Thursday, February 13, 2020

Field Hospitals For Drug Addicts

Recently, Pete Buttigieg was on Fox News Sunday where he said he was in favor of decriminalizing drug possession. I've heard this a lot from genuinely compassionate people. They favor treatment over punishment. It comes from a place of love, so it's not something to dismiss with a sneer.

Over my life, people close to me have become addicted to drugs. I've had plenty of experience living with them and trying to help them. When I hear well-intentioned folks talk about treatment, I think about the scale of the problem from two ends.

First, what does it take to "treat" a drug addict? I have a close friend who was a homeless drug addict for a while and had another fellow build a house for me who was also a recovered homeless drug addict. Those two are the only ones I know who've escaped. Everyone else has died or is in the process of dying.

Treating an addict isn't like treating someone who has the flu. You don't give them bed rest and fluids for a few weeks while they detox and then they bounce back and live normal lives. It's a grueling, long-term, high-effort thing. Most of the time it fails and detox is followed by relapse.

How many addicts can a single social worker manage? That's one side of the scale problem.

The other side of the scale problem is the number of addicts. I don't have time to look up the stats, but let's just say that Los Angeles has 60,000 homeless. Let's assume they're all on drugs and another 60,000 are addicted, but not on the streets yet. In LA alone, you'll need to treat 120,000 addicts. Where are you going to find enough social workers to even start to tackle those numbers?

In 1917, the French launched the disastrous Nivelle Offensive against the German lines. The Germans were prepared for it and the result was a massacre. French casualties overwhelmed their field hospitals. That's where we are right now with drug addictions. That's where we are with the homeless in California, Seattle and New York.

The difference is that some of these guys were healed after one visit. That's not the case with drug addicts. Each one will wear you out with a long string of relapses ending rarely in a cure, but mostly in death.
This is why I'm totally in favor of the war on drugs. If you wait until people are addicted to deal with the problem, you'll find the situation completely out of control, like it is in Los Angeles and San Francisco. You've got to attack it at every point and fight it constantly. Otherwise, you're going to see field hospital overflow all around you like they do in LA and SF.


tim eisele said...

The problem as I see it, is that when the drug addicts themselves are being treated as criminals, they are scared to look for help, because they are likely to get arrested for drug possession. And they are scared to cooperate with the police, because then they have the double risk of getting arrested, and of having the supply of the drug they are addicted to get cut off.

The real criminals are the dealers who are selling the stuff to them. And they are the ones who have the money to bribe the police to look the other way. So who goes to jail? Not the dealers, for the most part. So we end up with jails filled with addicts and with the low-level pushers who don't get to keep much of the money, while the bosses go untouched except for the occasional one that goes far enough that the police have to arrest him, bribes or not.

So here we are, with our decades-long war on drugs, and what is the result? If anything, even more homeless addicts on the street than before. What was actually accomplished? I mean, you have said in the past that the War on Poverty is a failure because in spite of the money spent, there are as many poor people as ever. Well, the War on Drugs is exactly the same kind of failure.

tim eisele said...

And in Portugal, where they largely decriminalized drugs back in 2001, it looks like on average they are somewhat better off than they were when drugs were illegal:

There is still drug use, but no worse than in neighboring countries, and the death rate is lower.

K T Cat said...

I don't know nothing about no Portugal, but I do know druggies in the US. When drugs are illegal, it's a barrier to possession. When they're not, that barrier is down and it's Katie bar the door.

Treatment is the most expensive phase of the drug addiction process. Once you get to that point, the game is almost certainly lost and to win a couple of cases, you'll need to invest insane amounts of time in effort on a lot of them as you won't know ahead of time which people will be able to pull out of the death spiral.

K T Cat said...

Shorter version: Treatment is the phase with the highest per-person cost and the lowest chance of success. Failure at this stage means death.

tim eisele said...

"When drugs are illegal, it's a barrier to possession"

You'd think it would be, but is it? People are ornery cusses, and everyone I ever knew who wanted drugs was able to get them, illegal or not. With many of them going ahead and using drugs specifically because they were forbidden. And if they found it a bit inconvenient to get, say, heroin, they were happy to switch to cocaine, or amphetamines, or even settle for just getting booze and drinking themselves to death.

The trick has to be to persuade people not to *want* to intoxicate themselves. Once they decide that is something that they want to do, I don't think you can stop them short of locking them up in solitary confinement.

Foxfier said...

Mrs. Hoyt over at According To Hoyt is from Portugal.

It's been a disaster. Crime went way up, theft got even worse, there are more crazy people, it's just not recorded as "drug related crimes."

Her elderly parents cemented glass to the top of the walls around their house and still get broken into.


You'd think it would be, but is it?

Yes, actually.

Because you can actually stop the drug dealers, if you catch them.

I actually hang out with some of the DEA and related folks; it is normal for them to basically punish drug-users by putting them in treatment.

That famous "the first hit is free" statement is an actual philosophy. That's the difference between alcohol and other drugs. You don't get hooked the first time on a beer. This is also why there were so many OD deaths when the cartels got ahold of cheap fet-- they started dusting even the pot, to get folks hooked. It's not humanly possible to eyeball the dose for fet that will get you high but not dead. (Spoiler: they don't care.)

The famous stats about people in jail for possession? When you look at the actual cases, it was plea-bargained down and drugs are an easy to prove claim. For example, the drug dealing ring that also broke into cars and stole identities who took my car tire was eventually charged with "possession." (Which was BS, they were caught red handed, but that's what's behind the stat.)

K T Cat said...

Making drugs illegal is a deterrent to some. Interdicting the supply lines at the border, which requires control of the border, is a deterrent to some. Whacking the drug lords is a deterrent to some. The point is that you want as few people as possible getting to the terminal stage of drug addiction.

Your action choices are bad, the success rates are poor, intervening all across the life cycle of drug distribution is costly, but simply dealing with people once they're addicted is the worst possible solution. Who knows, at that point, once you've accepted euthanasia as morally fine, you might just decide to start killing them so you can save your money for paying kids' student loans or something.

Me, I want attacks on the drug pipeline at every stage plus treatment for the addicts.

K T Cat said...

Foxie, I'll go check out Sarah Hoyt's blog for her Portugal take. Thanks for the tip!

K T Cat said...

You know, the other option is to cut out the social safety net and force addicts to find ways to earn a living. Some would die, but many would change their behavior.

I'm not in favor of this.