(Tell me again, why are we doing this?)
"I'm no wheelbarrow!" You know, everyone says that and the louder they shout the more predictable they become and eventually the easier they are to 'set up'! You see, wheelbarrows are powerless and empty objects that are filled with 'whatever' and go wherever the 'pusher' wants it to go!
Our first world market driven, consumer culture sets us up with three primary values. These suck us into a place where we believe the following values are so important. Now we may not write them down and rehearse them, but they are powerfully reinforced in culture and if left unchecked, they end up 'bumping' other values aside, values like courage, honesty, compassion and service.
These new 'values' are...a) Is it fun? b) Is it comfortable? c) Will it make "ME"'happy'?
If a couple of these three 'biggies' aren't on the table, or at least looked at, then we tend to walk away! But what are we walking away from? And ultimately where are we gunna end up? "Who cares" may be the 'try hard' reply... well, YOU DO! Unless you're so dysfunctional and messed up of course!
ICE wasn’t Andy’s first drug – no that was alcohol. He started bingeing at only 14. After using cannabis and some heroin, and then stopping for a season, Andy commenced ICE use after the death of his mother – it motivated him to get out of bed…but sadly much more than that followed.
Andy candidly, but unemotionally shares his concerns about the poor use of drug policy and the utter madness of ‘ICE Smoking Rooms’. Check out the full interview here…
Research shows that use of tobacco, alcohol, or illicit drugs or misuse of prescription drugs by pregnant women can have severe health consequences for infants. This is because many substances pass easily through the placenta, so substances that a pregnant woman takes also reach the fetus.91 Recent research shows that smoking tobacco or marijuana, taking prescription pain relievers, or using illegal drugs during pregnancy is associated with double or even triple the risk of stillbirth.92 Estimates suggest that about 5 percent of pregnant women use one or more addictive substances.93
Risks of Stillbirth from Substance Use in Pregnancy
[Let’s juxtapose this with the NCD (Non-Communicable Disease) of Illicit Drug use – Where should our focus be on drug policy? The following article was posted in October 2020 on Lancet – Public Health. We have simply quoted it verbatim but added our commentary in bracketed inserts. Dalgarno Institute]
In The Lancet Public Health, Howard Bolnick and colleagues extend this logic in the US context and quantify the proportion of US health-care spending in 2016 that was due to preventable causes [of which drug use is a growing part].
They found that more than a quarter…of health-care spending was due to these preventable illnesses [of which drug use is a growing part].The US health-care system is famously expensive: the USA spends 16·9% of its gross domestic product (GDP) on health care, twice the Organisation for Economic Co-operation and Development average of 8·8%.
Therefore, in absolute terms, the sheer cost of these preventable illnesses [of which drug use is a growing part] is staggeringly high, estimated at US$730·4 billion in the USA alone in 2016. To put this figure into perspective, it is more than the 2019 GDP of 171 countries in the world, or all but the 19 richest countries.
While this analysis is helpful to draw attention to the costs that the USA spends on diseases that it could avoid, [of which drug use is a growing part].it is also drawing attention to a status quo that we have long come to accept: a high proportion of illness and death is preventable, and a lot of money is spent on treatment because we do not do a particularly good job of preventing disease [of which drug use is a growing part].
Why do we continue to accept such a high burden of preventable disease [of which drug use is a growing part], even when the cost of it is known? One could point to the well-trodden discussions about the challenges of prioritising prevention, the immediacy of curative approaches, and the challenge of nurturing investment in avoiding poor health, rather than investment in treatment that gratifies those who are then cured.
The very existence of preventable disease and preventable deaths [of which drug use is a growing part]. should be a rallying cry, a motivation for anyone in any health profession, and really for anyone in a position of responsibility for populations in general. The COVID-19 pandemic has shown that health can come to the forefront of conversations. COVID-19 has resulted in the entire world changing its trajectory during the course of 2020, as national governments worldwide have aimed to prevent the pandemic from spreading. This has put prevention front and centre. Can we not extend the lessons learned in the past year to bring about a permanent doubling down on prevention, putting it at the heart of our conversations on health, well beyond the COVID-19 pandemic? This would require us to embrace the notion that no amount of preventable illness or death is acceptable, and that the $730·4 billion could be repurposed.
[Exactly! If we doubled down on the prevention of drug use, rather than tripling down on the drug use empowering and enabling mechanisms of ‘Harm Reduction’ only that, for the most part only endorse the ongoing promotion of the contagion of the NCD – DRUG USE itself, we can see serious preventative movement. For instance, COVID responses by governments have seen the reduction of drug harms in certain sectors as the result of shutting down vehicles of contagion, such as music festivals, rave events, and night clubs. In these settings, harms and deaths from the NCD of drug use have reduced to zero – complete prevention in these contexts – because one vehicle of contagion (both susceptibility and exposure) has been excised from public arena. As illicit drug use has no health, social or economic benefit, and has no claim as a ‘right’ in the classic human context – but it is a harbinger of non-communicable disease, then public health responses, (not dissimilar with COVID) should be about creating mechanisms that eliminate its capacity to be a contagion, should it not? Of course we realize that social and political will in this context is ‘tougher’ to conjure as this ‘disease’ of drug use has more to do with human agency geared to egocentric, hedonistic, or self-mediating pursuits that have an ‘attractiveness’ that Covid-19 does not; and therein lies the real issue of prevention that has to be addressed! Dalgarno Institute]
Achieving this focus on prevention would require a dramatically different formulation of our global health conversation. It would require that we think about health beyond health care, and that we accept that creating health requires investments in structures that minimise preventable risk factors.
Preventing these risk factors would require an engagement with subsidising the availability of nutritious foods, disincentivising the commercial production of harmful products, [of which drug use is a growing part]. investing in early childhood education that leads to healthy exercise and dietary habits, and creating cities that encourage healthy behaviours. It would also require an acknowledgment of the role of inequalities in wealth and opportunity in the narrowing of paths to better health.
Taken from The Lancet-Public Health VOLUME 5, ISSUE 10, E513-E514, OCTOBER 01, 2020
In recent decades the range and patterns of opioids used for extra-medical purposes have changed. The use of pharmaceutical opioids exceeds the use of heroin. In 2017, 63 percent of opioid deaths were attributed exclusively to pharmaceutical opioids, 28 percent to illicit opioids and 8 percent to both illicit and pharmaceutical opioids (aged 15-64 years).
The objective of this report was to estimate the social costs arising from extra-medical opioid use in Australia for the financial year 2015/16. Due to data limitations in most cases we only estimated the costs occurring in this 12-month period. For example, on-going care of chronic conditions was not included. The exceptions to this were for certain harms which occurred in 2015/16 but which had longer-term ramifications, for example premature deaths, where discounted streams of future costs (lost economic activity and lost contributions to household chores) and partially offsetting savings (future health expenditure ’avoided’ by premature deaths) were estimated. The authors also included the long-term costs of road traffic accidents, as were the expected future costs of opioid attributable imprisonment for those sentenced in 2015/16.
For complete report go to APO - Quantifying the social costs of pharmaceutical opioid misuse
Policy Reflection – Dalgarno Institute: The misuse of OST (Opioid Substitute Treatments) or MAT (Medically Assisted Treatments) or any other pharmaceutical displacement mechanism that does not have a sunset clause to usage, will continue to be a major contributor to both morbidity and mortality. This can either occur over a longer time simply due to the toxic nature of persistent opioid use on the human biological unit; or short term, by direct misuse of the legal opioid for ‘recreational’ or self-harming purposes, by either the client or their network.
This growing issue continues to be overlooked or deliberately discounted by certain sectors. Which means that this, arguably well-meaning, but poorly implemented ‘harm reduction’ mechanism continues to add to the drug using cohort and the increasing harms this ‘pairing’ collectively bring.
The net result of a no-exit, perpetual use of opioids, whether licit or illicit, only causes harm, the very thing the policy pillar was supposed to reduce.
If sunset clauses and exit strategies are not harnessed to these chemical mechanisms, then we will only see these harms grow, along with an ever-burgeoning pressure and cost to the health-care system. This is not best practice health care, and no longer rates as a positive ‘net community benefit’ economic rationale either.
Reducing drug use is the primary objective of the National Drug Strategy, and in both its intent and specifics does not promote, or we would argue, condone this policy and people failing measure.
Drug use exiting recovery is not only possible, but consistently achieved when actively facilitated in its best practice format too.
We will leave you with a very provocative quote (now 14 years old) but perhaps even more relevant today? A statement that could have only been published then, but with the ‘cancel culture outrage’ in play at present, may well be ignored now and for the very reasons it confronts.
“The medical profession and the addicted community have a complex, symbiotic, mutually dependent relationship that does none of us any good. Basically, they pretend to be ill and we pretend to treat them. And thousands of public employees make a good living out of it. Prescribing for opiate addicts is like throwing petrol on a fire; pointless, counterproductive, stupid, self-defeating. And yet we keep doing it.”
Dr Phil Peverley, PULSE, 22 June 2006