But Oregon is much, much worse. I spent 35 years as a prosecutor (in Eugene, Bend, Newport, and Astoria), the last 25 years as the elected DA in Astoria. When the DC-based Drug Policy Alliance single-handedly bankrolled Measure 110 on the 2020 ballot, Oregon functionally legalized ALL DRUGS.
The lie, told in a tsunami of clever and deceptive campaign ads, was that sending hapless addicts to prison was cruel and useless, and that Oregon needed to divert the vast sums being spent in the WAR ON DRUGS into treatment.
Except that Oregon's sentencing guidelines have blocked judges from sending someone convicted even 15 times for Possession of heroin or meth to any sentence longer than 30 days, and in reality capped that at 10 days. That had been the law since 1989. Oregon had the second lowest number of inmates in for drug crimes, only Vermont had lower rates. But in reality no judge sentenced a mere addict to ANY jail for at least two decades, instead opting for drug court. Then in 2017 the Democratic-dominated legislature reduced all drug possession crimes to misdemeanors, effectively defunding any court-ordered supervision.
When the vast majority of voters were told they could have the most "progressive drug laws" (M 110) in America, most bought the lie. Possession of 39 tablets of OxyContin is now a Class E Infraction, meaning it is less serious than having mud on your license plate. The courts "suggest" judges levy a $25 fine, assuming first that any police officer even bothers to cite the drug user, and even less likely that the addict makes a voluntary court appearance (no warrant can issue for even repeated failures to appear and the repeat addict's driver's license CANNOT be suspended). Drug citations, already at a tiny fraction of what they were just 5 years ago can now be counted on one hand in some counties. The theory was that junkies would opt to call a "hotline" to avoid paying fines. Thus far a grand total of 51 people have called, and a total of 8 have actually sought treatment.
Since the possession of a gram or two of meth or heroin is functionally legal, police no longer have probable cause for any crime, and cannot even ASK to search further, and certainly cannot seek a search warrant. Although fentanyl isn't included in the newly-legalized drugs, it almost always presents as bogus 30 mg. Oxycodone tablets, so without testing onsite, officers have no method and less incentive to investigate further.
Oregon now can claim the WORST overdoes rate in the nation, and also the least treatment options for addicts.
California needs a massive investment in psychiatric bed infrastructure. Even if we tighten the civil commitment laws, we simply don't have the treatment beds.
This is a good article, but I really want to know more about each individual's life circumstances--pre-conception onwards--before I shake my head sadly entirely at the "system" Rashid Rashid blames for his child's death.
I'm old enough to remember and decry the mass closings of public mental institutions after the genius ACLU fought so hard against their horrors that severely ill people were dumped on the street to enjoy their individual liberties.
But any of us who've read anything at all of history knows that incarceration for madness is a favored tool of totalitarian systems and their bastard spawn too.
There will never be a permanent solution to the problems inherent in any society run by human beings.
And it's not helpful, of course, to note that reducing the dreadful toll of mental illness begins in the grandparents' generation. Healthy well-nourished people not deficient in essential nutrients at the time they conceive children confers a huge advantage from the start in the hope of having reasonably stable and resilient offspring.
Of course we need many more excellent detox services and supportive housing facilities. But you could build a million and you won't solve the problem of people so intractably ill that no solution lasts for long.
And services that switch addicts from one life-long dependency to another i.e. methadone and suboxone maintenance programs--keep addicts attached to that life forever, with the same associates so toxic for them to mix with in the first place.
There's a very sad truth here. People unwilling to fight for their own lives can't be helped by others. The percentage of addicts suffering from diagnosable severe conditions such as schizophrenia need to be institutionalized, because they haven't the ability to fight for themselves. The others can't be allowed to suck up all the energy and money and good intentions in the world that cannot save them from themselves.
What is it specifically in California that other states don’t seem to have these problems to such an extreme extent. I do know Prop 47 made it easier to commit theft and shoplifting to fund drug addiction. What else makes California an outlier?
I lived in NYC in the 80’s when coke and then crack use was rampant. I buried three friends I can think of. White, urban well educated upper middle class. You just can’t help a junkie. They’re doomed. If they’re rich they can go through 10 or 12 visits to rehab and maybe, just maybe climb out of the hole, but it’s rare. They have to get clean. That can’t happen in jail and it almost never happens through rehab. Lock up the psychiatric patients. Crack down on all street drugs as hard as possible. Close the border. Give traffickers mandatory life sentences. Put addicts into mandatory 60 day cold turkey rehab. If they habitually commit crimes get tough with them. It’s time to think about what’s best for the rest of society. These people are lost. Quit making it easy for them to destroy themselves and by doing so, take the rest of their families and friends down with them.
It's a tough one. I used to work at a program called Samaritan Village, in New York, in the 1990s--back then patients would stay in the inpatient program for up to two years. That program wasn't for the mentally ill, just for addicts, but I worked in another program that did take people with schizophrenia. California doesn't seem to have a lot of long term programs. If you have a family member who has drug addiction and serious mental illness, your best bet is probably to move them to New York.
First, suddenly expressing suicidal intent as one becomes aware of a plan for discharge is suggestive of a situation called "malingering for shelter." Even if we suppose he was sincere, it's irrelevant to the ultimate outcome, because this gentleman did not commit suicide.
Narcan has a half-life in the body of about 60 minutes. By 2.5 hours later, it is pretty much gone (10-15% of the original dose might remain.) Narcan in the ambulance would have done nothing to prevent an opioid overdose 2.5 hours or more later. It just doesn't work like that.
The half-life of fentanyl is even shorter, incidentally. So either he took a large amount of a longer-acting opioid (doubtful, unless he got Narcan in the ED, or he would not have been able to walk out) or, more likely in these circumstances, he scored more drugs after leaving and overdosed for the second time that day.
Lack of mental health beds is a problem, the lack of detox beds arguably is one as well, but before we conclude that, we have to ask whether detox, or rehab either, are actually doing anything to free people from addiction. And if we find they are (very much an open question) then the follow-up question is: Is there any evidence forcing people into substance abuse programs involuntarily improves their outcomes?
There is one and only one kind of intervention for opioid use disorder that has been proven to work: medication assisted treatment (MAT) with partial opioid agonists (methadone or buprenorphrine.) But MANY detox and/or rehab programs DO NOT incorporate/allow this lifesaving intervention.
I've long recognized that there are some people who just cannot function in modern society. And no matter the reason, they are just not going to abide by society's rules and mores. And, to a certain degree, that should be OK. But when we let this situation get out of hand, as we have done here on the west coast, we will have a hard time pulling back from this.
Nothing will make an addict quit except themselves wanting to quit. And if they don't want to quit, they will die, as life on the streets trying to score a high is really difficult, dangerous, and in the end, deadly. So, sadly, the current addicts will take care of themselves. And while that sounds incredibly harsh and wrong, there isn't much you can do for those people. So, the real question becomes: what do we do going forward?
1)make drugs legal, and that means legal at every step of the process and treated just like alcohol. They need to be vetted by the FDA, sold in grocery or liquor stores and that will remove some of the stigma, the street dealers, and help break the back of the cartels. This will help with a lot of low-level crimes such as auto break-ins.
2) provide a way out for those who want it. Whether it is through the church, civic groups, or what, there needs to be a path, preferable multiple paths to help end this pattern for those who so choose.
3)no tolerance for bad behavior. When someone is out on the street doing damage to themselves or others, destroying property, etc., we as a society have to frown on that. And by frown, the social and personal stigmas must be great enough to keep people from returning to that behavior. A week scrubbing public toilets, picking up trash, and things like that to start with will go a long way to making this an intolerable act in public. Much like Driving Drunk, we need to stop enabling bad behavior and really get down to brass tacks.
4) we need to really be a better job of helping those with legitimate psychiatric issues, as the need for self-medication is often the driving force behind many addictions.
I know that having drugs be legalized and sold in stores sounds counterintuitive, but we need to be honest with ourselves and realize that the drug war failed. And with that failure is so much collateral damage and social damage that it is only now possible to see. Having the addicted hide in the shadows removes a lot of people from the cycle of recovery, and as they become involved in petty crime, and quick scores of bad dope they are only going to get worse. But, like a public drunk, this needs to be handled quickly and surely.
Hard to believe an unconscious body made a round trip to Antioch given the train turns back at Bay Point and you have to walk a few hundred feet to catch a shuttle. Might want to fix that sentence.
Is there anything on the addicts to get help here? So they have to wait a few weeks for long term care in a facility so amazing that they are gaining weight and feeling better, so they just leave? Any onus to keep taking their anti-psychotics? At what point does societial obligation end and the individual obligation begin, and is this one-sidedness part of the problem? We introduce Narcan and addicts use it to overdose repeatedly, often in the parking lot of the hosipital that saved them. Most addicts cycle through expensive free treatment multiple times. They have food and care but decline because they can't abuse people while at the shelters. Nobody seems to ask why they took this drug in the first place that everyone knows kills and maims. I have much more sympathy for alcoholics considering booze is ubiquitous in sociey and almost considered a rite of passage to adulthood, but at what point do we have the nerve to state the obvous, "Hey, maybe doing heroin is a bad idea, no matter how bad your life is right now?" Unlike the general consensus I keep hearing that "anybody can become a heroin addict", NO, only people who choose to do heroin can become heroin addicts. It doesn't strike you like lightning.
Mental health needs fixing but most of these poeple stopped taking their prescribed meds, so we know they received some care to begin with. Do we keep readmitting people who are non-compliant, and if so, whose fault is that? Seriously, the worse part was where addicts won't stay in a nice hospital waiting for FREE treatment but cry foul when they relapse.
I'm becoming callus. Let's just start handing out Darwin Awards and be done with this. Play stupid games win stupid prizes.
Very sad. However, it's easy to blame the hospitals but, in fact, more hospitals are having shortages of nurses and doctors. We need more trained people to work with mentally ill and addicted people.
Excellent, if grim reporting.
But Oregon is much, much worse. I spent 35 years as a prosecutor (in Eugene, Bend, Newport, and Astoria), the last 25 years as the elected DA in Astoria. When the DC-based Drug Policy Alliance single-handedly bankrolled Measure 110 on the 2020 ballot, Oregon functionally legalized ALL DRUGS.
The lie, told in a tsunami of clever and deceptive campaign ads, was that sending hapless addicts to prison was cruel and useless, and that Oregon needed to divert the vast sums being spent in the WAR ON DRUGS into treatment.
Except that Oregon's sentencing guidelines have blocked judges from sending someone convicted even 15 times for Possession of heroin or meth to any sentence longer than 30 days, and in reality capped that at 10 days. That had been the law since 1989. Oregon had the second lowest number of inmates in for drug crimes, only Vermont had lower rates. But in reality no judge sentenced a mere addict to ANY jail for at least two decades, instead opting for drug court. Then in 2017 the Democratic-dominated legislature reduced all drug possession crimes to misdemeanors, effectively defunding any court-ordered supervision.
When the vast majority of voters were told they could have the most "progressive drug laws" (M 110) in America, most bought the lie. Possession of 39 tablets of OxyContin is now a Class E Infraction, meaning it is less serious than having mud on your license plate. The courts "suggest" judges levy a $25 fine, assuming first that any police officer even bothers to cite the drug user, and even less likely that the addict makes a voluntary court appearance (no warrant can issue for even repeated failures to appear and the repeat addict's driver's license CANNOT be suspended). Drug citations, already at a tiny fraction of what they were just 5 years ago can now be counted on one hand in some counties. The theory was that junkies would opt to call a "hotline" to avoid paying fines. Thus far a grand total of 51 people have called, and a total of 8 have actually sought treatment.
Since the possession of a gram or two of meth or heroin is functionally legal, police no longer have probable cause for any crime, and cannot even ASK to search further, and certainly cannot seek a search warrant. Although fentanyl isn't included in the newly-legalized drugs, it almost always presents as bogus 30 mg. Oxycodone tablets, so without testing onsite, officers have no method and less incentive to investigate further.
Oregon now can claim the WORST overdoes rate in the nation, and also the least treatment options for addicts.
California needs a massive investment in psychiatric bed infrastructure. Even if we tighten the civil commitment laws, we simply don't have the treatment beds.
This is a good article, but I really want to know more about each individual's life circumstances--pre-conception onwards--before I shake my head sadly entirely at the "system" Rashid Rashid blames for his child's death.
I'm old enough to remember and decry the mass closings of public mental institutions after the genius ACLU fought so hard against their horrors that severely ill people were dumped on the street to enjoy their individual liberties.
But any of us who've read anything at all of history knows that incarceration for madness is a favored tool of totalitarian systems and their bastard spawn too.
There will never be a permanent solution to the problems inherent in any society run by human beings.
And it's not helpful, of course, to note that reducing the dreadful toll of mental illness begins in the grandparents' generation. Healthy well-nourished people not deficient in essential nutrients at the time they conceive children confers a huge advantage from the start in the hope of having reasonably stable and resilient offspring.
Of course we need many more excellent detox services and supportive housing facilities. But you could build a million and you won't solve the problem of people so intractably ill that no solution lasts for long.
And services that switch addicts from one life-long dependency to another i.e. methadone and suboxone maintenance programs--keep addicts attached to that life forever, with the same associates so toxic for them to mix with in the first place.
There's a very sad truth here. People unwilling to fight for their own lives can't be helped by others. The percentage of addicts suffering from diagnosable severe conditions such as schizophrenia need to be institutionalized, because they haven't the ability to fight for themselves. The others can't be allowed to suck up all the energy and money and good intentions in the world that cannot save them from themselves.
(deleted duplicate of this comment)
Hey, but on the bright side you guys have a bullet train between Bakersfield and Salinas, or maybe will have someday.
What a gut wrenching tale, I’m curious though - Exactly how much of Adam’s plight is Adam himself responsible for?
What is it specifically in California that other states don’t seem to have these problems to such an extreme extent. I do know Prop 47 made it easier to commit theft and shoplifting to fund drug addiction. What else makes California an outlier?
I lived in NYC in the 80’s when coke and then crack use was rampant. I buried three friends I can think of. White, urban well educated upper middle class. You just can’t help a junkie. They’re doomed. If they’re rich they can go through 10 or 12 visits to rehab and maybe, just maybe climb out of the hole, but it’s rare. They have to get clean. That can’t happen in jail and it almost never happens through rehab. Lock up the psychiatric patients. Crack down on all street drugs as hard as possible. Close the border. Give traffickers mandatory life sentences. Put addicts into mandatory 60 day cold turkey rehab. If they habitually commit crimes get tough with them. It’s time to think about what’s best for the rest of society. These people are lost. Quit making it easy for them to destroy themselves and by doing so, take the rest of their families and friends down with them.
"the system"
Huh. His dad bought him his last fix. This isn't the system, it's the inability of his parents to sort whatever problem this poor, disturbed kid, had.
It's a tough one. I used to work at a program called Samaritan Village, in New York, in the 1990s--back then patients would stay in the inpatient program for up to two years. That program wasn't for the mentally ill, just for addicts, but I worked in another program that did take people with schizophrenia. California doesn't seem to have a lot of long term programs. If you have a family member who has drug addiction and serious mental illness, your best bet is probably to move them to New York.
So, a few things.
First, suddenly expressing suicidal intent as one becomes aware of a plan for discharge is suggestive of a situation called "malingering for shelter." Even if we suppose he was sincere, it's irrelevant to the ultimate outcome, because this gentleman did not commit suicide.
Narcan has a half-life in the body of about 60 minutes. By 2.5 hours later, it is pretty much gone (10-15% of the original dose might remain.) Narcan in the ambulance would have done nothing to prevent an opioid overdose 2.5 hours or more later. It just doesn't work like that.
The half-life of fentanyl is even shorter, incidentally. So either he took a large amount of a longer-acting opioid (doubtful, unless he got Narcan in the ED, or he would not have been able to walk out) or, more likely in these circumstances, he scored more drugs after leaving and overdosed for the second time that day.
Lack of mental health beds is a problem, the lack of detox beds arguably is one as well, but before we conclude that, we have to ask whether detox, or rehab either, are actually doing anything to free people from addiction. And if we find they are (very much an open question) then the follow-up question is: Is there any evidence forcing people into substance abuse programs involuntarily improves their outcomes?
There is one and only one kind of intervention for opioid use disorder that has been proven to work: medication assisted treatment (MAT) with partial opioid agonists (methadone or buprenorphrine.) But MANY detox and/or rehab programs DO NOT incorporate/allow this lifesaving intervention.
I've long recognized that there are some people who just cannot function in modern society. And no matter the reason, they are just not going to abide by society's rules and mores. And, to a certain degree, that should be OK. But when we let this situation get out of hand, as we have done here on the west coast, we will have a hard time pulling back from this.
Nothing will make an addict quit except themselves wanting to quit. And if they don't want to quit, they will die, as life on the streets trying to score a high is really difficult, dangerous, and in the end, deadly. So, sadly, the current addicts will take care of themselves. And while that sounds incredibly harsh and wrong, there isn't much you can do for those people. So, the real question becomes: what do we do going forward?
1)make drugs legal, and that means legal at every step of the process and treated just like alcohol. They need to be vetted by the FDA, sold in grocery or liquor stores and that will remove some of the stigma, the street dealers, and help break the back of the cartels. This will help with a lot of low-level crimes such as auto break-ins.
2) provide a way out for those who want it. Whether it is through the church, civic groups, or what, there needs to be a path, preferable multiple paths to help end this pattern for those who so choose.
3)no tolerance for bad behavior. When someone is out on the street doing damage to themselves or others, destroying property, etc., we as a society have to frown on that. And by frown, the social and personal stigmas must be great enough to keep people from returning to that behavior. A week scrubbing public toilets, picking up trash, and things like that to start with will go a long way to making this an intolerable act in public. Much like Driving Drunk, we need to stop enabling bad behavior and really get down to brass tacks.
4) we need to really be a better job of helping those with legitimate psychiatric issues, as the need for self-medication is often the driving force behind many addictions.
I know that having drugs be legalized and sold in stores sounds counterintuitive, but we need to be honest with ourselves and realize that the drug war failed. And with that failure is so much collateral damage and social damage that it is only now possible to see. Having the addicted hide in the shadows removes a lot of people from the cycle of recovery, and as they become involved in petty crime, and quick scores of bad dope they are only going to get worse. But, like a public drunk, this needs to be handled quickly and surely.
Hard to believe an unconscious body made a round trip to Antioch given the train turns back at Bay Point and you have to walk a few hundred feet to catch a shuttle. Might want to fix that sentence.
Is there anything on the addicts to get help here? So they have to wait a few weeks for long term care in a facility so amazing that they are gaining weight and feeling better, so they just leave? Any onus to keep taking their anti-psychotics? At what point does societial obligation end and the individual obligation begin, and is this one-sidedness part of the problem? We introduce Narcan and addicts use it to overdose repeatedly, often in the parking lot of the hosipital that saved them. Most addicts cycle through expensive free treatment multiple times. They have food and care but decline because they can't abuse people while at the shelters. Nobody seems to ask why they took this drug in the first place that everyone knows kills and maims. I have much more sympathy for alcoholics considering booze is ubiquitous in sociey and almost considered a rite of passage to adulthood, but at what point do we have the nerve to state the obvous, "Hey, maybe doing heroin is a bad idea, no matter how bad your life is right now?" Unlike the general consensus I keep hearing that "anybody can become a heroin addict", NO, only people who choose to do heroin can become heroin addicts. It doesn't strike you like lightning.
Mental health needs fixing but most of these poeple stopped taking their prescribed meds, so we know they received some care to begin with. Do we keep readmitting people who are non-compliant, and if so, whose fault is that? Seriously, the worse part was where addicts won't stay in a nice hospital waiting for FREE treatment but cry foul when they relapse.
I'm becoming callus. Let's just start handing out Darwin Awards and be done with this. Play stupid games win stupid prizes.
Very sad. However, it's easy to blame the hospitals but, in fact, more hospitals are having shortages of nurses and doctors. We need more trained people to work with mentally ill and addicted people.