Saturday, March 19, 2011

If You Don't Quit Harming Yourself We Will Punish You

Yeah. "If you don't quit harming yourself we will punish you" sounds pretty stupid (to some of us) now a days. But at one time it was all that we had. There was no evidence to support any other way of treating substance addictions. We now know something else. Thanks to people like Alan Marlatt who died on Monday (14 March).

For years, the prevailing approach to confronting addiction in the U.S. could be summed up as "just say no." Abstinence was the only goal; addicts had to agree to quit drugs or booze entirely as a precondition for treatment.

The pioneering work of Alan Marlatt, a professor of psychology at the University of Washington, profoundly changed that attitude in recent decades.

Dr. Marlatt advocated "harm reduction," an approach that meets addicts "where they are" instead of demanding immediate detox and abstinence. Counselors strive to reduce drug or alcohol consumption, for example, while minimizing public-health costs through programs such as needle exchanges.

It's a model Dr. Marlatt called "compassionate pragmatism instead of moralistic idealism." And research shows it works.
And you thought that just because the Communists Utopians were discredited that all Utopians were discredited? Perish the thought. Don't you know that if every one believed in the right God the right way and acted properly on those beliefs we could end misery and suffering forever? It says so in some book or other. Some very old book. It must be true. Trouble is that it is in several old books and the books seem to disagree on several important details. I'm all in once it gets sorted out.

But back to addiction.
While now widely accepted, some of Dr. Marlatt's ideas were considered heretical when he first started writing and talking about them decades ago, colleagues said.

For example, counselors once shunned discussion of relapses when talking with alcoholics, believing it would only encourage further drinking. Dr. Marlatt challenged that as unrealistic. His research showed it was more effective to acknowledge the likelihood of relapses and help patients cope with them.

"When I first heard him talk about that in the late 1970s, people got up and accused him of killing alcoholics," said Frederick Rotgers, president of the Society of Addiction Psychology.
I guess telling the truth is more effective than lying to people. Who knew?
Dr. Marlatt supported Seattle's controversial apartment building for the city's most troublesome street alcoholics. The 1811 Eastlake building, which opened in late 2005, provides a home to dozens of hard-core alcoholics, who are allowed to drink in their rooms.

Though that concept drew plenty of criticism, a 2009 study found it saved taxpayers $4 million a year. That's because the residents were drinking less and not winding up as often in the emergency room or detox.
Now think of all the money that could be saved if we asked police to quit Herding Junkies.

Which is one reason Dr. Robert Marks [pdf] calls the whole exercize:
It does seem a bit harsh. But when you consider that we have been at it for nearly 100 years with no substantial effect other than to destroy supplier and transit countries and enrich criminals in America as well, what else explains it but psychosis? A disconnect from reality. Oh. Maybe not the small reality. But the bigger picture. And both Alan Marlatt and Dr. Marks have proved that even the small reality doesn't work the way most people think it does. More from Dr. Marks:
I am a consultant psychiatrist in Widnes, northern England and prescribe hard drugs such as heroin and cocaine. Ironically I may not prescribe hasheesh, nor opium nor coca. This is like being able to prescribe cognac but not wine. Nevertheless this policy has eliminated drug deaths, there is no H.I.V. infection, and a police study of our program shows a 15-fold fall in drug-related acquisitive crime. Most interestingly, the incidence of addiction has fallen 12-fold.


Daniel Roche is a citizen of Widnes. In adolescence he experimented with drugs. He gained a liking for cannabis. Avoiding the black market, he grew his own cannabis on local unused wastesites. He supplied himself, in this way, peacefully, for eighteen years. He was a cable layer, working for a large electrical company. He paid taxes. He had his own house. He was married, with children successful at school. In 1988 the police seized his cannabis, and he was fired from his job. He couldn’t pay his mortgage, so he lost his house. More cannabis was found growing in his garden. He was sent to prison and his family split up. He is now still in prison in Liverpool. I call this policy “harm maximisation”.
So we are harming the drug users. And harming the taxpayers. Who is making out in all this? Uh. Let me think. It is on the tip of my tongue. Give me a couple of days. I'm sure it will come to me.

I have never understood the concept "if we make life more painful for those taking unauthorized pain medications they will stop chasing unauthorized pain relief". You would have to be some kind of Utopian with a very old book to believe such a thing. Because it is very hard to understand how you can come to such a syllogism through logic and reason.

Cross Posted at Classical Values

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