Requiescat In Pace, SJR

SJR, my nephew, died at 47. He and I shared this disease: the disease of addiction. This is a tribute to him. This is a tribute to all who have addiction and endure the rotten behavior and insults that others throw their way. The others I have in mind are civilized folk, in most respects. They are folk whose lives are not directly affected by their targets for abuse. They are not family or friends. They are not employers of these suffering souls with addiction.

It is understandable that families, friends, and employers get frustrated by the poor choices that persons with addiction inevitably make: choices that ultimately erode their health and shorten their lives. So our families have earned the right to be upset with us, even if they do not understand the disease we have.

No. The folk I have in mind stand to profit from the harm that addiction does to those who have it. They are caretakers, first line medical staff. I have to admire the alcoholic in withdrawal who sits on his or her hands when a nurse or doctor lectures, berates, and gives rough handling while providing some palliative for the illness that happened to bring the person to the Emergency Department for care. I have a lot of contempt for those abusive folk.

Remember, I told a story in this blog about the male nurse who told my 98 pound Mickey to sit still while he inserted an IV. She was shaking because that’s what folks do in withdrawal. When I finished signing her in and caught up with her, it was late at night on the unit where she would be treated. I had to bully my way past a bunch of administrators to tell her “goodbye” and that I would see her in the morning. She was crying pitifully. That nurse had smacked her because she couldn’t be still. And hospital staff had rushed her away to prevent a scene by me. To their credit, they sent the nurse home right away.

60% of Emergency Room (ER) admissions suffer from some alcohol or other drug accident or illness when we arrive for help. As much as half of the business done by the medical community is generated by the various drug problems visited upon our citizens. That same medical community is in such a hurry for the next clinic fee that it quickly prescribes pills when a short conversation might suggest some other treatment. I won’t deny that some of us go out of our heads–pursued by the demons of withdrawal and hallucinations–and strike out rashly at some of our helpers. I will say that never have I been so rash with such brother or sister sufferer that I provoked that response.

Acknowledging a sufferer’s pain has a greater palliative effect, in most cases, than the prescribed meds. I have seen many a nurse or physician curl their lip and summon “security” at the first sign that a drug-affected patient might be a bit riled. “Safety first” is good policy when applied appropriately. I watched an admissions nurse who was so rattled that she had security stand next to the patient before she would process him. She insisted that he, and not I, answer her questions. He began drunkenly mooning over what a beautiful and kind angel she was–mistaking her angry insistence that we do her bidding, for urgent concern. “it’s all right, honey…” “I am not your honey, I need you to sign this paper.,,Security!” I had transported him to the ER and did not want to see him go to jail, so I hurriedly had a little conference with him about “Just answer ‘yes or no’ and tell me what to tell the nurse.”

That worked pretty well until he got a better look at the nurse: “Hell, she ain’t that good looking after all.” I nearly lost it, except that I saw the guard get a mean look in his eye. I cautioned my buddy to keep his mind on the business at hand. I caught that nurse on break a little later and apologized to her, and thanked her, and said, “I have a hunch that somewhere in your life, some drunk has run over you.” Without missing a beat, she replied, “My daddy…” and stopped. I nodded and reminded her that we professionals have to remember what we know, when we remember what we can’t forget. We sometimes can’t forget old harms done us; but we may not transfer our anger to others just because they have the illness.

The week before last, my nephew had himself hospitalized after finding himself unable to go to work because of the pain. A hard drinking man, he rarely missed work, making sure that his work shone well enough that bosses would have to overlook what was in his coffee thermos. Finally, pancreatic pain was so intense that he had himself admitted to the hospital, complaining of gut pain. They saw a drunk in withdrawal, and treated him for withdrawal. Finally, after nearly a week where he lay racked in pain, the treating physician looked deeper and ran him to surgery where they removed his pancreas, gall bladder, stomach and parts of his upper and lower intestine.

His pancreas had ruptured and damaged all of those organs. Thinking he was just another drunk, medical folk used that impression to tell his family about his ‘critical’ condition. My nephew’s last conscious choice turned out to be the worst he ever made: he trusted medical folk to listen to him as he described where it hurt. He could have gotten the pills they gave him anywhere. He sure as hell didn’t have to go to the hospital for them.

SJR wasn’t a saint. He was a beloved brother, son, nephew, daddy, and a working man. He had a pretty tough row to hoe in life. He never laid down his hoe. He lived with the disease as best he could. He was young and thought he had more time. He and I get a pass for the using part of our past: God loves drunks and children. When actively using, our brains are hijacked. Even drug free, that disease controls many of our choices and behaviors. As for children, children just don’t know any better. Ohh…that smile of his…. Requiescat in Pace.

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Save Social Security: Legalize pot use.

Following the second death of a loved one by overdose, I surveyed all the deaths in two thirds of the counties of Hal Rogers’ Congressional District 5, and discovered that there were 1860 of them between the years of 2006-2011 or 370 in those counties each year, or an average of 17.6 deaths per county. I didn’t have a population breakdown, so I am sure it did not average that in each county, but the death rate in some of the counties must have been catastrophic. Coroners are often funeral directors and they were saying to me when we went around, “We’ve (funeral directors in their county) been wondering when somebody was going to look at this…”

I published the study privately and made sure that folks at various government levels heard the results. There has been a resounding “Thud” as the information fell on deaf ears. The news you sometimes hear about the rate of death declining is a temporary downturn that has happened in each county one or more times—simply awaiting the next cohort to find the available poisons, when the “harvest” starts over.

In their notes on some of these deaths, Coroners sometimes commented: “known addict.” To their credit, coroners always drew drug toxicology on any death they perceived to have been overdose—though they often ruled it otherwise. That was how our count became so much larger than the official counts. Drugs-on- board and dead = OD, to us, for the purpose of the study. (For instance, “Morbid Obesity and Positional Asphyxia” with a BAC of 2.5 became “Overdose” in our count. So we looked for tox reports before considering the death certificate.) However, in our findings, there is a large and unexplored question that came to light. Toxicology reports of… “marijuana” only. This becomes pretty critical right now, in 2014.

Five of the deaths to “known addicts” were caused by…marijuana! “Not possible” I thought, so I googled what was usually listed as a cause of death when ‘undetermined’ is not used: “myocardial infarction, and marijuana.” What I found surprised me. It seems that marijuana competes in the heart for the heart’s own oxygen supply, and causes death when the heart goes into fibrillation and doesn’t stop. While we were surveying all those death certificates and files, we came across an inordinate number of ‘myocardial infarctions’ in their 20s to 60s—seeming to be pretty evenly spread through the age cohorts.

However, there were not toxicology reports because 1) the circumstances did not suggest use of other drugs; 2) marijuana is not thought to be a deadly substance; and 3) most of these folks are not ‘known addicts.’ Following its own research about this, one cardiac care hospital is now warning its post cardiac care patients to avoid marijuana.

But…, who wants to hear that in a state that is considering marijuana for legalization with all those available taxes, and all that “medical marijuana” drivel being touted?! We need to have drug tox drawn on every tenth myocardial-infarction-death to gauge the actual rate of drug death being caused by marijuana. Most folks think I am hysterical when I suggest that, but the question begs an answer, and I am willing to be wrong about it. “Cost” of all those tox reports is the reason given for not doing it—that, and the fact that Frankfort’s coroner’s toxicology lab is already inundated by the status quo.

I take pride in being a survivor of the great Social Security rescue sacrifice. I now tell the addicts I know that, as a subset of the population, addicts have done more to save Social Security than any other group—and the government is so grateful that it is doing absolutely nothing about the problem. When was the last time you heard a sitting President or a member of Congress moan about the dwindling reserves put aside for Social Security? Who knew? Peace!

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I came, looking for me…

I came, looking for me… On the occassion of my 43 anniversary as a Substance Use Disorders Counselor–I am reflectiing on the trip. (I have been called a lot of names over the years and so has my profession. SUDs Counselor is what they call me now.)

43 years ago this August, in 1971, I began to volunteer at Shalom Et Benedictus in Stephenson, Virginia. About three years later, I became that Commonwealth’s first Substance Abuse Program Director for the Drug Awareness Program (DAP), centered in Culpeper, Va. In 1978 my marriage fell apart, “because of my wife’s drinking and drug use,” and less than three months after that, I sought help at a nearby Community Mental Health Center (CMHC), in Winchester.

“Colleen Dill,” my counselor, was willing to help me do an intervention—but she ‘saw me coming’ and engineered my own entry into recovery by referring me to a 12-Step recovery program for family members. I refused to go, at first. I ‘hated’ 12-Step programs and wasn’t going to have anything to do with them. (Remember, I was a program director with 3 staff, by this time.) Colleen discussed my reservations with me one session and then got me to agree to ‘try it.’ When I had not done so, by the next session, she refunded my payment and sent me home, saying, “Call for an appointment, when you are ready to accept the help I am offering.” I did what she suggested.

Colleen also recommended me for a scholarship to Rutgers Summer School for Alcohol and other Drug Studies (1979). While there, I lost my fear of 12-Step recovery after rubbing elbows with so many insightful and talented people doing treatment who were themselves recovering. I remember crying through a course on intervention featuring Johnson Institute film on the subject–I identified with the main character in the film.

Following Rutgers, I attended the Willow Oak Farm Concerned Person’s Program. At that program, in my turn on the ‘hot seat,’ I confessed that I no longer knew if my ex-wife had a problem or not—but I was pretty sure I did. When I shared that revelation with Colleen at our next session, I remember she blurted: “O thank God!” at which I laughed. She knew all along! My recovery date is May 2, 1980.

I dropped out of direct services for a year, while I worked on my own recovery and developed a better and more collegial supervisory structure in the DAP. During that time I also helped spearhead Regional/Community-based Treatment Services (RCTS), with other program directors in Virginia’s HSA1. (Mo Moore of Charlottesville was our first chair.) With this program, we were able to offer public indigent clients a private bed in some of Virginia’s finest treatment programs at a sliding fee cost way below the per diem for those programs. I began then to oppose tiered treatment based on income. Classism should find no home in recovery.

A further accomplishment of RCTS at that time was to force state level cooperation with community programs—moving the power to the community level where needs were represented and utilizing the state coordinators’ connections to best effect for the communities they represented—an excellent service/funding design for utilizing public funds in a transparent manner.

Eventually, I changed jobs to follow my children, Megan and Tara, so that our visits would not be interrupted by distance. I worked in a Job Corps Center and became the Substance Abuse Programmer, as one aspect of my job. After that, I supported myself by carpentry and doing addiction consulting for a time. After that, I worked for another CMHC, doing Drug Counseling for 10 years, focused on what was termed “dual diagnosis .” At its startup, I became the clinical director of a medication assisted treatment (MAT) program utilizing methadone, and assisted that program in becoming Commission on the Accreditation of Rehabilitation Facilities (CARF) accredited. Since August of 2004, I am working at the KY Department of Vocational Rehabilitation’s Carl D. Perkins Vocational Training Center, in Thelma, Kentucky, as the SUDs Counselor.

Looking back over my career and store of information, I had begun writing this blog in April of 2011—undopedcut.com—just to have my say. I was particularly worried about a problem that was gaining momentum after 20 years: drug-related overdose. The purpose of the blog is to try to start a community dialogue about drug issues and to see if we can’t find a policy that will work for us to save lives and slow the rate of addiction in our community. But I am getting ahead of myself.

I’d met a woman, Mickey, nearly 14 years previously. We met in the rooms and began dating after about a year. Her children—Bobby, Traci, and Kellie—came into my life, too. Mickey had real problems staying free of drugs—and that problem accelerated when her/our daughter, Traci, died of overdose in April of 2004. Mickey moved out to stay close to her grandchildren by her/our other daughter, Kellie. Mostly, Mickey wanted to die, and did not want to be living with someone dedicated to recovery from addiction. She began using drugs and drinking as hard as she could. While we never stopped communicating, we were apart for nearly four years. Somewhere in there, Mickey found a doctor who prescribed the type of drugs in the quantities she wanted; and ‘Mick’ maintained at that level for quite a while.

Eventually she and her/our surviving daughter and the grandchildren moved back in with me. She began to use less and less—and finally stopped in December of 2010. She was not stopped long when we decided it was time to formalize our ‘marriage.’ We did that on January 13, 2011. Old patterns re-emerged, possibly in response to her changed marital status, specifically because of the loss of “her own” income from a disability check, and the sense of independence that check had given her. After years of living in abject marital poverty, having to ask for every dime she would spend, her change of partner did not matter. Both she and I had specifically asked Social Security representatives if her changed marital status would affect her check. “No” became “Yes” when they factored in my income—something neither of us were told when we asked prior to getting married. That deception cost her the will to live, and cost me my wife . When she lost her check, Mickey began to get her drug supply again—not keeping me in the know. Why? Did our marriage trigger old PTSD issues? Was she trying to replace lost income from a check she no longer received? Who knows why?

On May 6, 2011 Mickey had an outpatient test that involved being anesthetized. After the testing, we went out to eat, and spent the day doing things Mickey wanted to do. By that evening, I realized that she was using. The next morning I confronted her about it and Mickey told me she no longer had any pills. We patched things up before I went out to a meeting that evening. I brought back pizza for Mickey from my/our daughter, Megan. I talked to her when I came in, showed her my most recent 31-year anniversary token. She seemed ok. Mickey was busy and told me she would “Be right along.” I went to sit in the living room and find us a movie. She promised to be right in. She never got to eat that pizza. Looking back, I can see that it was the residual impact of anesthesia with her drug use that hit her so heavily. I’d had little sleep the night before, and had fallen asleep as I was eating pizza. When I woke a few hours later, it was too late. She died of overdose, in the wee hours of May 8, 2011. The remaining pills fell out of her pocket when I attempted CPR.

I am overjoyed to be in long term continuous recovery for 34 years. I am very grateful for the recovery community folks who keep me on my toes, even in rough weather. I don’t like being an addict. I didn’t want this for me or for anyone in my family. It just happened to us. At this point, there are two deaths in my generation, and two in our children’s generation because of addiction In my/our extended family, there are many more candidates for that kind of death.

I think that The Harm Reduction Model holds more promise for eventual solutions than any other comprehensive model for addiction programming—simply because no one controls public perceptions of the problem, or the number of new addictive substances that may be invented/discovered, or the use preferences of the general public. The weakness of that model is that it implies that only replacement therapies are valid methods for treating addiction. Addiction treatment is a continuum with interrupted use and replacement therapies on one end, and continuous abstinence and recovery on the other.

Today, in addition to my daily job, I provide supervision for counselors in two local MAT programs utilizing suboxone. I expect I will keep my hand in, until I have passed my job on to enough other folk that I can say, “It’ll happen without me now…” Then, I’ll retire to my wood shop and teach my grandkids some tricks…

Peace! Til next time…

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Rage, rage against the dying of the light: a call to action.

I have been using a term: “treatment on demand.” Why, treatment on demand? “Why not?” should be the question, by now. For twenty years, perhaps more, we have been watching an escalating overdose death rate climb until it outstrips every other form of death for persons 18 to 60 years of age. Most, though not all of those who are dying, are persons with addiction. Given that the Substance Abuse Mental Health Services Administration (SAMHSA) has said that nearly 93% of those with addiction are not receiving treatment or benefitting from recovery—this has become a plague that operates with our nearly dumb acquiescence. This is the modern version of a “slaughter of innocents.” Folks are dying without ever realizing that the disease is treatable and death might be forestalled.

If most of the dying belonged to a minority population of any other kind, legal action would have begun, civil disobedience protests would be underway, boycotts organized, and the actions of the movement would be prominent in the news. As it is, even the September Recovery Day Celebration has trouble finding page one at the news stand. I am sickened by the numbers of people slipping shamefully un-noticed into the grave. Well, this article is a call to action: in Dylan Thomas’ words, “Rage, rage against the dying of the light.”

No politician running for even the most humble office without substantive thought on this issue will get my vote. At political events and rallies, I am going to demand their views on the overdose death problem. I want them to understand that this issue must be the major focus of their health agenda. They need to understand that they can meet their constituents more frequently by mourning with them at funerals for loved ones than they can by attending their children’s weddings. I want saving Social Security to be a problem again. The death rate has taken that debate off the table for anyone paying attention. Abortion? Your stand on abortion is immaterial if you ignore this issue. “Tinkling bell, sounding cymbal.” And I don’t care who marries who. There are fewer dollars at stake there for individual tax payers than there are for the thousands whose overdose medical costs have to be paid whether they live or die. Typically, there are five overdoses, with the last adding a funeral expense. Want to bring down medical costs? Really? Then what is your plan to reduce overdose rates? How are you going to fund treatment on demand?

I understand that men of faith must deal with issues like caring for an aging population, abortion, and gay marriage. Try as we might to pretend that we have no social obligation to deal with these issues—they will continue to press into our every-day living and demand from us a moral response. What I do not understand is how anyone can ignore, as we have, the immoral and downright shameful loss of so many of our citizens, cut down in their prime by overdose death. If you believe that our morality is slipping—I will tell you it went off the rails when we began to barter with death for taxes on liquor, drugs, and gambling—without making any accommodations for treating persons who might come to harm as a result of their use. Providing for treatment on demand is an attempt to right a poorly run and badly listing ship of state.

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Lessons From Vernon Johnson’s Feeling Chart

Today, I am loosely following concepts incorporated in a Vernon Johnson “Feeling Chart” chalk talk, heard at the Rutgers School for Alcohol and Other Drug Studies in 1979. I am grateful to him, for his work in the field of addiction, and for helping me find my road to recovery through it.

Defenses are the usual physiological (using organ/muscle-energy connected to thought) behaviors by which we mediate and manage our feelings. Using drugs teaches us a no-energy way to manage feeling states, one that varies from person to person—though each has his or her idiosyncratic palette of substances to choose from, in our culture. This brain training happens at a preconscious level in the Pons/Medulla/Limbic system of the brain. As such, the neural pathways are too central for a lobotomy to be a safe option—though that is the only way one could completely alter the brain training outcome.

Persons with addiction do not respond well to retraining—partly because their complex neuro-structures conform to genetically engineered changes in the brain’s cellular structures. In non-addicted persons, a great degree of behaviorally conditioned re-routing of these pathways occurs—when the individual has a negative outcome from drug use. At present, the only way of marking the distinction between addicted persons and those who are not is behavioral. Both experience using a chosen substance as having a positive effect on one’s feeling state. Practiced repeatedly, all drug users begin to think “it works every time.” A second bit of information that becomes grooved and is also socially reinforced by DUI programs, and other legal and social sanctions is that “I control how, when, and where to use, and how much.” These commonly held beliefs may be changed in the non-addicted person, if negative outcomes occur as a result of drug use. The defense mechanism of questioning oneself comes into play and the individual alters pre-peak-feeling use patterns to say: “I’ll never do that again.” And s/he doesn’t do that again.

The person with addiction has defenses that protect the using behavior—so, rather than questioning oneself, s/he wonders, “What in the environment or events surrounding the use was responsible for the negative outcome I experienced?” Invariably, some paltry excuse or reason is found for the negative outcome. The initial confidence in a positive outcome (“it works every time’) and in my power to control my use (“I control how, when, and where to use, and how much”) is reinforced by my “reason” for the negative outcome. And so it rolls: the non-addicted person challenges and changes his or her own behavior leading to the peak feeling one gets from using; and the addicted person challenges or alters the environment to find the problem, thereby assuring the negative outcomes will continue to occur.

After a period of time of flying in the face of reason, the addicted person loses the ability to reason. Literally, s/he becomes unable to critically challenge his or her own behavior; and s/he becomes convinced by the negative reactions of society or persons around them that the problem really does lie with others rather than self. The defenses completely support using substances to mediate feeling states, and normal emotional give and take with others becomes less and less possible. The person with addiction may believe that s/he would be OK if certain other persons would change. S/he may even change friends and life partners in an effort to find the “right” kind of people. Typically, this has the effect of surrounding the person with others with whom s/he might never have associated—prior to becoming a drug user.

Standards and values once held as sacred are also gradually lowered to be within reach of a more relaxed (read: “less critical”) state of mind. The person develops an alibi system to explain the distance between reality and dreams of once-hoped-for life outcomes. “If my wife/husband had been more understanding—we would never have separated or divorced.” “My boss really liked my work until s/he had to do more work because of the business that I brought him. I wore myself out for him/her and needed the extra time off. How dare s/he cite ‘unpredictability’ as a reason to pass me over for promotion. ” The person with addiction often retaliates, both aggressively and passively, to get even for resented insults to those once held dreams.

This is the insanity of addiction. It is so compelling and strong that fully 93% of person with addiction never succeed in realizing that they have it and cannot bring themselves to get help. Of those who get help, only about 3.5% achieve any success at leading a normal life. Because of shame and stigma surrounding addiction, many of those success stories are never told, because it is too painful to collect the prize by publicly owning the problem. Meantime, the 96.5% of persons with active addiction continue to raise families, work on assembly lines, run businesses, lead persons into battle, run for office and make laws. All such work is negatively impacted by addiction that society as a whole has accommodated so long that it no longer realizes the damage being done…or perhaps our denial just makes it easier to own our powerlessness in the face of obvious social decay. Nearly one fifth of US are addicted and/or will suffer from its direct effects in our lifetime.
One bright spot exists.

In September of every year for the past decade, those persons who are surviving and recovering from addiction are shouting about how it is done—getting more of their story told. In the process we are seeing heads of families discuss the roadmap to recovery, for self and family. We are seeing workers and business leaders explain how the crooked and damaged product of addicted commerce can be repaired and improved. We are hearing from respected leaders about the benefits derived from owning and walking through the pain to correct the damage done in a drugged past. Unavoidable human suffering can be redemptive: Celebrate Recovery in September.

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How much is a life worth? 07152014

Kentucky’s General Assembly had a bill before it to allow police officers to carry Narcan, since they are often the first responders to emergency situations in Counties without paid fire and rescue workers. The cost per dose of Narcan is about $20–far below the usual costs for failed life support on unconscious victims who never fully recover, if they recover at all.

Narcan works miracles. Sprayed up the nostril of a victim of overdose, blown by rescue breathing into the airway of an unconscious person whose heart is beating–Narcan temporarily reverses the overdose, and does it miraculously fast. Then one must get the victim to help and on oxygen fast. When the Narcan wears off, other measures may be needed to assure recovery. Narcan does not seem to have any harmful effect if it is given to an unconscious victim who is not overdosed but who is nevertheless unconscious when help arrives.

In Lexington alone, emergency workers have saved more than 54 persons a month for the past two calendar years. In that time, more than 1300 lives have been saved (about 650 each year). That cost comes to $26,000 spread over two years–well below the cost of the initial hospital stay of a victim of overdose with residual brain damage. Actually, only three of those victims would have had to die to leave behind a $26,000 bill for inexpensive funerals–not to mention the untold grief to families and friends.

If the program had only saved 21 persons in the two years, and if each had worked a minimum wage job for a year, their combined tax burden alone (21 x $1279.20) would have paid for the program. Over the two years, Lexingon stands to recoup better than 63 times, in taxes, what it spent on the program–from the people whose lives were saved, by making sure that fire and rescue workers were trained and equipped with Narcan to treat persons who had overdosed. It strikes me that there are few routine emergency runs that hold that much promise for the responsible bodies of government that fund them.

This year, Lexington is already projecting on the basis of monthly averages to use Narcan on 750 overdose victims, at a cost of about $1500. Those persons will likely add to legitimate local commerce more than $11,700,000 in wages, or in disability income. (The reader should bear in mind that many persons who overdose are making far more than minimum wage, so these projections are probably quite conservative.) While all the costs of such a lifesaving run are not represented in the cost of the dose of Narcan–few of these runs will be loss leaders. In other words, an organ of government that invests in saving lives from overdose is actually putting money in its coffers and assuring economic recovery.

Remember that Narcan Bill. The Commonwealth’s General Assembly failed to pass the bill, assuring that all first responders would be equipped to save lives. In effect, legislators are going to assure that the costs of life support, eventual recovery from brain damage, and vocational rehabilitation will be as expensive as possible, and borne by the taxpayers. The victims’ families who do not survive will become unexpected financial burdens to their devastated families who will bury them. And for this we must thank our legislators who made certain that a drug that is essentially harmless unless it saves a life will not be available to all first responders. I wonder if legislators are sending a message to persons with addiction that we are simply not ‘worth’ their time. Hopefully, this essay will dispel some of that idiocy.

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God is watching US…& I think She’s angry. 07092014

Several years ago, the President of Mexico characterized the US as “that big addict” up North. As hard as that was for us to hear, it is an accurate portrayal of the US role in illegal drug commerce issues facing most if not all of our South of the Border neighbors. Were it not for US and a consistent and increasing demand for drugs—legal or illegal—most countries would not have the “shadow governments with shadow economies” that drug cartels become operating within their borders. Were treatment on demand a policy for US drug addicted persons, craving would cease to be the driving force that it has become for international policy.

These drug gangs behave much the same way that gangs behave everywhere: they sell dope, sex, and protection; and they struggle within to control turf and status. It’s a bloody game, and the guys who are best at it run a tight ship, enlarge territory when they can, and continually look for ways to improve the “services” they offer. They terrorize 12-year old girls to find prostitutes for their brothels—age and lack of sexual experience is no barrier for the cartels: it improves their hold on “fresh meat.” Nor do boys escape the recruiters. A few years back, the “best” hit-man in the business in one of these countries was a 12-year old on a bike. Who’d suspect him?! Resist their methods and become another missing person in a shallow grave.

And all of this is driven by US, a neighboring country to the North with an addiction problem that is fed by the ease with which medication is dispensed, and a cultural expectation that all pain or suffering is unnecessary and useless—and that addiction happens to others who are lesser people. Numb behind the fuzzy thinking and the fog in our heads, we see these “unaccompanied children” crossing our borders and joining the ranks of other undocumented workers already trying to make a go of it here. Though most of US are unwilling to do the kinds of work these folks will do, we want something done about them!

Now, if it was some Middle East government forcing refugees at gunpoint to return to countries of origin where war and political upheaval have made life too unstable to plant a crop of wheat and harvest it—our diplomatic efforts would be to urge the receiving country to welcome and help the poor unfortunate refugees and we would back that up with aid. But, here, where we have created the pressure that causes these children to flee to safer parts—we just want to deport them and send them back into harm’s way with the least real dollar cost to US, and the least amount of fanfare possible.

Now, tell me again, just where did we come from? I am Irish and German, with a little French thrown in for good measure. Not one ounce of Native American blood in me. I am not bragging. I am grateful to the gentle folk we called “wild Indians” (with our usual ability to confuse fact with fiction). Interestingly, those indigenous people are still fighting to protect “rights” US lawmakers “gave” them. (Last time I checked, rights were inalienable, and cannot be given by one peer to another.) Only God gives rights. And God is watching US.

God is watching as we increase the emotional and life burdens already shouldered by children driven under fear’s lash to make treks most of us would shudder to consider: but we don’t want to know. We treat these new immigrants with the same insensitivity that we demonstrate when we allow overdose death to become the leading cause of violent death for US-born children. Do we think we can ignore human rights without cost? Persons fleeing danger have a right to safe harbor—no matter what the cost. We knew that when we were an immigrant nation. People who have the disease of addiction have a right to treatment on demand. We learned that under the Affordable Care Act—after half a century of struggling to manage the nation’s addiction health piecemeal. There is no debating the rights to life, liberty, and the pursuit of happiness that God has given US. God is watching.

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