I read the letter from Dr. Kenneth B. Stoller from Johns Hopkins University School of Medicine, and I have a couple of comments ("Md. prisons need a more enlightened approach to drug treatment," July 22). Dr. Stoller maintains that medications like suboxone, methadone and naltrexone should be made available in state correctional facilities and for inmates upon release, continuing this cycle of "addiction treatment." The good doctor seems to be meshing two terms that are bandied about a great deal in topics like the one above by folks who don't know the difference. What non-addicts don't seem to understand is that no matter how much methadone or suboxone is administered to addicts, it will never be enough. The aforementioned drugs were only designed for short term use for stabilization and to mitigate withdrawal. Addicts always want to get high, and they will never be satisfied. These are people who are not only chemically dependent but addicted. Addicts only want to get high.
There is a fine line here. Chemically dependent people need the drug to function. However, addicts continue to seek to get high and not ever be stabilized. A person can be chemically dependent without being addicted. A strictly chemically dependent person will not rob, steal or worse for the next hit. The chemically dependent person's brain is not overtaken (yet) by the getting and using and finding ways and means to get more drugs. An addict is both. Addicts are driven by cravings, compulsions, complete loss of control and continued use despite severe physical and mental consequences.
Any person incarcerated who remains abstinent in a controlled environment and returns to active use and back into active addiction has not "relapsed." Relapse only occurs when an addict is attempting to work a program of recovery which is a daily concerted effort to positively change their lives in all life areas, not just abstinence from drugs and alcohol. I have seen people working a strong program of recovery while serving a life sentence. It doesn't matter whether any individual is behind bars or not. It's the state of mind and spirit in the individual which indicates recovery.
"It is time for Maryland to follow the guidance of the U.S. Department of Health and Human Services, and other enlightened states, by mandating that these medications be made available to all arrestees and prisoners based on medical necessity," he writes. What necessity? There are no deaths from opiate withdrawal. On the other hand, alcoholics in withdrawal are subject to seizures and potential death during alcohol detoxification. What about them? Most of them pay taxes, work and are seldom incarcerated as often or as long as practicing addicts. Those folks need medical management. Check the numbers.
Does the good doctor actually believe that by administering 140 milligrams per day of methadone for life is actually treating addiction? Many methadone clients abuse Xanax and similar drugs that in themselves feature life threatening withdrawal (just like alcohol). Why? Addicts only want to get high, and Xanax enhances the effect of methadone. So what the addicts are given will always be unappreciated, and of course, will never be enough.
Who pays for all that synthetic dope to be administered to self-indulgent people who will continue to find no earthly reason to treat their addiction the right way? All of the medical treatment in the world won't come close to treating self-centeredness and entitlement which are at the core of the disease of addiction. The chemical use, abuse and dependency displayed by the addict are but a symptom.
All of those "enlightened people" in other states have followed the lemmings and the pied piper into the abyss. They throw their tax dollars into a black hole. The hole gets bigger every instant. The more money it eats, the more it wants. Sounds like a familiar theme, doesn't it?
I have been in the addictions field as a certified counselor in this state for over 20 years, and I know from my own experience that "harm reduction" is not treating addiction. I have administered a highly respected treatment program and reentry services for a county health department inside of a county jail for over half of my career. I am speaking from experience and not just opinion.
The last paragraph talks about the jails' "revolving door spinning." That sounds like he believes if the taxpayers give them enough synthetic dope on the taxpayers' dime, society will no longer be burdened by the disease of addiction. If that isn't extortion disguised as "harm reduction," than what is it? Keep me medicated and I won't steal. Sounds like a demand doesn't it?
Doctors believe they know all of the answers, but all they really know about addiction is how to write prescriptions. Let's give drug addicts drugs and we'll keep the jails empty. Really? When will the doctors show some humility? I'm waiting.
George Hammerbacher, Baltimore