Coverage of the death of Philip Seymour Hoffman has been humane, which is how we should deal with drug abuse by anyone, especially if we expect to be successful in reducing the personal and societal damage of drug abuse and moving toward prevention.
More people are beginning to see that, and King County is on the forefront of more-effective approaches, but we are just getting started down a better path than the failed War on Drugs.
Hoffman, an acclaimed actor, was found dead Sunday, apparently of an overdose of heroin. Here’s the first sentence of a story in The Seattle Times on Tuesday: “Philip Seymour Hoffman suffered from a chronic medical condition that required ongoing treatment.”
Addiction is a health problem. Health conditions are not best addressed by police and courts and jails, but the country has taken the criminal-justice approach for decades because it was politically advantageous, because it courted the public’s fears and allowed elected officials to sound tough.
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But it didn’t do a good job of saving lives or making communities safer, and in recent years communities around the country have been searching for something better. At the core of that something is treating abuse as a medical issue.
Molly Carney, executive director of Evergreen Treatment Services
in Seattle, is part of that effort, and she told me, “We are lucky to live in a progressive community that has been listening to the scientific evidence.” She said addiction causes chemical changes in the brain that make it difficult to quit and easy to relapse. Experts now call addiction a chronic, relapsing health problem, something that can be managed, but not cured.
Evergreen handles the treatment part of a pilot program called Law Enforcement Assisted Diversion (LEAD), which is in the middle of a five-year trial in Seattle’s Belltown neighborhood and in Skyway.
The program grew out of frustration with the arrest-and-jail approach and was created by law-enforcement agencies, public officials and community groups. It started with a conversation between a police captain and a defense attorney.
In a speech last spring, Jim Pugel, then one of Seattle’s assistant police chiefs, said officers were arresting the same people over and over, and the officers were getting criticism for focusing on Hispanic and black users.
He acknowledged there were lots of white users, but finding and arresting them might require informants and search warrants for condos and other dwellings. The police concentrated on the people they got complaints about, those most visible.
Police arrest lots of users and low-level dealers, people who sell enough to buy their next dose. No one argues against going after and punishing big-time dealers, but arresting users makes one street corner look better temporarily without solving the larger problem.
The shortcomings of that approach to drug abuse have long been evident. Before LEADS, King County created a drug-diversion court in 1994. It’s for low-level offenses. People arrested and charged can be referred to the court, and if accepted into the program, they undergo treatment and get help getting their lives straight, all under court supervision. Time in the program varies, but it’s usually about 15 months. If the person successfully meets all the judge’s goals, the court can dismiss the initial charges.
LEAD doesn’t involve arrest and charging. Officers identify people they believe would benefit from medical treatment, and candidates accepted into the program are treated as patients, not prisoners. The approach seeks to reduce the harm users do to themselves and to the community.
The War on Drugs began as a militarylike approach to cocaine use, particularly to crack cocaine, which was wrapped in myths about the nature of the drug and its users that drove the irrational response.
Today the country is experiencing a heroin epidemic, and it is affecting 18- to 29-year-olds disproportionately, rural areas, as well as cities, according to Caleb Banta-Green, a research scientist at the Alcohol and Drug Abuse Institute at the University of Washington.
Banta-Green said Hoffman’s death illustrates how “the powerful lure of opiate addiction reorganizes the priorities in your life. He (Hoffman) abandoned his three young kids.” Staying off the drugs is not a matter of character or willpower because of the way they alter the brain, but he said, “We have really good treatments.” (Here’s a link to help and information resources: http://adai.uw.edu/hotlines.htm. His data show 84 people in King County died of heroin-related causes in 2012 versus 49 in 2009. Prescription-type opiates were involved in 112 deaths in 2012.
Rather than criminalizing addiction, and driving users underground, the medical approach can encourage users to seek help.
“We want to keep this person alive today, so we can help them get better tomorrow,” Banta-Green said.
Patients are always in recovery, and because of the nature of the addiction, relapses are expected. Treatment is ongoing work, with much better results than the criminal-justice approach.
“The medication-assisted treatment approach is the gold standard,” Carney said. Heroin is replaced by methadone or another less-harmful drug, and that is paired with counseling and other assistance.
Treatment, she said, costs only a small fraction of the cost to a community of hospital emergency rooms, police calls, court and jail time. Studies show it significantly reduces drug use and repeat crimes. And it is the humane, science-based solution.
Jerry Large’s column appears Monday and Thursday. Reach him at 206-464-3346 or firstname.lastname@example.org