Posts Tagged ‘Addiction’

Tennessee Should Fund Mental Health Expansion Through County Health Departments

April 24, 2021 Comments off

In the mid-1990s when I was Superintendent in Maryland the State mandated that each school have a certified nurse. After running some numbers in the district I led it was clear that we would have to use every “new dollar” we would reasonably expect to pay for this initiative since we had nurses assigned to only 10% of our schools and no one on our staff to supervise or support them. Moreover if we paid the nurses on the teacher pay scale we would be paying more than the local hospitals by far. The solution that was best for all, I believed, was to have the county health department hire them, and partner with schools to recruit, support and evaluate them. In that way we would not disrupt the local hospital’s workforce, provide opportunities for many nurses to get work hours that matched their children’s school hours, and fulfill a state mandate and. need without compromising our budget. This idea worked for all concerned.

This personal experience was brought to mind when I read about the Governor of Tennessee’s ideas about providing universal mental health services in schools which he viewed as being offered through the systems or the states. His funding gambit, creating a trust fund, might have promise as well if he could get the billionaires who support charter schools to direct their donations to the foundation for mental health.

What If the War on Drugs Had Been a War on Inequality?

January 3, 2021 Comments off

Whenever a I read an article like Sarah Lahm’s recent Common Dreams essay on how our economic policy influenced the racism that exists today, I wonder how things might have played out had our nation continued supporting the kinds of policies Jimmy Carter advocated over those of Ronald Reagan?

Ms. Lahm uses the life of George Floyd to indirectly pose this question. She offers this terse description of the world George Floyd entered as a child:

Floyd was raised by a single mother in a racially and economically isolated public-housing development, where he and his siblings often did not have enough to eat. The family of six was crammed together with too few beds, yet Floyd’s mother was reportedly a generous soul who took in other kids in need.

Floyd was born in 1973 and came of age in the 1980s. Ronald Reagan’s presidency shaped the backdrop of his formative years, when austerity measures and trickle-down economics were bumping up against the gross excesses of Wall Street and the glorification of the yuppie lifestyle.

What if, instead of treating addiction as a moral failure that required the writing of new laws and the incarceration of those who violated the laws the government policy it treated addiction as the disease it is? What if, instead of directing billions to police and prisons the Federal, state, and local funds were directed to support the well-being of children. Maybe a “generous soul” like Floyd’s mother would have been paid to care for kids in need in a house that would provide them each with their own bedroom. Maybe the government could have provided Mrs. Floyd with sufficient funds to buy food and clothing for the children under her care and paid for any medical and dental bills they required. Maybe the government could identify the many “generous souls” who reside in impoverished communities across the country and offer them support, helping them create a nurturing environment that could offer the children under their care the well-being that they lack through no fault of their own.

Instead of intervening when it would make the most difference, though, we chose to “declare war” on the misconduct that manifests on the back end. When children and young adults are desperate for well-being and can only find it when they use drugs and when the use of those drugs is seen as a defiance of law and order, money gets spent on policing and incarcerating misbehavior… and we spend billions paying to segregate those who suffer from the disease of addiction. We provide them with food, clothing, and shelter and adult supervision at a cost that is daunting but unquestioned. Instead of developing an infrastructure to help “generous souls” like George Floyd’s mom, we set up  an infrastructure to isolate young men and women who suffer from a disease from the rest of our society… and the economic conditions that led to the disease remain in place forever.

Trump’s Criticism of Hunter Biden’s Addiction and Recovery Should Appall Everyone Touched by the Disease

October 1, 2020 Comments off

I intentionally missed the debate on Tuesday knowing that it would not be informative and would be unsettling… and having read descriptions of the debate and watched “highlights” I clearly made the right decision. The President’s lies and invitations to fringe White Supremacy groups to arm themselves in support of his continued leadership garnered much of the post-debate coverage.. but Scott Bixby’s Daily Beast coverage of a particularly appalling attack by the President did not find its way into the headlines of the major media the day after the debate. Here’s Bixby’s recounting of the exchange, beginning with the President’s interruption of Mr. Biden:

“Are you talking about Hunter?” Trump said late into the debate, interrupting Biden as he reflected on his late son, Beau Biden, who died of brain cancer in 2015. “Hunter got thrown out of the military. He was thrown out, dishonorably discharged for cocaine use—he didn’t have a job until you became vice president, and once you became vice president, he made a fortune.”

Trump’s callous and incorrect comments—Hunter Biden was not dishonorably discharged— about his opponent’s lone surviving son’s past drug use were clearly wielded to leave a mark, but Biden responded with defiance.

“My son, like a lot of people, like a lot of people we know at home, had a drug problem,” Biden said. “He’s overtaken it. He’s fixed it, he’s worked on it, and I’m proud of him. I’m proud of my son.”

Joe Biden is deservedly proud of his son’s conquering of addiction… as I am certain George H.W. Bush was proud of HIS son’s overcoming addiction and many voters are proud of their own conquest of substance abuse disorder. But, as Bixby notes, the President’s insinuation that addiction is a moral failing was a setback for many:

The moment horrified advocates for addiction treatment and substance who told The Daily Beast that they fear Trump’s comments, and comments like them, could seriously harm the millions of Americans affected by substance abuse nationwide.

Addiction is a medical condition that affects millions of Americans each year, irrespective of any demographic. It is a disease, not a moral or character failing,” Marvin Ventrell, CEO of the National Association of Addiction Treatment Providers, told The Daily Beast. “It is inappropriate, harmful, hurtful, and irresponsible when a public figure or person of influence disparages people suffering from addiction.”

The attempt during the presidential debate to shame a father whose son may have struggled in the past with a substance use disorder is wholly unconstructive and serves to perpetuate misconceived perceptions of addiction,” said Dr. Paul H. Earley, president of the American Society of Addiction Medicine. “Our nation must respond with compassion and evidence-based treatments if we want to treat addiction and save lives.

Trump’s comments, which characterized substance use as a character failure, also undercut the hard-fought understanding in the medical community that addiction is a disease, said Dr. Lawrence Weinstein, chief medical director of American Addiction Centers, which provides treatment for substance use disorders.

“The stigma surrounding mental health and addiction has been shown to be a significant barrier to treatment and prevents many people from seeking the help that they need,” said Weinstein, who called addiction “an indiscriminate, chronic, complex and relapsing brain disease.

This disease is not the result of a moral failing, poor judgment, or weakness—it is a chronic condition that requires lifelong maintenance,” Weinstein said.

But characterizing addiction as a moral failing buttresses the need for militarization of police to fight the “war on drugs”… After all, if the best response to a disease is to respond with compassion and evidence-based treatments there would be no need to spend millions of dollars for police departments to acquire training to use military grade equipment and to seek no-knock warrants. There would be no need to spend billions to incarcerate people who’s major offense was, at root, suffering from “an indiscriminate, chronic, complex and relapsing brain disease.” But here’s the political reality: you can’t be a “law and order” President if you characterize addiction as a disease that requires compassion… especially when most of the voters in your base view it as a moral failing, a “bad choice” that someone made. And so another disease is politicized… and like the disease of COVID 19 dealing with addiction will require a national understanding of it’s spread, a national willingness to find and/or redirect money, and— perhaps most difficult of all— a national willingness to rethink a fundamental understanding about addiction itself. Those who are afflicted with the “indiscriminate, chronic, complex and relapsing brain disease” at one point DID make a bad choice… but that choice was no more a moral failing than the decision a college student who becomes an alcoholic makes to join his friends at the bar to have a drink. As a nation we seem to have concluded that alcoholism— or addiction to alcohol IS a disorder… but we persist in believing that DRUG addiction is a moral failing and so we are mis-directing billions of dollars of resources and wasting the lives of tens of thousands of our citizens. MAYBE one outgrowth of the President’s appalling misrepresentation of Hunter Biden’s affliction will be a greater understanding of the disease of addiction… or maybe it will just turbocharge the militarization of the War on Drugs and the proliferation of prisons to deal with it. 

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