An Ohio Councilman believes that having an opioid addiction should be a death sentence: he wants to create a "three strikes" policy in which anyone in that state's Middletown who has overdosed twice before would not receive emergency care because it's costing the city too much.
Dan Picard told the local Journal-News, "I want to send a message to the world that you don't want to come to Middletown to overdose because someone might not come with Narcan and save your life… We need to put a fear about overdosing in Middletown." He's asked the city to explore the legality of the proposal. This is about as sensible as Trump Opioid Commission member and advisor Kellyanne Conway's recent comment that the solution to the opioid crisis is "will"—and shows just about as much understanding of the disorder.
But don't worry, Dan: no one wants to come to your nowhere little town to overdose, even if it is where bestselling Hillbilly Elegy author J.D. Vance grew up. The people who are overdosing there are your neighbors and their friends, families and loved ones—maybe even your own family members or their friends, whom, given your level of compassion are unlikely to discuss their problems with you. Everyone tries to claim that people with addiction are outsiders or "transients"—but that's not what even a quick read of the Journal-News' recent coverage suggests.
And people with addiction are not choosing to overdose repeatedly because they enjoy it: it's quite a hellish experience to be revived and put into instant withdrawal, actually. Instead, they're doing it because addiction itself is defined—by both the National Institute on Drug Abuse and psychiatry's bible, the DSM—as compulsive drug use that continues despite negative consequences.
In other words: if fear, punishments, and consequences could stop addiction, by definition, the problem wouldn't exist. We've tried for at least the past 100 years to fight a problem defined by its resistance to punishment with ever more punishment—in the same way that people with addiction continually up the dose in hopes that this time, maybe, they'll be able to feel OK again.
It doesn't work because it can't work: people with addiction take drugs because they are attempting to cope with emotional pain, typically due to childhood trauma, mental illness, economic and cultural displacement, or, frequently, all of the above. Adding more pain only adds more fuel to the addictive fire.
No one would ever say we should stop reviving heart attack or stroke victims because they kept eating French fries or because they didn't exercise as much as we all know we should. No one would suggest not treating lung cancer as a way to get people to quit smoking—or not treating people who were speeding when their cars crashed.
We don't suggest these things because we recognize the humanity of people who overeat and under-exercise, people who can't quit smoking, people who speed. We know that they're just like us—but until we recognize that the same is true for other kinds of addictions, we're not going to make any real progress in cutting the death toll.
Update 6/30/17: A reader named Shane contacted Middletown fire chief Paul Lolli to ask if people could donate to help pay for Narcan. His response follows:
Shane, We do have a fund for people who wish to donate to a Narcan fund. The check can be made out to The City of Middletown, and sent to One Donham Plaza, Middletown Ohio 45042; Attention Finance Department; make sure you indicate that it is to be used solely for the purchase of Narcan. Shane, thank you very much for your thoughtfulness. It is individuals such as yourself that will help us solve this problem, Chief Lolli.
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