Letter to the Editor: State failing to address real issues of opiate addiction
On April 9, I attended an open forum with State Attorney General T.J. Donovan and Rutland County State’s Attorney Rose Kennedy, arranged by the family of Leo Branchaud. Leo was walking beside the road when he was struck and killed. The person accused of killing him had eight prior felony convictions and 33 prior misdemeanor convictions. Under Vermont law, after three felony convictions, prosecutors have the option of pursuing habitual offender status, which has the potential sentence of life imprisonment.
Patrick McCardle announced the forum in a newspaper article, which stated that Donovan and Kennedy had no agenda, but wanted to hear the concerns of the citizens. While I respect Donovan for appearing before the public, it appeared to me that their presence was a thinly disguised promotion of the current model of addiction treatment. You should be aware that Rose Kennedy’s husband is chief legal counsel for Westridge Clinic (operated by Rutland Regional Medical Center).
T.J. Donovan began the forum by pointing out that it cost the state of Vermont approximately $60,000 to incarcerate a man for a year. Treatment costs the state approximately $6,000 to $10,000 per year. Because of financial concerns, the legal system tries to divert “low level” offenders to these treatment programs. Obviously, our legal system considers eight felonies to be low-level offenses. Donovan offered no cost comparison for repeatedly processing individuals through our legal system or the cost imparted to their victims. Because our legal system fails to control individuals who cannot control themselves, families like the Branchaud family are paying the ultimate price.
Donovan also pointed out there are no treatment programs available in jails. Why not? If we can spend multi-millions to provide minimally effective treatment through private outpatient sources, why can’t we make treatment programs available while incarcerated? Inmates can pursue a college education, have the benefits of a fitness club and yet we can’t manage an effective treatment program? And why are drugs so readily available to inmates? If we are investing multi-millions in new treatment facilities, private practices, safe sites, etc., why can’t we build a secure prison facility that can address addiction treatment while protecting public safety?
As for treatment programs, here are a few problems with our current models that no one wants to talk about:
1. There is no way to be certain that drugs provided in outpatient treatment are not diverted, meaning sold “on the street” or supplemented, meaning additional doses are bought “on the street” and used by the treated patient.
2. The goal of addiction treatment programs is not commonly a cure, meaning a drug-free existence, but simply maintaining an addiction to an alternate opioid.
3. The drugs used in treatment have no level of impairment defined, as there is with alcohol. My physician requires a blood test before he will consider changing the dosage of my thyroid medication, a natural hormone. Without empirical data, what are physicians in the hub and spoke system using to determine appropriate doses? Are they relying on patient reported symptoms and how does that avoid drug seeking behavior?
4. Urine tests are used to “prove” compliance. If these are litmus tests checking only for the presence of drugs it does not prove compliance without a quantitative, specific level of the prescribed drug present. Nearly anyone with experience of drugs can tell you how to camouflage or falsify urine tests. In fact, you can find the information online with little effort.
5. No one is responsible for keeping impaired drivers off the road. This is a danger to the general public but also to the addicted person being treated. Because of treatment in these outpatient clinics, impaired drivers are protected by HIPPAA laws. Is the dramatic rise in highway fatalities due to simply texting or to more drivers legally driving under the influence? How would you know?
6. The medical and pharmaceutical industries are complicit in the opiate crisis devouring our country. Physicians have admitted to over-prescribing opiates, as much as 75 percent. It has been reported that doctors have felt pressured to prescribe potent painkillers to get good patient reviews in order to be promoted or funded. It’s been reported that pharmaceutical lobbies have inflated the incidence of pain in the country to promote their agenda. MSNBC reported that pharmaceutical companies flooded millions of opiates into a small West Virginia town to feed the addiction. Now, these same entities proclaim the solution to the epidemic they helped to create, is to maintain a life-long addiction to their alternate legal opioid.
While it’s obvious our society needs an effective form of addiction treatment, which aims to eliminate addiction, our first priority should be safety, of the public and the treated individual. Repeated criminal activity should result in incarceration. Where the law already exists, it should be enforced and applied consistently, not resultant on the workload of a prosecutor or the efficiency of a court. No Vermonter should lose their life because our lawmakers fail to protect the public safety.
Citizens Advocating Responsible Addiction Treatment
Mark A. Nelson of Bristol
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