Text 2260, 166 rader
Skriven 2006-06-09 20:49:00 av Robert E Starr JR (2706.babylon5)
Ärende: Re: Atheists: America's m
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* * * This message was from Josh Hill to rec.arts.sf.tv.babylon5.m * * *
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@MSGID: <8b2k82hohp96an9po85bh7a9e0jm19ph94@4ax.com>
@REPLY: <kurtullman-0F6E4E.15301405062006@news.west.earthlink.net>
On Fri, 9 Jun 2006 21:56:13 +0000 (UTC), Kurt Ullman
<kurtullman@yahoo.com> wrote:

>In article <ae5j821hm4bbp89dk4os217er3af9jj4v4@4ax.com>,
> Josh Hill <usereplyto@gmail.com> wrote:
>

>> >> In fact, I've long believed that not only should we provide treatment
>> >> on demand, but allow commitment for mandatory treatment with probation
>> >> and testing. That's because I've seen again and again how people who
>> >> become addicted to hard drugs go down the tubes, watched their
>> >> families and friends struggle unsuccessfully to convince the addict to
>> >> help himself, and seen that often the only thing that leaves a Heroin
>> >> addict lucid enough to be reached is jail. Surely we can do better
>> >> than that?
>> 
>> >       Describe commitment. IF criminal charges are involved, testing 
>> >and treatment can be made part of the probation (which can't be 
>> >prolonged beyond what they would have done under probation w/o the drug 
>> >part). If no criminal charges are involved, you can't constiutionally 
>> >require treatment. 
>> 
>> Offhand, I can envisage several scenarios:
>> 
>> - An individual is arrested. Then, as you pointed out, treatment and
>> testing could be mandated as a condition of probation.
>> 
>> - An individual seeks government assistance. In that case, treatment
>> and testing could be preconditions for government assistance.
>
>
>     Generally can't do that with current programs. Can't tell you right 
>off if that is related to the legislative language (which is changeable) 
>or because of court cases saying it is discriminatory (which isn't as 
>easy to change). Also it would be REAL interesting to see if this would 
>pass muster under Americans w/ disabilities act. 

Probably not, but I've always thought that the Americans with
Disabilities Act was fairly ridiculous in that regard -- I mean, no
one in his right mind would equal opportunity hire a drug addict
because he's considered "disabled"!

Sometimes the effects of this misclassification are pernicious, as
when they decided to allow disabled residents to move into government
housing for the elderly here, and decided that that included drug
addicts. Needless to say, the addicts started stealing from and
otherwise terrorizing the old folks.

>> - A concerned third party seeks commitment. I believe this is already
>> legal in the case of minors. In the case of adults, as I understand
>> it, commitment is constitutional if mental illness causes significant
>> risk to self or others. It seems to me that a good argument can be
>> made that addiction to Heroin, crack, and meth (and for that matter
>> serious addiction to alcohol) carries with it such a risk, and I
>> believe addiction is already widely classified as a mental illness.

>         Problem with committment is that it is very term limited, 
>especially in the case of substance abuse. Generally you can only keep 
>someone until the crisis is over and they are no longer a danger to self 
>or others.  Even with regular longer-term commitments, the alternatives 
>aren't all that great. IF they somehow meet the criteria they could be 
>rehospitalized. But in civil commitment there really is not an effctive 
>stick to go with the carrot, especially in SA cases. You can't send 
>someone to jail for instance. A good tongue lashing from the man in the 
>black robe is about the best. 
>We actually have more alternatives with schizophrenia and the other 
>mental illnesses.

I wonder if a Constitutional case could be made that addiction, and
therefore the risk of harm to self and others, doesn't end after
detoxification. That would certainly accord with reality. Mandatory
testing and re-committal as necessary would then simply be part of the
outpatient treatment plan . . .

>> Finally, possession of these drugs is illegal, and while as I
>> understand it the presence of narcotics in the body isn't currently
>> considered illegal, I wonder if a law couldn't be written so that the
>> presence of high levels of drugs in the blood would be sufficient to
>> demonstrate low-level possession. I'm assuming that the blood test
>> would require a warrant which would be issued only under strictly
>> defined conditions, e.g., sworn testimony that the individual is an
>> addict, or arrest for a drug-related offense, e.g., DUI. But haven't
>> really thought out the implications.
>> 
>    Probably could be if you could get some sort of agreement on what 
>constitutes "enough" and how to test. There are plenty of qualative 
>tests, has anyone taken anything at any place over a certain period of 
>time. Fewer usable quantative, how much they got on board RIGHT NOW.

I agree that that's a problem. One would need some kind of objective
metric of addiction. Perhaps, in the case of Heroin, a blood test
coupled with observation of withdrawal symptoms. Not sure what you
could do in the case of crack or methedrine, since the withdrawal
isn't physical and AFAIK there's no practical way to distinguish
objectively between occasional and chronic use, or between powdered
cocaine and freebase.

>> >    We probably can't do better than that in real life, since it is the 
>> >PERSON and not the system that is the restraining variable. You can lead 
>> >a person to sobriety, but you can't him not drink (to coin a phrase). 
>> 
>> But is that so? I've seen some people stop using even the likes of
>> crack after spending a few days in jail. Consequences do matter, and
>> the drug addict typically needs lots of bad ones to counteract the
>> pangs of withdrawal and the pleasures of use.

>       The bottom is VERY individualized. I know of a friend of mine 
>that swore off entirely the first time a cop stopped, and he was just 
>barely not drunk (that time) I have a patient I worked at the hospital 
>who was 45 years old, had 150 arrests for public intoxication, a really 
>bad liver and was still drinking heavily. Thus you can lead, etc. People 
>won't stop any kind of addictive behavior until they hit THEIR bottom. 

I've seen the same thing. One person I know spent a single night in a
drunk-driving unit for DUI, and that was enough to put a stop to his
alcoholism. He said one guy there had been sentenced to a year because
he kept getting arrested.

>> Those who failed their probationary tests would spend time locked away
>> in mandatory treatment, which would likely cost the government less
>> than the cycle of crime and jail while being less brutal to the addict
>> and less likely to spread HIV. And while they were in rehab or
>> straight, the addicts wouldn't get their friends started, selling
>> drugs, or giving money to the dealers -- which would mean fewer
>> dealers trying to hook people. At some point, I like to think that
>> you'd overcome the broken window syndrome.
>
>  Won't work. See above. You'll just get people saying what they think 
>you want to hear to get out. Or they might actually think about it and 
>be willing in the program, but soon break down under the strain of 
>respectability when they get out. Also, unless part of criminal 
>probation you can't mandate locked treatment. I can see possibility of 
>it being more expensive because this kind of treatment is REALLY 
>expensive.

I was thinking in terms of commitment on the basis of a formula -- no
subjectivity involved. It wouldn't be just the treatment that provided
the benefits, but the ongoing testing and the threat of re-commitment.

Since drug treatment programs don't seem to be all that effective
anyway, I'm not sure that you'd have to provide too much by way of
counseling, group therapy, and rehabilitation. But even a bit of it
would be much better than what addicts get in jail, particularly if it
were combined with some kind of supervised half-way situation. I've
seen addicts dumped on the street out of treatment facilities and
jail, and if they no longer have a family and friends willing to
support them, that can in itself can be a near-guarantee of failure,
since they're still messed up and forced to turn to their drug-using
friends for support.

-- 
Josh

"I'm not going to play like I've been a person who's spent hours involved with
foreign policy.
I am who I am." - George W. Bush
                                                                               
                                
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