Pubdate: Wed, 20 Jan 2016
Source: Los Angeles Times (CA)
Copyright: 2016 Los Angeles Times


Suddenly, heroin is hot. Or rather, talking about heroin, addiction, 
treatment and non-punitive responses is hot, especially among 
presidential candidates as they canvass for votes in New Hampshire. A 
standard part of this year's campaigning has been a visit with a 
family who lost a child to an overdose, or a confessional talk at a 
drug clinic.

That's because the explosion in U.S. heroin use that began about six 
years ago has hit New England particularly hard.

The nation has experienced such drug trends and epidemics in years 
past, but heroin was then generally associated (in the popular mind, 
at least) with urban areas, poverty and African Americans. This time 
it's different: Those candidate visits take place in largely white 
working-class and middle-class communities, in rural areas and small 
towns, where farming, fishing and factory-based economies have been 
devastated by a generation's worth of economic restructuring. There 
is more talk now about treatment, insurance coverage, recovery and 
family support than about arrests, crackdowns and incarceration.

That's a welcome change. It may be that as a society we have become 
more knowledgeable and sophisticated about opiates and other drugs, 
and that we have learned enough from the blindness, heartlessness and 
futility of the war on drugs - and the long prison sentences and lost 
lives it has brought-that we have chosen a different path.

Certainly, though, that old path was hewn through a landscape colored 
by race and racism. It was easy and comfortable for leaders, 
lawmakers and voters to vilify and punish black drug users - 
alongside the violent criminals who fed and profited from their 
habits. One of the most blatant race-based excesses of the time was 
the meting out of much harsher sentences for possession of equal 
amounts of crack, more often used by poor blacks, than powder 
cocaine, generally preferred by wealthier white users. The new and 
welcome spirit of charity toward white heroin addicts, as compared 
with the enduring punitive approach toward their African American 
counterparts, can be seen in that context.

In the mid-1990s, when the war on drugs and the roundup of crack 
users were at their peak, pharmaceutical companies began pushing (a 
loaded but appropriate word) physicians to prescribe a new class of 
opioids such as OxyContin with a time-release formulation that was 
attractive to sufferers of chronic pain. It may be that the drug and 
others like it were over-prescribed, or that patients failed to 
follow their doctors' instructions, or that pills were shared with 
friends or relatives without prescriptions, or that clever amateur 
chemists remanufactured the pills to circumvent the time-release 
function and pack the full effect of the drug into one powerful 
punch. Whatever the reason, tens of thousands of Americans became addicted.

A generation that grew up with Betty Ford's courageous acknowledgment 
of her addiction was prepared to address the problem with at least 
some measure of understanding. There were snickers when influential 
conservative radio host Rush Limbaugh - a savage critic of leniency 
in the drug war - was arrested after getting different OxyContin 
prescriptions from different doctors. But there was little outrage 
that he escaped a harsh prison sentence.

By 2010, drugmakers had produced, and the FDA approved, new 
painkiller formulations that were harder to abuse. It seemed like a 
smart and obvious step, but it left addicted users desperate for a 
drug that acted on them in much the same way. They found heroin. Some 
have been lost to overdose, others are struggling with addiction and recovery.

Meanwhile, the mostly nonwhite users of crack are coming home from 
prison. Too few were treated there. Many carry felony records that 
make them ineligible for most public housing or otherwise hinder 
their efforts to get back on their feet. Until recently, they weren't 
even eligible for food stamps. Their records put most jobs out of reach.

As communities in New Hampshire and elsewhere wrestle with heroin, 
and as they work to find and fund the kinds of treatment and recovery 
that families, friends and neighbors want for loved ones in the 
drug's snare, Californians would be wise to remember the treatment 
and the welcome home that a generation of other drug users never got 
- - and that they still need today.
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MAP posted-by: Jay Bergstrom