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Prison or treatment is question for drug addiction
(by Tony Lange - November 03, 2010)
Prison or treatment is question for drug addiction
By TONY LANGE
He was stationed in a low-key parking lot. His heat blasted on high and his tunes turned low. He sat subdued behind the steering wheel of his sport-utility vehicle in the dark hours of a Saturday evening and dragged on a cigarette. It was the typical scene for a dope deal. His rendezvous, however, wasn't with a junkie. He was with a journalist.
"Hi, my name is Matt. I am a recovering addict," the young man in the driver's seat said. "I've been to four meetings this week."
Last names are usually omitted. Some introduce themselves as addicts, some as alcoholics. Others identify as alcoholic addicts. It does not matter what or how much they used; members of 12-step meetings, which include Alcoholics, Narcotics and Cocaine Anonymous, have at least one thing in common -- the desire to stop using mind-altering chemicals.
Before attending meetings and before he was admitted to Impact's outpatient treatment, a chemical-dependency rehabilitation program at Mercy Medical Center in Canton, Matt never thought he would be able to live without his drug of choice -- something he referred to as his "kryptonite." The 24-year-old was an intravenous heroin user.
"Today, I'm very optimistic," he said. It was 75 days after his last injected dose. "I never thought that I would have the desire to stop using."
What differentiates Matt from thousands of other addicts statewide is the support he received when starting his journey toward recovery.
DEADLY ALTERNATIVE
According to the National Survey on Drug Use and Health, conducted by a federal agency in the U.S. Department of Health and Human Services, more than 200,000 Ohio citizens report needing but not receiving rehabilitation services for illicit drug use each year. Many of those individuals will end up in jails, institutions or dead. Drug overdoses now kill more Ohioans than car accidents, according to the Ohio Department of Health and the Ohio Highway Patrol.
If it were not for Impact, Matt said he would be buried in the ground.
"You would not be talking to me. Nobody would be talking to me, because I would be 6 feet in the ground," he said. "That's one of the three things an addict will turn up at if they continue to use."
Steve Howe, one of Impact's chemical dependency therapists who helped treat Matt, said the situation of drug users wanting rehabilitation and not receiving it is a problem he has dealt with throughout his 15-year career.
Insurance companies severely limit benefits for mental-health or chemical-dependency-related treatment, he said. Impact's 10-week outpatient program costs roughly $10,000. Publicly supported facilities, which can be more affordable, he said, have long waiting periods that contribute to the 200,000-plus Ohioans who go untreated each year.
"What we are doing is putting a Band-Aid on a gaping heart wound," Mr. Howe said. Addicts "continue to use and probably wind up committing crimes that could have been prevented if they were allowed reasonable access to treatment," he said. "Part of it is our society is still operating on a punishment model rather than a rehabilitative model."
PUNISHMENT MODEL
Costs of warehousing humans vary from prison to prison. The Ohio State Penitentiary in Youngstown spends more than $50,000 a year for each inmate, according to the Ohio Department of Rehabilitation and Correction. In May 2010, the penitentiary housed 546 people. That's close to $30 million of taxpayers' money being spent each year at one facility.
With 750-plus inmates per 100,000 population, the United States has the highest incarceration rate in the world, according to the Human Rights Watch, an international non-governmental organization dedicated to protecting human rights and exposing abuses. Thus, Americans are spending a large chunk of tax dollars turning the key on nonviolent criminals -- about half of their country's jail population.
U.S. lawmakers need to revise some existing laws to reduce the sanctions and penalties that are not warranted, said state Rep. Vernon Sykes, D-Akron, chairman of the Ohio House Finance and Appropriations Committee.
He said the majority of the 50,000-plus people locked up in his state are there for nonviolent, minor crimes such as drug offenses.
That contributes to Ohio's overcrowded prisons, which are designed to house fewer than 39,000 inmates, according to the American Civil Liberties Union, a nonprofit organization that works in the courts, legislatures and communities to defend the individual rights and liberties guaranteed by the Constitution and laws of the United States.
It's a problem of elected officials being responsive to their constituents, Mr. Sykes said. Calling it a "bifurcate" issue, he said, "On the policy side, you can say, 'Well, we don't need to have so many nonviolent offenders put in prison.' But on the political side, politicians who run campaigns and say that they're going to reduce punishment on criminals don't get elected or don't get re-elected," he said. "So that's the issue. The political side always drives the policy."
Although 25 percent of world's prisoners are in the United States, which represents just 5 percent of the world population, officer Donald Schismenos, who has worked with the Akron Police street crimes and gang unit, as well as the street narcotics uniform detail, said the United States is getting less stringent on criminals.
PEOPLE VICTIMIZED
With a revolving prison population, very few people spend a lot of time incarcerated for a particular or a single offense, he said.
When asked why there are so many prisoners in the U.S. behind bars for nonviolent crimes, Mr. Schismenos said drug offenses should not be considered nonviolent. Drug offenders burglarize houses and rob people, he said.
"Just because they get picked up with a rock of crack that's not related to any of those other crimes, you got to ask yourself, 'Where did they get that 20 bucks or 50 bucks or whatever to get that rock?'" said Mr. Schismenos, who has 17 years of experience in Akron. "They're out victimizing other people."
Mr. Schismenos also said he supports treatment programs more than incarceration in terms of helping addicts recover.
"I don't think our prisons are built for rehabilitation. They're punitive," he said. "And I am all about rehabilitation, but there are some people that are way beyond that."
Mr. Howe, a rehabilitation professional, disagreed.
Of the 500,000-plus people in prison or jail in the U.S. for drug offenses, none of them is untreatable, he said. When people go in and out of prison, it supports underground economies, people working for less than what they're capable of earning and a class of society that would be considered unemployable, he said.
"It feeds the system," Mr. Howe said. "I haven't met anyone yet that wasn't able to be treated. If the treatment is good, the patient will respond. I've seen that in 100 percent of the cases."
Matt, who described himself as stubborn and arrogant, said he doubted a treatment program like Impact would be able to change some of his old habits.
Therapists and fellow addicts don't frown upon one another, he said. They congratulate each other for progress.
"That's something I've never gotten before. There's so much love in those rooms," Matt said. "It's not like you go in there and you're a number to them, like you are in a prison. You are a living person."
Before his treatment, all Matt cared about was getting high and how he could get his next fix, he said. "In short, it was hell," he said. "I couldn't even look myself in the mirror from all the pain that I caused my family members and friends. I absolutely hated myself."
DISEASE OR DEFICIENCY?
After a couple months of treatment, Matt lost some of his guilt and shame, he said.
"It's given me a different perspective knowing that addiction is a disease," Matt said. "It took some burden off my shoulders knowing it's nothing I could have prevented. It's just like catching cancer."
A difference between the two is one is illegal and the other is not.
The majority of Americans may acknowledge addiction as a disease, Mr. Howe said, but, on a deeper level, he doesn't think they believe or agree with it. A lot of people look at chemical dependency as a result of poor parenting, lack of willpower and moral deficiencies, he said.
Experts who conduct research on twins may change those beliefs.
By studying patterns of drug use among pairs of twins, Dr. Kenneth Kendler, director of the Virginia Institute for Psychiatric and Behavioral Genetics at the Virginia Commonwealth University School of Medicine, concluded that genetics play a greater role than environment in terms of drug tendencies.
Dr. Kendler's National Institute on Drug Abuse report, supported by the HHS, stated that identical pairs of twins, who share the same genes (monozygotic), will tend to be more concordant in drug use, abuse and dependency than fraternal pairs of twin, who are no more genetically similar than non-twin siblings (dizygotic).
In one example from the NIDA report, the concordance rate for both twins abusing or not abusing cocaine was 47 percent for identical pairs compared to 8 percent for fraternal, disputing poor parenting as a cause for addiction.
It is probably very confusing for someone who doesn't necessarily understand that addiction is a disease and a person who suffers from it doesn't have legitimate control over his or her use, Mr. Howe said.
In the early to middle stages of chemical dependency, the disease makes people feel good before it makes them feel worse, he said. Then, because a person develops an emotional attachment to his or her chemical, he or she winds up blaming negative consequences on something other than the actual chemical use, he said.
"'I had a bad day at work. I was stressed out. I've got money problems. Therefore, I need to use,'" Mr. Howe said, characterizing an addict in the late stages of chemical dependency. "What people end up doing is attempting to treat the effects rather than treating the causes."
Although officer Schismenos supports treatment programs, he does not agree with medical and psychological professionals who say drug addiction is a disease.
"Whatever they say, I don't totally support their ideas about it being a disease," Mr. Schismenos said. "I think it's an addiction. I don't think addiction is a disease."
People who are forced or tricked into using drugs are not criminals, he said, but every single other person addicted to drugs made the conscious decision to start using.
"That's a criminal offense," Mr. Schismenos said. "Now, if they've become addicted to it, that's just the price they pay when they decide to start using the stuff."
DRUG PROHIBITION
Public health issues and criminal issues can be distinguished by the behaviors a society deems unlawful.
It is not illegal for a diabetic to stop taking his or her insulin. It is not illegal for an obese child to eat chocolate cake. Tobacco, which, according to the U.S. Food and Drug Administration, kills more than 400,000 Americans each year, also is not illegal. The most commonly used drug, alcohol, isn't either.
Killing fewer than 20,000 people a year, illicit drugs are criminalized in the United States not because they are destructive to individuals but because society considers them a public safety concern, Geauga County Probate and Juvenile Judge Charles Henry said.
"You can drink and put yourself at risk and ultimately kill yourself consuming alcohol, as long as you don't put other people at risk," he said. "In our society, we criminalize certain types of behavior and not others."
Mr. Henry said he'll use jails and detention centers as tools to motivate a drug abuser to want to be treated.
"You want it to be a wake-up call," he said, when talking about penalizing first-time offenders. "You don't want it to be an experience that takes all their hope away."
With high recidivism rates, some critics say incarceration doesn't work very well at rehabilitation. About two-thirds of people released from prison are rearrested within three years, according to the U.S. Bureau of Justice Statistics, a federal agency of the U.S. Department of Justice.
Drug recidivism occurs, because dope influences people to be irrational, Mr. Sykes said.
Psychologists and sociologists say the love between a mother and child is the strongest love experienced, he said. "When a mother will sell her child for some crack cocaine, for some narcotic, it indicates that there's no reasoning or rational decision being made by that individual," he said. "So you can't leave it up to them to want, need or show the indications that they'd like treatment."
If a person is addicted to drugs, treatment is what he or she needs, Mr. Sykes said.
He also said he doesn't oppose legalizing drugs to take away profits made by dealers and offer more treatment options for addicts.
"I think that's a great idea," Mr. Sykes said. "Money drives this whole drug business. If you take the money out of it, then the whole idea of pushing goes away."
TRAGEDY OF ADDICTION
The greatest tragedy of addiction is it's a disease that allows people to really profit off of human suffering, Mr. Howe said.
As a recovering person, Mr. Howe said he has concerns about legalizing drugs, because he doesn't know what it would do in terms of access and making it easier for kids to use.
"But on the other hand, I would certainly sit here and say it doesn't look like we're winning the war on drugs," he said. "By legalizing some of these drugs you could certainly offer or afford some regulation in terms of taxation and using that money to provide treatment for those who really need it."
For the addict who still suffers, take it one day at a time, Matt said. "That's just plain and simple. You take life one day at a time, you take one step at a time, one minute at a time," he said. "The craving is not going to last forever."
Sooner or later, time always catches up, Matt said. Addicts who continue to use end up dead, institutionalized or incarcerated.
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