The Cost of Wide Open Hearts

I started to get interested in highlighting different themes in the “current” opioid crisis, things that I haven’t talked about to date yet.  The opioid crisis isn’t new, it just became a bigger crisis it seems to me when majority white states and soccer moms started to crash their mini vans into trees on the freeway.  The crisis of addiction has always been a problem in people of color communities, and my harm reduction newsletter reminds me of these things. Perhaps the Fentanyl crisis in the midwestern states will cause some movement to happen that didn’t happen in South Central with crack in the 80s.   “The old assumption that there is a correlation between poverty and people of color and drug abuse leaves many of the white rural families of potential addicts woefully ignorant of the signs of abuse and treatment.” At least the situation is seen as a Federal emergency which is supposed to inject more help than harm, however, some skeptical parties feel that the damage that punitive drug war tactics and mass incarceration will cause will continue to affect QTPOC disproportionately.  

Harm Reduction centers seem to espouse a social justice framework that is simply based on not letting people die or be punished for where they are currently at.  While most of the workers have been drug users themselves, even if not actual drug users, working in the trenches of harm reduction often creates its own victim/rescuer identity that creates its own psychological addiction around the endless supply of cases and placing the volunteer or outreach worker in an epidemic that will never be solved for many community members.  It becomes a new identity after one gets clean or an alternative high and crash cycle for others. This doesn’t take away from the fact that great work that often very few people want to do is still done. Joelle Puccio, who works with a lot of prenantal addicts says that automatically assuming that certain behaviors of prenantal addcts are an endemic cause and effect relationship are due to the fact that we cannot ethically study this sample of the population fairly.  “What I am saying is that there is simply no evidence to support the harms that our society blames on perinatal substance use. In scientific research, perinatal substance use is associated with negative outcomes. It is important to note that associations are not a cause and effect relationship. Good research is difficult to perform and interpret, entirely due to the legal and ethical status of substances. It is impossible to design a randomized controlled trial where you take group of pregnant people and tell half of them to smoke meth because you want to find out if it hurts their baby. Because of the threat of criminal and child services consequences, the only families that we are able to study are those that have been caught.”  

There is also more than just overdose that is costing money.  There are Hepatitis C infections
“ there is a cure for hepatitis C; the bad news is that the cheapest course of treatment costs more
than $20,000 and ranges all the way up to $90,000. “ and because users are shooting with dirty water
from toilets and rivers, they are getting infections called bacterial endocarditis which are treated at the
rate of 40-50,000 new cases each year.  It causes heart valve infections and strokes in patients that
are as young as 20-30 years old. They often have to have open heart surgery to replace an infected
heart valve. The treatment can cost up to $120,000 per patient to treat.
Sometimes patients require multiple complicated surgeries, including open-heart
surgery, with no guarantee that one will be enough if the patient can’t stay clean.  
Medical programs in some states will pay for the treatment for curable Hep C only
if the patient is clean, making their drug treatment a priority and added expense.

https://www.vox.com/2018/3/6/16453530/america-opioid
-crisis-epidemic-bacterial-endocarditis-hepatitis-c

http://harmreduction.org/blog/amplifying-hope/