Re: Atheists: America's most distrusted minority

On Fri, 9 Jun 2006 21:56:13 +0000 (UTC), Kurt Ullman
<kurtullman@xxxxxxxxx> wrote:

In article <ae5j821hm4bbp89dk4os217er3af9jj4v4@xxxxxxx>,
Josh Hill <usereplyto@xxxxxxxxx> 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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