One Factor To Address Many Louisville Citizens’ ConcernsApril 29, 2022
By Gene Gilchrist, Ph.D., Chief Executive Officer
A 2021 report in the Courier Journal listed the concerns of Louisvillians. Among them:
- Public Safety – 25%
- Education – 9%
- Homelessness – 14%
- Affordable Housing – 8%
- Police Reform – 10%
- Jobs – 5%
The recent attempt on the life of one mayoral candidate has affixed that issue in a noticeable way for him and many others.
A national survey by the Pew Research Center study from the same year listed a wider list but overlapping items including Education (58%), Crime (52%) Criminal Justice (45%). The Pew list also noted Healthcare Costs (61%), Jobs (52%), and Poverty (44%). One item ranking low on the Pew Research list would make a substantial contribution to at least eight of these issues – treating and reducing addiction and substance abuse.
Consider the impact of alcohol and drugs on crime. The National Council on Alcoholism and Drug Dependence reports that 40% of crime is committed by individuals with alcohol abuse issues, 36% of crime is committed under the influence of alcohol, and 15% of robberies, 27% of aggravated assaults, 37% of sexual assault involve alcohol. According to the Bureau of Justice Statistics division 14% of violent crime involves drugs, 21% of inmates committed crime to obtain drugs, and 40% of crimes were committed while using drugs
Concerning criminal justice reform, alcohol and drugs are major contributors to incarceration. According to “The Nation’s Health”, 85% of inmates nationwide had histories of substance abuse, were under the influence of alcohol or other drugs at the time of committing their crimes, committed their offenses to get money to buy drugs, were incarcerated for an alcohol or drug violation. No surprise that drug use continues inside prison. According to The Marshall Project hospitalizations for drug related disorders among inmates increased 35% between 2014 and 2017 and drug overdose deaths increased 35% between 2019 and 2020.
Educational attainment is impacted. According to the National Institutes of Health, students who are using alcohol and drugs see significantly different outcomes:
Grade of A – 32%
Grade of D/F – 68%
Grade of A – 10%
Grade of D/F – 46%
Grade of A – 1%
Grade of D/F – 13%
According to the National Institute for Drug Abuse Statistics 21.6% of 8th grades and 61.5% of 12th graders have used alcohol and 21.3% and 46.6% respectively have used drugs.
Homelessness is also a result. The Department of Housing and Urban Development reports that among the homeless 38% suffer from alcohol abuse and 26% abuse drugs.
Obviously, the “War on Drugs” has not solved these problems. Rather, much of the prison population is the result of the War on Drugs. Similarly, temperance unions, Prohibition, Just Say No have all failed. Being honest, 2022 is not the high point of American alcohol or drug use. The highest consumption of alcohol per capita likely occurred during prohibition. The high point of drug use was likely in the 1960s. Rather, our approaches have not worked and the symptoms — crime, criminal justice, education, poverty, homeless and health care have continued to get worse.
It is only fair to offer alternatives. We have done so and repeat them here:
- Eliminate Stigma: when a relative is diagnosed with cancer no one thinks they lack moral fiber. Addiction was defined as a disease in 1956;
- Promote the Facts: The Member Survey of Narcotics Anonymous reports the addict is just like your neighbor not the popular image of the young, dissolute, unemployed, homeless. Addiction is am equal opportunity brain disease;
- Problem Screening: reimburse physicians to screen for addiction. Current rates of $17.32 are not proportional to the problem;
- Deploy Genetic Testing: Genetic testing is being used for diagnosis and prophylactic treatment today. Reimburse physicians to use the tests to introduce addiction as a disease;
- Stop the War: it failed. It is OK to say so. Move on. Do not discontinue interdiction but stop making war on people with a disease;
- Invest in Evidence Based Treatment: much treatment is based on an 85 year old model of waiting to “hit bottom”. Let’s not wait until the disease metastasizes. Treatment works, there are many paths, let’s research them, refine them, promote them and have a nationally funded research program to do so;
- Promote Recovery Symbols: The traditions of AA and NA specifically admonish about public disclosure. Let’s engage AA, NA and Al-Anon in figuring out how to promote that treatment works including, possibly, the face of those in recovery as opposed to self-anointed, public representatives we see today;
- Reimburse Realistically With Accountability: in too many States and for too many payors rates are too low to support treatment. Hence, too much treatment is self-pay posing a barrier for too many people. Let’s set realistic, evidence based rates and pay those with accountability and tracking outcomes;
- Focus On Adolescents: clearly, we are not getting this job done;
- Arm Influencers: let’s also engage ministers, rabbis, imams, civic leaders, elected officials and provide them with the facts and the tools they need to change the narrative. They care, they try. Let’s help them;
- Epidemiology Strategies: like Typhus let us deploy epidemiologists to do the research, determine the “hot spots”, and identify community solutions that work;
- Deploy Medical Assisted Treatment (MAT) Wisely: no one flinches about the “the nicotine patch” but discuss MAT and the reactions are wide-ranging. Many, not all, counselors and physicians agree that withdrawal is too often a barrier to recovery. Opioid use disorder relapse exceeds 90%! Let’s use MAT wisely and always combined with counseling;
- Support Employers: only 19% of employers have comprehensive drug policies and too many are willing to ignore this issue during low unemployment. Let’s encourage them to deploy policies, encourage treatment, and lower insurance costs and liability when they do.
We have deployed too many, ineffective approaches and it has cost in in myriad ways. Let’s be honest about that and get after it in a comprehensive fashion. In doing so we will substantially reduce the impact of those eight other issues of concern.
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Stay Clean is a groundbreaking approach to create additional opportunities for addicts, alcoholics and their loved ones to find an answer. Created by recovering addicts and alcoholics, and people with experience in codependent relationships, Stay Clean is a cloud based, easily accessible, 24 hour community of recovering people and their loved ones helping each other and offering a comprehensive array of recovery services online. Members will access online Recovery Meetings, directions to find on site 12 step meetings in their area, and interact with each other in forums to find answers to their questions. There are proprietary treatment options similar to distance education and face-to-face counseling via telehealth. Counselors and peer coaches will always be highly qualified, highly credentialed, very experienced.
Finally, and perhaps most importantly, members will find easily accessible resources to work through life skills such as relationship building, parenting, career and employment, legal issues and financial management to name a few – they will find help with those kinds of issues that suffered the most during their years of active addiction.
For more information, please visit the Stay Clean web site at https://www.stayclean.com/.
ABOUT THE AUTHOR
Gene Gilchrist, Ph.D. is the Chief Executive Officer of Stay Clean a cloud-based clinical treatment and recovery community headquartered in Louisville, Kentucky.
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