• Toward treatment
    May 13,2014

    One of the significant accomplishments of the recently completed legislative session was the creation of a program to divert criminal defendants toward drug treatment and away from prison.

    The program was patterned after a similar program in Chittenden County that brings personnel into the process to weigh the risk posed by a defendant who is charged with a drug-related crime and to assess his or her needs.

    The bill was the Legislature’s response to Gov. Peter Shumlin, who captured national attention when he devoted his State of the State address in January to the epidemic of drug abuse in Vermont. There is a wide consensus in the law enforcement, health and political communities that the state cannot arrest its way out of the drug problem and when drug users are charged with a crime, they are especially susceptible to the appeal of treatment programs.

    The new program was accompanied by tougher penalties for those caught trafficking heroin into the state. Thus, the state is easing up on the user who can use help to get free of drugs while getting tough on the dealers who are exploiting the addiction of the user.

    Wide attention to Vermont’s drug problem briefly trained the national spotlight on Rutland, which was highlighted in an article in The New York Times. But other recent stories in the national press have shown that Rutland is far from alone, and the struggle to confront the problem of addiction is a difficult one.

    The Sunday New York Times Magazine focused on Hazelton, Pennsylvania, a city of 30,000 that is a highway crossroads and a hub of the drug trade. As depicted in the story, the city has suffered the kind of decline that has afflicted many Eastern cities. The terrible struggles of one young woman who is addicted to heroin show the difficulties faced not only by the addict, but also by anyone trying to help her.

    The woman was able to obtain the heroin she needed by selling it on behalf of her supplier. When the police got hold of her, they persuaded her to help them arrest the supplier. Eventually, she headed off to jail, which she hoped would help her confront her addiction.

    Ultimately, we don’t know whether she will become a lost soul, a fatality or a hopeful example of recovery. Providing an actual program, rather than a waiting list, to help addicts get clean, with the added incentive of a criminal charge hanging over their head, improves the odds that the individual stories will end up as stories of recovery.

    Another recent story, this one in The New Yorker magazine, details the way the opiate crisis took off in the area of Wichita, Kansas. There a doctor who appeared naive and ignorant freely overprescribed opioid pain killers, leading to the deaths of numerous patients. He and his wife, who managed his clinic, ended up in federal prison for their indiscriminate distribution of the drugs.

    It is widely understood that oxycodone and other pain killers have created an addiction that has led to the heroin boom in Vermont as in Wichita. Heroin, it turns out, is cheaper and more easily available than prescription drugs. The story from Kansas shows how changing attitudes toward the treatment of pain and aggressive marketing by drug companies have combined to persuade all too many doctors to overprescribe dangerous opiates. The doctor in Kansas specialized in low-income Medicaid patients who were unable to get effective treatment for their pain. As a substitute for meaningful health care, they received addictive pills.

    Vermont’s medical establishment is working to create procedures that will help limit the over-prescription of opiates, but new attitudes about pain have led some patients to believe they are entitled to pain killers. Thus, the scourge of drugs is a broad social problem. By helping criminal defendants find the doorway to recovery, the Legislature, at Shumlin’s instigation, has taken an important step to address that scourge.

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