Wednesday, September 23, 2015

Drug Crime: Is it really victim less?

In Massachusetts, there were 1000 deaths related to heroin or illicit opiate use last year (Lazar, 2015). This represents an increase of 3.3% in heroin and/or opiate related death from the previous year, and a 33% increase from 2012 (Lazar, 2015). This rise in opiate and heroin drug related death is indicative of the rising heroin problem in Mass overall. That means, in Massachusetts, there were at least 1000 families who were indirect victims of drug crime activity in just the last year. This number excludes those friends, family and strangers: who were stolen from and victimized to support the addiction habit of a drug user, victims of violent crime perpetuated because of drug related crime, and injury and suffering sustained by law officers while enforcing the laws against drugs use. While it is not very obvious, in my hometown of Abington, Ma heroin use is following the state trend on incline in both criminal activity and death related to use. In fact, this past May an article was published, in the Metro West Daily News, which called Brocton Ave in Abington, Ma the “Heroin Highway” after six heroin busts were made in a two month span on this one road (Paulin, 2015).

Using the cost-of-illness methodology, as outlined by Hodgson and Meiners (1982), the three primary types of costs related to illicit heroin use include direct costs, indirect cost and psychosocial cost (Mark, Woody, Juday &  Kleber, 2001). Direct cost pertain to medical care expenditures for addiction “diagnosis and treatment”, its “medical sequelae”, as well as, nonmedical expenditures like “prison and law enforcement related costs” (Mark…et al, 2001). Indirect costs result from “losses in output” such as loss of earnings due to “premature mortality, incarceration, and reduced human capital” (Mark…et al, 2001). Finally, psychosocial costs that include the total reductions in “quality of life” for both the heroin addict and members of his/her social network (Mark…et al, 2001). Using this model, the estimated cost of heroin addiction in 1996 was $21billion dollars in the United States (Mark…et al, 2001).

That being said, I am not without empathy for the drug addict.

Most persons who abuse drugs do not start with the intention of abusing the drug or becoming addicted. Opiates themselves are highly addictive because of their components (The Hills Treatment Center, 2015). Once ingested the opiate substance binds with neurotransmitters to effectively inhibit pain on both physical and emotional levels (The Hills Treatment Center, 2015). It also produces an initial euphoric feeling (The Hills Treatment Center, 2015). However, like most addictive substances, the substances effectiveness and euphoric propensities decline over time (The Hills Treatment Center, 2015). This leads one to needing more of the substance or even stronger substances to receive similar effects (The Hills Treatment Center, 2015). Unfortunately, as the levels of substance decline in the addicted person’s body the person begins to experience symptoms of withdrawal, which are often unmanageable without medical help (The Hills Treatment Center, 2015). Because the symptoms are unmanaged without help the drug user continues to use drugs to ward off withdrawal, often without ever achieving that same initial high.

Post injury addiction is common. Of those persons entering an opiate addiction detox clinic 42% were previously non addicted persons who sought surgical treatment for a medical problem and got addicted to opiates while under the treatment of a doctor (The Hills Treatment Center, 2015). As many as 92% of those [entering an opiate addiction detox] admitting buying other narcotic drugs, such as heroin, to help them manage their addictive symptoms and inhibit withdrawal (The Hills Treatment Center, 2015). The reason cited for using was other drugs was availability and effectiveness (The Hills Treatment Center, 2015). Not surprisingly, surveys indicate that as many as 4 out of 5, or up to 80%, of heroin users begin their heroin addiction with taking opiates (Lazar, 2015).

Our text book defines a victimless crime as a “consensual crime” that lacks “a complaining participant” (Conklin, 2008).

I personally think victimless crime is misleading and prefer the term consensual crime instead. The difference is that the term consensual crime indicates that both participants willingly are engaging in unlawful activity, such as prostitution, drug use, and gambling, that by nature of the activity does not necessarily violate the person and property rights of non-consenting uninvolved participants and/or directly create a complaining victim. I like the latter definition because it describes that in a so called “victimless crimes” both parties are aware and consent to criminal activity between themselves without intent to create unwilling victims though violating the rights of those who are not consenting--even if the crime may indirectly hurt themselves or society as a whole.

As for me, I personally don’t agree that most drugs and drug deals are victimless crimes, even if they lack a complaining party and are consensual. In the case study mentioned, the woman was described as one of many who become addicted to pain pills after using pills legally. It was also mentioned that she wanted to go to rehab but did not have the money to do so. Now her kids, who were taken while she is custody, have to remember this awful moment and bear witness to their mother’s trials and tribulations through addiction. So they too are victims. Furthermore, it is certainly disheartening to hear that so many get addicted through legal use administered from a doctor, but then the treatment for the disease that resulted from treatment is out of reach. Sadly, I see it all the time around here.

I guess free treatment it’s not completely out of reach, said facetiously but also seriously, I recently read if you go to the right prison in Massachusetts you might get into a medication assisted therapy program.

Medication-Assisted Treatment (MAT) refers to the use of pharmacotherapy in conjunction with traditional substance abuse therapies to help addicts recover from addiction and improve social function (SAMHSA, 2015). Medication-Assisted Treatment has been used effectively in the United States for the treatment of both alcohol and opioid dependence (SAMHSA, 2015). Research indicates when Medication Assisted Treatment is used in conjunction with a comprehensive treatment program, MAT can improve: survival, treatment retention and employment rates, as well as, birth outcomes with perinatal addicts (SAMHSA, 2015). Other documented advantages of MAT programs participation include decreases in: illicit opiate use, hepatitis and HIV seroconversion, and criminal activity (SAMHSA, 2015). Evidence based models that evaluate the effectiveness of programs offered to inmates in hopes of reducing recidivism indicated, when MAT is provided in Modified Therapeutic Communities the result is a 9.7% reduction in crime with a cost benefit ratio of $6.27 per every dollar invested (Massachusetts Results First, 2015). 

 

References

Lazar, K. (2015). Mass. opioid deaths topped 1,000 in 2014. Boston Globe. Retrieved from https://www.bostonglobe.com/metro/2015/04/28/more-than-people-died-from-heroin-and-other-opioids-state-figures-show/697gYjFZS6DnuKhREzfEcO/story.html

Mark, T. L., Woody, G. E., Juday, T,, Kleber, H. D. (2001). The Economic Costs of Heroin Addiction in The United States. Drug and Alcohol Dependence, ISSN 0376-8716, 61:2, p. 195 – 206. Retrieved from http://www.sciencedirect.com.libproxy.edmc.edu/science/article/pii/S0376871600001629

Paulin, B. (2015). Abington Police Make Six Heroin Arrests in Two Months along Brockton Avenue. Metro West Daily News. Retrieved from http://www.metrowestdailynews.com/article/20150519/NEWS/150516257

SAMHSA. (2015). Medication Assisted Treatment. Substance Abuse and Mental Health Services Administration. Retrieved from http://www.samhsa.gov/medication-assisted-treatment

The Hills Treatment Center. (2015). Drug Addiction Related to Post Surgery Prescription Medicine. The Hills Treatment Center. Retrieved from http://thehillscenter.com/addiction/prescription-meds-post-surgery/

Massachusetts Results First. (2014). Cost-Benefit Analysis. Pew Charitable Trusts. Retrieved from http://www.pewtrusts.org/~/media/Assets/2014/12/ResultsFirstMassachusetts2014Overview.pdf