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Officials say Trump's opioid emergency won't mean new money

Carjosse said:
Then that should still be included in a spending plan. The problem is not where the money comes form but rather there is a plan for how it is spent and that is completely absent here. All that would be needed for example would be say $200 million of the DEA budget will be allocated to the opioid crisis, that would be a spending plan.
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. And you think the president should be giving the DEA detailed plans on how to spend their budget rather then direction and focus. Do you have any idea of how absurd that sounds.

All your posts in this thread do is show everyone that facts really don’t matter to you. Only how you can attack Trump and it matters not on how distant from reality you have to put yourself to make those attacks.
 
JasperL said:
Objective claims can be supported with evidence. Do you have any that drug treatment costs more than jail? I've provided links earlier that show they save money. Here's another.

Do Drug Courts Work? | NCPA



If you've got studies that show otherwise, it would be great to read them and compare the results.
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Drug courts have some good evidence behind them, but I think that when many people talk about treatment, they mean in-patient substance abuse treatment, aka rehab.

A few years ago, my son was given xanax at school and became addicted it. That journey has been very enlightening in learning how little we really know about treating substance addiction. A lot of our go-to strategies have zero evidence behind them. Rehab in many cases is a total joke. Some rehabs end up getting patients hooked on other drugs such as suboxone.

This is not going to be an easy solve, and I fear that Trump lacks the ability to process complex information that will be necessary to lead the charge.
 
pillars said:
Drug courts have some good evidence behind them, but I think that when many people talk about treatment, they mean in-patient substance abuse treatment, aka rehab.

A few years ago, my son was given xanax at school and became addicted it. That journey has been very enlightening in learning how little we really know about treating substance addiction. A lot of our go-to strategies have zero evidence behind them. Rehab in many cases is a total joke. Some rehabs end up getting patients hooked on other drugs such as suboxone.
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That's true about evidence based treatment options. When I started dealing with my own problems I read at least a couple dozen books on the subject and there just wasn't much out there about what actually works. AA is great, IMO, but it's not really treatment. More of a group support program without something else behind it. And if fails most people, so then what?

I've come around a little bit on medications as part of treatment. Treating opioid addiction with other opioids obviously isn't ideal, or even good, but it can be the least bad option, and the harm reduction switching from street drugs and heroin to one of the treatment options is proven to be substantial. So I support the FDA's announcement last week to clear the path for MAT as part of the acceptable treatment options.

This is not going to be an easy solve, and I fear that Trump lacks the ability to process complex information that will be necessary to lead the charge.
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I agree, but I do have to applaud him for highlighting the issue. It's sort of sad that it appears to me we're jumping on the opioid problem because it's affecting people we don't normally think of as the "drug addict" type - rural, middle age white men and women - but I'm never going to complain about shining a light on a problem that really affects every demographic there is.

Good luck in your own family's struggle. I know how hard it is.
 
JasperL said:
That's true about evidence based treatment options. When I started dealing with my own problems I read at least a couple dozen books on the subject and there just wasn't much out there about what actually works. AA is great, IMO, but it's not really treatment. More of a group support program without something else behind it. And if fails most people, so then what?

I've come around a little bit on medications as part of treatment. Treating opioid addiction with other opioids obviously isn't ideal, or even good, but it can be the least bad option, and the harm reduction switching from street drugs and heroin to one of the treatment options is proven to be substantial. So I support the FDA's announcement last week to clear the path for MAT as part of the acceptable treatment options.



I agree, but I do have to applaud him for highlighting the issue. It's sort of sad that it appears to me we're jumping on the opioid problem because it's affecting people we don't normally think of as the "drug addict" type - rural, middle age white men and women - but I'm never going to complain about shining a light on a problem that really affects every demographic there is.

Good luck in your own family's struggle. I know how hard it is.
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I do appreciate shining a light on drug addiction whenever and wherever it happens, and I echo your sentiments on it only seeming to matter when it happens to middle class white people.

On the flip side, 3 kid I know have died of OD in the past 3 years (and not kids I know because of my son's struggles)--all upper middle class white kids. That's crazy.

My son has gotten a lot of support and help from AA, and having a sponsor has been tremendously valuable. But more than anything, I think it is 2 steps forward, 1 step back. he is in a much better place than where he was.

You are right about the harm reduction of switching from a harder drug to something less dangerous. In his case, he switched from xanax to weed. But, if you have addictive tendencies, even weed can be quite addictive. So that is his current struggle. But he is in a much better place than he used to be.

AA and Al Anon have been very helpful to us, but the anonymity of this problem also is one of the problems. It can happen to anyone. It can happen to anyone's kid. All of the kids I know who have OD'd had good, very Christian families, and still fell prey to this poison. Same with my son. My son was a star athlete, but the stress of moving to a new school made him vulnerable, and the rest is history.

I think that families and individuals who have been affected by this disease need to speak out more about what is needed and get rid of the shame that keeps families with addiction in the closet so to speak.
 
braindrain said:
. And you think the president should be giving the DEA detailed plans on how to spend their budget rather then direction and focus. Do you have any idea of how absurd that sounds.

All your posts in this thread do is show everyone that facts really don’t matter to you. Only how you can attack Trump and it matters not on how distant from reality you have to put yourself to make those attacks.
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How is it absurd that the federal government details how federal money in federal agencies is spent? The DEA is a federal agency and its budget is controlled at the federal level.
 
pillars said:
AA and Al Anon have been very helpful to us, but the anonymity of this problem also is one of the problems. It can happen to anyone. It can happen to anyone's kid. All of the kids I know who have OD'd had good, very Christian families, and still fell prey to this poison. Same with my son. My son was a star athlete, but the stress of moving to a new school made him vulnerable, and the rest is history.
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That last part is incredibly important to point out - lots of addicts are, in short, fine people in every way, but they are also addicts. Some of it's also clearly genetic. Others go through a rough patch, and turn to drugs as self help, and then can't get off later. Lots of reasons... but it's not or shouldn't IMO be an indication of moral failure or weakness.

I think that families and individuals who have been affected by this disease need to speak out more about what is needed and get rid of the shame that keeps families with addiction in the closet so to speak.
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I agree for the most part and don't try to hide my own issues. Oppo research would find out in about an hour or so. All my good friends and family know, I don't request in any way they keep it secret, so many more know, but I don't make a point of sharing my problems with casual friends or at work or with my wife's coworkers because there IS a big stigma attached to it, a different kind of Scarlet Letter, and people will judge you even if you've been clean/sober for a while. It also changes social situations in a weird and uncomfortable way at first. People who you know want to drink, and will usually drink, asking, "Do you mind if I have a class of wine?" and if they don't ask, they're thinking it. So you're like the SNL Church Lady sitting there at the table ruining everyone's fun time. It's really uncomfortable - changes everything. After a while people I'm around a lot learned to deal with it (essentially no longer think about it) and it's fine now but for casual acquaintances I don't want to go through it.

But if casual friends or coworkers are having problems or dealing with family, I'll make a point to let them know about my history and make myself available to talk.
 
JasperL said:
That last part is incredibly important to point out - lots of addicts are, in short, fine people in every way, but they are also addicts. Some of it's also clearly genetic. Others go through a rough patch, and turn to drugs as self help, and then can't get off later. Lots of reasons... but it's not or shouldn't IMO be an indication of moral failure or weakness.



I agree for the most part and don't try to hide my own issues. Oppo research would find out in about an hour or so. All my good friends and family know, I don't request in any way they keep it secret, so many more know, but I don't make a point of sharing my problems with casual friends or at work or with my wife's coworkers because there IS a big stigma attached to it, a different kind of Scarlet Letter, and people will judge you even if you've been clean/sober for a while. It also changes social situations in a weird and uncomfortable way at first. People who you know want to drink, and will usually drink, asking, "Do you mind if I have a class of wine?" and if they don't ask, they're thinking it. So you're like the SNL Church Lady sitting there at the table ruining everyone's fun time. It's really uncomfortable - changes everything. After a while people I'm around a lot learned to deal with it (essentially no longer think about it) and it's fine now but for casual acquaintances I don't want to go through it.

But if casual friends or coworkers are having problems or dealing with family, I'll make a point to let them know about my history and make myself available to talk.
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On the flip side, I hope I can someday go an entire day without worrying about whether my son will use.

Yeah, it is difficult all the way around. I think there is some easiness for him in being with people who are also addicts, as they never have to have these kinds of conversations.
 
pillars said:
On the flip side, I hope I can someday go an entire day without worrying about whether my son will use.
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I understand, and the worry is rational, which is what's hard about it. Took my wife a couple years at least to trust me - maybe more - and that was the right call, unfortunately.

Yeah, it is difficult all the way around. I think there is some easiness for him in being with people who are also addicts, as they never have to have these kinds of conversations.
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Yeah, absolutely. Unless you've been there, it's really impossible to understand and with fellow addicts, you know they do. It's a big reason why AA and NA are so good. People tell stories about some of the incredibly stupid and harmful stuff they've done over the years, and a lot of times others laugh, and it's not because it's funny at all really, but everyone gets it, that is what addicts DO, and isn't judging. Tell the same stories to non-addicts and they'd be horrified.
 
JasperL said:
Do Drug Courts Work? | NCPA

.
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Read the whole thing. Nowhere does it provide information on the ratio of times of treatment vs success. It's not a one to one ratio which is what all these studies seem to focus on.

Again, one example I gave: addict arrested, offered prison or rehab. Prison is more expensive. Addict chooses rehab. Addict fails rehab -Or- succeeds and then starts abusing again. Addict has now wasted that $$, so it's no savings at all and now the cycle begins again. Over and over and over. Cost more $ each time.

I only used $$ for this example but the toll on family and friends is brutal as well.
 
Lursa said:
Read the whole thing. Nowhere does it provide information on the ratio of times of treatment vs success. It's not a one to one ratio which is what all these studies seem to focus on.
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No they don't - they look at costs per person, whether they succeed or fail rehab. Costs are lower, recidivism is lower, therefore fewer victims of crimes, better outcomes all around.

Again, one example I gave: addict arrested, offered prison or rehab. Prison is more expensive. Addict chooses rehab. Addict fails rehab -Or- succeeds and then starts abusing again. Addict has now wasted that $$, so it's no savings at all and now the cycle begins again. Over and over and over. Cost more $ each time.
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Except the alternative to rehab or other treatment is prison, and what the EVIDENCE shows is recidivism is lower following treatment than prison. So the "addict" wastes MORE money while he's in prison, because without treatment the odds of him reoffending and coming back to prison his higher than if he was diverted to drug treatment.

I only used $$ for this example but the toll on family and friends is brutal as well.
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Bottom line is your feelings aren't relevant here. We are asking an objective, evidence based question here - does diverting low level offenders from jail or prison to treatment cost more or less than jail or prison. I've looked and the EVIDENCE I've found indicates diversion saves money, and it's not close. If you have EVIDENCE that I'm wrong - missed some studies, whatever - present it. Otherwise I'm pretty surprised you're still making this argument with no evidence to support it. It's illogical.
 
JasperL said:
Bottom line is your feelings aren't relevant here. We are asking an objective, evidence based question here - does diverting low level offenders from jail or prison to treatment cost more or less than jail or prison. I've looked and the EVIDENCE I've found indicates diversion saves money, and it's not close. If you have EVIDENCE that I'm wrong - missed some studies, whatever - present it. Otherwise I'm pretty surprised you're still making this argument with no evidence to support it. It's illogical.
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Because none of the evidence you provided...and apparently no one is collecting this information...is that the costs still do not reflect ratio of treatment attempts per single incarceration. The incarceration is not for that long, a few years at the most. And yet, if they choose treatment, they often yo-yo back and forth between emergency rooms, additional treatment, etc. All these things cost, it's not a one for one ratio i.e., 1 treatment (rehab, drug court, etc) / 1 incarceration. So you cant just look at the cost of one single (the initial one assigned) treatment and 1 single incarceration.
 
Carjosse said:
How is it absurd that the federal government details how federal money in federal agencies is spent? The DEA is a federal agency and its budget is controlled at the federal level.
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You didn’t say the federal government. You were whining because trump did tell them how to spend their money. You seem to think the president no matter who it is knows better then the folks running the DEA on how better to deal with this problem which is completely absurd. If the president is simply going to tell each individual federal agency in detail how to spend their money then why exactly do those agencies have managements and leaders.
Do you even think about this stuff before you post it or is all you can do is scream about Trump.

All you are doing is whining about Trump but what you don’t realize is how ridiculous you are making yourself look while doing.
 
braindrain said:
You didn’t say the federal government. You were whining because trump did tell them how to spend their money. You seem to think the president no matter who it is knows better then the folks running the DEA on how better to deal with this problem which is completely absurd. If the president is simply going to tell each individual federal agency in detail how to spend their money then why exactly do those agencies have managements and leaders.
Do you even think about this stuff before you post it or is all you can do is scream about Trump.

All you are doing is whining about Trump but what you don’t realize is how ridiculous you are making yourself look while doing.
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Trump should have created a detailed spending plan for how federal agencies are going to tackle this instead of declaring an emergency and doing literally nothing. It is literally his job.
 
Lursa said:
Because none of the evidence you provided...and apparently no one is collecting this information...is that the costs still do not reflect ratio of treatment attempts per single incarceration. The incarceration is not for that long, a few years at the most. And yet, if they choose treatment, they often yo-yo back and forth between emergency rooms, additional treatment, etc. All these things cost, it's not a one for one ratio i.e., 1 treatment (rehab, drug court, etc) / 1 incarceration. So you cant just look at the cost of one single (the initial one assigned) treatment and 1 single incarceration.
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As you've done many times on this thread, you ignore substantive points that address your claim like this one:

No they don't - they look at costs per person, whether they succeed or fail rehab. Costs are lower, recidivism is lower, therefore fewer victims of crimes, better outcomes all around.
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and this one:

Except the alternative to rehab or other treatment is prison, and what the EVIDENCE shows is recidivism is lower following treatment than prison. So the "addict" wastes MORE money while he's in prison, because without treatment the odds of him reoffending and coming back to prison his higher than if he was diverted to drug treatment.
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Of course you don't have to believe me - just refer to the multiple cites backing these claims up, which you haven't one cited in your arguments.

Bottom line is you're wrong, and contradicted by all the evidence I've seen. And your response, as always, is "Facts, evidence? LOL! I don't need no stinkin facts or evidence!!!"
 
JasperL said:
As you've done many times on this thread, you ignore substantive points that address your claim like this one:



and this one:



Of course you don't have to believe me - just refer to the multiple cites backing these claims up, which you haven't one cited in your arguments.

Bottom line is you're wrong, and contradicted by all the evidence I've seen. And your response, as always, is "Facts, evidence? LOL! I don't need no stinkin facts or evidence!!!"
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There's no data to find to support or not for my claim. ***That's my point.***

So we continue to throw money at something that is a complete crapshoot.

Money that might be better spent on other ways to fight this epidemic if we opened up our minds to search for OTHER solutions.
 
Lursa said:
There's no data to find to support or not for my claim. ***That's my point.***

So we continue to throw money at something that is a complete crapshoot.
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That's false. I've cited data that contradict your claim. The studies show it's not a "crapshoot" at all - they find that diversion saves thousands per person diverted from prison to treatment. That's just a fact. I've cited the studies, twice, and you ignore them, pretend they don't exist.

I really don't get it.

Money that might be better spent on other ways to fight this epidemic if we opened up our minds to search for OTHER solutions.
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The data show diversion SAVES MONEY. I don't know why you're so committed to the failed approach of arresting and jailing low level drug offenders. Even if we accept your false premise - that we don't know if diversion saves money and it's a "crapshoot" - there is still mounds of evidence jailing them without treatment does. not. work. So why not try something new, when the alternative, treating drug addiction and the related crimes as exclusively a criminal justice problem and not in part a public health problem HAS FAILED.

Just for fun, here's some more evidence. https://jpo.wrlc.org/bitstream/hand...s of Drug Courts on Recidivism.pdf?sequence=3

And just so you can see I'm trying to be honest here, I am citing the full abstract, including parts of it that tend to support your view:

Purpose: The objective of this research was to systematically review quasi-experimental and experimental
evaluations of the effectiveness of drug courts in reducing offending.
Methods: Our search identified 154 independent evaluations: 92 evaluations of adult drug courts, 34 of juvenile
drug courts, and 28 of DWI drug courts. The findings of these studies were synthesized using metaanalysis.
Results: The vast majority of adult drug court evaluations, even the most rigorous evaluations, find that participants
have lower recidivism than non-participants. The average effect of participation is analogous to a
drop in recidivism from 50% to 38%; and, these effects last up to three years. Evaluations of DWI drug courts
find effects similar in magnitude to those of adult drug courts, but the most rigorous evaluations do not uniformly
find reductions in recidivism. Juvenile drug courts have substantially smaller effects on recidivism.
Larger reductions in recidivism were found in adult drug courts that had high graduation rates, and those
that accepted only non-violent offenders.
Conclusions: These findings support the effectiveness of adult drug courts in reducing recidivism. The evidence
assessing DWI courts' effectiveness is very promising but more experimental evaluations are needed.
Juvenile drug courts typically produce small reductions in recidivism.
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The most telling graphic is Figure 1, (page 65 on the original, 6 of 12 on the pdf) which summarizes the findings of about 50 different studies for adult drug courts. ALL 50, 50 of 50, 100% of them, every single study, find that drug treatment leads to better outcomes than the alternative traditional approach in that study (e.g. jail, traditional probation). The magnitude varied, but the findings didn't. Drug courts work better, i.e. LOWER RECIDIVISM, than the traditional criminal justice approach.

Some further analysis:

The analyses presented above support the conclusion that any effect
adult drug courts have on recidivism is not limited to the shortterm.
Rather, the available research suggests that adult drug court
participants have reduced recidivism during and after drug court
treatment, and these effects appear to last at least three years postdrug
court entry.
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And 3 years is as long as the studies examine.

And there are multiple studies that examine costs, and they all, that I've seen, find drug courts save money, like this one.
 
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