Opioid Addiction Drives Grim Business

[LadyTevar]

Business is booming for one somber industry in West Virginia: the transportation of dead bodies.

The state's Department of Health and Human Resources paid private contractors $881,620 in fiscal year 2017 to shuttle corpses from one place to another — more than double the expense two years before. The number of body transports went from about 2,200 in fiscal year 2015 to about 4,200 in fiscal year 2017 (which ended June 30).

Public health officials and funeral directors alike blame West Virginia's soaring number of fatal drug overdoses for those sharp increases.

Jim Lowry, who's been in the funeral business for 62 years, came out of retirement three years ago to help Charleston Mortuary Services handle the increase in bodies that must be shipped to the state morgues. Needle marks on arms and hands and body bag tags that read “Pending Tox” identify those who likely died of a drug overdose. They are mostly younger adults, ages 18 to 30.

“Now, it's nothing for us to have two or three in the same day … or six or seven in a week,” said Lowry, a licensed embalmer. “It's just out of sight.”

About 880 people died of drug overdoses in West Virginia last year — a record number. The state has the worst drug overdose death rate in the nation.

Every fatal overdose requires at least two trips — from the place of death to a state morgue and then from the morgue to a funeral home. Each corpse must be autopsied, and a toxicology report must attempt to pinpoint the drugs that caused the death.

Some overdoses involve even more trips — to a hospital, for instance, where a county medical examiner conducts a preliminary exam before referring the body to the Office of the Chief Medical Examiner for autopsy.

“If there are 20 needle marks, you get some idea of what's going on after the initial examination,” said Dr. Rahul Gupta, the state's public health commissioner.

Following autopsy, the dead are loaded into vans and returned to funeral homes or mortuaries, many to be embalmed.

Lowry explained that process: “You raise an artery, a carotid one here in the neck or a femoral in the leg, an artery and a vein, and you inject the embalming chemical into the artery, and it goes through the circulatory system and washes out the vein.”

In the case of someone who died of a heroin overdose, “we use a little bit of a stronger solution than, say, on somebody that dies of a heart attack,” Lowry said.

One company earned $3 million
The opioid crisis has been building in West Virginia for more than a decade. Over those years, no company has profited more from body transports there than Tri-State Mortuary Services, based in Poca. Since 2003, the state has paid the company $3.2 million for that service, records show.

A 2015 legislative audit found that Chad Harding, owner of Tri-State, and Mike Scragg, then operations chief at the medical examiner's office, had signed a handwritten contract that was meant to steer all body transport business statewide to Tri-State from 2008 to 2018. Auditors concluded it was invalid.

But Tri-State had already become the go-to contractor. In 2012, the company received 94 percent of the state's transport business to the state morgue. Payments to Tri-State even increased in years when overall spending for body transports dropped.

“The reason they had so much business was that they had an insider throwing business their way,” said Rob Kimes, executive director of the state Funeral Directors Association.

What's more, auditors reported, a state Bureau of Public Health employee was typing up the invoices that Tri-State submitted for payment. No other contractor received a helping hand.

The audit also found that Tri-State was billing West Virginia for “wait time at the scene” — a prohibited expense. The extra fee was handwritten on each invoice. State policy allows contractors to charge only for mileage and only when a body is on board the vehicle.

A follow-up report issued earlier this year criticized body transport contractors for “miscalculations” and “billing errors” that drove the state to spend at least $141,000 more than it should have between 2010 and 2014.

Last month, the state banned Tri-State from picking up and delivering bodies to the chief medical examiner's office, citing the company for a potential “breach of confidentiality.” In a letter, the medical examiner's chief administrator wrote that Tri-State was in possession of confidential documents that appear to have been taken from the state morgue's personnel and decedent case files.

Tri-State is affiliated with Gatens-Harding Funeral Home, which has itself faced years of state scrutiny. In 2015, West Virginia Attorney General Patrick Morrisey brought a complaint against the funeral home, alleging that it violated state law by cashing in on pre-need funeral contracts before customers' deaths. Harding recently settled the case, after Gatens-Harding agreed to audits and a $25,000 fine.

Since Tri-State's suspension in August, there has been no shortage of body transport contractors willing to step in and do the job.

“There's enough people out there that's going to pick up the slack,” Kimes said. “They're ready to make the call when called upon.”

On Sept. 8, Gatens-Harding notified the state that it planned to sue Morrisey's office and the medical examiner's office over the decision to suspend Tri-State's license to transport bodies. The funeral home's lawyer, Ramonda Lyons, wrote that the suspension was “arbitrary and capricious.” Lyons declined to comment last week.

'You see so many young people'
Lowry, 74, started working at a funeral home when he was 12 years old. By age 18, he was embalming bodies.

In 1972, he was the first embalmer at the Buffalo Creek flood, a disaster that killed 125 people when a coal slurry impoundment dam burst in Logan County. He embalmed 65 bodies that week.

He figures he's embalmed 67,000 bodies over his career.

“I hate to say it — and this is going to sound cold and callous — but you just learn to get along with it,” Lowry said. “To a certain extent, you get used to it.”

But now the epidemic of drug overdoses has increased the number of younger West Virginians whose bodies must be picked up and delivered. And that is taking a toll, he said.

“Seeing all these young people coming through the medical examiner's office and coming through here … you see so many young people with promising futures who are dying needlessly,” Lowry said. “It's sad that it's affecting our young people.”

No holidays for body transport
The body transport business is not difficult to break into in West Virginia. There are few regulations. “All you need is $2 million of liability insurance, a van, a cot and a driver,” said Kimes of the Funeral Directors Association.

With Tri-State out of the picture, the medical examiner's office now selects contractors on a rotating basis. They have to be willing to pick up bodies day and night.

West Virginia has two state-operated morgues — in Charleston and Morgantown — where medical examiners conduct autopsies. The Morgantown office, with just one medical examiner, can handle only 250 autopsies a year. It typically takes two weeks to autopsy a body after a fatal overdose, a delay that upsets some grieving families who must put off funeral services.

The transport companies, meanwhile, are often driving long distances to pick up bodies, which also hikes the costs. Berkeley County in West Virginia's Eastern Panhandle has the second highest overdose death rate in the state. The county saw 94 overdose deaths last year. It's also a four-and-a-half-hour drive from Charleston or a two-and-a-half-hour trip from Morgantown. On the state's western border, Cabell County has one of the highest overdose death rates in the U.S. It saw 132 fatal overdoses last year. The county is about an hour from Charleston.

“We go anywhere the M.E. has us go,” said Lowry, whose Charleston mortuary has three drivers and five vans, each retrofitted to make space for two cots.

Since 2003, West Virginia has paid $7.7 million to companies that transport the bodies that require investigation — people who apparently died from overdoses, car wrecks, shootings and other causes. During the legislative session earlier this year, state lawmakers approved $500,000 in supplemental funding to pay those rising costs.

To reduce the burden on taxpayers, the state forbids transporters from charging for two trips if two bodies are hauled to the morgue in one van. The state reimburses for 1.5 trips in such cases.

By law, however, the state picks up the expense for shuttling bodies to the medical examiner's office and returning them to funeral homes chosen by their loved ones. Families aren't left on the hook for transport costs.

“Some of these people, they don't have anything,” Lowry said. “They spent it all on drugs.”

[Flagg]

It really is just a sad, sorry, almost hopeless state of affairs. This is what happens when greed, good intentions, and human misery intersect. And the response feels to me like nothing was learned.

Of course they will just crack down harder on access to narcotic painkillers, even for those in legitimate need of them (its to the point in WA that cancer patients are having problems. Even people in hospice care, places that exist solely for those who are terminally ill, in great pain, under constant care, and fully monitored 24/7 by doctors and nurses, who will only be leaving in a body bag, and they are being denied adequate narcotics to keep them comfortable!) rather than tackle the root causes, like crippling poverty, mental illness, and any myriad of other social ills.

Of course many of the addicts who may or may not have said legitimate need will turn to buying it on the street and possibly get fentanyl instead of oxycodone like Prince, OD, and die. If they don’t just join the ranks of the skyrocketing number of heroin users, OD, and die.

I’m not saying there isn’t a huge problem with past overprescribing of opioid painkillers that has led to this point, but I’d rather see addicts get narcotics under the care of a doctor with weekly appointments and piss tests than buying it on the fucking black market and getting who knows what or just scoring smack.

And the truly sad part is that this is the result of pharmaceutical companies lying to doctors (the vast majority of whom prescribed painkillers responsibly given what they didn’t know, but you had some greedy shitheads who were happy to write for anything as long as they got paid) about the addictive qualities of their product. Going so far as to claim that a drug like OxyContin was a miracle painkiller with absolutely no addictive qualities and no risk of abuse since it’s a slow release pill that lasts all day. Unless you crush it, then you get high as fuck (I don’t have first hand experience on that, slow release medications don’t work on me due to my gastric bypass. They just end up in my large intestine without the coating even dissolved and since I’m not a junky I never crushed one up to try it that way) which is why it’s called “hillbilly heroin”.

So you had over a decade and a half of doctors giving that (and your run of the mill Vicodin and Percocet) shit out like fucking candy. Now the pendulum has swung so far in the opposite direction that cancer patients are treated like criminals.

[LadyTevar]

When a doctor/pharmacy is issuing 50,000 pills to a town with population 350, something is fucked up.

Huntington WV is still considering the "three strikes" idea, where if you are found OD'd a third time they're not going to 'waste' the meds to save you. Medical folks are not happy with the idea, they want to save lives. Police want to simply make it to where if you OD, you can be arrested, not just walk away refusing medical transport.
While I know our prisons are overcrowded with folks whose only sin was "possession", I happen to agree with the police in this case. If they're arrested, they are more likely to get at lease SOME help.

[Flagg]

When a doctor/pharmacy is issuing 50,000 pills to a town with population 350, something is fucked up.

No disagreement there, but why have the doctors not been prosecuted? What about the pharmacists?

Huntington WV is still considering the "three strikes" idea, where if you are found OD'd a third time they're not going to 'waste' the meds to save you.

That’s called negligent homicide. Possibly even second degree murder.

Medical folks are not happy with the idea, they want to save lives.

They also don’t want to be accessory to murder.

Police want to simply make it to where if you OD, you can be arrested, not just walk away refusing medical transport.
While I know our prisons are overcrowded with folks whose only sin was "possession", I happen to agree with the police in this case. If they're arrested, they are more likely to get at lease SOME help.

If they are thrown in jail or prison they will just get drugs there. The junkies aren’t the issue, the doctors and pharmacists writing and filling the scripts are.

[Dragon Angel]

Getting help for addiction is something that should at least be under the purview of involuntary commitment to a hospital ward, not a prison. A prison could turn someone into a thing far worse than a drug abuser thanks to unchecked violence and rape, and could possibly kill them.

I definitely do not agree with the police there. And certainly not with that cartoon evil proposal that is "three strikes or you stay dead".

[Broomstick]

When a doctor/pharmacy is issuing 50,000 pills to a town with population 350, something is fucked up.

Agreed.

In the case of West Virginia you have a trifecta of weak economy, lack of proper medical care, and mental illness/despair/hopelessness. All of these have roots going back well over a century. Basically, chickens are coming home to roost.

Huntington WV is still considering the "three strikes" idea, where if you are found OD'd a third time they're not going to 'waste' the meds to save you. Medical folks are not happy with the idea, they want to save lives. Police want to simply make it to where if you OD, you can be arrested, not just walk away refusing medical transport.

When an ambulance or squad car rolls up how the hell are they supposed to know if it's a first OD or a third? How the hell is that supposed to be tracked? WTF?

Of course, I'm one of those nutballs who actually worked at an addiction treatment center for a number of years, chiefly because I needed a job but also because I believe in treatment over the alternatives. If anything, after four years I believed that even more strongly than before.

While I know our prisons are overcrowded with folks whose only sin was "possession", I happen to agree with the police in this case. If they're arrested, they are more likely to get at lease SOME help.

Sincere question: why do you think that?

Because, again, I worked four years in the field, in the City of Chicago, and the addicts that got incarcerated got NO treatment, aside from maybe access to AA or NA meetings while in jail. Hell, they often didn't get proper medical treatment, the usual procedure being to lock them in a cell and let them detox/withdraw without any supervision whatsoever than their fellow prisoners, who might range from completely indifferent to compassionate to thieving/abusing to said addict going cold turkey.

Arrest/incarceration is zero guarantee of help for an addict.

Sorry about the negativity, but I saw some really terrible things. For that matter, I used to process the paperwork on our dead patients/clients and on one occasion helped the nurses deal with an elderly man who died in the waiting room one afternoon. He actually had a rather peaceful end, he might have nodded off for a nap and simply faded away.

If I was in WV and looking for work that is definitely a field I'd look into. The dead don't bother me, heck, I come from a long line of gravediggers and funeral directors, my dad grew up above a funeral home and learned to embalm in his teens.

Lady Tev, I know you're looking for work and I also know you'd be compassionate to any family/friends you'd encounter on the job - is that sort of work something you could do? If you don't feel you could I totally understand, but apparently there is a need for people to do that in your state. Somebody has to do this, after all, better someone compassionate than some random, uncaring asshole. On the other hand, if the dead bother you it could become very corrosive very quickly.

[The Romulan Republic]

When a doctor/pharmacy is issuing 50,000 pills to a town with population 350, something is fucked up.

Huntington WV is still considering the "three strikes" idea, where if you are found OD'd a third time they're not going to 'waste' the meds to save you. Medical folks are not happy with the idea, they want to save lives..

Because most medical professionals still have souls, I guess. Pity the same apparently can't be said for conservative politicians.

By all rights, any medical professional who refuses to save a life when they have the means to do so should at minimum be fired, barred from working in the profession ever again, and suffer crippling losses in a civil suit.

I wouldn't be adverse to prison sentences, either.

What is this but a backdoor way of making "being an addict" punishable by death (without due process)?

[Dragon Angel]

I wouldn't be adverse to prison sentences, either.

What is this but a backdoor way of making "being an addict" punishable by death (without due process)?

Not singling you out here, but I should restate: the former is extremely likely to only result in the latter, or worse. As Broomstick brought up, prisons don't tend to care about how an addict recovers, coupled with the fact that the environment is only going to end up worsening their situation, or just get them outright killed. You're essentially locking up a nonviolent offender who may have not even done anything intentionally wrong, and may have gotten hooked onto opioids through other means such as chronic pain, with other offenders that could be very well violent.

Now, consider all the flaws of the American penal system today. Does anyone, with any seriousness think that this is any sort of environment for recovery? Or are we just going to end up creating even worse monsters--turning nonviolent offenders into worse, which American prisons have been known for--which will include people who may have gotten hooked completely against their will? Like, consider people who are being locked up for marijuana use right now but instead, now locked up for abusing a drug that may have not even been their intention to abuse in the first place?

It's like saying prisons are replacements for psychiatric wards (yes I've seen this actually, literally argued). Correctional officers are not replacements for trained nurses and doctors. It's worse than just doing nothing and letting them go. I have huge concerns over the mental health system in this country too, but hell, at least the professionals who work in it actually have "recovery for their patients" as a part of their ethics and duties!

[Flagg]

It needs to be stated clearly that not administering a “save shot” to prevent a death by OD is criminal homicide, up to second degree murder if there is a “depraved indifference” clause on the books. The very idea is monstrous. And as Broomstick said, how will they tell it’s a “third strike”? Maybe a tattoo with their SSN on their arm?

[Dragon Angel]

It needs to be stated clearly that not administering a “save shot” to prevent a death by OD is criminal homicide, up to second degree murder if there is a “depraved indifference” clause on the books. The very idea is monstrous. And as Broomstick said, how will they tell it’s a “third strike”? Maybe a tattoo with their SSN on their arm?

Yeah, it's basically cartoon villainy. I should clarify though, when I said "it's worse than just doing nothing and letting them go" I meant, worse than doing nothing after administering the saving shot. I'd rather they get some sort of long-term help managing their addictions because that shit can wreck them, but it's certainly better to let them back outside than to incarcerate them. The prison industry overlords must be satisfied first though.

[Flagg]

It needs to be stated clearly that not administering a “save shot” to prevent a death by OD is criminal homicide, up to second degree murder if there is a “depraved indifference” clause on the books. The very idea is monstrous. And as Broomstick said, how will they tell it’s a “third strike”? Maybe a tattoo with their SSN on their arm?

Yeah, it's basically cartoon villainy. I should clarify though, when I said "it's worse than just doing nothing and letting them go" I meant, worse than doing nothing after administering the saving shot. I'd rather they get some sort of long-term help managing their addictions because that shit can wreck them, but it's certainly better to let them back outside than to incarcerate them. The prison industry overlords must be satisfied first though.

I understood that. But I think sending nonviolent addicts to prison is worse than not giving them the save shot, TBH. They will come out an addict with a masters in criminality.

But I’ve been saying for years that drug policy is a public health concern as opposed to a criminal justice one. Having a system set up to where nonviolent drug offenders are essentially “Baker-Acted” into an acute rehab clinic for safe detox. Then a hearing before a judge with lawyers that deal only with those types of cases to determine what is best for the addict, be it long-term residential rehabilitation or outpatient rehabilitation (most likely some combination of those) is something that I think would be much better than putting them in an environment with rapists, armed robbers, and murderers where they can still get relatively easy access to drugs.

[Flagg]

And also as you said, most people addicted to opioids became that way due to no fault of their own. And it can be virtually impossible for those who do seek help to get it.

So the Nazi “let ‘em die” or the draconian “lock ‘em up” shit is just wrong on every single level.

[Simon_Jester]

Making matters even worse, we have viable treatments for opioid addiction that work on the medical level, blocking the chemical pathway that causes trouble with withdrawal.

And there are massive political obstacles to its use, including some that come from the drug rehab clinics themselves.

[Flagg]

Making matters even worse, we have viable treatments for opioid addiction that work on the medical level, blocking the chemical pathway that causes trouble with withdrawal.

And there are massive political obstacles to its use, including some that come from the drug rehab clinics themselves.

Yeah, AA and NA are just cults. They don’t work for the vast majority of people because addiction cannot be warded off by willpower.

And Suboxone is awesome. It controls my pain and I don’t have to live on a fucking 4 hour schedule.

[Broomstick]

Making matters even worse, we have viable treatments for opioid addiction that work on the medical level, blocking the chemical pathway that causes trouble with withdrawal.

And there are massive political obstacles to its use, including some that come from the drug rehab clinics themselves.

And here I am again, lending my few years experience to the thread.

I worked four years at a clinic that offered methadone as the default treatment for opiate addicts. Yes, medications like methadone and suboxone can help an addict and they are a useful tool, but they are not miracle cures. It's not enough to give them alone.

Opiate addiction is often compared to diabetes and there is some validity to the comparison. You don't simply hand a diabetic a box of medication and expect everything to be alright. Diabetics need to make lifestyle changes along with the medication. So do addicts. Just as 12-step programs can become dogmatic and used one tool on all problems so too can methadone or suboxone be used as a blunt instrument without the additional tools that make them most effective.

In part, there is still a deep lack of understanding that addiction is two-fold: it's physical AND mental cravings. When a person walks out of a 30 day treatment program they are no longer physically dependent on the opiate, their withdrawal is weeks behind them. However, as noted in the second article, their brain chemistry has undergone real changes and the normal level of innate opiates is no longer adequate for them. Again, think of diabetes - the body no longer produces sufficient insulin, or the body is no longer able to utilize it properly and efficiently. Likewise, in a recovering opiate addict the brain no longer responds properly to normal endogenous opiate levels. We ask addicts to return to normal functioning yet we seem puzzled when their brain chemistry is still askew, it's like looking at a type II diabetic and saying "well, you lost weight, you gave up sugar - why are you still diabetic?". This brain chemistry problem is why sober opiate addicts suffer from things like depression, anxiety, and hypersensitivity to pain, and why they relapse - they're self-medicating. They're trying to take the pain away. It's not a physical pain, it's a mental pain, but it's still real pain. Asking an opiate addict to do it with a 12-step program is like asking a diabetic to overcome an insulin deficiency through sheer willpower and self-discipline. Yes, for a very few diabetics whose internal systems aren't too askew diet and exercise alone can control their disease, for a very few addicts willpower will work, but for the majority more is needed.

But simply giving out drugs is not going to work either. It is vital to combine it with counseling because an addict does require new coping mechanisms, does need an understanding of what addiction actually is (which is all too often not provided information), often has other problems outside of addiction that need to be addressed, and does need psychological support during a recovery that takes years - Reports that a celebrity addict has done a 30 day detox program anger me, because that's not a cure it's at best just a beginning. You don't get over an addiction in 30 days. My clinic used to mandate two years minimum treatment before even considering tapering a person off methadone, which might take six months to two years to get that done.

A lot of addicts have unaddressed psychiatrist issues - methadone/suboxone aren't going to fix those. You need real counseling by real mental health professionals to deal with those. Too often the focus is on the addiction as the primary or only problem. Very often it's not - child abuse, sex abuse, depression, anxiety, PTSD... very common in the addiction community. Probably more common in the general population than anyone wants to admit, too, but combined with addiction it's not something for amateurs to try to fix.

There is ENORMOUS pressure not only from other addiction groups but also state and Federal agencies to get addicts off ALL drugs, permanently. We had to justify people who weren't doing the program fast enough to satisfy the Powers-That-Be. We had some addicts who were long-term maintenance folks (some having been on low-dose maintenance for thirty years and more) that were highly functional in their lives, paid as private patients out of their own pocket, stayed out of legal trouble, etc. yet rather than let these people continue there was continual pressure on the clinic to get them off drugs. Most of them, when taken off methadone, would relapse. Put them back on and they're fine. My theory (which of course counts for nothing as I'm not an "addiction specialist" or MD) is that the brain changes were such that either they could no longer manufacture adequate endogenous opiates or normal levels no longer worked effectively so a low steady dose of methadone restored function to a normal level. Take that away you have problems, just as taking away a diabetic's medication results in a rise in blood sugar.

I also saw another phenomena coming out of the radical "NO DRUGS!!!" sobriety crowd - they didn't just preach no opiates or alcohol, they preach no drugs whatsoever, even medically necessary ones. They'd want the addict to also give up things like blood pressure medications and yes, even diabetes medication. This is horribly dangerous. It's 12-step as religion rather than a tool. Over the four years I worked at the clinic we did have a couple people wing up in the hospital after being convinced to give up medically necessary drugs by 12-step folks.

12 step does have a role to play for some people, the meetings and the camaraderie can provide important psychological and moral support, having someone you can call at 2 am to help you through a crisis is invaluable. It does not work for everyone, and all too often the courts sentence people to 12 step without really knowing what it is or what it can or cannot do. It's a tool in the toolbox, but it's not the only tool, and may not even be the most effective for many.

Finally - methadone and suboxone are also merely tools in the toolbox as well. They don't work for everyone. They have side effects. There are addicts who have methadone as their primary poison who can't be managed on a methadone program. Even if every opiate addict had access to these medications without waiting we're still going to have a significant number of relapses and a number of those relapses OD'ing and a subset of those will die from that OD. Addiction is a disease, a malfunction, and it's not always fixable. That doesn't mean we shouldn't keep trying, but realize there is NO magic, easy, simple cure for this problem. At the deepest level it's a brain malfunction. It can be managed but very few people will have a true remission.

Yeah, AA and NA are just cults. They don’t work for the vast majority of people because addiction cannot be warded off by willpower.

^ This.

And Suboxone is awesome. It controls my pain and I don’t have to live on a fucking 4 hour schedule.

If it works for you I'm glad. Chronic pain is hell, and you deserve some relief.

[Ralin]

And as Broomstick said, how will they tell it’s a “third strike”? Maybe a tattoo with their SSN on their arm?

I suspect a combination of tracking the phone number/address the emergency call comes from and the paramedics/doctor/etc recognizing the overdose-ee, or having a notice come up when they check enter their name into whatever database the hospital keeps of patients.

[Broomstick]

No hospital is going to make patient information available to police without a warrant, and even if there is a warrant, might still resist giving the information if the purpose is to without life-saving emergency treatment.

[Khaat]

Yeah, AA and NA are just cults. They don’t work for the vast majority of people because addiction cannot be warded off by willpower.

That's because you're supposed to trade your addiction (drugs, alcohol) for their addiction ("Jeebus take the wheel!").

[Flagg]

And Suboxone is awesome. It controls my pain and I don’t have to live on a fucking 4 hour schedule.

If it works for you I'm glad. Chronic pain is hell, and you deserve some relief.

Yeah, but like you said it’s not a panacea. It means I don’t have the physical craving, but having been on powerful narcotics for several years means I do get that mental itch.

One really good thing is that I’m much more clear-headed.

[Flagg]

And as Broomstick said, how will they tell it’s a “third strike”? Maybe a tattoo with their SSN on their arm?

I suspect a combination of tracking the phone number/address the emergency call comes from and the paramedics/doctor/etc recognizing the overdose-ee, or having a notice come up when they check enter their name into whatever database the hospital keeps of patients.

I was making a holocaust reference because this “3 strike” proposal sounds a lot like “passive euthanasia” of “undesirables” which is pretty much where the Nazis started.

[The Romulan Republic]

I wouldn't be adverse to prison sentences, either.

What is this but a backdoor way of making "being an addict" punishable by death (without due process)?

Not singling you out here, but I should restate: the former is extremely likely to only result in the latter, or worse. As Broomstick brought up, prisons don't tend to care about how an addict recovers, coupled with the fact that the environment is only going to end up worsening their situation, or just get them outright killed. You're essentially locking up a nonviolent offender who may have not even done anything intentionally wrong, and may have gotten hooked onto opioids through other means such as chronic pain, with other offenders that could be very well violent.

Now, consider all the flaws of the American penal system today. Does anyone, with any seriousness think that this is any sort of environment for recovery? Or are we just going to end up creating even worse monsters--turning nonviolent offenders into worse, which American prisons have been known for--which will include people who may have gotten hooked completely against their will? Like, consider people who are being locked up for marijuana use right now but instead, now locked up for abusing a drug that may have not even been their intention to abuse in the first place?

It's like saying prisons are replacements for psychiatric wards (yes I've seen this actually, literally argued). Correctional officers are not replacements for trained nurses and doctors. It's worse than just doing nothing and letting them go. I have huge concerns over the mental health system in this country too, but hell, at least the professionals who work in it actually have "recovery for their patients" as a part of their ethics and duties!

I meant that medical professionals who refuse to treat addicts should go to prison for negligence/manslaughter.

[LadyTevar]

For the Record: Several doctors and pharmacists have been brought up on charges. Several drug stores have been shuttered, although some have reopened "under new management". Rumors have said doctors have lost their licenses to prescribe, but there's been no public notice of such. Just notices that certain doctors 'no longer practice' with certain hospitals or clinics.

I do know that jail isn't the best place for rehabilitation, drug or otherwise, but leaving them on the streets to OD over and over again isn't the answer either. Families intervene when they can, but there's also only so much the psych wards can do. Actual Drug Rehab Clinics cost too much. It's a never-ending cycle of helplessness.

[Dragon Angel]

I do know that jail isn't the best place for rehabilitation, drug or otherwise, but leaving them on the streets to OD over and over again isn't the answer either. Families intervene when they can, but there's also only so much the psych wards can do. Actual Drug Rehab Clinics cost too much. It's a never-ending cycle of helplessness.

The crux of the issue, though, is prison time can not only put a helpless drug user into an even more dangerous situation, but it can turn them into a criminal that will be more than a danger to themselves, but now also to others around them. Even if one refuses to consider how badly this will affect the user, it can't be ignored that it will end up making society even more unsafe in the long-term.

The supposed treatment here, even if it is conceded to be a stopgap, is enormously worse than the disease.

[Flagg]

I do know that jail isn't the best place for rehabilitation, drug or otherwise, but leaving them on the streets to OD over and over again isn't the answer either. Families intervene when they can, but there's also only so much the psych wards can do. Actual Drug Rehab Clinics cost too much. It's a never-ending cycle of helplessness.

The crux of the issue, though, is prison time can not only put a helpless drug user into an even more dangerous situation, but it can turn them into a criminal that will be more than a danger to themselves, but now also to others around them. Even if one refuses to consider how badly this will affect the user, it can't be ignored that it will end up making society even more unsafe in the long-term.

The supposed treatment here, even if it is conceded to be a stopgap, is enormously worse than the disease.

While just letting them die by withholding a save shot is flat out murder, it’s better for society than putting them in the criminal justice system. What would be better for everyone is heavy investment in real drug treatment programs (as opposed to the “You are helpless, pray to Jesus and call your sponsor for a pep-talk!” bullshit) and better follow through by social workers who aren’t given so much case-load that they burn out and quit after 6 months.

I also wonder if the people behind this heinous “three strike and we murder you with neglect” idea support denying liver transplants to alcoholics. Well no I don’t, they would never do such a thing.

[Dragon Angel]

While just letting them die by withholding a save shot is flat out murder, it’s better for society than putting them in the criminal justice system. What would be better for everyone is heavy investment in real drug treatment programs (as opposed to the “You are helpless, pray to Jesus and call your sponsor for a pep-talk!” bullshit) and better follow through by social workers who aren’t given so much case-load that they burn out and quit after 6 months.

I also wonder if the people behind this heinous “three strike and we murder you with neglect” idea support denying liver transplants to alcoholics. Well no I don’t, they would never do such a thing.

But it's 'murrica, where we can't REALISTICALLY devote any money to programs that help people get better. But we can funnel necessary infinite money to the corporate jail lords instead. To keep us safe! Get it right, citizen.

In all seriousness, yeah ... this is one of those things where you can't have halfway measures. There needs to be a serious change of priorities in the government. If this is done lazily at all, we end up making everything far, far worse and we have even more of a fiasco compared to what was previous.