July 7

The Controversy over Harm Reduction

This post originally appeared on healingrefuge.org

By all measures so far, 2020 set records for the number of people who died from drug overdoses. Last week, the New York Times reported that the Biden administration has begun to support “harm reduction” approaches in order to reduce the death toll from addiction. These include controversial programs like needle exchanges, Narcan availability, and support groups. The controversial methadone and Suboxone maintenance approaches, which replace illicit drugs with a long-acting, legal (but hard-to-kick) opioid, are also considered harm reduction, though the article does not specifically say the Biden administration supports these.

The article saddens my heart. It does so not because harm reduction is a bad thing– it is absolutely a good thing. Rather, much of what we call “harm reduction” most western nations call basic decency. Why shouldn’t addicts have access to Narcan in case of overdose, and clean needles so they don’t get hepatitis or HIV? Why shouldn’t there be testing to ensure that the drugs an addict uses aren’t contaminated with deadly chemicals?

The answer lies in our antiquated approach to addiction. Science tells us addiction is a disease. But our society, from politicians to law enforcement to the justice system, treats drug addiction as a moral problem. In essence, we say, “They chose to become an addict, they get to live with the consequences not only of their addiction but of choosing a life that gets them cast out of society.” We won’t help them. We won’t even treat them as human anymore. Nothing that could possibly enable that addiction will be provided, whether that’s a clean needle or a decent-paying job. (Many drug violations are felonies, and you can’t get a decent job with a felony on your record.) Instead, we lock them up until they’ve learned their lesson.

Imagine for a moment saying to someone who has cancer, “We’re going to lock you up until you decide to get better.” Let the absurdity of that sink in for a moment. Sure, addiction creates behaviors we don’t approve of. But if it is biological in nature, we don’t get to blame the sufferer for having it any more than we get to blame the diabetic for having diabetes. (If the diabetic robs a candy store, that’s another story. I would never say that an addict is not responsible for the behaviors they engage in to support their addiction, but they are surely not responsible for having the disease of addiction that compels them to use drugs.)

A couple of weeks ago, I went to court to testify on someone’s behalf at their sentencing. He was last on the docket, so I got to see eight other men and women sentenced. All but one were being sentenced for committing a drug- or alcohol-related offense while on probation. Every one of these struggling addicts received at least a year in jail. One man, who pleaded that he’d never been to rehab and had no idea how to stop using drugs, received six years in prison.

This is our answer to addiction: lock them up. It’s absurd, like locking up a heart attack patient. It’s cruel, dehumanizing, and alienating those who so desperately need help. And it doesn’t work. Which may be why judges are so frustrated that they’re locking repeat offenders up and throwing away the key. Some 68% of those incarcerated for drug offenses are rearrested within 2 years, so why let them out?

The most successful approaches to addiction, including the Twelve Step programs, all recognize one simple truth: someone struggling with addiction can’t quit without help. If we accept that as true, then our societal approach to addiction, which expects a person to just decide to quit and then do so, basically says, “An addict is not worth helping.” Our approach is a death sentence, because addiction is a fatal disease.

So long as harm reduction remains controversial, we are a nation that kills its sick rather than curing them. And that should be offensive to all of us. But harm reduction is just the beginning. Abstinence is the ultimate goal for anyone who has passed into the realm of addiction. My next post will explore what is needed for an effective abstinence-oriented approach, and why it is so difficult for addicts to get the help they need.

March 8

Goodbye, Facebook!

I’ve had a love/hate relationship with Facebook for years. I’ve quit, but always went back. Because the fact is, despite its inherent dishonesty, decreasing user-friendliness, and nonexistent customer service, it’s the only way to keep in contact with some of my friends.

But my relationship with Facebook is now over. They ended it. Thank you, Facebook, for doing what I couldn’t.

It began when I received an email that I had changed my password. But I hadn’t changed my password. So I immediately tried to recover my accunt, which had been hacked. The problem was, they not only changed the password, they changed the email address. After hours of trying, I finally was able to reset the information to point to me, not the hacker.

But I still couldn;t log in. Apparently, there’s a setting to require a “code generator”– I still don;t know exactly what that is– in order to log in. The hacker selected it. The problem is, according to Facebook’s admittedly vague documentation, you have to be logged in to use this code generator.

In other words, you havce to be logged in to get logged in. Yes, you read that right.

After more hours of trying to figure this pout, a friend walked me through the alternate recovery process. That involves uploading an ID, which I did. I was instructed to allow 48 hours for my account to be reset.

It’s now been over a week.

If you’ve ever tried to actually contact Facebook, you klnow it’s not possible. They have no contact links, no email address, and no phone number staffed by a person. There seems to be no way to resolve this. Their security is so good, the account owner can’t even get in!

So this is goodbye. Which means no one will ever read this post, because we all read posts on Facebook now, not on individual blogs.

Oh, well. I should probably be interacting with people face-to-face, anyway.

November 5

Don’t Make Success into a God

Stephen Cottrell writes,

“If what you’re doing is worthwhile, if you are persevering to the best of your ability, if the vision that inspires you is worth the investment of your work, your gifts, your energy, your soul, then don’t make success into a god… Do not be deterred by failure.”

These are wise words in a culture that worships success, money, and power!

(Stephen Cottrell, Hit the Ground Kneeling: Seeing Leadership Differently, London: Church House, 2008, 77-78.)

November 18

This Thing of Darkness – How I Dealt With Nightmares

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Richard showers first. I sit in a wooden chair by the window and enjoy a soft breeze that blows in off the sea a few blocks away. The mosquitoes aren’t bad tonight; the wind keeps them at bay. The smell of the ocean is mixed with night jasmine blooming somewhere nearby. This, I reflect, is a very pleasant moment. I’ve haven’t been noticing as many pleasant moments lately, and I resolve to enjoy this one for as long as it lasts.

Ten minutes later, Richard returns from the bathroom wearing a sarong, his hair wet.

“It’s all yours,” he says. “But I didn’t leave you any hot water.”

“Jerk,” I reply.

The joke is old and worn. We don’t have hot water. All our showers are cold. After a long day during the hot season, I love a cold shower. But on a cooler evening after the rain, I shiver at the thought.

I first arrived in Sri Lanka on December 6, 1993.  In honor of International Human Rights Day, Sarvodaya headquarters displayed a collection of children’s art .  The graphic images drawn by young children shocked me.  I had never before visited a place in which such gross human rights violations were a part of daily life.

My first stay took me through the uncertainty and fear of Chandrika’s death-defying election in 1994, the hope for peace that followed once the outgoing government agreed to step down without violence, the assassination by the LTTE of Chandrika’s opposing presidential candidate, and the collapse of the cease-fire in early 1995.  These events were dramatic, frightening, and impacting, but did not threaten me in any direct way.

In 1998, I returned to interview peace workers across the island.  On this trip, I traveled by bus to the eastern city of Batticaloa, which according to government sources was safely in government hands.  In reality, the government held most of the city, and they controlled the main roads in and out during daylight hours.  The rest was controlled by the LTTE rebels.  I saw things on that trip that would haunt me for years.  Soldiers herded Tamil travelers at gunpoint.  A pre-teen boy had lost both hands to a booby trap.  A woman showed me a medical report, in English, graphically detailing her husband’s torture at the hands of the government. A brave Sinhalese woman talked of risking her life in her efforts to support Tamil families who were caught between the two fighting forces.

I came back from that trip changed, acutely aware of the fragility of security.

The following year, I sat in the dark as a battle raged outside a compound near Padaviya in the northeast.  Artillery shells landed not far away, and I realized that people were dying out there and there was nothing I could do to stop it.

That’s when the nightmares started.  I returned home unable to work and afraid of social situations.  I exhibited all the classic symptoms of PTSD.

As the bus revs its engine and departs town, there’s a sinking feeling in my chest, an inexplicable sense of loss. Soon we are in the countryside, and I see why they keep the bus so well-maintained. There’s nothing out here. On either side of the one-lane paved highway, I see only empty grassland. Kebithigollewa really is the frontier. You wouldn’t want a bus to break down on this road.

Occasionally there are stretches of jungle, and even less occasionally abandoned homes. Each home has white Sinhalese letters hand-painted on its front.

“What do they say?” I ask Richard.

“Budu saranay,” he reads from the first one.

We’ve both been here long enough to know that it means “Blessings of the Buddha.”  I consider that for a moment, and realize, just as I see from his change of expression that Richard too has realized, that these are homes where someone has been killed.

I continued to work for peace in Sri Lanka for another eight years, and I sought help from therapists from time to time.

Ten years after the Padaviya trip, one therapist had me write about my experiences.  This helped so much, I wrote a story that sought to express what I saw and felt.  I showed it to a friend of mine, and he encouraged me to publish it.  He even designed the first cover for it.  That’s how This Thing of Darkness came into being.

Reader commentary of the first version convinced me that the story wasn’t finished.  It was a raw look at the emotional struggle of an unprepared man caught in a war, but the story and character development were weak.  Earlier this year, I rewrote the story and republished it.  It’s a much better story now.

This Thing of Darkness is a work of fiction based loosely on that 1999 trip to Padaviya.  Its goal is to convey the emotions I felt during my work there, from culture shock and fascination to horror and fear.  I hope it also conveys some understanding of what war looks like now that we no longer have two or more nations battling each other.  But above all, I sought to make this a good story, and I hope you enjoy it.

“I admire your courage, kid,” the priest says, as my tears begin to run dry. “You’ve got chutzpah, coming out to a place like this. You cry as much as you need to. Then we’ll go back to the others, and you can keep your dignity. You did okay.”

I nod. Then, in a shaky voice, I ask, “Chutzpah?”

McMurphy smiles.

“One of the hazards of working with a rabbi,” he says, “is that I’ve picked up a little Yiddish.”

March 21

Now Mobile-Friendly!

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I don’t know why people would read a blog from their phone.  Their eyes must be better then mine!  Nevertheless, Google wants all sites to be mobile-friendly, and what Google wants, Google gets.  So, as of today, my blog is mobile-friendly.