By Mansfield Frazier
The sense of urgency was palpable as over 600 medical/health care professionals, scientists, drug treatment specialists, politicians, legal experts, members of law enforcement and concerned family members crowded into the amphitheater of the InterContinental Hotel on Cleveland Clinic’s main campus last Thursday to grapple with what is now being characterized as an epidemic: The sharply rising number of deaths in Ohio due to heroin overdoses.
In one recent weekend alone six people in Cuyahoga County died and experts are predicting that in excess of 600 people around the state will succumb to the deadly disease before year’s end … far outstripping the number of murders or accidental deaths in Ohio.
The goal of the one-day summit was to come up with an action plan by December to stem the tide of deaths and hopefully begin to dramatically lower the number of individuals that lose their lives to the deadly drug. However, in spite of the nobleness of the cause and the brainpower devoted to it, such an effort is akin to turning around a huge ocean liner … it’s going to take tremendous effort … plus lots and lots of time.
Time that some addicts simply don’t have. The way policy is usually changed or implemented in most states, a lot more people are going to be stone, cold dead before the cavalry arrives.
But the good news from the summit is that addiction experts, such as Cuyahoga County Chief Clinical Officer Dr. Christina Delos Reyes; Dr. Gregory B. Collins, the long-time head of the addiction unit at Cleveland Clinic; MetroHealth’s Dr. Joan Papp, the medical director of the DAWN Project; and Case/Western adjunct professor Stephen R. Sroka, PhD (and a host of others) really, really know their stuff. The bad news is that the lion’s share of funding in this arena is still going to go to law enforcement for interdiction efforts … causing programs that offer commonsense treatment options to continue to go begging.
But it’s not as if law enforcement isn’t aware of the fact that we will never be able to “police” our way out of this problem; Joseph Pinjuh, who heads up interdiction efforts for Northeast Ohio’s U.S. Attorney’s Office, couldn’t be more clear on the fact that efforts directed at choking off the supply of heroin are all but futile in terms of reducing the number of deaths, but in the next breath he was just as adamant that such efforts would continue to be vigorously pursued. Talk about conflicted.
But then, it’s far easier and more comfortable to blame far off Afghan poppy growers, Mexican drug cartels, and even the street level pusher than to ask ourselves how did we allow this to happen. What did we do wrong along the way that now causes so many of our young people from communities of relative privilege to run into the open, seductive arms of King Heroin? I only heard one woman ask this questions all day … and she got no response.
But virtually every speaker on the numerous panels advocating for education and treatment at some point spoke to the same issue: a critical lack of funding to accomplish their mission. Dr. Delos Reyes referenced the fact that, while laws have been on the books since 2008 requiring that healthcare professionals treat drug addition like any other disease, treatment on demand remains something addicts can only wish for in this country. “In America we don’t turn away patients that show up at hospitals with any kind of medical problem … except for addiction,” she said.
While we as a society can always find funds for more prison beds, treatment beds remain scandalously scarce. And a big part of the reason has to do with the anachronistic mindset of … “since addicts created their own problems by their own willful behavior, why should we expend any resources assisting them?” All the while many of the purveyors of such heartless sentiments loudly tout the fact we’re a “Christian nation.” Really?
The DAWN Project, run by Dr. Papp, utilizes Naloxone — an opioid antagonist drug developed to counter the effects of heroin or morphine overdose. When the drug is administered (via a nasal mist inhaler) to someone who is experiencing a drug overdose, in virtually every instance a life is saved. While a bill was passed by the Ohio Legislature to allow Lorain County to establish a pilot program that trained first responders in the use of the drug, police were at first reluctant to embrace its utilization.
But the persistent efforts of Lorain County Corner Dr. Stephen Evans won law enforcement over when he touted the success of a similar program run in Quincy, MA. Efforts are underway in Columbus to pass legislation that would utilize the technique statewide, but legislators (perhaps fearful of a backlash) are dragging their feet on the issue.
A positive side effect of the Lorain experiment noted by Dr. Evans is a lessening of the antagonism between first responders and addicts. Usually law enforcement views addicts as the scum of the earth, and addicts view law enforcement as dudes bent on locking them up; but now that first responders are saving the lives of addicts, both sides are beginning to look at the other in a more humane light.
One of the dirty little secrets surrounding the whole issue of opiates and overdoses is that members of the medical profession — doctors and pharmacists — are among the most organized group of drug dealers in Ohio … and it’s probably like this in the entire country. Many of the addicts that eventually find themselves “in a dirty room with a needle and a spoon” got started down that path via prescription medications.
Policing the professionals who sometimes do more harm than good — albeit, in most case unintentionally, but sometimes for purely pecuniary reasons — falls to OARRS, the Ohio Automated Rx Reporting System, an arm of the State Board of Pharmacy that’s tasked with monitoring how often doctors prescribe addictive medicines and how often pharmacists fill such prescriptions.
“Doctor shopping,” the practice utilized by addicts to go from one doctor to the next to obtain a supply of pills, could be drastically curtailed if OARRS is fully implemented but Chad Garner, the director of the program, stated that federal funding, which comprises 80 percent of his budget, is drying up. Just as with virtually all other preventative measures that are proven will save lives, he has to scramble for dollars to stay afloat.
And dollars (and who controls and dispenses them) are what much of this is about. A Brad Pitt character in a recent flick stated, “America isn’t a democracy; it’s business.” Tru dat.
The most immediate way (and this still would take a long time before real benefits are realized) to curtail overdose deaths and see a decline in them would be for funding — especially at the federal level — to be reallocated. The majority of the dollars now spent on futile interdiction efforts should go towards treatment beds, education, and harm reduction efforts… efforts that are proving their utility all across Europe in terms of reducing overdose deaths. But no one should expect that to happen anytime soon.
Richard Nixon declared a “War on Drugs” 40 years ago, and in spite of the fact the prices for drugs now considered illegal have consistently fallen during that period (if interdiction efforts were in any way successful, prices would have climbed, it’s simple supply and demand), we still solider on while people are dying in unprecedented numbers. But the vast bureaucracy created to fight this war will never willingly relinquish any of the funding it receives — heroin deaths be damned.
At one point during the day, Pinjuh, the old-line drug warrior, stated that perhaps one way to deter youth from using opiates is by explaining to them their usage of heroin — since the majority of the world’s poppy fields are in Afghanistan — supports the Taliban, which, in turn sponsors worldwide terrorism. No kidding, the man was serious … which demonstrates how clearly out of touch he is with the Zeitgeist.
And he said this right before he made the statement that the legalization of marijuana was sure to lead our country straight down the road to ruination. How are we going to argue with such outdated, reactionary thinking … let alone wrest any treatment dollars from individuals with this antiquated mindset? The answer is, in the short term, we’re not. They’ve got the ball (or in this case the dollars) and they’re going to say and do anything to scare the bejesus out of the citizenry to assure they remain fully funded.
There’s a basic immorality to all of this, and it was best personified by numerous speakers throughout the day when they alluded to the fact that we’re now in a crisis because Devil heroin has slipped outside the bounds of the inner city and now is claiming lives of white kids in Solon, Independence, and Westlake.
More than one person I spoke to during the conference (blacks and whites alike) raised the question: why wasn’t this a “crisis” when it was only in the inner city? Why wasn’t it dealt with when it was mainly infecting kids of color? Well, this still being America, we know the answer to that one, don’t we? But indeed, immorality in terms of public policy comes at a price, and sometimes a steep one. Chickens always come home to roost.
Cleveland Mayor Frank Jackson has consistently and repeatedly stated that anyone who thinks the problems plaguing the inner city are going to stay locked up inside city boundaries are fooling themselves. That turning their backs on Cleveland’s problems would only result in the problems eventually becoming theirs. This epidemic of heroin deaths is proof positive of the validity of that statement … the Devil is now past the doorstep of wealthy suburban communities … he’s completely moved in and taken up residence. And it’s going to be a real bitch getting him out.
From Cool Cleveland correspondent Mansfield B. Frazier mansfieldfATgmail.com. Frazier’s From Behind The Wall: Commentary on Crime, Punishment, Race and the Underclass by a Prison Inmate is available again in hardback. Snag your copy and have it signed by the author by visiting http://NeighborhoodSolutionsInc.com.
5 Responses to “MANSFIELD: The Devil’s in the House”
Dick Peery
Mansfield–Don’t dismiss the relevance of Afghanistan despite the bizarre comments of Joseph Pinjuh of the US Attorney’s Office. That country is fueling the world wide heroin epidemic. The NATO American invasion of Afghanistan led to bumper crops with American troops sometimes protecting the poppy fields.
According to a British study cited in Wikipedia, “In July 2000, Taliban leader Mullah Mohammed Omar, collaborating with the United Nations to eradicate heroin production in Afghanistan, declared that growing poppies was un-Islamic, resulting in one of the world’s most successful anti-drug campaigns. The Taliban enforced a ban on poppy farming via threats, forced eradication, and public punishment of transgressors. The result was a 99% reduction in the area of opium poppy farming in Taliban-controlled areas, roughly three quarters of the world’s supply of heroin at the time. The ban was effective only briefly due to the deposition of the Taliban in 2002.”
More recently, the New York Times reported a couple of weeks ago, “…the NATO-led coalition has abandoned any crop eradication by its soldiers for fear of driving farmers over to the insurgents, a policy strongly criticized by the Russians, among others. ”
Our tax dollars at work
mansfield frazier
Dick,
I was not dismissing the relevance of Afghanistan, only making the point of how we love to blame others for the heroin problem in America. We can totally eliminate all of the poppies there, and the crop will spring up somewhere else in the “Golden Triangle.” In spite of Omar’s eradication efforts, the supply to American cities didn’t diminish, it was just replaced by “black tar” heroin from Mexico.
My point was, and is, that we’ll never be able to solve the problem by cutting off supply, it simply can’t and won’t work. The bedrock principle of American-style capitalism is supply and demand, where there is a demand, there will be a supply. Period. The only question is high how the price of a kilo will be. And in the last 40 years the price has gone down, not up, since we are losing the 40-year war on drugs … a “war” that can’t be won.
Dick Peery
Mansfield–My point is that availability is a necessary component of drug mania and cannot be stopped unless we change American foreign policy. At least since the end of WWII, heroin and other drugs have been slipped into the country as an integral part of our conduct of war. Whether talking about the poppies financed by the CIA so Kuomintang soldiers could survive in Southeast Asia after they were driven from China or about the Reagan administration’s Central American gunrunners who were allowed to bring cocaine back on return trips to the U.S. and fueled the crack epidemic, it’s about foreign policy. Now, Afghanistan has become the world’s humungous supplier with American support.
Demand is manufactured. When the British wanted to weaken the Chinese so they could be conquered, they flooded the nation with opium. When the Chinese regained control, addiction abated.
Neevan
Brad Pitt movie in Killing Them Softly, “My friend, Thomas Jefferson is an American saint because he wrote the words ‘All men are created equal’, words he clearly didn’t believe since he allowed his own children to live in slavery. He’s a rich white snob who’s sick of paying taxes to the Brits. So, yeah, he writes some lovely words and aroused the rabble and they went and died for those words while he sat back and drank his wine and fucked his slave girl. This guy wants to tell me we’re living in a community? Don’t make me laugh. I’m living in America, and in America you’re on your own. America’s not a country. It’s just a business. Now fuckin’ pay me. “
mansfield frazier
Dick,
Changing foreign policy will change nothing when it comes to the drug trade. “Availability” is a canard, propagated by those who want to continue the useless drug war. Even when we are not at war, drugs continue to flood into the country. It’s simple supply and demand, the form of capitalism our country’s foundation is built on. Choke off supply from one source and others will fill the void. Should we then declare war on Mexico when it becomes the primary poppy growing country (as it surely will)? We’ve already turned South American countries into narco-states with our unending demand, how far should we go?
Why not focus on harm reduction, which has proven to work in other countries, but that would require we begin to answer the questions we don’t like to ask: Such as, why is little Johnny doing heroin in the first place?