Undoped Cut: prescription for drug sanity

Well, this is the last installment of suggestions for improving the sanity of our drug handling in the Commonwealth of Kentucky. Someone told me that this could never fly–not because in would be too dangerous or expensive–it’s no more dangerous or expensive than doing nothing at all different, if the truth be known. No, it will never become our drug policy because it puts the pharmaceutical industry on notice that they will be held to a strict standard, and inflationary sales practices will be over. They would never allow any policy that will interfere with or even threaten their bottom line: They alone have profited during every quarter of the recession that has rocked this country–and they will not allow that to be threatened.

23) Publicize the spiral into death caused by gradual impairment of the amygdala from overdose.
Explanation: The amygdala alerts the brain to be ready for anything. If you will, it is the part of us that triggers the screaming when we go over the edge in the roller-coaster. An overdose causing unconsciousness and loss of oxygen affects this part of the brain first, and cell deaths occur here first. When it is no longer 100% efficient, a person loses the sense of danger posed by particular situations and becomes more prone to risk-taking behavior. When Mickey had her second to last overdose, she was carried out of the house, darting angry glances at me, by rescue squad personnel. The next day, her doctor told us, standing next to Mickey and facing me, “You made it just in time—a little longer and she would have been gone.” He could not see Mickey rolling her eyes. The impact of it all did not hit her until I burst into tears. Mickey said, “That will never happen again.” However, her early warning system had already been turned off. The next time was the last time.

24) Begin to explore therapies for rebuilding skill sets in which the amygdala plays a major role.
Explanation: Currently, there are no commonly used therapies to assist in re-sharpening this early warning system. The numbers of persons whose overdoses have not ended in death are left with brains poorly able to defend against risk—even after they have ceased using substances. “Their chances are less than average…”

25) Establish a national drug-related death registry.
Explanation: In the War on Drugs, there is a body count and we cannot accurately account for the numbers of our dead.

26) Develop effective and dependable drug testing for use in jails and hospitals to determine when a person is medically compromised by virtue of drug or alcohol toxicity.
Explanation: If we needed a test for an epidemic of testicular cancer, we would find some quick tools to accurately predict even its treatability. These drug tests might ultimately affect nearly one third of our population. Half of those who will be affected are men. The tools we have now are getting better—but not nearly as quickly as if it were an important population at risk.

27) Require medical facilities to develop secure rooms where uncooperative consumers whose lives are at risk may be safely housed until they are medically stable, as demonstrated by a reasonably safe or drug-free toxicology screen and stable vitals.
Explanation: Nearly every population has earned the right to be treated as a respectable group of people. Is it not time to extend that courtesy to persons affected by drug use and the disease of drug addiction?

28) Require jails and jailers to take toxic clients to these secure medical holding facilities.
Explanation: Addiction is a disease. The factors affecting drug-using people are matters of medical and physical safety. It is high time we made our practices conform to those facts.

29) Do a blood toxicology report on every 10th death ruled a myocardial infarction in every county in the state of Kentucky, testing for THC or other cannabinoids, as well as other drugs.
Explanation: In conducting the research for the Mickey S. Recktenwald Drug Related Death Survey, researchers came across many young people with myocardial infarctions. Most of the time, this cause of death was not complicated by a drug toxicology report. Five times, reports indicated this form of death in a person suspected of other drug use, when the only drug found was marijuana. Many more times, no toxicology report was done, simply because no one knew if the person was an addict, or not. A lot of young folks are dying of heart attacks. A high percentage of young folks use drugs, even occasionally. Without the toxicology reports, we will not know if the upturn in myocardial infarctions among young Kentuckians is simply stress related, or possibly drug induced. A one year study would be fairly inexpensive to do, and would yield life-saving information.

30) Enforcement of the law becomes a matter for the local Health Department, the Bureau of Standards, and the Revenue Department of the State, since the only things regulated are pure products, standard doses, and the tax per dose sold. (On the Federal level, obviously, the IRS, and the FDA, would also have regulations governing taxation, manufacture, and distribution.)
Explanation: In point of fact, the current system sets the Commonwealth up as the enemy of persons who use drugs, among whom are some of its leading citizens who live double lives to avoid detection. The changed system sets up as friendly to consumers of drugs as it is friendly to any other commercial operation and its customers. Anyone who violates those universal standards may be prosecuted freely, jailed for short terms (long enough to allow competition to make them nervous), and fined liberally. Promulgate the “filthy conditions” under which drugs are produced, or the amount of fillers used to sell “standard doses that are light on product,” or the amount of taxes-turned-profit this crook bilked his customers and the Commonwealth out of. Enforcement becomes a moral-neutral, citizen-protective process—and the overall effect paves the way for “drug busts, dealers, and runaway addiction rates” to become an interesting footnote in the history of the Commonwealth.

Next week: a rant about “liking” the unthinkable.

About bomij

60something artifact from the 60s. Hippy. Conscientious Objector. Have more in common with Vets than those who marched with me to protest. My fellow protesters stopped marching. The Vets march now. Have spent nearly 40 years in the trenches as an addiction counselor. Stay current with the new research and methods. Have always worked with folks who have no money or insurance left when they decide to get help. Haven't had a raise in 20 years. Makes me think that counseling is not valued as a change tool for addiction. Peace!
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