry into the US to prevent her from having any opportunity to reclaim her custody even before the courts had awarded custody to my grandparents. That's how powerful and deep the anti-addiction/anti-drug stigmas ran in the late 70s and early 80s in my case.
posted by saulgoodman at 12:55 PM on October 30, 2015 [30 favorites]

I'm having a hard time with this. Yes, it's a net good. Yes, people need help and I'm glad when they can get help, so glad. Yes, I'm 100000000% against the drug war. Yes, it feels so stupid to be angry about this. But I can't stop thinking about my uncle, who did the prescription opiates to heroin journey and long incredibly painful story short ended up hanging himself in a jail cell three months ago at the end of a years-long spiral in which he tried so many times to get help and just... couldn't. Hey, maybe if he'd been Bon Jovi's daughter and not just some guy on the street, someone important would have given a damn about him, but he was just one of those icky junkies and not a sweet young white girl.
posted by palomar at 12:56 PM on October 30, 2015 [14 favorites]

If Big Tobacco ultimately was liable for billions in health care costs, then ultimately every Rx for narcotic pain killers should include a coupon for rehab paid for by the fat cats who marketed Oxycontin onto the public and doubled down on production and sales when it caught on for being recreational. And the definitely can afford the bill and stay rich.
But that's not a soft war so much as product liability 101 (forseeable, proximate cause, stream of commerce etc)

A soft war looks more like this:

1. disband the DEA
2. legalize MDMA
3. Immediately begin to crop-dust the Middle East
(Reapplication might be necessary for a few generations, apply liberally as req'd )
posted by Fupped Duck at 12:57 PM on October 30, 2015 [2 favorites]

3. Immediately begin to crop-dust the Middle East

The what now?
posted by Juffo-Wup at 1:01 PM on October 30, 2015 [6 favorites]

I definitely can say that every single white person I know who is known to have done heroin is someone who I already knew abused opiates previously. It's just that around here, you can't get them like you used to. Hell, I hoard legitimately-acquired cough syrup because half the doctors I've seen in the last ten years don't want to give out codeine. That makes this a double-sided problem: People didn't want to have empathy for heroin users until they were their white friends and neighbors. They also didn't want to admit their white friends and neighbors had real drug problems until they started using "real drugs".

And then you can track all of this further back to the idea that I think nobody wanted to admit that opiate use was a serious drug problem because nobody wanted to admit that these people we were close to had serious mental health issues and needed actual treatment and that was going to cost more money than letting them take pain pills and seem... sort of okay. Opiates seem to actually do really well at alleviating serious depression, anxiety, bipolar and borderline... they just leave you with something else just as stubborn with more broadly-reaching negative impact. But I look at the people I know, and I think, you know, I've got Vicodin left from an oral surgery several years ago that I'm perfectly capable of parceling out in quarter-pills when my cramps get bad and it'll probably last me at least several more years. Because I'm not self-medicating. You can't tell people "don't do drugs" but not give them an alternative way to feel better and expect that to work.
posted by Sequence at 1:03 PM on October 30, 2015 [15 favorites]

And that is, by the way, a sentiment I think goes 10x for minority drug users, who historically have had terrible access to mental health care, and just generally an idea that the virtuous thing to do when your life circumstances are terrible is grin and bear it. A virtue proposed primarily by the people who don't have to.
posted by Sequence at 1:05 PM on October 30, 2015 [12 favorites]

The what now?

I believe the hypothesis is that if you dosed them all with MDMA ( via crop-dusting ) , they'd work out their interpersonal issues.

I would suggest this hypothesis is predicated on an unwarranted belief of humanity's essential rationality. That does not necessarily mean I would not approve field trials, depending on the proposed experiment.
posted by mikelieman at 1:08 PM on October 30, 2015 [3 favorites]

The what now?

I think it was some weird comment about killing off all the opium poppies? I hope? If it's some "hurr durr middle east is violent mdma will fix it!" comment that's kind of a shitpost.
posted by emptythought at 1:10 PM on October 30, 2015

The what now?

I believe he means destroy the poppy fields.
posted by futz at 1:11 PM on October 30, 2015

I thought it was talking about sending George W. Bush over to fart while walking around.
posted by clawsoon at 1:11 PM on October 30, 2015 [10 favorites]

As Heroin Use by Whites Soars, Parents Urge Gentler Drug War

Parents? Which parents? You mean white parents? I see the NYT is expanding the lingo of their Real Estate section, where they coyly forget to use the word "white" when they want to pretend they mean "everyone," ie "More and more people are moving to Bed-Stuy."
posted by the_blizz at 1:19 PM on October 30, 2015 [23 favorites]

This all reminds me of how a lot of men say they didn't really understand that sexism or misogyny existed until their wife told them about it, and how the main reason they cite as to why it's bad to treat women poorly is "That's somebody's daughter!" Like OK, good for you for engaging with the absolute minimum of human decency, but the fact that you were apparently unable to develop empathy for half of the human race until you acknowledged that what they were experiencing might even affect someone you know personally is kind of unsettling to me. Not to mention an object lesson on where the roots of complicity are formed, and why people get so upset when you call them out for acting like things that don't happen to them can't possibly be happening at all.

And that paragraph quote by Botticelli is one of the most cripplingly depressing things I've ever read, bar none. I've read it a dozen times and I just can't wrap my mind entirely around it. For seven godforsaken years, I lived with someone (mom's second husband) who was addicted to crack and there was absolutely no awareness of what the fuck we could possibly do about it except get him taken away by the cops over and over again. Like none, not even when he took his infant son to a crack house and accidentally left him there. I swear to god I didn't even know that long-term substance abuse counseling or rehabilitation (aside from those rich-people-only detox retreat sort of deals) was a thing that existed until I was in my 20s... I guess I just assumed that it all got straightened out temporarily every time he went to jail, that there would never be any kind of permanent fix, and that that's why poor people died of drug overdoses. So to know that even the U.S. drug czar is like, "The educated, resourceful, middle-class whites know what to do, that's why they get results!" is just... I dunno. I despair.
posted by divined by radio at 1:19 PM on October 30, 2015 [37 favorites]

Any ideas for the unicorn spike in 2006?

The short answer is :Afghanistan and Columbian Drug Cartels.
Most people think Columbian Cartels only sell cocaine, but you would be very, very, very wrong. The cartels sell whatever is lucrative and will make them the most money. Heroin makes a lot of money.

I personally knew at least a dozen people at that time that were trying (and failing) to hide a heroin/opiate addiction. Luckily for them, most of them lived through it, got treatment, and are now older and wiser from the experience. Some of them, though, it just feeds into their own self-centered worldview, and really does seem to mold their behavior into the typical "junkie". "Never trust a junkie."

Sidenote: heroin has never been "out of style", it just moved from one sub-culture to the next and leaves a trail of dead bodies and broken relationships in it's wake. It is fascinating to note that there is an unbroken line of "heroin-chique" fashion / art / music from even as far back as the Civil War.

And please, please, please, never ever ascribe the use of any particular drug to any ethnic or racial group. That is just lazy thinking and also entirely not true. Yes, crack was sold in poor minority neighborhoods across the country. But so is a huge amount of heroin. If it was illegal, organized criminal gangs have always made money with the trafficking and sale of anything. Hell, some of the best movies and television made are specifically about the heroin trade (The Wire, for example. The main drug that was used by almost everyone was heroin). A persons race does not determine what drug they abuse. The availability of the drug determines what will be abused.
posted by daq at 1:25 PM on October 30, 2015 [7 favorites]

Re: Racial makeup of opiate (and other hard drug) abuse...

My wife works for an adoption agency. They work with birth mothers from all manner of social/economic/racial backgrounds across the entire state. Life being what it is, this also includes birth moms with various histories of drug abuse, quite often current abuse. Overwhelmingly, the birth moms who test positive (or admit up-front) for big-time drugs (meth, heroin, oxy, coke, etc.) are white. According to my wife, it's crazy rare that any of their black or Hispanic birth moms test positive for anything stronger than weed.
posted by Thorzdad at 1:29 PM on October 30, 2015 [8 favorites]

The short answer is :~~Afghanistan and Columbian Drug Cartels.~~ Mexico.

Mexican cartels used to be small potatoes; at best, they did last-step processing. Now they're playing with the big boys, and doing a horrifyingly thorough job of it.
posted by Sys Rq at 1:32 PM on October 30, 2015 [1 favorite]

Yeah, race, substance use and incarceration are super intertwined, no doubt. But a problem I have with the "because whites are suffering = empathy/questioning of zero tolerance policies is increasing" because it overly simplifies the DECADES of resistance against such policies and the advocacy to change them. No doubt an increase in white use of opiates is accelerating changing views , but so too are larger societal changes that have been developing for years and (thank god) finally beginning to emerge as something approaching a consensus. Needle exchanges, drug courts, reduction in sentencing, etc.. these are all things that began PRIOR to increasing white use of opiates. A similar thing can be seen in the evolving views of mass incarceration and mandatory sentencing laws - blacks are still primarily the survivors of such policies. Yet, there is a noticeable and significant shift in views among all Americans, including the most powerful demographic, which is the white middle class.

Can we all, for just a second or two, put down our cynicism and negativity and acknowledge that even the privileged have made progress here? Throwing up our hands in frustration over real or perceived shitty white behavior DOES NOTHING to make things better and, I think, actually stalls progress by making enemies with people that, at least on this point, agree with you.
posted by the lake is above, the water below at 1:38 PM on October 30, 2015 [11 favorites]

Some of them, though, it just feeds into their own self-centered worldview, and really does seem to mold their behavior into the typical "junkie". "Never trust a junkie."

Oh yeah, this is something with substance users I focus really hard on, which is challenging internalized perceptions of users as all horribly broken awful people. It really does, I think, make it easier for people to slide into behaviors that, without the stigma, shame and self-denigration, they would be less likely to engage in.
posted by the lake is above, the water below at 1:45 PM on October 30, 2015 [3 favorites]

@the lake is above, the water below

I'm going to have to disagree with you sharply. You can call it cynicism or negativity but I prefer to call it seeing the world through a black lens. Generally speaking, we tend to see big shifts in policy when it starts to affect middle to upper middle class white people. We see that from income inequality to marijuana legalization. When white people become part of the conversation then people notice. When it's just us black folks no one tends to give a fuck. I really want to feel bad for the people in this NY Times article but I can't. Having seeing dozens of black lives forever destroyed by our draconian and racist drug policies which were fervently supported by a LOT of white (and a good number of black) people I have no option but to sneer at their new found sense of empathy. What happens to the millions of lives already destroyed? What does empathy from a white person do for those people? Why should I care about people who generally don't give a shit about me?
posted by RedShrek at 2:05 PM on October 30, 2015 [18 favorites]

I would like to challenge people in this thread to think about the language that you use to describe people who use drugs, including people who have problematic substance use. Using language like "user", "addict", or "junkie" exacerbates the stigma and shame of drug use, which makes it harder for people to make their way out of problematic substance use. We are people first, and then the health conditions we have or the substances we consume. Drug use is the same as any other criteria, in terms of language and its impact on how we think about people.

Also, to agree with some of the comments above, although some kinds of drugs are stereotyped as being used by certain populations, the reality is that whites use drugs at higher rates than blacks or Latinos. More whites consume crack than blacks. Thinking of crack as a drug used only by black people is part of the stereotypes and racism that got us into this problem. On another data point, very little of the heroin in the US comes from Afghanistan. On the West Coast, it is predominantly black tar from Mexico. On the East Coast, it is mostly from Colombia. And Vancouver gets it direct from SE Asia.

I definitely have a lot of frustration and anger at people who have come late or slowly or out of self-interest to the movement to end the war on drugs. A lot. Some of them are aware of their privilege and some aren't. But I need to welcome them all. Building a movement for social change is hard to do if you keep turning away the people who are finally hearing you and stepping forward.
posted by gingerbeer at 2:18 PM on October 30, 2015 [16 favorites]

Is this any different from people becoming more sympathetic towards LGBTQ people when someone in their family comes out?
posted by Apocryphon at 2:25 PM on October 30, 2015 [3 favorites]

" More whites consume crack than blacks."

i remember hearing that blacks consume cocaine more in crack form (smokable freebase cocaine) and whites consume cocaine more in powder form. It looks like that crack exploded in the poor neighborhoods in the mid-1980s because it was significantly more cheaper than cocaine for various reasons (I'm looking at the crack epidemic article on Wikipedia). I remember hearing about how the sentencing guidelines were vastly different for the 2 forms of virtually the same drug. But, yeah, gingerbeer's points are good to know.
posted by I-baLL at 2:29 PM on October 30, 2015

" More whites consume crack than blacks."

> i remember hearing that blacks consume cocaine more in crack form (smokable freebase cocaine) and whites consume cocaine more in powder form.

Given that there are more white people than Black people in the U.S., even if percentage-wise that's true, that doesn't mean more Black people than white people use crack cocaine.
posted by jaguar at 2:39 PM on October 30, 2015 [2 favorites]

I want to thank everybody here sharing their experiences from different angles, as counselors, activists, people in recovery, family members, etc. This is a great thread and I appreciate the level of nuance. I don't have as much personal experience with this subject, but I have seen family members struggle with addiction in this system, and it seems like it's totally rigged against you when you're poor. I was actually working in a federal law library when the sentencing guidelines finally shifted a couple of years back and it was amazing to see. I am skeptical of a narrative that assigns the responsibility for these social and legal shifts to well-connected motivated white families when activists of color and advocates were pushing hard on this for decades. It's like the ball gets rolling and everyone thinks the last guy to give a push was the one who got it moving. But having more upper-class white poster children for politicians to care about obviously doesn't hurt.
posted by thetortoise at 2:48 PM on October 30, 2015 [8 favorites]

A more accurate title would have been "As Heroin Use by Whites Soars, White Parents Urge Gentler Drug War."

I suspect increased heroin use among whites has not changed attitudes toward the drug war among non-white parents. Anyway, treating attitudes toward heroin as a racial problem is off-base. There are certainly racist elements to the drug war, like the crack-powder cocaine sentencing disparity, and the vast racial chasm in prosecution rates.

Heroin, however, is not particularly racialized. Unlike marijuana and crack, there is no history of heroin being used to make people of color look crazy or dangerous. The image of a heroin addict is typically white (just Google image search "heroin addict" to see depictions in media). The prototypical heroin user looks like Kurt Cobain, Janis Joplin, or Lou Reed. There are famous black heroin addicts too, like James Brown, but popular focus around their addiction has not been racialized.

American anti-drug hysteria has had both racist (crack, marijuana) and non-racist (alcohol prohibition, heroin laws, anti-tobacco efforts) motivations. It is good that people are becoming aware of the overtly racist history behind much of the drug war. It is bad that people who should know better distract from important issues by making everything drug war-related about race—it isn't, and freeing society of drug war bullshit will require more than dubious, click-driving headlines.
posted by andrewpcone at 3:08 PM on October 30, 2015 [2 favorites]

Is this any different from people becoming more sympathetic towards LGBTQ people when someone in their family comes out?

I think it's slightly different because we're talking about a much broader systemic problem here. It's been a long time since being gay has carried the same social stigma -- and harsh punishments -- as being a drug user. And since these punishments seem to fall primarily on blacks (whereas being gay doesn't necessarily have a racial or class element associated with it), the shift discussed in this article is tied up in a huge national debate we've been having since the United States was founded.

I agree with gingerbeer that we should be challenging our perceptions not only of whites and blacks, but of substance abuse in general. And as I read from RedShrek's post, it's also clear to me that it's impossible to see the world without our own lens. That can be for the worse, but to ask why we've been so racist for so long is only productive when you're talking about long term social and political change, it doesn't really help people who need help right now get it. It's a good point, but it's not the only point. It also occurs to me that a certain amount of empathy for people who are only now "seeing the light" is in order. When your your education (or lack of it), your family and your community are all a certain way and predispose you to thinking a certain way, it can be jarring to have that all shattered.
posted by Jacks Dented Yugo at 3:09 PM on October 30, 2015 [1 favorite]

Yeah, race, substance use and incarceration are super intertwined, no doubt. But a problem I have with the "because whites are suffering = empathy/questioning of zero tolerance policies is increasing" because it overly simplifies the DECADES of resistance against such policies and the advocacy to change them. No doubt an increase in white use of opiates is accelerating changing views , but so too are larger societal changes that have been developing for years and (thank god) finally beginning to emerge as something approaching a consensus. Needle exchanges, drug courts, reduction in sentencing, etc.. these are all things that began PRIOR to increasing white use of opiates.

I am skeptical of a narrative that assigns the responsibility for these social and legal shifts to well-connected motivated white families when activists of color and advocates were pushing hard on this for decades. It's like the ball gets rolling and everyone thinks the last guy to give a push was the one who got it moving.

I want to favorite these quotes multiple times. I think there's an unintentional effect sometimes where rhetoric intended to emphasize the ongoing severity of institutional inequalities ends up sounding quite dismissive of the efforts of the people who have been pushing against (and slowwwwwly moving back!) those inequalities for years.
posted by atoxyl at 3:15 PM on October 30, 2015 [5 favorites]

Any ideas for the unicorn spike in 2006?

In addition to poppy cultivation, US soldiers rotating back with supply.
posted by j_curiouser at 3:16 PM on October 30, 2015 [2 favorites]

rehab, insurance for rehab, and help of any kind has been there for some time for whites
so. so. wrong. maybe way-upper-middle-class-well-insured whites. not 'whites'. have you looked at the inpatient options for someone voluntarily seeking treatment? well, i have, and it's 'none'. or intentionally-get-arrested to receive court-ordered rehab.
posted by j_curiouser at 3:26 PM on October 30, 2015 [5 favorites]

Heroin, however, is not particularly racialized. Unlike marijuana and crack, there is no history of heroin being used to make people of color look crazy or dangerous.

This is just flat out wrong. You somehow missed the 70s, when "urban" crime driven by "street junkies" was causing "white flight" and cities were in fatal decline. Sadly, the American stereotype of the "hardcore addict" is a black person and the New York Times has written the story of heroin spreading out from the "ghetto" to the middle class multiple times over the decades.

In fact, the "addict" stereotype— and regardless of the demon drug of the moment, it's always the same— is of a lying, criminal, devious, stupid, violent child. In other words, it's identical to the stereotype of the n-word. This is why nearly every white person with addiction at some point in their story feels obliged to say "I'm not your typical addict," because the "typical addict" must be black.

Regarding rehab: we really need to recognize that the best treatment for addiction, just like the best treatment for mental illness, is not inpatient. This is particularly true for opioid addiction: the only treatment that cuts the death rate by 75% is long term maintenance with methadone or suboxone. That is the gold standard— and what's sad is that so many of these parents fight for insurance to cover expensive and ineffective abstinence-based rehabs that put their children at risk of overdose death over and over. And then they blame the deaths on lack of insurance coverage for longer term treatment. What's needed is not longer term inpatient treatment: what's needed is longer term outpatient maintenance, without pressure to become abstinent. Yes, some people may eventually be abstinent, but that doesn't make them superior to people on long term maintenance, only at higher death risk if they relapse.
posted by Maias at 3:37 PM on October 30, 2015 [35 favorites]

The history of heroin as an illicit drug is very definitely a racialized one. If you include opium, that's the very first substance we criminalized the use of as an overt measure of racial control, targeting the Chinese in San Francisco. With heroin, it was jazz musicians and other dubious characters, mostly black, being targeted. Johan Hari's piece on Billie Holliday is worth reading.
posted by gingerbeer at 3:43 PM on October 30, 2015 [15 favorites]

@andrewpcone

Nah! The origin of Drug prohibition is rooted in white racism. The outcome of the drug wars has been an unequal and racialized application of the criminal justice system.. There's no separation of race from the war on drugs. It's inherent to it.
posted by RedShrek at 3:44 PM on October 30, 2015 [4 favorites]

“These dealers aren’t just selling it,” she said. “They’re murdering people.”

Yup, definitely the dealers' fault. Not the legislators that passed laws that make it hard to find help with addiction. Not the police who are largely more interested in arrest numbers than helping people.

Indeed, this attitude is a big part of how we got the not-so-gentle drug war in the first place (and why a lot of black politicians actually threw in with the drug warriors early on). And as somebody already mentioned in this thread there's definitely kind of a stereotype of those evil dealers being black or latino while the poor addicts are white. So uh please lets not go there with the murderous drug dealers, please. You probably don't need me to tell you this but at the retail level a lot of heroin dealers are heroin addicts, and the ones who aren't are often just doing pretty much the only "job" they've ever had - doing it to support a family sometimes, imagine that!
posted by atoxyl at 3:49 PM on October 30, 2015 [5 favorites]

Regarding rehab: we really need to recognize that the best treatment for addiction, just like the best treatment for mental illness, is not inpatient. This is particularly true for opioid addiction: the only treatment that cuts the death rate by 75% is long term maintenance with methadone or suboxone. That is the gold standard— and what's sad is that so many of these parents fight for insurance to cover expensive and ineffective abstinence-based rehabs that put their children at risk of overdose death over and over. And then they blame the deaths on lack of insurance coverage for longer term treatment. What's needed is not longer term inpatient treatment: what's needed is longer term outpatient maintenance, without pressure to become abstinent. Yes, some people may eventually be abstinent, but that doesn't make them superior to people on long term maintenance, only at higher death risk if they relapse.

Yes, yes, yes on this too. (You could append this to most things Maia says but I'm gonna actually say it here)
posted by atoxyl at 3:50 PM on October 30, 2015 [2 favorites]

don't get all locked up in 'superior' ways of kicking dope. i don't think anyone here is talking about moral superiority - just access to treatment. more and better inpatient *will* help relapse rates.

anecdata...

the dirty street kids tell me: "sub is just as hard a kick as dope, and it takes longer...and you've gotta have your shit together enough to stay on maintenance...show up for tests and shit. shoot, i can't even remember to brush my teeth some days...if yer clean, ya know, just, if ya fall off, smoke the shit for chrissake, don't shoot."

statistically, maintenance has a better ~~harm~~ death-reduction track record. but imnsho, the infrastructure isn't there to keep the kids in the program.

i don't want to turn this into a resource-allocation discussion as much as i want varied medical treatment options made available to everyone who needs them. since we're going to be 'great again', let's have some of that.
posted by j_curiouser at 3:53 PM on October 30, 2015 [1 favorite]

Sub?
posted by Carillon at 3:57 PM on October 30, 2015

Suboxone, a maintenance drug.
posted by j_curiouser at 3:59 PM on October 30, 2015

what infrastructure do you need to keep the kids in the program? you provide the maintenance medication (suboxone or methadone), they show up to take it. There's little evidence that forcing people to accept counseling or other "services" in addition to the medication adds to the success. That stuff can help when people *choose* it, but when you are doing maintenance as harm reduction, all you need is to provide the medication. And if you are providing the medication, they don't need to "kick"— the whole point of maintenance is that you stay on it!

This idea that maintenance is bad because it's "harder to kick than heroin" misses the point. The point is stabilizing people to get on with their lives, not getting them to some supposedly superior state of abstinence.

Also, 1000 times ++++ to the comment on how absurd it is to blame dealers. Fortunately, many of the parents now realize that when there is an overdose, it could just as easily be their kid who is charged for murder for supplying the drug as it is their kid who dies. But some still remain fixated on the idea that it's possible to affect the supply by locking up dealers.
posted by Maias at 4:01 PM on October 30, 2015 [8 favorites]

what infrastructure do you need to keep the kids in the program? you provide the maintenance medication (suboxone or methadone), they show up to take it.
yes. if this were the implementation, but it's not. in my county, you can't even voluntarily admit yourself to detox and get sub for 24 hours. no hospitals will do sub/detox even if you come into the ED begging for help.

if you are providing the medication, they don't need to "kick"— the whole point of maintenance is that you stay on it!
for life?

The point is stabilizing people to get on with their lives, not getting them to some supposedly superior state of abstinence
yeah...'superior abstinence' is not a rabbit hole i'm going down.
posted by j_curiouser at 4:06 PM on October 30, 2015

More that anything it's artificially hard and expensive to get on Suboxone/bupe maintenance.
posted by atoxyl at 4:16 PM on October 30, 2015 [1 favorite]

Parents can be an enormous force for good if they push for the right approaches— ie, making maintenance widely available, destigmatizing it, increasing insurance coverage for it, decriminalizing possession, getting rid of mandatory minimums, creating alternative sentencing for dealers, etc.

But yeah, we'll just get more of the same if we continue pushing failed drug war approaches like locking up dealers, unaccountable abstinence-only treatment, etc.
posted by Maias at 4:21 PM on October 30, 2015 [5 favorites]

anecdata...

the dirty street kids tell me:

What do you mean by dirty?
posted by futz at 4:32 PM on October 30, 2015

I always remember Richard Pryor's remark on stage about media use of the phrase crack epidemic. "It's an epidemic now," he said. "That means white folks be doin' it!"
posted by Paul Slade at 4:33 PM on October 30, 2015 [4 favorites]

The what now?

I believe he means destroy the poppy fields.

Afghanistan: not in the Middle East.
posted by bq at 4:36 PM on October 30, 2015 [3 favorites]

Well, gingerbeer, maybe you're right but I'm a recovering "user" of an addictive substance myself, though not heroin, something even more shameful in the social circles I move in, because of its lower class white cultural associations, and I don't mind referring to myself as a former "user" or "junkie" or whatever because the factors that contributed to my disorder were a hell of a lot nastier and more complex than a matter of insensitive word choice, though I guess we each try to exert influence over problems in the ways we can relate to best, and controlling language is a pretty classically elitist way to approach controlling people's thinking and also requires the least actual effort while still imparting a nice warm glow of sanctimony. Speaking only for myself, I don't think anyone using the word junkie around me is going to trigger a relapse, but if your experience is otherwise, I'll try to be more careful about the language myself in the future.
posted by saulgoodman at 5:24 PM on October 30, 2015 [2 favorites]

You are welcome to use whatever language works for you to describe yourself. And I respect your choices about the language you use for yourself. I have no interest in controlling people's language or their thinking. I do, however, want people to be conscious of how the words they use affect how they think about other people, and how it affects other people. The stigma around drug use makes it that much more difficult to end the war on drugs, because people believe the myths and stereotypes about people who use drugs. See the comment about "personal responsibility" directly above yours.

Words like "junkie" and "addict" and "abuser" definitely exacerbate the stigma around drug use.
posted by gingerbeer at 5:35 PM on October 30, 2015 [4 favorites]

At one point do we say, you know, this person decided to take their first hit. They made a consious decision to take a drug they knew was bad for them, and it had consequences. Nope, it always has to be someone else's fault.

Jubey, have you ever made a mistake?
posted by Juffo-Wup at 5:38 PM on October 30, 2015 [12 favorites]

They made a consious decision to take a drug they knew was bad for them, and it had consequences.

Going based on the people I know who either before or after they started were diagnosed with real mental ailments, with all due respect, why is this the thing that matters? The criminal justice system does not acknowledge it, but there isn't a line between "responsible for your actions" and "not your fault". There is a huge, pulsating miasma of a spectrum in there, and in that lies a huge part of those people who end up with addiction problems. "Bad for them" infantilizes this problem in such a disgusting way. This isn't like "don't touch the hot burner" bad for you. This isn't "someone was totally fine and then they did a thing they should have known was going to destroy their lives". I'm sure someone knows a counterexample, but the typical addict did not start out fine.

Of course they made a decision that turned out to be wrong. But what do the rest of us get out of shaming them for it? If they're likely to make wrong decisions in future that hurt people, like they have a history of criminal violence, then there's a logical argument to be made that we need to keep them away from others even if that isn't helping them. With addiction, though, they're hurting themselves first and foremost. What do we get out of taking the hard line on that?

The "personal responsibility" narrative only exists to make those of us who are okay feel better and safer about the fact that we're okay. It doesn't help people who aren't okay to become okay. As a person who does not have an addiction to opiates, I am not the one who needs to be made to feel better.
posted by Sequence at 5:53 PM on October 30, 2015 [13 favorites]

That's fair, ginger beer. Sorry if I'm prickly about it. To me, it was a big deal, and helpful, to realize I had become what I was always raised to think of as a junkie. It helped me accept how far I'd gone and work my way back out, and gave me a new appreciation/ more empathy for what my mom must have gone through.
posted by saulgoodman at 6:00 PM on October 30, 2015 [1 favorite]

I'm hearing a lot about who to blame here, the legislators, lack of effective rehab, the dealers who are 'murdering' their kids or their friends who are selling to them. Not once has anyone mentioned personal responsibility. At one point do we say, you know, this person decided to take their first hit. They made a consious decision to take a drug they knew was bad for them, and it had consequences. Nope, it always has to be someone else's fault.

Jubey, I don't want to dump on you here, but given what little I know of social science, I think this philosophy of personal responsibility is going to seem obscenely inhumane and untruthful in the coming years. I've been down this road with obesity before and it is far too easy to say that this is about people making bad choices, rather than about destructive systems in which these choices are rational, because people under various forms of stress or in poverty have their options limited both externally and internally. And then there's brain research that is still in progress and which I don't pretend to understand, but it sure doesn't look like everyone has the same response to substances and the same propensity toward addiction. Beyond the potential for cruelty in the personal-choice approach, it's just not even useful. Guilt and shame can't do what dollars, compassion, social support, and the means for self-determination can.

I don't want to get too much into this because of respect for their privacy, but I have a couple of family members I grew up with. We were all smart kids with high IQs, are pretty kind and decent, and share a lot of the same genes and predisposition toward depression. They are poor and lacked a basic level of support from their parents and community in their most vulnerable years, and fell through the cracks in the U.S.'s minimal social safety nets; I have always been upper-middle class and gotten most everything I needed. I take antidepressants and go to therapists; they struggle constantly with substance abuse and with problems with the law that follow them everywhere and make it hard for them to get and hold a job. It gives me an awful pang to think about someone being like, "good job, thetortoise, you've never been tempted by drugs!" while they're out in the cold. It hurts.
posted by thetortoise at 6:22 PM on October 30, 2015 [21 favorites]

Jubey,

You are lucky that Just Say No has worked for you. Others have different lives.

As with many topics, understanding drug dependency in general may require reading books on the topic. Personal beliefs and common sense aren't the path to understanding that they are believed to be.

I can recommend the book 'In The Realm of Hungry Ghosts' by Dr. Gabor Maté. Maté is a physician who has worked with patients with drug dependencies.

As a Jewish boy in Nazi occupied Hungary, Maté's brain was changed in ways that are permanent, unconscious, and not controllable by him.

Maté' writes that all of his patients suffered trauma as a child. Trauma includes verbal or physical or sexual assault. Sometimes the grinding nature of poverty results in a child not growing up to be a fully complete adult.

Everybody has aspects of their life that they did not choose and can not change. Drug dependency can be such an aspect.
posted by llc at 6:23 PM on October 30, 2015 [9 favorites]

I'm sorry, I didn't phrase it the right way. I'm really, really not trying to guilt or shame anyone and I understand that there are extenuating circumstances in everyone's lives that lead them down that path. So surely then, we should offer that same compassionate reasoning to drug dealers and everyone else in this chain. Because everyone has circumstances which lead them to make poor choices, why blame one group and not the other?
posted by Jubey at 6:33 PM on October 30, 2015 [2 favorites]

Reading your followup, it sounds more like what you're saying is that it's dishonest for parents to offload responsibility for the situation to an easily-demonized class of dealers who don't resemble their perfect privileged kids, and that I would definitely agree with.
posted by thetortoise at 6:43 PM on October 30, 2015 [9 favorites]

In my experience, serious addiction (which I realized after I went through it, I had never really gone through before) may start out with questionable choices, but once you're actually caught up in the worst of it, choice is the last thing you have anymore and it's indescribably humiliating and painful to feel and see the evidence of your self control slipping further and further away.
posted by saulgoodman at 6:45 PM on October 30, 2015 [6 favorites]

The tortoise, yes that's exactly what I'm saying. White middle class parents are calling drug dealers murderers when in actual fact there's every chance they are in exactly the same situation as their own child - potentially worse, with less education, less opportunity, born in poverty and lord knows what else - which is how they ended up addicted or dealing. But it's still easier to vilify them.
posted by Jubey at 6:50 PM on October 30, 2015 [8 favorites]

The point Jubey raised is something I've thought about a bit. I've heard drug addiction described as a disease and I kind of understand it. But there is an element of choice there. I think most people are not forced to take drugs the first time. And some people can just stop. So while I think it's important to avoid blaming people for being addicted, it also does not serve anyone to pretend there is not some difference between someone who can just stop and someone who can't, or someone who never starts.
posted by kat518 at 6:58 PM on October 30, 2015

That's fair, ginger beer. Sorry if I'm prickly about it. To me, it was a big deal, and helpful, to realize I had become what I was always raised to think of as a junkie.

I am similarly irritated by being lectured on "offensive" language, using person-centered, etc. by people who are not actually in-group members (in cases where I am) even though it is often of course well-intentioned. "Junkie" belongs to the junkies. But gingerbeer is pretty clearly not just well-intentioned but putting in work on the side of good on this issue in general.
posted by atoxyl at 7:05 PM on October 30, 2015 [3 favorites]

What happens to the millions of lives already destroyed? What does empathy from a white person do for those people?

You're right - Nothing. There is absolutely nothing white empathy can do for these people. No amount of present day empathy by the powerful can do anything for their victims of the past. But I am talking about present behavior (whatever the motivations).

I can be both angry at the larger straight world that damaged my psyche in ways I'm still unraveling AND acknowledge that it was straights (motivated "selfishly" by their own gay sons and daughters) who (due to their powerful status) helped turn the tide in favor of gay rights. We could not have done it without them - not in a society in which they constitute 90+% of the population.

When white people become part of the conversation then people notice. When it's just us black folks no one tends to give a fuck.

This, unfortunately, is exactly the nature inherit in any unequal power dynamic, male/female, white/black, straight/gay. Powerful groups HAVE POWER and more readily use that power to benefit others if they see something in it for themselves. While it's fucking shitty that we (blacks, gays, drug users, whatever) have to convince others of our humanity, that's our obligation in the power dynamic. And, to an appreciable extent, we've succeeded. Without the groundwork laid by those who've experienced draconian drugs laws, their families, counselors and advocates, there would be vastly less tools/ideas/concepts with which to make things more humane.

My point in my earlier comment wasn't to let whites off the hook or to deny the suffering of victims of their policies. It was to highlight and respect that it was the hard work of the less powerful to convince the powerful to be better human beings in regards to substance use. I think that the cynicism I was addressing actually reifies (ugh, I know, that word!) the power dynamic it is meant to challenge.
posted by the lake is above, the water below at 7:19 PM on October 30, 2015

Sorry for so many comments, but this post brings up a lot of things I've been thinking about lately and the quality of this thread is great..

The point Jubey raised is something I've thought about a bit. I've heard drug addiction described as a disease and I kind of understand it. But there is an element of choice there. I think most people are not forced to take drugs the first time. And some people can just stop. So while I think it's important to avoid blaming people for being addicted, it also does not serve anyone to pretend there is not some difference between someone who can just stop and someone who can't, or someone who never starts.

In the greater scheme of things, I think we've spent so much energy on the side of "personal responsibility" that it seems to miss the point to bring it up in a conversation about larger policies and social views currently devastating huge swaths of the population.

But, on an individual basis, personal responsibility is really all anybody has to make meaningful change in their lives. There's very little (but not nothing!) an individual homeless heroin user can do to sway public policy on drugs. But he CAN make it to a methadone consultation appointment. He CAN decide to use clean needles and CAN learn to inject himself properly. He CAN acknowledge that he's engaged in behaviors that have led him to his current condition.

None of that requires denying the social conditions that made failing easier for him than succeeding, but they do allow him to maintain his individual agency and humanity. While we shouldn't be cruelly blind to the structural oppression of drug users, we also shouldn't treat them like helpless children either (it's disrespectful!)
posted by the lake is above, the water below at 7:52 PM on October 30, 2015

There's very little (but not nothing!) an individual homeless heroin user can do to sway public policy on drugs. But he CAN make it to a methadone consultation appointment. He CAN decide to use clean needles and CAN learn to inject himself properly. He CAN acknowledge that he's engaged in behaviors that have led him to his current condition.

Sure. And that's a hell of a lot easier if he knows he's not going to be locked up for decades for seeking help. And that's a hell of a lot easier if there's a needle-exchange program local to him. And that's a hell of a lot easier if there's some sort of supportive treatment available to him. And that's a hell of a lot easier if he knows he can still get a job if he's forced into treatment.

Public policy has a huge impact on the viability of one's personal choices.
posted by jaguar at 8:16 PM on October 30, 2015 [7 favorites]

Completely agree. Public policy is huge.

But so is individual agency.

Two things can be true.
posted by the lake is above, the water below at 8:23 PM on October 30, 2015

Yes, both things are true. But I think it's wrong to automatically blame people with substance abuse problems for not seeking help, because a lot of the time they have totally valid reasons for it. "They should just take responsibility" can also be a way of infantilizing people with substance-use disorders, because it assumes there's no valid reason or obstacle in the way of doing so. So focusing on eliminating those obstacles and holding off on blaming individual users until all obstacles are eliminated is a reasonable stance.
posted by jaguar at 8:29 PM on October 30, 2015 [1 favorite]

A member of my family struggled with heroin addiction for years. He went through several rounds of court ordered rehab and would get clean - and stay clean - sometimes for years. He'd get a job, an apartment, a life. But there just weren't community resources (that he or our family could afford) available to support him in the longer term. Now he's been clean for 7 years in prison.
posted by congen at 8:30 PM on October 30, 2015

But, on an individual basis, personal responsibility is really all anybody has to make meaningful change in their lives. There's very little (but not nothing!) an individual homeless heroin user can do to sway public policy on drugs. He CAN acknowledge that he's engaged in behaviors that have led him to his current condition.

Well, only if you believe in free will in the first place...

But regardless these

He CAN decide to use clean needles and CAN learn to inject himself properly.

are very weird examples to use because these are notably not things that anybody chooses not to do if they are aware of and have access to better options.

But he CAN make it to a methadone consultation appointment.

Even this, while it's a course of action someone might in fact willfully reject, is something that's often made very difficult for people who do wish to pursue it.

And this

He CAN acknowledge that he's engaged in behaviors that have led him to his current condition.

is something that basically everybody knows but that doesn't help a lot of the time it just makes you want to go do more drugs and not think about it.
posted by atoxyl at 8:54 PM on October 30, 2015 [3 favorites]

I didn't say blame individuals. You can acknowledge your own problematic behaviors without blaming. Acknowledging is not blaming.

I work with substance users every single day of my working life. I can assure you that if I sat there and told them, "You know what? You have absolutely no control whatsoever over your life. You can do nothing to help yourself because society/your mom/your brain damage/your trauma/patriarchy/heterosexism and capitalism are just waay too much to fight against. Might as well give it up." They'd probably kill themselves (or more realistically, fire me) . And rightfully so.

They'd just as surely be upset if I sat there and berated them for poor life choices, weak willpower and stupidity for picking up the pipe/needle in the first place.

If you've ever been in any of the rooms, been to substance use therapy groups or sat with a substance user, you will be familiar with the demands to "call me on my bullshit!" I *am not* okay with the way in which many people almost demand to be berated when they ask this. But I try and understand it as, on some level, a cry for me to acknowledge their humanity. Heavy, problematic users are familiar enough with losing control (nobody willingly does the things that heavy users do to themselves and their families - they are, mostly, not in control of their behavior). In my experience, they really don't need me to be complicit in some notion that they don't have any responsibility or agency. There would be no purpose in trying to change if that were the case. Ultimately, no reason to go on.
posted by the lake is above, the water below at 8:56 PM on October 30, 2015

I mean you could probably come up with examples of people who are attached to one unsafe injection technique or another - injecting pills that just shouldn't be injected might be a better example - but seriously who uses dirty needles when they have fresh ones?
posted by atoxyl at 8:57 PM on October 30, 2015

But I think it's wrong to automatically blame people with substance abuse problems for not seeking help, because a lot of the time they have totally valid reasons for it.

Also let's be honest: there aren't any decent treatment options available with a better than nothing track record of success, and the more effective ones require massive investments of time that people who work for a living can't necessarily afford to make.

Also, denial is an intensely powerful thing. The shame you feel over confronting your lack of self control makes it really hard to admit it even to yourself and look it squarely in the face. It took outside social pressure--basically, an intervention--for me to break through mine and finally understand how crazy and inconsistent all my denial distorted self-narratives actually were.
posted by saulgoodman at 8:58 PM on October 30, 2015 [1 favorite]

are very weird examples to use because these are notably not things that anybody chooses not to do if they are aware of and have access to better options.

but seriously who uses dirty needles when they have fresh ones?

I'm sorry, this is just not my experience with people deep in addiction and the psychosocial issues/instability that goes along with it. And to me, this comment illustrates a way in which people who don't use heavily(but are well-meaningfully compassionate), on some unconscious level, see users as fundamentally different then themselves. Because you can't imagine not using a clean needle ever.single.time.you.got.high.multiple.times.a.day then the fact people do so ALL THE TIME, just a few blocks from the needle exchange must not actually happen. But it does. I assure you. But the long-term irrationality of that behavior is, fundamentally NO DIFFERENT than smoking, eating fast food, or spending too much time on metafilter. You do those things, but somehow, in your quest to be compassionate (as opposed to understanding some heavy users' actual lived reality) you overlook that both you and the heavy user share much in common.
posted by the lake is above, the water below at 9:29 PM on October 30, 2015

Personal responsibility exists and is important in addressing an individual's problem. Believing that personal responsibility is a good approach to addressing the general problem is a crippling and expensive habit. This habit prevents us from having medical clinics that provide free heroin to people dependent on heroin. This approach is greatly superior to the current black market approach.

Free government heroin greatly reduces the black market and makes available the money currently spent on the fantasy that Law Enforcement will someday achieve a supply side reduction. Once the person who uses heroin has their primary, daily problem resolved, they may be able to address their other problems, perhaps by taking advantage of the services offered at the clinic they are visiting daily. Clean injection sites reduce the rate of hepatitis and HIV in the using population as well as in the general population.The sites also mean less spent on emergency medical services in alleys and stairwells.

A downside to free heroin is that people will have to give up their belief in the primacy of personal responsibility. That is a hard habit to break even though the results of this belief have been awful.
posted by llc at 9:36 PM on October 30, 2015 [1 favorite]

Our recently-ousted Prime Minister kept trying to shut down safe injection sites even after the Supreme Court ruled in the sites' favour. The Centre for Addiction and Mental Health (CAMH; Canada's major psychiatric hospital) issued a report a year or two ago calling for full legalization of marijuana, and our new PM made committments to legalization while on the campaign trail--we'll see how much foot dragging there is now. My guess is he either does it soon, or close enough to the next election that it's top of mind.

You nailed it with your last line.
posted by feckless fecal fear mongering at 9:43 PM on October 30, 2015 [1 favorite]

I'm sorry, this is just not my experience with people deep in addiction and the psychosocial issues/instability that goes along with it. And to me, this comment illustrates a way in which people who don't use heavily(but are well-meaningfully compassionate), on some unconscious level, see users as fundamentally different then themselves. Because you can't imagine not using a clean needle ever.single.time.you.got.high.multiple.times.a.day then the fact people do so ALL THE TIME, just a few blocks from the needle exchange must not actually happen. But it does. I assure you. But the long-term irrationality of that behavior is, fundamentally NO DIFFERENT than smoking, eating fast food, or spending too much time on metafilter. You do those things, but somehow, in your quest to be compassionate (as opposed to understanding some heavy users' actual lived reality) you overlook that both you and the heavy user share much in common.

I think you're a little off-base about where I am coming from and why I might feel qualified to speak about this. Every.single.time.you.got.high.multiple.times.a.day is not a concept that you need to explain to me. But I will admit I'm not, like, the guy who's been living that life for years or anything. I haven't even lived enough years to be that guy really and I have a lot of advantages that helped me keep me shit together. So I actually apologize for making assumptions about other people. It's just not what I observed among people I knew.
posted by atoxyl at 9:47 PM on October 30, 2015 [3 favorites]

I don't have a source but I read some people don't carry clean needles because if they get stopped and frisked they get arrested for drug paraphernalia. So some prefer to use what is available when they get where they are going.
posted by llc at 9:49 PM on October 30, 2015 [2 favorites]

Sorry if I wasn't clear - I wasn't talking about personal responsibility but neuroscience, epigenetics, nature vs nurture, etc. Someone above mentioned the role of trauma, for example. There are reasons that we have not yet identified that do not include personal responsibility that explain why one kid has a rough upbringing and becomes a fine upstanding citizen while another kid struggles with addiction. If we understood those things better, we could develop interventions to help kids and families.
posted by kat518 at 9:51 PM on October 30, 2015

Well that's the kind of thing I was talking about that effectively prevents access to clean needles. I was coming from an angle of sticking up for drug users but he was coming from a different angle than I thought.
posted by atoxyl at 9:52 PM on October 30, 2015

That is a hard habit to break even though the results of this belief have been awful.

Last comment - but this is a great line and reminds me of this old article written in the 80s in which the author used the DSM's (or some other authority's) criteria for addiction to illustrate, point by point, how the judicial system and the "Just Say No" crowd are addicted to their irrational policies despite all evidence to the contrary. It was AMAZING.
posted by the lake is above, the water below at 9:57 PM on October 30, 2015 [1 favorite]

If you've ever been in any of the rooms, been to substance use therapy groups or sat with a substance user, you will be familiar with the demands to "call me on my bullshit!" I *am not* okay with the way in which many people almost demand to be berated when they ask this. But I try and understand it as, on some level, a cry for me to acknowledge their humanity. Heavy, problematic users are familiar enough with losing control (nobody willingly does the things that heavy users do to themselves and their families - they are, mostly, not in control of their behavior). In my experience, they really don't need me to be complicit in some notion that they don't have any responsibility or agency. There would be no purpose in trying to change if that were the case. Ultimately, no reason to go on.

I have, and I have, and I have, and I've run those groups. And I've done research into the most effective treatment options for people with co-morbid/dual-diagnosis disorders, and I've paid attention to what seems to resonate with my own clients. And I've found that harm-reduction models are a hell of a lot more relatable than AA/12-step paradigms for people who aren't already indoctrinated into AA's bootstrap mentality. "You have agency, and it's *great* if you can exercise that agency to be *even just slightly better* than what you did last week, even if that means you're still using but your use is even just slightly less problematic than last week" tends to go over best.
posted by jaguar at 10:01 PM on October 30, 2015 [7 favorites]

"Any positive change" works a lot better than "I am powerless..."
posted by gingerbeer at 10:13 PM on October 30, 2015 [4 favorites]

I'm an avid harm reductionist myself! Hello!
I agree w/all you say. Any change is positive change. And all change takes agency. And we can help facilitate that change by empathetic respect of that agency.
Okay, that's my last comment, for real, but just wanted to say hi to all y'all HRers out there..
posted by the lake is above, the water below at 10:15 PM on October 30, 2015 [1 favorite]

I do wish that generally available treatment options were more than AA/12-Step Meetings or inpatient treatment (and I realize that inpatient treatment is not always generally available). "Find a psychiatrist and therapist for outpatient treatment" is usual for most mental-health disorders, and it's upsetting that it's not the usual for substance-use disorders. I get that some people may first need detox intensive-inpatient care, but not everyone does, or is willing to do, and even if they do they're often left with no options other than a 12-Step group.
posted by jaguar at 10:21 PM on October 30, 2015

And I should have added: Normalizing relapse also seems to help. People with addictions who are totally committed to ending those addictions will most likely relapse -- and that's ok. They can still get better. Stigmatizing those relapses, in my experience, makes the addiction worse.
posted by jaguar at 10:34 PM on October 30, 2015 [3 favorites]

I've heard drug addiction described as a disease and I kind of understand it. But there is an element of choice there. I think most people are not forced to take drugs the first time. And some people can just stop. So while I think it's important to avoid blaming people for being addicted, it also does not serve anyone to pretend there is not some difference between someone who can just stop and someone who can't, or someone who never starts.

I don't understand what you're trying to say with this.
posted by palomar at 9:52 AM on October 31, 2015 [1 favorite]

Because you can't imagine not using a clean needle ever.single.time.you.got.high.multiple.times.a.day then the fact people do so ALL THE TIME, just a few blocks from the needle exchange must not actually happen. But it does. I assure you.

Are they rejecting using clean needles, or are they rejecting having to go to the building that everyone knows is the needle exchange and out themselves as an IV drug user? I have a lot of personal experience with many aspects of this story, including the actual heroin addict part, and if you or the addicts you know would reject a clean (or even clean-ish) needle from a friend who stole a few of grandma's insulin needles because they are "irrational" then that is very different than my lived experience, where a fresh, clean needle from a trusted source was like gold.

But the long-term irrationality of that behavior is, fundamentally NO DIFFERENT than smoking, eating fast food, or spending too much time on metafilter. You do those things, but somehow, in your quest to be compassionate (as opposed to understanding some heavy users' actual lived reality) you overlook that both you and the heavy user share much in common.

Are you literally, IN ALL CAPS, claiming that the impact of a crippling heroin addiction is fundamentally no different than spending too much time reading MetaFilter?

I'm sorry, this is just not my experience with people deep in addiction and the psychosocial issues/instability that goes along with it. And to me, this comment illustrates a way in which people who don't use heavily(but are well-meaningfully compassionate), on some unconscious level, see users as fundamentally different then themselves.

I accept that this was not your experience, but that is my experience , and apparently atoxyl's experience, too, and I think your characterization of their comment is unfair and condescending. Like them, I also questioned your statement, "He CAN decide to use clean needles." It was totally reasonable to express surprise at that statement and in no way implies a lack of personal knowledge of the subject.

Also, re "CAN learn to inject himself properly" there is "learn to inject yourself properly" and "learn to inject yourself properly, until your veins collapse, you can't hit anything on your feet, that one good vein has an abscess the size of a plum, and your bones hurt so much you think you're going to die from the pain so you give up and improperly inject into your butt cheek." These statements remind me of the bootstrappy "poor people CAN save money by cooking at home!" you see in threads about public food subsidies, often from people who have never wondered where their next meal was coming from.

(the lake is above, the water below, I obviously have a lot of issues with this one particular comment, but I'm not trying to make any generalizations about your other contributions to this thread, whether I agree with them (I do) or not (some of that, too.)

I used to say that it was a miracle I've never been arrested or been to jail. Then one day, after reading about privilege here I thought back to the time when the paramedics came to my BFF's house because someone OD'd (again) and when they left they said, "If we have to come here one more time we're going to have to call the police." That's when the lightbulb went off and I got it. No miracles, privilege. And maybe a pinch of luck.
posted by Room 641-A at 10:46 AM on October 31, 2015 [8 favorites]

“I don’t think we should lock up white kids to show we’re being equal.”

Wow. We all knew you were thinking it, but we can't believe you thought it was a good idea to say that out loud to a New York Times reporter.
posted by mbrubeck at 10:58 AM on October 31, 2015 [8 favorites]

This article. I just want to bang my head into a wall. Yes this will be a net positive overall if these people can affect some kind of change into the so called war on drugs. Here is my problem. My family and community was decimated in the 80's and 90's due to crack and heroin. I grew up in East New York, Brooklyn. My parents were addicts, as were many aunts, uncles, cousins. Many of them would get locked up, temporarily clean up in jail, get released, and start the process all over again. Eventually most of these people became infected with HIV. We've had to deal with the stigma of race, addiction, and then disease. There was a lack of everything but drugs.

It is so easy to dismiss when it's poor people, people of color. But now that people with power have been affected it's a serious problem and something must be done. Well, fuck.
posted by mokeydraws at 11:35 AM on October 31, 2015 [7 favorites]

if you or the addicts you know would reject a clean (or even clean-ish) needle from a friend who stole a few of grandma's insulin needles because they are "irrational" then that is very different than my lived experience, where a fresh, clean needle from a trusted source was like gold.

I think the dual misunderstanding between me and lake above has mostly been addressed but yeah its just - when you are shooting tar half a dozen times a day or more you pretty inevitably reach a point where each shot is an ordeal of bloodletting so I just find it hard to imagine even the more fucked up people I've met turning down a fresh sharp rig if it's there. I remember people from less tolerant areas (than where I was) talking about fucking sharpening old ones by hand! But I think lake was coming from a perspective of trying to persuade people to take a little more initiative to take advantage of the resources that are available even if it's not quite so easy. Out of context it seemed pretty baselessly unfair to IV drug users though.
posted by atoxyl at 3:24 PM on October 31, 2015 [2 favorites]

I used to say that it was a miracle I've never been arrested or been to jail. Then one day, after reading about privilege here I thought back to the time when the paramedics came to my BFF's house because someone OD'd (again) and when they left they said, "If we have to come here one more time we're going to have to call the police." That's when the lightbulb went off and I got it. No miracles, privilege. And maybe a pinch of luck.

Where I am it's the law that they (supposedly) won't send the cops with an overdose 911 response. The one time I had to make that call I didn't know that though - but I sure did know that cops wouldn't be happy with me if they figured out some of the details of the situation. Good times! I want to tell people this story sometimes because you learn some important things about yourself making (versus not making) that call but it's a hard thing to slide into a conversation, you know?
posted by atoxyl at 3:33 PM on October 31, 2015 [4 favorites]

Addiction is a learning or developmental disorder (this is the subject of my next book, which is called Unbroken Brain). We get all this confusion about its nature because we try to dichotomize it into "disease" or "sinful choice."

In fact, it is a distortion of the emotional learning systems that evolved to make us persist despite negative consequences in love or parenting. About 2/3 of people with addictions have serious trauma histories and at least half have a pre-existing predisposition or already manifest mental illness, often they have both. So, basically, the 10-20% of people who try cocaine, heroin, alcohol, marijuana or amphetamines and get hooked are *different* before they try the drugs and trying the drugs isn't the "decision" that traps them. What traps them is a mix of their current situation and their predispositions and the way they learn that drugs are useful for coping.

So, once we get this, we should be able to recognize several things. One: addiction isn't about being "bad" or "making the wrong choices." It involves choices that are made either unconsciously or without clear knowledge of the alternatives, which then narrow future choices. In other words, people who get addicted aren't "to blame"— but they aren't just will-less zombies either. Their choices are more limited, not non-existent, which is why you get some people who will steal to get drugs but refuse to deal, some who will deal and not steal, some who will prostitute themselves but not be violent; some who will be violent but not prostitute themselves, etc. etc. The things people are willing to do to get drugs are based on their values, which are stressed by the addiction, but not eliminated or made up from whole cloth. This is why you don't get businessmen becoming muggers; they commit white collar crimes to get theirs. it's also why it's rare for people who weren't sexually abused to become prostitutes during their addictions.

Two: punishment and shame will not fix addiction. It is defined by compulsive behavior *despite* negative consequences. If punishment worked, addiction wouldn't exist. Rewards, however, are quite effective at helping people recover— but we don't want to use them because we think it's rewarding "bad" behavior.

Three: banning any particular substance or changing the supply side will be about as effective in stopping addiction as, say, banning trains or punishing hand flapping will be in preventing autism. Yes, you can reduce harm by doing things like getting addicted people to choose marijuana over opioids, but you are not addressing the roots of the compulsive behavior that drives addiction here. These live in the person's relationship with the substance, not in the drug alone. That's not to say we shouldn't do harm reduction— but we should realize that simply cutting supply of one drug isn't going to do anything to help and often harms by pushing people to more harmful substances.
posted by Maias at 5:45 AM on November 1, 2015 [8 favorites]

Softening sentences, losing leverage
posted by the man of twists and turns at 9:36 AM on November 1, 2015

That argument by the prosecutors and the whole business of trying to hold someone other than the addicted person responsible when things go wrong is completely wrong-headed.

For one, if mandatory minimums are such a great tool, why was there any heroin for her to buy in the first place? Does anyone really believe that getting rid of this one guy or this one network of dealers will make any difference? If you do, I have a bridge to sell you in Brooklyn, along with a few hipsters.

Second, as the prosecutors themselves admit, the worst mandatories are off the table already because of Holder's guidance— and no additional disaster or reduction in cooperation has occurred. What people don't realize is that dealers aren't sitting there thinking, "Well, if I sell this much and someone OD's, I'll get 10 years, but if I only sell that much, I'll get five."

It's basically arbitrary to hold this guy responsible for this tragedy: he certainly wasn't selling drugs in order to cripple people or kill them, he was selling them because people want to buy them. It's one thing if you drive drunk, knowing you could kill someone: you are responsible for making that choice and you know it could do real harm to someone who is completely uninvolved with addiction. But opioid overdoses can't happen to bystanders: you have to take the drug yourself and blaming the guy who supplied it, whether it's heroin from a dealer or a pill from a doctor, doesn't help stop addiction. The only way to stop addiction is to help people with addictions recover or to prevent them from developing the compulsive coping style that makes them vulnerable in the first place.
posted by Maias at 11:48 AM on November 1, 2015 [1 favorite]

Softening sentences, losing leverage

Well that hits all the fuckin notes - including the racial ones! Sorry guys but you haven't even managed to describe your system without making it sound awful.
posted by atoxyl at 12:56 PM on November 1, 2015

Ground Zero For Election 2016—And Heroin Deaths

Addicts Among You (Yes, You)
posted by telstar at 5:42 PM on November 8, 2015

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