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Children of the Opioid Epidemic (nytimes.com)
66 points by dsr12 on May 12, 2018 | hide | past | favorite | 42 comments



I feel a great deal of sadness and sympathy for drug addicts when I think about them, and a great deal of resentment and anger at drug addicts when I think about the other people in their lives.


i can understand this sentiment, but there are many mental illnesses that bring pain to the people around the afflicted. why do we single drug addicts out for judgement?

anecdotally, i have seen that the ones that recover do not succeed through willpower or strength of character. the main factor is the strength of their support network. it is not a moral deficiency.


No drug addict is an addict due to moral deficiency? I find that people's individual circumstances vary dramatically.


Some people simply don't get addicted to the same drugs despite similar usage habits as others. So I suspect susceptibility to addiction is almost purely a function of biology.

That's not to say people can't get past the handicap, but IMO it's not even close to a level playing field.

Personally, I have zero attraction to alcohol and drink something like 3-5 times a decade. However, even a brief exposure to cigarettes as a teen as in less than a single pack was enough to get a very strong craving. I responded to that by avoidance, but even 20 years later I still have a craving it simply never went away. However plenty of people have the reverse reactions with heavy alcohol addiction.


i can understand this sentiment, but there are many mental illnesses that bring pain to the people around the afflicted. why do we single drug addicts out for judgement?

At some point a drug addict, predisposition and circumstances aside, had to make a choice to start taking drugs. Someone with a mental illness never chose to flirt with mental illness, they’re just mentally ill.

Now, I also have a lot of sympathy for drug addicts, because we can’t ignore predisposition and environment, but it was still, somewhere in their past, a matter of choice. I don’t think that means we should hang them out to dry, but it’s not quite the same as someone who was just born sick. Of course that does exclude the hefty portion of the drug addicted populace who found their way to drugs as the result of a mental illness...


Talking about environment, I saw a very good quote by a woman named Tine Brubak Jahren, that I have taken the liberty to translate to English:

"It's odd when it comes to sympathy for drug addicts: Everyone has much sympathy for sexually abused children, children of drug addicts, victims of violence and abuse, people with mental health issues that are not helped by the system. BUT, when they grow up to become dysfunctional adults that use drugs to take away the pain and their problems, then it is suddenly full stop for the sympathy.

Suddenly, they are expected to take charge of their lives and behave like everyone else, and if they can't do that, there is no lack of suggestions such as sending them to desolate islands, forced sterilization or simply locking them up for life."

She makes a great point, that also highlights the absurdity of using fines and prison for addicts. The system essentially punishes them for something the system has predisposed them to.


I agree with the conclusion, but the problem with perception is that no sexually abused child or child of an addictt ever made a choice to be that child. 100% of the time, they’re purely victims. A lot of drug addicts are the same way, but quite a few are also people who enjoyed doing drugs until it got the better of them. They’re not all abused children or mentally ill, some are just drug addicts. The result is that you can be unreservedly sympathetic with abused children, but need a bit of background to feel the same sympathy for an addict.

Now, I’d argue that either way treatment and support is the answer, not jail. I’d also argue that the addicts who were screwed over and over into addiction are enough of a majority that we should give all addicts the benefit of the doubt. However I also understand the perspective of people who have been urned by those addicts who are just selfish assholes, and can’t manage that. They shouldn’t set policy, but they’d have a valid view too.

tl;dr All victims of child abuse are victims, some drug addicts are only victims of their own poor decisions.


Except that twin research shows that drug use and progression from light drugs to hard drugs to addiction is largely from genetics: https://archives.drugabuse.gov/news-events/nida-notes/twin-s...

Some quotes:

> "The progression from the use of cocaine or marijuana to abuse or dependence was due largely to genetic factors."

> "The genetic influence for abuse was greater for heroin than for any other drug."

Different paper: https://onlinelibrary.wiley.com/doi/pdf/10.1002/978047001590...

"For instance, it is estimated that 50–60% of the variation in risk for alcoholism is accounted for by genetic factors."

Now add this on top of the stuff that affects you growing up you can't control.

Saying, "enjoyed doing drugs until it got the better of them" ignores that whether or not you're going to be driven towards drugs is largely determined before you're even born.


> At some point a drug addict, predisposition and circumstances aside, had to make a choice to start taking drugs. Someone with a mental illness never chose to flirt with mental illness, they’re just mentally ill.

as you point out later in your comment, there is significant overlap between drug addiction and other mental illness. it seems unfair to make the "original bad choice" argument in regards to people who didn't start off with a sound mind.

i see a couple other issues with this common indictment of addicts. many people use alcohol without negative consequences, and it is considered acceptable to do so. are you going to go back and fault an alcoholic for taking the risk of having a first beer? another issue (and i believe this may be controversial) is that addiction as a mental disorder may exist in some latent state well before a person ever tries a drug. if so, the question is less "will they become addicted to drugs?" and more "if not drugs, what will they become addicted to instead?".

my final objection is that drug addiction is not particularly unique among mental disorders in that it is possibly caused/triggered by an initial poor choice. explicit decisions (like deciding to try/use drugs) and more general lifestyle are significant risk factors in many mental illnesses (e.g. depression, schizophrenia), but people with these afflictions receive sympathy that is far less conditional.

my personal take: we see addicts behave in ways that appear irrational and antisocial. when we are close to them, it causes us immense emotional pain and it can cost a lot of money to help them. we resent that they seem to be blissfully high while we clean up their messes. there is not a whole lot of incentive to understand how it isn't their fault. the less we can blame them, the harder we find it to draw the line where we can feel okay about cutting them off.


> but it was still, somewhere in their past, a matter of choice

what about people who were just obediently following their doctors' prescriptions?


This is one of the most beautiful and hopeful articles I've read in a long time. I was expecting a depressing read but was delightfully surprised.


To get an idea of how the New York Times depicted children of a drug addiction epidemic when it was black children affected, see here:

CHILDREN OF CRACK: ARE THE SCHOOLS READY? - A SPECIAL REPORT: Crack Babies Turn 5, and Schools Brace

https://www.nytimes.com/1990/05/25/us/children-crack-are-sch...


Although it has been 27 years since then. I would hope the same article would be written differently today.


27 years and the heroin epidemic has broadened to poor White people


It would be nice if an approach with such a humanitarian tact used in the OP's article were used back then. Hopefully we continue to grow in such a way.


The article points out that race has a lot to do with how these two epidemics of addiction were portrayed.


New York times is 35% racial think pieces now. I tapped out.


*the New York Times of almost 30 years ago


And the result policies are with us till today. It was influential journal that shaped how people got treated and current culture, racial divisions, activism etc etc were influenced by that.


> It was influential journal that shaped how people got treated and current culture, racial divisions, activism etc etc were influenced by that.

Alternatively, we were already hard on drug addicts and it was reflection of the time. Fast-forward to present day, we've been steadily shifting towards a more reasonable approach towards drugs, slowly but surely.

It's also well established that the black community was for the harsh laws of the crack epidemic, having believed it would help end the crisis by keeping criminals off the streets. In that light, the results start to look more as a result of unintended consequences than some type of modern-day chattel system as implied by present-day activists.


> It's also well established that the black community was for the harsh laws of the crack epidemic

What does 'black community' mean here? Is there such a thing as a representative body that speaks for all blacks and this is what they were asking for? Or did people go out and ask a few black people who were felt to be community leaders, or was it done by a survey?


Yep. Acting as if there was one monolithic black community position is extremely problematic.

> The debate leading up to passage of the laws in 1973 was fierce, exposing rifts within the community. Some black lawmakers dismissed Gov. Nelson Rockefeller's black allies as "palace pets." Others, like Brooklyn’s Vander L. Beatty, one of the top black legislators at the time, said the Rockefeller laws didn’t go far enough. He wanted the death penalty.[1]

It's also problematic to equate wanting tougher laws for dealers with wanting tougher laws for simple possession, or the heroin epidemic with the crack epidemic, or New York with America. There is a point to be made that we sometimes have too simplistic a narrative in our heads, but the solution isn't to replace it with another overly simplistic narrative.

[1] https://www.wnyc.org/story/312823-black-leaders-once-champio...


> What does 'black community' mean here?

Leaders of prominent groups that promote / lobby for African-American issues, one would assume.

To be frank, your response reads like a "No True Scotsman" - could I not just write off Black Lives Matter as "Not representative of the black community" then? Who are those activists to say what the real problems are?


Alternatively, we were already hard on drug addicts and it was reflection of the time. Fast-forward to present day, we've been steadily shifting towards a more reasonable approach towards drugs, slowly but surely.

The only time there is a more "reasonable" approach is when it is happening in the burbs with prescription pills and "rural" areas. They are still more than willing to lock up "inner city thugs".


Is it more reasonable because it's white folks, or because we've evolved our understanding?


Statistically. Blacks get longer prison sentences for the same crime as Whites.

https://abcnews.go.com/Politics/black-men-sentenced-time-whi...


They argued also for social services which they did not get. They did argued for tying criminality with blackness either.

Every single thing and act is product of it time in same sense. People have no agency nor choice nor make decisions in such view of world.

20 years old 30 years ago are 50 years old now. The people who were shaped by these things are the ones ruling world now and it influences their reactions to events now. Including reactions to youth activism which is, again, reaction to their policies.

What I am saying is that it is not distant past 2000 years ago, it is recent past very relevant to now.


You're making salient points, but it's being undermined by grammatical errors.


It was never well established the black community asked for harsh punishment. That was only dreamed up by right wing media to justify continued racist criminal justice policies. If someone asks for a glass of water you don’t strap them into a chair, waterboard them, and then say “it’s what you asked for.”

The black community asked for basic policing to be done. What they got was mandatory minimum, 3-strikes laws, escalated drug charges, and stop and frisk.

Those long active activists have got it exactly right. Only conservative media and politicians have created a new narrative of unintended consequences because of how obviously racist their racist policies were being seen.


Nixon’s counsel for domestic affairs, John Erlichman, later said:

The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn't make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.

IOW the War on Drugs is based solely on an obsolete, sinister political agenda.


I don't dispute the War on Drugs is founded in partisanship and racism. However, it is worth pointing out that it was supported by many, including those from the communities most negatively impacted.

Folks need to stop trying to repaint it as this purely right-wing racist conspiracy and attempting to wield it as some type of political cudgel. We need reform, badly, and attempting to turn this into a wedge is bullshit partisan politics.


> That was only dreamed up by right wing media to justify continued racist criminal justice policies.

From Slate, a left-wing publication:

> Well, in 1973, in New York, many black activists pushed for drug laws, and in the ’80s many black activists pushed for punitive crime policies and supported aspects of Ronald Reagan’s war on drugs. When Reagan signed the Anti-Drug Abuse Act of 1986 into law, the one that created the crack-cocaine disparity, Charlie Rangel was onstage with him. And at the time they pushed this because they thought previous policies were not doing the job and that they needed to get tougher on the drug problem in urban communities. And as the drug problem worsened, many of them continued to push for more punitive policies and more aggressive policing.

http://www.slate.com/articles/news_and_politics/crime/2016/0...


We are reading different parts of the same article. The interviewee even stressed that the bill they supported was not the one they asked for.

“What is often missed, however, is that most of those black activists and politicians weren’t asking only for toughness. They were also demanding investment in their schools, better housing, jobs programs for young people, economic-stimulus packages, drug treatment on demand, and better access to healthcare. In the end, they wound up with police and prisons. To say that this was what black people wanted is misleading at best.”

https://www.thenation.com/article/hillary-clinton-does-not-d...


I find this hard reading, the seeds of tragedy sown early.

How many children are abandoned to poor parenting - and is there a fix?

I know this is somewhat SF utopian but I keep banging on about "MOOP" - massive open online psychology. the idea that we are monitored day in day out by our phones, listening to us and our interactions, the actual useful data that could be extracted about our psychology, our behaviour and how to improve it is immense (yes the risks huge - but that's why it should be open)

anyway - imagine a fridge that says "don't eat the chocolate" or a phone that's says "don't take the opioids"

Or a phone that's suggests new ways to talk with your children.


When you're a technologist, all problems look like technology problems I suppose.

My own solution to poor parenting isn't any more appealing, mind you. If meritocracy is desirable in a society, and parents have such a huge effect on the opportunities and potentials of their children, then the obvious solution is to do away with parenting. All children would be raised by trained experts and parents would, ideally, never know who their children are. They'd all have medical care, food, shelter, schooling, and other things that many children are currently deprived of because they simply fell out of the wrong womb. With this approach, having children is no longer as life-altering an event as it is currently, so abortion should be less frequent. Another advantage is that you can move the children around frequently, exposing them to many different regional cultures and other children from all over the country, broadening their understanding of the nation and its people.

Obviously there are disadvantages, not the least of which is that human nature makes the whole concept completely non-viable because very few people will accept the idea of not raising their own children. Worse, the idea that the state is solely in control of their education is downright horrific to some, and the inevitable homogenization of national culture would be seen as a threat by existing cultural enclaves. Not to mention that, deep down, people really don't actually want meritocracy at all.


It truly would be a brave new world at that point.


Wow. that's further out than me ...

Gotta think the unthinkable.


You are describing exactly what Google and Facebook and others are doing. With the minor difference that they are telling you "eat that chocolate".


*brought you by Nestle^tm


>I know this is somewhat SF utopian but I keep banging on about "MOOP" - massive open online psychology. the idea that we are monitored day in day out by our phones, listening to us and our interactions, the actual useful data that could be extracted about our psychology, our behaviour and how to improve it is immense (yes the risks huge - but that's why it should be open)

And who will control what gets told to whom?

>Don't look at his hunky ass, you are wrong in gods eyes.

Would have been what every gay would have heard in the 1950s.

>Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience. They may be more likely to go to Heaven yet at the same time likelier to make a Hell of earth. This very kindness stings with intolerable insult. To be "cured" against one's will and cured of states which we may not regard as disease is to be put on a level of those who have not yet reached the age of reason or those who never will; to be classed with infants, imbeciles, and domestic animals.


Yeah, and then there's reverse psychology. Fuck you, fridge: I came here looking for carrot sticks, but if you're going to be like that I'll just have some chocolate instead.


To be quite frank about it, that's a fridge that's just going to have to experience a terrible accident to its loudspeaker.




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