How America Overdosed on Drug Courts
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How America Overdosed on Drug Courts
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Re: How America Overdosed on Drug Courts
#2This points to a more general problem of the lack of accountability of judges.
Re: How America Overdosed on Drug Courts
#3This points to a more general problem of the lack of accountability of judges.
So how do we get there? More mandatory minimums? Less judicial discretion?
Since I think the solution is to get rid of the drug courts and move them into the medical system, and not to demand more accountability.
Plus, what of accountability for the politicians who set up the policies in the first place?
Re: How America Overdosed on Drug Courts
#4>By the time Darren was assigned to drug court, his addiction story carried almost every possible red flag for high-mortality risk: prior overdose, prior treatment failure, a childhood ADHD diagnosis, and a family history of mental illness. Any addiction doctor—or anybody who simply follows evidence-based treatment guidelines—would know exactly what to prescribe for him: opioid maintenance, by far the most effective treatment, known to lower the death rate of opioid addiction by between 66 and 75 percent.
I am a psychiatrist, and I treat many people with addiction problems. This formulation is a gross oversimplification. Opioid agonist therapy (methadone or bupronorhpine) is not trivial or one-size-fits-all. There are many other factors to consider, not the least of which is the person's interest in getting clean.
Re: How America Overdosed on Drug Courts
#5This points to a more general problem of the lack of accountability of judges.
To me, it only hints at that (a problem that I agree is substantial). The main issue is that our legal system is simply not very well-equiped to deal with issues that require true expertise from a professional outside of those with law degrees.
Re: How America Overdosed on Drug Courts
#6>By the time Darren was assigned to drug court, his addiction story carried almost every possible red flag for high-mortality risk: prior overdose, prior treatment failure, a childhood ADHD diagnosis, and a family history of mental illness. Any addiction doctor—or anybody who simply follows evidence-based treatment guidelines—would know exactly what to prescribe for him: opioid maintenance, by far the most effective…
Why is a psychiatrist on hackernews, just curious?
Re: How America Overdosed on Drug Courts
#7This points to a more general problem of the lack of accountability of judges.
So how do we get there? More mandatory minimums? Less judicial discretion? Since I think the solution is to get rid of the drug courts and move them into the medical system, and not to demand more accountability. Plus, what of accountability for the politicians who set up the policies in the first place?
IMO we need to decriminalize drugs, treat addiction as a medical issue, and shift our cultural attitudes away from seeking punishment out of the justice system. But none of those will happen because there are too many people making too much money from the current paradigm.
And politicians have worked long and hard to ensure they have no accountability. As long as the place that they're from is aligned to their party affiliation, they have a job for life regardless of what they do.
Re: How America Overdosed on Drug Courts
#8>By the time Darren was assigned to drug court, his addiction story carried almost every possible red flag for high-mortality risk: prior overdose, prior treatment failure, a childhood ADHD diagnosis, and a family history of mental illness. Any addiction doctor—or anybody who simply follows evidence-based treatment guidelines—would know exactly what to prescribe for him: opioid maintenance, by far the most effective…
How right you are. I have a friend whose been on Suboxone for years. First thing she does when she gets her prescription is sell it or shoot it. I have no idea how to help her anymore (as if I ever did). Her ex was the same way.
Re: How America Overdosed on Drug Courts
#9>By the time Darren was assigned to drug court, his addiction story carried almost every possible red flag for high-mortality risk: prior overdose, prior treatment failure, a childhood ADHD diagnosis, and a family history of mental illness. Any addiction doctor—or anybody who simply follows evidence-based treatment guidelines—would know exactly what to prescribe for him: opioid maintenance, by far the most effective…
It is a generalisation but a good one. "Getting clean" is a loaded term. Most (not all) people who have "drug" problems actually have police problems. The drugs do them very little harm (impurities are a different story, but not as common as people think) but the police and legal systems do them untold damage.
Making the drugs available is by far the best treatment for most forms of drug addiction in the vast majority of cases. The simplest way to do that is to remove criminal sanctions from drugs and make prescription for addiction legal.
Addiction is a complex beast and demanding that people deal with the chemical dependence before dealing with the other problems in an addicts life is usually a cruel approach and ineffective.
This is something a psychiatrist should know.
Re: How America Overdosed on Drug Courts
#10Earlier quoted context omitted.
So how do we get there? More mandatory minimums? Less judicial discretion? Since I think the solution is to get rid of the drug courts and move them into the medical system, and not to demand more accountability. Plus, what of accountability for the politicians who set up the policies in the first place?
IMO we need to decriminalize drugs, treat addiction as a medical issue, and shift our cultural attitudes away from seeking punishment out of the justice system. But none of those will happen because there are too many people making too much money from the current paradigm. And politicians have worked long and hard to ensure they have no accountability. As long as the place that they're from is aligned to their party…
"none of those will happen because there are too many people making too much money from the current paradigm"
Portugal
Colorado/Washington/Alaska
In the UK they have returned to prescribing heroin to drug addicts
In New Zealand there is new law around novel drugs that will make them legally available in shops if they can be proved safe
It is happening.