Unfortunately, drug treatment has become a very, very lucrative industry. Being an alcoholic who needed medical detox recently, the horrors of finding an adequate facility I could afford was rough. Too many predatory companies out there are just looking to make a quick buck off the vulnerability of others.
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I lost two family members to fentanyl in one year. My aunt was so fucked up she didn't realize she cracked the back of her skull open on the floor when she fell, and then she got back up and went to bed for the last time. A few months prior to this, her grand daughter died of a fentanyl overdose. The mother died many years ago due to overdose.
Fuck addiction. And fuck fentanyl in particular. I worked professionally with an adult population which had high rates of drug use, and everyone will tell you how much more dangerous it is, regardless if they're a mental health professional, a drug user, or both.
We need so much more funding for evidence-based programs and resources. We need to address and tackle homeless as well, because the two problems are so intertwined. I can't tell you how many clients I had on my caseload tell me that they never had drug use problems until they had to live on the streets.
The sad truth is that severe mental illness, disordered drug use, and homelessness are highly related, and the Department of Corrections (DOC) is the largest mental health provider in the U.S. since deinstitutionalization. It's a revolving door where an individual gets arrested, becomes sober/stable on anti-psychotics and/or mood stabilizers, is released without a proper support system, relapse occurs and/or medication is failed to be refilled, a psychotic episode or drug-induced psychosis presents, 911 is called, and rinse and repeat.
I worked exclusively with adults living at residential care facilities and assisted living facilities which this population often ended up at, especially if the courts were petitioned to assign a public administrator as a court-appointed guardian (most of my clients fell into this category). Some RCFs and ALFs were far from ideal and I hotlined facilities/assisted DHSS and DMH with investigations at various facilities.
But we need more places like this that can be described almost as a cross between a nursing facility and a halfway house, that provides residential care for these individuals (food, cleaning, meds, etc.). I worked for a 3rd party agency providing case management services for this particular population, and the type of work I did was called Community Psychiatric Rehabilitation.
I would work with these people to teach them coping skills/utilize evidence-based resources, I hosted an illness management and recovery (IMR) group, taught them how to improve their daily living abilities, helped apply for grants and resources, and I would assist people in the community (e.g. teaching budgeting skills or ensuring healthcare literacy in medical appointments). Essentially, my ultimate purpose and goal was to help these people transition from their facilities back into the community, or at least to a more independent setting.
In order to address the opioid/fentanyl crisis, we must also address the homelessness crisis as well as establish a better safety net and social programs to actually support our previously incarcerated population. There needs to be systemic change in the way we treat our criminals and individuals with severe mental illness and/or substance use disorder.
One thing that my years at that job working with that population really cemented is that black and white thinking is just a false construct, and we all really live in the grey. I worked with great humans who committed truly bad acts which they regretted deeply. It's too easy for people to marginalize this population, but they are very vulnerable individuals who deserve a proper shot at life with real support, often for the first time in their lives.
At the same time, having personal relationships and loss of members of family who fell into this population, you also have to set firm boundaries and make hard decisions to protect yourself from friends/loved ones struggling with addiction.
Thank you for doing that work.
Maybe they will realize soon that they have fucked this world up so bad that disproportionately more people don’t even want to deal with it. Fuck, Canada has the same issues, and we even have MAID now that they suggest to people because the country doesn’t want to care for them anymore (veterans, disabled people who can’t afford rent with the lower disability payments).
Then you have the fact that the medical systems still push too many opioids, and people who reach too high of a tolerance on standard opioid medications seek out something stronger like fentanyl. If only they made access to other pain relief as easy (like cannabis), but that won’t happen until Purdue can put it into a prescience bottle.
Fuck, Canada has the same issues, and we even have MAID now that they suggest to people because the country doesn’t want to care for them anymore (veterans, disabled people who can’t afford rent with the lower disability payments).
MAID requires two separate doctors to sign off on. Is there any actual evidence that people struggling to pay rent have been recommended for MAID?
Or is this just so deliciously outrageous that we're just going to repeat it often enough that it becomes mistaken for the truth?
It required two doctors to sign off, but there is no restrictions on who can recommend it.
https://beta.ctvnews.ca/national/politics/2022/12/2/1_6179325.amp.html
https://globalnews.ca/news/9176485/poverty-canadians-disabilities-medically-assisted-death/amp/
Anyone can recommend anything. I recommend you find a large trash bin and sleep in it like Oscar the Grouch to save on rent and improve your current smell. Please find find two doctors to sign off on it.
Anybody deemed mentally sound should have the option of a safe and painless suicide. Or is it only okay to kill people when they are guilty of a crime?
Might be time to stop prescribing painkillers that used to be for palliative care to people with tooth aches.
At the absolute bare minimum make Purdue Pharma pay for aftercare to make sure the patient doesn't have withdrawals or turns to illicit use.
The only way a one time fine makes sense, is if they stop profiting from it.
We did that, that's part of how we got here.
The people that were already addicted (not to fentanyl, mind you. More to the likes of Vicodin, oxycontin, etc.) turned to street vendors because we didn't offer them any support to get off the drugs. Used to be they got heroin. Then, the street vendors more and more were cutting fentanyl into other painkillers to cut costs as demand and tolerances crept higher and higher. That's how these overdoses happen; many of those that suffer a fentanyl overdose didn't know that they were using fentanyl. Even if they do know what they're using, the difference between an overdose and living another day is less than a milligram of the stuff. Better hope whoever cut it had the tools and wits to be extremely precise about it.
Rest assured though, it's far more difficult now to be prescribed any clean, government regulated painkiller beyond ibuprofen even with a legitimate short-term use case.
It’s still not that difficult to get opiate prescriptions in the us.
The drug war foments its own problems. The drugs aren't the problem.
Stopping drugs wasn't the purpose of the war on drugs.
Congress effort?
Congress DOES stuff?!?!?!
Alright, sorry for the dumb question, but what exactly is fentanyl and where does it come from? Why has it replaced other drugs? Why is it so cheap?
All of those questions sound easily googleable.
No thanks