Drug Wars, Drug Addiction, and Social Justice Issues


I have been reading Johann Hari’s Chasing the scream: The first and last days of the war on drugs. 

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This book provides a very detailed account of how we came to be an anti-drug and pro-prohibition nation that lead the way toward making criminals out of people who struggle with use of substances and millionaires out of people/ cartels who sell drugs on the black market. I have found the book in some aspects hard to read because the political manipulation of our global population and the injustices that have arisen from this global movement. I get angry about what has happened as I read and I have to step away for awhile.

Some key points from this text for nurses to consider:

  • The dominant medical establishment (in particularly the AMA) was initially very against “drug” prohibition, but key vocal players were forced into silence by the government.
  • Overall, 90% of people use substances we call “illicit drugs” without having addiction issues, yet we continue to think that people need to be cautious with drug use. For instance, many (not all) soldiers used heroin in Vietnam to get through the hellish experiences, yet many (not all) had no issues with heroin addiction when they returned stateside.
  • There is a clear connection between lack of social support, childhood abuse, and adverse childhood experiences (ACEs: see the CDc website for more info on this) with addiction. We need to be compassionate toward those who are suffering, because these childhood experiences literally changed how their brains function, making them very vulnerable toward addiction. Adverse childhood events impact young people across the socio-economic spectrum, and many people who came from “good families” have also experienced a lot of childhood trauma.
  • When it comes to death and illness, our two leading “drug use issues” are likely nicotine and alcohol, both legal, and both toxic and deadly. Yet, we simply put warning labels on these drugs and let folks self-determine their fate. Why are these drugs okay, but others are not? Because they are socially acceptable? Because they are “cheap”?

When we think of the opiate crisis, one of the biggest issues of course is people not having safe and affordable access to opiate medications: when people are cut off from safe supplies (ie, their pain prescriptions which the medical establishment has endorsed and prescribed, with potentially some of the cost covered by their medical insurance ), they may turn toward heroin and other “street” opiate medications. These drugs are expensive, sometimes hard to find, and in many ways they force or perhaps support people to live a life of crime in order to maintain their habits. And people overdose because they have no idea what is in the products they are obtaining.

Maybe, we have created an addiction monster in our society.

However, Portugal has found a way out of the addiction monster’s clutches. In 2001, with a growing heroin addiction problem, Portugal decriminalized all drugs and began to consider addiction to be a public and personal health issue. Drug addiction was viewed for what it is:  a chronic, debilitating illness. People caught with a 10 day supply of any drug are referred to a sociologist who helps to determine their treatment options. And what Portugal has realized is that not only is this a more humane approach, it is also far less expensive to provide adequate medical care and treatment to addicts versus incarcerating them. Portugal has experienced a 75% drop in addicted persons from the 1990’s, and their addiction rates are 5 times lower than the rest of the EU. Meanwhile, drug related HIV infections have dropped by 95%, and the stigma around addiction has lessened dramatically.

http://www.npr.org/sections/parallels/2017/04/18/524380027/in-portugal-drug-use-is-treated-as-a-medical-issue-not-a-crime

As nurses, we are concerned about social justice issues and public health issues. I would posit that nurses and politically active nursing organizations should be taking action around the opiate crisis in several ways:

  • Calling for safe injection sites and distribution of clean needles (or needle exchange centers) and free condoms.
  • Looking at prevention and early identification of at risk persons (both ending early childhood trauma through supporting parents at risk for enacting trauma and assessing for early childhood trauma both across the lifespan and across all populations to determine risks for addiction).
  • Supporting harm reduction techniques.
  • Supporting a view of addiction as a public health issue, and a chronic disease issue.
  • Considering a call toward decriminalization of drugs and ending incarceration for addicts (the Portugal Model).
  • Acting compassionately toward all addicts (even the “drug seeking” ones).

If you are interested in this topic, I do recommend reading Chasing the scream. This text provides great historical insight into how we came to where we are at with the global  “war on drugs” and the escalating issue of for-profit prisons.

We have become the nation with the greatest number of incarcerated individuals (not %, but sheer number!): though we only have 5% of the world’s population, we incarcerate 25% of the world’s total prison population (this link looks at the complexity of these numbers and supports the idea of the truth that in the land of the free, we incarcerate a much higher percentage of people due to lack of alternative ways to provide help https://www.washingtonpost.com/news/fact-checker/wp/2015/07/07/yes-u-s-locks-people-up-at-a-higher-rate-than-any-other-country/?utm_term=.1ca70c3620af).

Columbia University’s CASA group has released multiple reports that link drug addiction issues to crime, incarceration, and repeat offenses. Sadly, while 65% of our prison population qualify for addiction treatment, only 11% actually receive treatment. Meanwhile, the majority of violent crimes are committed by those suffering from addiction. https://www.centeronaddiction.org/newsroom/press-releases/2010-behind-bars-II

Poverty, race, and income inequality also play a role in both addiction and incarceration, and as nurses, we are ethically obligated to advocate for change in healthcare and system wide policies that impact vulnerable populations. Raising awareness is a first step, but perhaps nursing organizations need to also start taking stances and lobbying for more humane treatment of those who struggle with addiction.

 

 

Nurses Take DC for Safe Nurse:Patient Ratios on May 5!


For a number of years, nurses have marched on DC to call for changes in nursing and healthcare that the conditions under which nurses care for patients.  This year the specific issue is safe nurse:patient ratios, calling for passage of bills that are already in both the House and the Senate that set national standards for nurse:patient ratios.  This event promises to be an invigorating event with inspiring speakers and the opportunity to be part of a strong, non-partisan event focusing on issues of great concern for all nurses.  The march also coincides with the following week designated as “nurses week” – a U.S. tradition highlighting tokenism at its best (full disclosure – my personal opinion!).  The march has the potential to energize nurses across the country to bring the activism home, and during nurses week take local action calling for safe ratios at home – in place of roses!

For more information, visit the Nurses Take DC website.  You can also follow the Nurses Take DC Facebook page, or follow #NursesTakeDC on Twitter.

One thing you can do – now


#NursesResist

All the talk about repealing the U.S. Affordable Care Act (ACA) is scary stuff for those of us who are concerned about those who would be harmed immeasurably if this were to happen.  Of course this is a U.S.-specific problem, but all countries face ongoing threats that weaken healthcare systems worldwide (for example, the U.K. “Brexit” initiative is a significant threat for their National Health Service). Here in the U.S. we are at least a bit encouraged by the signs that repealing our fledgling ACA may not be easy – that the voices of the people letting MoCs s (members of Congress) know that this is not a good idea – may be getting through.  However, as Rachel Maddow has been advising us for weeks now – watch what they DO, not what the say. In fact one of the most damaging things we can do is to repeat over and over what they say, which only reinforces their message.

So fortunately, we have folks stepping up to help us watch what they do, and giving us leads about what we can do about it.  When, just a few days ago, Tom Price, avid opponent of the ACA, became Secretary of Health and Human Services, put up a proposal to make it harder and more expensive to get coverage under the ACA, and also supporting DJT’s speakupexecutive order that gives insurers freedom to deny and limit benefits for those who already have it – most of the public had no way to know that this was happening.  The brand new DCReport.org, established by David Cay Johnston, is filling this void.  Read the report on the new ACA proposal here – Administration Moves To Block Access To Health Insurance.  Here is the action box that accompanies this report:

Citizens have until March 7 to weigh in on the new rule. Use the rule-making code CMS-9929-P in any correspondence.

Write: Centers for Medicare & Medicaid Services / Department of Health & Human Services / Attention: CMS-9929-P / P.O. Box 8016 / Baltimore, MD 21244-8016. The phone number is 410-786-7195.

You can also comment online. This link will take you to the text of the proposed rule. There is a comment button on the right.

Of course this is not a dramatic, showy kind of action, and it certainly will not remove the threat that our country is facing. But if nobody speaks up now, then this administration will be further emboldened to continue down a damaging path.  We can at least put them on alert by sending strong and clear messages that they do not have a mandate to continue.

We will continue to alert all NurseManifesters of actions we can take related to health and healthcare – but to stay alert for any issues that concerns you, follow DCReport.org, and other trusted news sources that help guide your own actions.

#ProtectTheTruth
#HealthForAll
#FreePress
#MakeJournalismGreatAgain

Postcard campaign – #Idesoftrump, #TheResistance


Nurses Declaration of Solidarity and Resistance

There is an organic, world-wide movement afoot to participate in a massive show of resistance to the new U.S. President – write a simple postcard with your message of resistance and mail it on March 15th. This is an opportunity for those of us who are nurses to join in sending messages affirming our support for world-wide health and opposing all that threatens health of the earth, and all that inhabit the earth. Check out the source I refer to below (The Daily Kos) below for details! Here is the basic information about what to do to participate:

Prepare for March 15th, 2017, a day hereafter to be known as #TheIdesOfTrump. Postcards are important here! Regular mail must go through content inspections that slow them down, whereas postcards don’t have such postal obstacles.
Write one postcard. Write a dozen! Take a picture and post it on social media tagged with #TheIdesOfTrump ! Spread the word! Everyone on Earth should let Donnie know how he’s doing. They can’t build a wall high enough to stop the mail.
Then, on March 15th, mail your messages to:
President (for now) Donald J. Trump
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500
from The Daily Kos, February 7, 2017

The Call for Community, Art, and Artists in the Resistance Movement


This week, members of the Nurse Manifest Team gathered together by the warmth of our computer screens for engaging video conference. We took the time to welcome some new members and talk about the future of the movement. I have to say for me, being with like minded #NurseResisters was so energizing (even though I have been suffering through a bout of the flu this week!) and also very comforting.

It’s important for #NurseResisters to remember we are not alone and to gather those around us during these challenging times: when change seems to be happening at a rapid pace, when social media pages are filled with what resisters might find to be concerning or bad governmental news, when there are 10 things you would like to take action on, but you can’t be on the phone all day….it can become easy to become discouraged, overwhelmed, or burned out. This is where truly being with a like minded community can lift your spirits and buoy your endurance.

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And endurance is what we will need. I know right now it sometimes feel like a sprint…get out there and get things done now, get to this march, make your signs, write your emails and postcards, get on the phone….because the administration has been creating changes at a rapid pace, the media and social media have been bumping up our energy, and we feel drawn to create change now.

The thing is, this is not a sprint and it’s not a solo race…it’s more like a team based marathon or ultra-marathon, and it is going to take teams of like minded community members to both participate in and complete the race.

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Individual Sprint

Versus

Team Marathon

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We need to carry lights, march together through the dark night with our nightingale lamps, and strive toward unity. There is no clear finish line, and no medals for winners, second, and third place. There is a beautiful planet and population of people that need caring for and this endurance test is in part about not giving up that vision of a caring, compassionate, kind, peaceful, unified, and spirit filled world.

I suggest other #NurseResisters start gathering with your communities in real life or as we did last week, in real time via video or phone conferencing. Set aside thoughtful, meaningful time to be together, to discuss future actions, and also to just support one another, to laugh together, to share your stories. Communities can rejuvenate and recharge us, and they are a must for folks who plan to run the long race.

I also did want to share that part of our discussion last week focused on the use of humor, satire, parody, art, and music to support and gather people together. Saturday Night live is becoming a great example of the power of humor, parody, and satire to help us lighten our load, to help us rejuvenate, to connect us across time and space.

 

 

While there are many older political songs we can use (Carol King just re-released One Small Voice with free download!: https://soundcloud.com/user-844282824/one-small-voice), it remains imperative that we also create new art and new music that reflects our current siutation here, now in 2017. Until then, let’s be strong together:

“One small voice speaking out in honesty
Silenced, but not for long
One small voice speaking with the values
we were taught as children
Tell the truth
You can change the world
But you’d better be strong”

(Carole King/ copyright Rockingdale Records).