Harm reduction

[wenglund]

A pattern emerges from the answers to my OP: people who have first-hand experience with drug users and/or HiV/HepC tend to favour the harm minimisation approach, while those who argue only from logic and conjecture without the benefit of experience tend to dismiss it outright.

I too, have close relations with drug problems. The emerging pattern as I see it is emotionalism vs reason.

Thanks, -Wade Englund-

[wenglund]

Fascinating discussion. How can we break this down to show influences from Mormon theology...

I think the folks that say consequences are there for a reason, that clean needles equate to enabling drug usage, etc. really connect with Jehovah of the Old Testament. That God is big on punishment and reward. If you slip and touch the Arc of the Covenant, too bad, you're still get zapped. It doesn't matter if it was an accident. This is the God of Tough Love: "Hey, Adam and Eve, go make your way in the cruel wide world. By the way, I made mosquitos just out of spite and you don't get indoor plumbing."

I see the people that lean towards harm reduction, i.e. "People are going to use drugs. Let's at least give them clean needles to minimize their stupidity.", these people tend to go with a Christ of the New Testament "Love the sinner, not the sin" sort of thought.

I see Joseph Smith handing out clean needles, but Brigham Young no. What do you guys think?

I think your rose-colored glasses may be distorting your view. JS and Christ were about offering viable solutions to overcoming sin, not enabling the sinner in their sin.

Thanks, -Wade Englund-

[Nathair/|\]

Yep, most people here speak from a factual basis of 0. The compassionate ones have been there or a near relative has. I was strung out pretty good 25 years ago. I went to my new bishop (I kept moving to try and run from myself) for help, prayer, a blessing or something. All I got was "come back when you are clean". I was lucky to survive long enough to get clean. Actually, Heavenly Father saved my life several times so it wasn't really luck. Of course harm reduction helps the person live long enough (hopefully) to get clean and not spread disease to innocent victims. Harm reduction can simply be a friend who is addicted to heroine keeping another friend from using that particular drug. My junkie friends would not let use no matter what, we could smoke and snort anything else but no H. I thank them to this day for that.

Enough personal stuff, here are a few points.

1. Most drug addicts don't want to be addicted. They are well aware that they are on a path of destruction but they can't stop anyway.

2. Most drug addicts will only go as far as their moral upbringing to secure the next high. If they are not thieves to begin with, they won't start stealing to pay for it. If they are not promiscuous to start with, they won't start hooking to pay for it, etc..

3.They are among you. They are driving on your hiways to their next score, working in your offices and working on your construction sites. They are regular people with a huge problem. I hid my problem for years.

4.Harm reduction would include flop houses and legally obtained drugs. We are losing the drug war. Making all drugs legal would eliminate the black market and all the gang warfare that goes with it. When is the last time you heard about a smuggling war over booze? All of the law enforcement efforts that are now being used in the drug war could be aimed at border protection and anti terrorism efforts.

5.The money saved from the drug war could be used for rehabilitation for those that desire it. Interventions work, kind of like you see on TV. It has to be family members and friends that care. The person, yes we are people, has to desire to be clean first. The gospel is very important and comes with the 12 step program. I've reviewed the LDS program, I wish we had it back in 1984.

6. It's an endless battle, it may take 2 or 3 interventions until it sticks. The person may channel his addictive behavior towards less damning drugs.

I smoke and drink coffee, I struggle with the coffee and sometimes do well. I wake up every morning and tell myself that cigarettes are going to kill me but I still can't quit. The desire to get a TR will ultimately be my motivator. As bad as it seems, when ever I think of doing a big ol' line of coke or meth it makes me want to puke. I am so thankful for that healing from Jesus Christ that I'd like to help anybody any way that I can. Feel free to PM me.

Thank you for sharing this. I can't imagine how hard it must be to be where you are. For what it's worth, when you go to the temple, my heart will be there with you. Welcome home, brother, It's good to have you back.

[Bernard Gui]

amm... for the sake of argument, yes.

Needle distribution is namby-pamby. If we want to reduce harm, we need to get serious.

My scenario is far more humane. No one gets harmed. The addict gets to enjoy their addiction at state expense.

Well, look at what prevents people from using drugs. What prevents an M.D. from himself using drugs? What prevents most people from using drugs? What prevents YOU from using drugs?

Me? I have made covenants not to. Also, I've been scared to death by what I've seen first hand.

That is if you do nothing to help them get out, something which I don't advocate.

There is nothing you can do to help them get out. Death of the addict is the natural solution.

Again, what prevents those that do not use drugs from using them?

Self-control or fear.

Not state-owned but privately owned.

Privatizing liquor stores reduces alcoholism? How is that?

Bernard

[LeSellers]

some of the first replies were "I have no idea what you are talking about". That is sad, and shows a lack of willingness to learn anything related to drugs.

I plead guilty, as I have no need or desire to learn anything about drugs.

There are millions of things I could learn about, and I am learning about many of them day by day, but this is one topic on which I have no motivation to educate myself. If, in the future, the motivation appears, I will attack the subject.

We are all faced with the limited resource of time, so it is not helpful to complain if others do not share your passions.

Lehi

[LeSellers]

My scenario is far more humane. No one gets harmed. The addict gets to enjoy their addiction at state expense.

Someone does get hurt: the taxpayer.

There is no such thing as "state expense. the state has no money (or anything else) it does not confiscate from someone first (or later, when borrowing).

Why should the addict get to "enjoy" his addiction? And, above all, why at my expense?

Lehi

[Bernard Gui]

I believe this is so true. I don't have answers for anyone. My son is a heroin addict. It has destroyed his life, and has almost destroyed the lives of the family members who have tried to help him. My wife is damaged because of his choices. So am I. There are no easy answers. But the one thing I do know, that condescending, self righteous judgment will not help the situation. It turns people away.

A clean needle is better than a dirty needle. I would do that for my son to prevent further damage.

Is there an LDS 12-step program for family and friends of addicts in your area?

If there isn't, you can start one. It is extremely helpful.

Bernard

[Bernard Gui]

Someone does get hurt: the taxpayer.

But that hurt is less than paying for the havoc created by uncontrolled drug use.

There is no such thing as "state expense. the state has no money (or anything else) it does not confiscate from someone first (or later, when borrowing).

We all pay for drug abuse now and later.

Why should the addict get to "enjoy" his addiction? And, above all, why at my expense?

We're trying to find the most compassionate approach, right?

Bernard

PS. I hope you can sense the sarcasm in my suggestions.

[species373]

Ha!

Wade, you silly guy... my rose colored glasses indeed.

You must be a Jehovah fan.

[elguanteloko]

Ha!

Wade, you silly guy... my rose colored glasses indeed.

You must be a Jehovah fan.

Please, I beg you guys to keep this respectful.

[LeSellers]

I hope you can sense the sarcasm in my suggestions.

Missed it entirely.

Lehi

[nicolasconnault]

I plead guilty, as I have no need or desire to learn anything about drugs.

There are millions of things I could learn about, and I am learning about many of them day by day, but this is one topic on which I have no motivation to educate myself. If, in the future, the motivation appears, I will attack the subject.

We are all faced with the limited resource of time, so it is not helpful to complain if others do not share your passions.

Lehi

Why did you even reply to the OP then? You must have had some interest in the discussion that ensued? I am not passionate about drug users, but I don't keep my eyes shut and pretend the problem doesn't exist, or even that it may affect people I love and am close to. Anyone in the LDS Church with a responsibility over adults is likely to have within their stewardship people who are caught in the cycle of drug use. What would the Saviour do? He also had limited time and resources, didn't He?

[nicolasconnault]

Someone does get hurt: the taxpayer.

There is no such thing as "state expense. the state has no money (or anything else) it does not confiscate from someone first (or later, when borrowing).

Why should the addict get to "enjoy" his addiction? And, above all, why at my expense?

Lehi

Have you thought that, perhaps, the drug user to whom you allude may not have chosen to become addicted, and is now unable to break the addiction? Have you thought that perhaps not everyone is born within the same circle of beneficent influences and friends as you may have? Do you really believe that all drug users have gone out of their way to get themselves addicted, just to get a kick and "enjoy" themselves?

As you hinted, you don't seem to know anything about the subject, and you don't even want to learn, so it baffles me why you are making these comments.

[Bernard Gui]

Missed it entirely.

I apologize. I go crazy when the conversation turns to drugs. I have zero tolerance.

1 year minimum bootcamp for addicts, or until clean and sober.

Military solution for dealers, transporters, and producers. Nukes if necessary.

On this I am serious.

Bernard

[nicolasconnault]

I apologize. I go crazy when the conversation turns to drugs. I have zero tolerance.

1 year minimum bootcamp for addicts, or until clean and sober.

Military solution for dealers, transporters, and producers. Nukes if necessary.

On this I am serious.

Bernard

LOL. So dealers, transporters and producers all live in a nicely defined geographical area, and are all worthy of death? Sometimes I wish this forum was a bit more cosmopolitan in its pool of participants...

[toon]

Have you thought that, perhaps, the drug user to whom you allude may not have chosen to become addicted, and is now unable to break the addiction? Have you thought that perhaps not everyone is born within the same circle of beneficent influences and friends as you may have? Do you really believe that all drug users have gone out of their way to get themselves addicted, just to get a kick and "enjoy" themselves?

As you hinted, you don't seem to know anything about the subject, and you don't even want to learn, so it baffles me why you are making these comments.

One of the most common groups of drug addicts are those whose addiction is not the result of recreational drug use. Prescription pain medications are often as strong as the most potent street drug, and many become addicted through either intentional or unintentional misuse. I even know people who have become addicted by simply taking what their doctors prescribed. Some move on to street drugs, and some do not, but at some point, it's debatable whether moving on or misuse is volitional.

I'm curious what else would be considerd harm reduction other than needle exchange programs. Methadone? Suboxone? I had a friend who needed to check into detox and rehab, but the preferred hospital didn't have an open bed for a few days. In the meantime, I monitored his condition and dispensed the drug at regular intervals in order to prevent withdrawal symptoms until the bed opened up and he could be checked in and properly monitored. Is that harm reduction?

[elguanteloko]

As expected, you are mistaken. See footnotes 22 to 32.

Thanks, -Wade Englund-

Oh, to be honest, I thought you were only talking about the quote your provided from the wiki article that does not include a source (the one you quoted in post #64). Anyways, let's focus on the wiki article that contains footnotes 22-32.

The 2004 review by the World Health Organisation (WHO)^[22] on the effectiveness of needle exchanges in the prevention of HIV transmission has been considered by supporters of needle exchange to be the most definitive review up until that date ^[23].

It starts like this and it seems like this actually supports my position. It continues....

However the WHO review contains serious errors which when corrected nullify its claims of demonstrated effectiveness as follows. The WHO review had found 11 journal studies on needle exchanges which demonstrated sufficient scientific rigor to judge effectiveness or otherwise, and had judged 6 of the studies to show a positive result for needle exchanges regarding reduced HIV transmission. Three returned a negative result (i.e. increases in HIV in needle exchange populations), and 2 were inconclusive. Of the 6 studies judged positive, the 1993 Heimer et al. study did not measure HIV prevalence among IDUs but only in returned needles, which can not be directly translated into a population and therefore should not have been included. The 2000 study by Monterosso and co-workers was misclassified as positive for NEP, whereas in fact the result was statistically non-significant and should have been labelled inconclusive. The purportedly positive 1991 Ljungberg et al. study had found HIV seroprevalence in Sweden

[nicolasconnault]

Something else people might not be aware of: needle exchange facilities do not just provide free needles. They also provide additional equipment, some of which at a marginal cost: spoons, filters, tourniquets, sterile water for mixing, needle disposal containers, post-injection cream etc.

On a different note, people who proclaim that drug addicts must simply stop sinning and all will be alright might want to consider their own self-destructive habits, and wonder whether they are willing to cast the first stone... It's not that easy to stop sinning.

[CV75]

The Gospel of Jesus Christ truly is the only solution to all the world's ills in all their complex interrelationships. The solutions we come up with on our own are simply insufficient and create collateral problems we do not foresee (just as obedience to God's law creates collateral blessings we do not foresee). That is why those who hold the keys concentrate on promulgating the Gospel and little else.

In making (or, as in this case, debating) public policy, there are winners and losers, both pushing solutions with their own merits and failings; the policy is then either accepted or imposed, depending on the perspective of the citizen. Even something as innocuous as fluoridated water has its detractors, and the money spent on it may prevent another benefit more sorely needed by someone else. Even something as controversial as Proposition 8 may simply be the lesser of two evils when considering some of its more exceptional and indirect ancillary effects, unintended consequences, etc. upon individuals. But in accepting the Gospel, everyone becomes a winner.

[nicolasconnault]

The Gospel of Jesus Christ truly is the only solution to all the world's ills in all their complex interrelationships. The solutions we come up with on our own are simply insufficient and create collateral problems we do not foresee (just as obedience to God's law creates collateral blessings we do not foresee). That is why those who hold the keys concentrate on promulgating the Gospel and little else.

In making (or, as in this case, debating) public policy, there are winners and losers, both pushing solutions with their own merits and failings; the policy is then either accepted or imposed, depending on the perspective of the citizen. Even something as innocuous as fluoridated water has its detractors, and the money spent on it may prevent another benefit more sorely needed by someone else. Even something as controversial as Proposition 8 may simply be the lesser of two evils when considering some of its more exceptional and indirect ancillary effects, unintended consequences, etc. upon individuals. But in accepting the Gospel, everyone becomes a winner.

That's very laudable, but a bit utopic. The Gospel of Jesus Christ will never be accepted by everyone, this is the old problem of evil. I would love everyone to accept the gospel of Jesus Christ, however I know that not everyone will. In the meantime, I want to protect those that do from those that don't, both from physical and spiritual harm. This may include helping the source of harm become less harmful, and hopefully get in contact with them so that they too can hear the gospel of Christ and accept it.

My other question is this: are drug addicts worth converting, and, if yes, how do you suggest they should be approached? What is the point of contact during which the opportunities will arise? Should we wait for them to grope and find their own way to the local meetinghouse, or for the missionaries to stumble on them? Are you likely to come in contact with them in your everyday actions?

You can either ignore that these people even exist, dismissing them as "someone else's problem", or you can actually grab hold of the opportunities (or create them!) that the community provides for getting close to them. Needle exchange programs are one such opportunity. I haven't heard a better idea on this thread yet, but I've read a few answers that sounded like "Am I my brother's keeper?".

[Deborah]

You can either ignore that these people even exist, dismissing them as "someone else's problem", or you can actually grab hold of the opportunities (or create them!) that the community provides for getting close to them. Needle exchange programs are one such opportunity.

No one is advocating ignoring those people. For those who've had first hand experience we've tried all kinds of things, even locking a loved one up for their own good. But you soon realize until they want to change they won't and you'll just keep going through the same old cycle. You reach a point where you have to let go and leave it in the hands of the only one who can really help, the Savior. I just think the needle idea is oversimplified and for the sole purpose of making some people feel good that they are really doing something good when in the long run they may be prolonging the problem.

[Jason]

In a letter to Nancy Rigdon after she declined his marriage proposal, Smith wrote:

"That which is wrong under one circumstance, may be, and often is, right under another.

[Jason]

This is working under the assumption that, overall, giving people free syringes increases drug use... that is not true. http://drugwarfacts.org/cms/?q=node/66

The studies showing that giving out needles does not increase drug use are quite simply wrong.

[semlogo]

The studies showing that giving out needles does not increase drug use are quite simply wrong.

CFR

[Jason]

CFR

Personal experience while on my mission, which was in the Netherlands, one of the most liberal nations in the world with regard to drugs. There is a park in several cities (especially Amsterdam and Rotterdam) across from the central train station where needles and sometimes methedone were given out freely with no questions asked. The same people are there every day, with no motivation to give up their addiction. Why should they? It's safe now, and they have tacit government approval of their habit. Everybody does it and no one complains.

Just about every city in the country has a hash bar where you can buy marijuana and smoke it. Some cities have a hash taxi that performs home delivery. I learned to recognize the smell of marijuana and avoid the homes where it was being actively used (because there is no point trying to bring the Spirit into such a setting).

The poor in that country labor under their addictions because of the Dutch tolerance of all kinds of destructive behavior and their compassion - which while admirable in its intent is ultimately misguided and unhelpful to those whom it seeks to aid, usually merely prolonging the time before they get into real trouble. Many, many people are just surviving, with no desire to do anything, no real prospects for the future, and no reason to care.

And for the record, while I have never struggled with illegal drug addiction myself I do have personal experience with addictive behavior. I can speak from personal experience that enabling an addiction while trying to make it "safe" does more harm than good.

I will not go into any further details.