Bob Schwartz

Category: Drugs

Opiods and Heroin: Where Does It Hurt?

There is bipartisan agreement that we have a national problem of opiod and heroin addiction. But few politicos are willing to discuss the hard questions.

The political consensus is that we address the addicts and how to treat and end their addiction. Which is a good and humane objective.

But there are two other aspects the politicos are less willing to take on.

Supply chain

The old school war on drugs went for the top of the supply pyramid. Think El Chapo. In the case of opiods, that supply chain leads up from pharmacies to doctors to pharmaceutical companies. But if you listen to the grandstanding from Democrats and Republicans, you hardly if ever hear the legal producers of the drugs called to account. It is true that product makers are not unconditionally responsible for how people ultimately use their products—not alcohol makers, not cigarette makers, not gun makers. But at least those suppliers can be spotlighted as significant stakeholders.

Where does it hurt?

Pain killers are a blessing to those who suffer from chronic physical pain or from intermittent severe physical pain. That kind of pain is a damnable thing, and we should all be glad that we have developed such a solution.

Millions of those who use painkillers, prescription and otherwise, are not in physical pain. But many of them are in psychic pain, whether out of loss, desperation, frustration, purposelessness, difficult circumstances, or just boredom. It is convenient but not completely helpful to lump these into “mental Illness” for which increased funding and access could be made available. This kind of pain is not illness; it is just a response to a condition or injury, no different than the hurt that might come from being hit over the head really hard.

Politicos don’t want to talk about this. The solutions to this kind of pain involve changes in society and in people’s lives that require lots of self-awareness, lots of politically tricky analysis, lots of controversial proposals that go beyond better addiction services. And lots of hard questions that politicos don’t want to ask, let alone try to answer. Such as:

Where does it hurt?

Still Waiting for 21st Century American Politics

Pelosi McConnell Reid Boehner

We are still waiting for the emergence of 21st century politics in America.

The first part of this may seem simplistic and overgeneralized. The second part may seem silly. But this is about politics, so what can you expect?

1

Many Republicans seem to be stuck at some point in the 19th century—not just Robber Barons and the Gilded Age, but certainly that. Many Democrats seem to be stuck with some version of 20th century progressivism—not a bad thing, by any means, but constructed in a different world under different circumstances.

2

Forget the bourbon and beer political summits. The President, Mitch McConnell, Harry Reid, John Boehner, and Nancy Pelosi should take advantage of D.C.’s new legalized marijuana and share the peace pipe. The scripts would fall away, they would be channeling some different higher power. (Question: Which of these, besides Obama, has actually smoked pot before? Answer: All of them, even if it was just a puff, even if it was just a dare, even if they didn’t inhale.)

Music and food might be issues. Not knowing their individual tastes, and if the point is to get to a better and more creative, communal, and enlightening space, Bob Marley could do the trick. Shoulders swaying, spirits lifting, to the heavenly prayer of One Love.

Food? Whatever’s in the fridge.

3

As I said, simplistic, overgeneralized, and silly. But if politics keeps trying to recreate some ideal of a bygone era, country, or world, two centuries ago, one century ago, fifty years ago, it won’t work. Yes, of course there are timeless values that deserve our allegiance. But these are always set in temporal realities. Being current means more than just being “relevant” or using the latest technologies to drive your message home or appealing to ascendant populations. It means that however much you love the way it was, just inhale, exhale, and breathe the air of 2014, 2016, and beyond. Because, politicians, it’s not your parents’ air—it’s not even yours.

The News and the Wheel

The Wheel - Jerry Garcia

The wheel is turning
and you can’t slow down
You can’t let go
and you can’t hold on
You can’t go back
and you can’t stand still
If the thunder don’t get you
then the lightning will

The Wheel
Jerry Garcia

If you are still listening to, watching, or reading the news, oh boy. If the world seems out of balance, that’s not just the news talking. That’s the way it is.

Thousands of U.S. troops sent to fight Ebola. No troops but planes and bombs to fight thuggish madmen disguised as religious fanatics whose organizational name we can’t keep straight. Honored gladiators beating their wives and children. Police shooting the people they are sworn to protect. The most powerful legislature in the world doing nothing when something is called for, something when nothing is called for, and blabbering on when silence is golden. Rampant use of destructive drugs, demonizing of less destructive drugs. Speaking of drugs, powerful pharmaceuticals interrupting your entertainment with the news that they can cure you, but may also kill you, harshly and slowly. And that’s just for starters.

Every time that wheel turn round
bound to cover just a little more ground

Won’t you try just a little bit harder
Couldn’t you try just a little bit more?
Won’t you try just a little bit harder?
Couldn’t you try just a little bit more?

Breathe. If it seems like madness, that’s because it is. But it’s our madness and we just have to live with it. Being strong and smart will move us forward, but it’s never enough. Being strong and smart will not, for example, cure our madness, and like those very high-tech pharmaceutical drugs, can do more harm than good. Misplaced confidence in our strength and our brains is like putting a thumb on the scale. Which is no way to get in balance.

Hobby Lobby and Peyote

Peyote

Peyote is at the heart of today’s Supreme Court decision in the Hobby Lobby case.

Hobby Lobby does not sell peyote. When Hobby Lobby attends church, its religious practices don’t include eating peyote. Its Christian beliefs do include opposition to certain forms of contraception, and therefore it opposed having to provide health insurance under ACA that includes such contraception.

Hobby Lobby’s objections reached the Supreme Court. In today’s 5-4 decision, the Court found that the entity that is Hobby Lobby has a claim to religious freedom from that requirement, grounded in the First Amendment and in the Religious Freedom Restoration Act of 1993 (RFRA). And that is where peyote comes in.

This begins with the case of Employment Division, Department of Human Resources of Oregon vs. Smith (1990). Two employees of the State of Oregon were members of the Native American Church, and ingested peyote as a sacrament. They failed a drug test and were fired. The Supreme Court found that despite their claim of religious freedom, Oregon had the right to terminate them.

In response to this and other decisions, activists from the left and right, religiously and politically, came together to push for a legislative remedy. How universal was support for a fix? The House vote for RFRA was unanimous, the Senate 97-3, and President Clinton signed it.

More than twenty years later, what hath God and Congress and the Court wrought? Characterizing this new allowance for religious exceptions to laws as narrow seems wishful, hopeful, or just plain wrongheaded. There will be more attempts than before to see just how big this hole is and what sort of company policy vehicle can be driven through it on the basis of religious freedom.

Quite possibly, the next big test will be to see exactly what closely held companies that have religious objections will be permitted to do about homosexual employees. We have no federal law on employment discrimination against gay people, and in a country where we can’t even pass equal-pay for equal-work for women legislation, that isn’t likely any time soon.

God apparently doesn’t endorse IUDs but approves of peyote. His judgment on Hobby Lobby and the Supreme Court is still out.

Teach-in and Dope in the Senate

Teach-in
Yesterday some Senators, mostly Democrats, held an all-night “talkathon” on the Senate floor about climate change. It wasn’t any kind of filibuster, because there wasn’t any particular piece of legislation involved.

Back in the 1960s, this might have been called a teach-in, which was just this sort of session during which change-minded people would learn about the radical issues of the day. Except those people were more likely to be professors and students (or “outside agitators”), and it was more likely to take place in a college administration building than the U.S. Senate.

Two occasional hallmarks of extended teach-ins were sex and drugs. We don’t dare speculate whether any U.S. Senators were having sex during this “talkathon,” but we might just wonder if anybody snuck out to the cloakroom for a quick hit.

In the delightful and trenchant Amazon political comedy Alpha House, one of the four Republican U.S. Senators living in the eponymous D.C. house is seen relieving the tension of running for reelection by bonging it in the bathroom. (The much more serious and dangerous Netflix political series House of Cards also shows the ambitious Frank Underwood, played by Kevin Spacey, sharing joints with his Lady Macbeth of a wife. Sex of all varieties too.)

Back to the climate change teach-in. Even if no substances were involved in the event, what are the odds that any of those participants occasionally indulge, or that any of the rest of the Senate does? As a variant on the old speaker’s trick of imagining your audience without clothes, maybe it would be easier to watch the U.S. Senate if we as citizens just imagined our favorite or least favorite Senators sitting in those iconic smoke-filled rooms passing the pipe. Dope in the Senate. That would explain so much.

The Book of Matt: Hidden Truths About the Murder of Matthew Shepard

Kennedy Monore Kennedy
When the legend becomes fact, print the legend.
Director John Ford in The Man Who Shot Liberty Valence

The Book of Matt by Stephen Jimenez is about the heinous and now-legendary murder of Matthew Shepard. It obliquely brings three people to mind: John F. Kennedy, Bobby Kennedy and Marilyn Monroe.

All three are legends apart, so maybe it is not surprising that legends have grown up about all three in various pairings, and even all together on at least one purported occasion. Whether or not Monroe had an affair with either or both of the Kennedys, whether Bobby was with her on the night of her death, whether evidence of those affairs was covered up or destroyed, is almost certainly never going to be incontrovertibly established. Some will say that some of it appears near certain while other of it is sordid and unsubstantiated conjecture. For the most part, we’ve reached a general consensus that none were saints, none were complete role models, but that we liked some of what they did, and we liked them for what they did, including inspiring us, and the rest is just shades of humanity. JFK helped prevent a nuclear war, Bobby Kennedy helped end the Vietnam War, and Marilyn was just Marilyn. If they didn’t live like saints, they died as complex and heartbreaking lessons.

Jimenez has investigated the Matthew Shepard murder for more than a decade. He concludes that this was not a vicious hate crime against a young gay man. Instead, it is a cautionary tale about the epidemic of methamphetamine. According to this report, Shepard was troubled, and was involved in the Laramie meth scene. The killer, who knew Shepard, was a meth head who had been up for a week, and was trying to get information from Shepard about a meth deal. He intended to coerce the information from Shepard, but out of his mind, simply beat Shepard mercilessly and insanely. The killer and his accomplice pled guilty, which kept details of the local meth market and the killer’s gay dealings with Shepard—trading meth for sex—secret.

The police investigation never involved a hate crime. The now-infamous imagining of Shepard being trussed up on a fence in a crucifix position never happened; he was found on the ground, hands tied behind his back. The anti-gay angle for the horrific event was soon added.

This might present a problem.

Jiminez has found himself in an odd position. He is accused of being anti-gay, though he is gay himself, in which case he is accused of being a “traitor” to a cause. He is accused of being a tool of the reactionary right wing, though he himself is far from being a right winger. What he is, he repeats, is a journalist who wants to do what he is supposed to do: find and tell the truth, as best as it ever can be found and told.

Matthew Shepard has become very important to the movement for gay rights. It is a powerful story: the young man who did nothing wrong, who only wanted to live a free and openly gay life, who had the misfortune of running into a black-hearted, hate-filled, intolerant stranger—the sort that fifteen years ago, and today, you can meet anywhere.

If it turns out that some or more than some of what Jimenez concludes is true, what happens to Matthew Shepard, the young man and the legend? In essence, Jimenez says that nothing happens. The issues remain the same, the good fight remains the good fight, but we will be fighting it armed with a little more truth about the story, convenient or not.

That sort of complication should be welcome, but it may not be, at least not everywhere. We like our stories simple, because so much of life is convoluted and mysterious. There are lines that are clear, but simple stories are mostly for children. Grownups have to work and stretch. This is a warts-and-all age, so we take our big characters as they come: flawed but still valuable. People work every day, their entire lives, on establishing equality—some of those people under the Matthew Shepard banner. That cause isn’t going away, and if we have to accept a little bit of historical adjustment, that’s the price we pay for having our eyes open.

The Marijuana Dilemma: It’s About Age

Marijuana
This was going to be a note about the Gallup poll showing that 58% of Americans think that the use of marijuana should be legal, and that 38% have tried it. It would include arguments about how pot stands in relation to other legal intoxicants—alcohol, tobacco, firearms (sorry, that’s the federal law enforcement agency)—and about how our justice system is distorted and how lives are ruined by reflexive, thoughtless, moralistic public policy.

But no. This is about a simple solution. It won’t make everybody happy, particularly those hypocritical it’s-all-bad-for-you-and-society Puritans who apparently missed the Sunday School class where Jesus mentioned getting the log out of your own eye before criticizing someone else’s splinter. But this might work.

Add marijuana to the list of acceptable American intoxicants. Then take the three biggies—alcohol, tobacco and marijuana—and make their distribution to children, particularly younger children, an even bigger deal than it is, so that the jail cells currently filled with marijuana-guilty adults could then be filled by real bad guys. Draconian punishment. Because while adult use of these intoxicants may be equivocal, childhood use of them is not.

We did not need American alcohol prohibition to learn that nothing will stop people using intoxicants. (Another hint: sex, at least if you’re doing it right, is also an intoxicant, the world’s most popular and, yes, one that the Puritans have also tried to circumscribe.) In another missed Sunday School lesson, Jesus did not smash the jars at the wedding at Cana, as he did the moneylender tables at the Temple; he actually made more wine for the celebrants. The poor we have with us always; so too the wine drinkers.

It is widely agreed that none of the three intoxicants are perfect: all of them are abused, all of them have real potential for ruining life and health. (America’s other big intoxicant, coffee, is excepted from this discussion, in part because any regulation of coffee would start a national revolt that really would prompt a new party, the Coffee Party, and in part because it is coffee that makes posts like this possible.) But as much as adolescents want to indulge, and as much as they already find a way to do it, if there’s a beneficial bargain to be made, this may be it. Let the grownups smoke/drink/smoke, let them explain to their kids why it isn’t a good idea for the younger set.

If you are currently a pre-teen or teenager yourself, or you once were, and you indulge in weed or once did, this may seem silly, arbitrary and unworkable. Here’s the news: all social policy is ultimately unworkable, or at least challenging and perplexing. The truth is that marijuana abuse by adolescents, just like alcohol and tobacco abuse by them, really is a bad thing, and really can cause irreversible damage. Adults should be free to get blissed out or ruin their lives (with minimal harm to others); kids shouldn’t be. If we are going to have some sort of marijuana policy, it ought to be a lot more sensible than the one we have now, even if the solution isn’t perfect.
10:39 AM 10/23/2013