Guest post: The Opioid Crisis—Personal Responsibility, Choice, and the Law

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In Commonwealth v. Eldred, an underreported July 16 case with nationwide implications, where addiction was an underlying issue in a criminal case, the Massachusetts Supreme Judicial Court ruled that it was not cruel and unusual punishment to put a person who is on probation in jail after one positive test for drugs.

Less than two weeks after a court ordered Julie Eldred to not use drugs while on probation, she tested positive for the opioid fentanyl. Consequently, Ms. Eldred, a chronic substance abuser, spent about 10 days in jail until an inpatient treatment bed was available.

In the subsequent appeal, Lisa Newman-Polk, Ms. Eldred’s attorney, argued that incarceration was unconstitutional cruel and unusual punishment because Ms. Eldred’s substance abuse disorder made her incapable of remaining drug free.

Newman-Polk, a certified social worker with clinical experience treating addiction, called the decision a “massive blow” that would place the court “on the wrong side of history.”

The court did not agree. Nor do I. To the contrary, adoption of Miss Eldred’s disease theory would dangerously undermine America’s efforts to combat its metastasizing opioid epidemic, almost certainly lead to increased drug related deaths, increased risks to public safety, increased recidivism, longer prison sentences for addicts without the possibility of probation or parole, fewer options like drug courts to incentivize recovery, and millions of new dollars invested in unproven community drug treatment programs.

Most important, it would remove an addict’s personal responsibility in the recovery process, the sine qua non of successful recovery.

According to the Diagnostic and Statistical Manual of Mental Disorders, substance abuse disorder (SUD) occurs when a person’s use of drugs or alcohol leads to health issues or problems at work, school, or home. Relapse is often a part of the recovery process.

But not everyone agrees with the disease model.

The court cited the Commonwealth’s behavioral model which postulates that SUD may affect an individual's urge to use substances, but it does not render that individual without the free will to use substances.

The majority ultimately concluded that the defendant's claim of SUD rested “on science that is not tested.”

Justice David J. Lowry, writing for the majority, emphasized that a defendant who violates probation is not being punished for the violation (drug use), but “anew on his [or her] underlying conviction.” The court recognized that “addiction is a status that may not be criminalized.”

Continuing, the requirement of remaining drug free is not, as Ms. Eldred contends, “an outdated moral judgment about an individual's addiction. Rather…. the requirement is based on the (sentencing) judge's consideration of the defendant's circumstances and that she committed the underlying crime to support her drug use.”

Having worked with many addicts for many years, I can attest that many former users credit a stint in jail (or the mere threat) for jump starting their recovery.

Justice Lowry’s well-reasoned opinion will help protect defendants by giving them clear motivation to remain substance-free while providing for the protection of the public.

Ironically, should she remain clean and sober, Ms. Eldred may one day thank the sentencing judge for saving her life.

This article was written by a friend of the Urchin who practices law, and has a long-term interest in the legal and scientific study and treatment of substance abusers and substance abuse issues.  He is a regular contributor to articles pertaining to these topics.

With Love,

The Recovering Urchin

 

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Page 87

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Several years ago, one of my colleagues sent an email to his boss’s boss.  He sent the email in anger. The email was typed in capital letters, with multiple colored fonts.  Some of it wasn’t very nice. There were curse words and accusations. He lost his job the next day.

My guess is that he regretted hitting the “Send” button on that email.

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One of my friends in the program likes to say “let’s think about Page 87” when things get heated.  Anytime there is a clash of personalities, or someone gets upset, he says “it’s Page 87 time!”

He is referring to a passage in the book Alcoholics Anonymous, on (you guessed it) page 87, that states “...we pause, when agitated or doubtful, and ask for the right thought or action”.  A couple of sentences later it says “we are then in much less danger of excitement, fear, anger, worry, self-pity or foolish decisions”.

My guess is that the colleague who sent the email in different color fonts (and lost his job) would have benefited from pausing.

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I attended a training course at work a few years ago, and they described “the 24 hour rule”.  The idea was that any time I see an email that makes me want to yell, I should wait 24 hours before responding.  In other words, I should pause. (By the way, I am convinced that World War III is going to start with an email).

In our society, we put so much emphasis on acting quickly, on responding right now.  That makes a lot of sense if you work in an emergency room, but for the rest of us, it pays to wait sometimes.

I use this tool at home a lot.  I will ask for a day to think about something (“can I think about this overnight and get back to you?”), and I wait.  That gives me time to ask my sponsor, or one of my role models. I can pray and meditate. Whatever I do, if I take my time, I avoid some foolish decisions this way.

Just after the text on page 87, at the top of page 88, is a one sentence paragraph:

“It works -it really does”.

They were right.  It really does.

With Love,

The Recovering Urchin

 

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Humility

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I attended a meeting today where people were talking about humility.  In the book 12 Steps and 12 Traditions, in the chapter on Step Seven, the author (Bill W.) writes about humility, and provides a good definition:  “the basic ingredient of humility, a desire to seek and do God’s will”....I would like to say that I always have the desire to seek and do God’s will, but sometimes I find myself thinking much more about seeking and doing my will.

Humility is one of those things that I struggle with.  I know that I am struggling with it when I say something snarky like “Do you have any idea who I am?!”  

I am lucky enough to live in a prosperous place.  I am blessed. I know that, most of the time. But every once in a while, I see someone driving a status symbol car, or I drive by a status symbol mansion, and I think “what is wrong with me?”

The truth is that there is nothing wrong with me.  A Ferrari or a mansion won’t make me any better of a person than I already am, and not having those possessions doesn’t make me any worse, either.

But for some reason, I notice status symbols more than most of my friends.  When I get on an airplane (a frequent occurrence in my life), I notice who gets to turn left and go into business class.  Then I spend some time feeling “less than”. I forget that I am lucky enough to be on that plane, healthy enough to walk onto that plane, and free to go wherever I want, whenever I want.  So who cares if I have to sit in the back of the plane?

My sponsor used to say “compare self to self”.  He meant that I should try not to compare myself to other people, because I will always find a way to make myself feel less than I should.

Early in my sobriety, he shared the following prayer with me:

“I am no more than I am

I am no less than I am

I am the I am that I am

And AA teaches me to be

the I am that I am”

I pray today to be the best I am that I can be.

With Love,

The Recovering Urchin

 

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Honesty

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Early in my sobriety, my wife and I received our monthly credit card bill.  My wife noticed that there was a $1500 credit. The credit was a mistake-it should not have been on our bill.  This was a big mistake. $1500 then was like $10,000 now.

My first reaction was “Shopping spree!”  My wife (let’s call her Saint Theresa) reminded me that:

  • the money wasn’t ours

  • we had an obligation to notify the credit card company of the mistake

  • the credit card company was probably aware of it already anyway

She called the credit card company, and just as she had predicted, the company had already corrected the error.

I share this story with you because it shows that my first reaction is not my best reaction.   I find it difficult to be honest sometimes. Dishonesty is one of my character defects.

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I don’t think I am alone here.  In the first 100 words of “How It Works”, the root word “honest” appears three times:

1) ...”usually men and women who are constitutionally incapable of being honest with themselves”....

2) ...”they are naturally incapable of grasping and developing a manner of living which demands rigorous honesty”....

3) ...”but many of them do recover if they have the capacity to be honest”.

In the first 164 pages of the Big Book, the word “honest” (or honesty, or dishonest) appears 38 times.

It must be an important part of sobriety.

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Bill W. understood this.  Several times he wrote about Fear, Selfishness, Resentment and Dishonesty in the Big Book as the primary character defects to be analyzed (and hopefully relieved).  

My experience is that dishonesty with others is only part of the problem.  I understand that it is wrong to lie to other people. I think I do much better with this today.  But for some reason, I struggle to be honest with myself. The word for this is “denial”. I was in denial for years about my alcoholism.  I have company here. I recently heard someone say that “my alcoholism was bad only for the last 15 years”. Only 15 years?!

I have blind spots in my life.  There are things that are present in my life that I don’t want to see, so I choose not to see them.  Then other people take a quick glance at me, and they see those things immediately.

My sponsor and my wife (two of my role models) help me with this.  They gently nudge me towards seeing the truth about myself. They help me with those blind spots that I can’t see.

Lord, help me to be honest with others, and myself, today.

With Love,

The Recovering Urchin

 

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The Purity of the Message

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I attended a meeting this week where the topic was the Eighth Tradition.  The Eighth Tradition states “Alcoholics Anonymous should remain forever nonprofessional, but our service centers may employ special workers”.  We also touched on the Sixth Tradition, where the second part of the tradition states “...lest problems of money, property and prestige divert us from our primary purpose”.

Our “primary purpose” in AA is to stay sober, and help other alcoholics to achieve sobriety.  If you are a member of another twelve-step fellowship, your fellowship has a primary purpose focused on something else-but the principle is the same.  You have a primary purpose.

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One of the reasons that the message of recovery works is because it is pure.  When I hear the message of recovery in a meeting, I know two things about that message:

1) The person who is sharing it has had the same (or similar) experiences as me.

2) The person who is sharing it is sharing it freely, without thought of personal gain or profit.  

They aren’t charging me anything to hear that message. They are sharing that message because they have the same primary purpose that I do.

If I thought that someone in a meeting was there to make a profit off of me, I would have the same type of skepticism that I have when I go to purchase a car.  I know that the salesperson is there to make money off of me (I’m sorry if you’re a salesperson, I am not a very trusting buyer). In the back of my mind, I wonder if the salesperson wants the best for me, or if that person just wants my money.

People who go to twelve-step meetings aren’t selling anything to anyone.  There is no profit motive. As it says in the Preamble, “....there are no dues or fees.  The only requirement for membership is the desire to stop drinking”.

That is a pure situation, as pure as it was when first designed in the late 1930’s.  Had it been any less, I don’t know if I would have stayed for a second meeting to hear the rest.

With Love,

The Recovering Urchin

 

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Recovery Resources

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When I work with newcomers, I try to work the Twelve Steps with them.  I encourage them to attend as many meetings as possible (a “90 in 90”), especially as they begin their journey.  I encourage them to have a sponsor, and a prayer life, if possible.

What follows is a list of additional ideas for people in recovery, especially for those times when a meeting or a sponsor is not available.

Speaker Recordings:  I almost called these “speaker tapes”, because when I first came into recovery, the speakers were recorded on tape.  That was a while ago. There are thousands of recordings of speakers available in almost every twelve step fellowship.  If you do an internet search on “twelve step speakers”, several sites display. Many of these speakers are available as free downloads. (This is useful for those of you who travel by airplane a lot).

Telephone meetings:  do an internet search on “twelve step telephone meetings”.  Most Twelve Step fellowships have telephone or internet meetings.  I don’t find them as useful as face-to-face meetings, but there are times I cannot attend a face-to-face meeting, and a substitute is helpful for me.

Using the Telephone - it is easy to collect telephone numbers. For me, it is difficult to use those numbers.  I try to practice my dialing skills 2-3 times a week at a minimum.

Literature - I cannot emphasize enough how important the Big Book (Alcoholics Anonymous) and the “12/12” (The Twelve Steps and Twelve Traditions) have been to me.  There are now electronic, searchable versions of these books available for download, or available on the internet for browsing. E-readers are useful for finding a favorite passage, when I can’t remember where the passage is in the literature.  They are also helpful for reading on an airplane, because there is no book cover to hide. There are also audiobooks available for some of the most popular recovery texts.

Joe and Charlie - I will write about them in more detail sometime later, but I strongly encourage people in recovery to listen to the full Joe and Charlie series.  For the uninitiated, Joe McQ and Charlie P were two fellows who started a 12 hour (approximately) study of the Big Book, and the Twelve Steps. They conducted hundreds of weekend-long workshops.   One of my sponsors told me “Joe and Charlie changed my recovery”. I encourage you to listen to them.

E-mail and Text lists:  some of my friends have started e-mail and text distribution lists as a way to stay in touch with each other.  Some send daily text “Thought for Today” messages. These are nice recovery reminders.

With Love,

The Recovering Urchin

 

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What’s The Problem?!

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About 35 years ago, I was driving a clunker of a car.  One day I hit a pothole in my city, and my car started making a lot of noise.  I thought the noise might be my muffler, so I drove to the muffler shop. I told the mechanic that I thought I had a muffler problem.  He lifted my car up on the jack, took one look at the underside of my car, and said “the problem is that you no longer have a muffler”.

I have a friend who likes to ask “What’s the problem?” when he hears people complaining.   What he means is that he wants to know what the root cause is. Until he understands what the problem is, he can’t possibly know what the solution is.

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When I first realized that I had a problem with alcohol and drugs, I decided that I was going to quit.  That seemed like a reasonable solution. I thought that the problem was alcohol and drugs, and that the solution was quitting.

So I quit (“once and for all, I swear I mean it this time!”).  I quit “once and for all” four different times in the last 18 months of my active alcoholism.  I did not understand why I kept relapsing after I had quit with the best of intentions. After all, hadn’t I quit forever?

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At my home group, I sometimes share that “the problem isn’t alcohol”.  That seems like a provocative thing to say at an AA meeting.  I believe it to be true.

I believe it to be true for several reasons.  The first reason is that that is consistent with what is in the book “Alcoholics Anonymous”.  On page 103, it says “our bottles were only a symbol” (of our problems). On page 64, it says “our liquor was but a symptom”.

I also believe that alcohol isn’t the problem because I quit “once and for all” four different times.  If alcohol was the problem, then quitting would have been the solution.

Lastly, I can share with you that my life actually got worse early on in AA.  I was abstinent for 90 days in AA, but I was in so much pain that I finally asked my sponsor for help.  If alcohol had been the problem, shouldn’t I have gotten much better after 90 days of not drinking?

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So as my friend likes to ask- What’s The Problem?

I believe that the problem is that I do not know how to live my own life.   That is a difficult thing to admit.  In my culture, and my upbringing, I was taught to show self-confidence, and never admit problems publicly.  Admitting problems would not be consistent with “keeping up with the Joneses”.

But in AA, after working through the Twelve Steps, I finally had to admit that I had made quite a mess of my life.  Only with the help of AA, my sponsor, and the Twelve Steps, have I been able to reconstruct my life and rebuild trust with my family and friends.

So I ask you-if you are struggling to stay sober, or if you are struggling with some major life problems- what’s the problem?  The problem may not be what you think it is.

With Love,
The Recovering Urchin

 

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Roll Call

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When I was in elementary school, my teachers assigned us seats in every class, and they took “roll call”.  Roll call meant that the teacher read out the names of the students, and we had to respond if we were present.  (By the end of the first week, the teacher could take attendance without roll call, once the teacher knew our names).

The point of Roll Call is to know who is present, and who is absent.  The point is also to make it obvious that someone is taking attendance, and to show that there are consequences for not attending class. 

I sit in the same seat at every meeting.  I receive some good-natured teasing about this, but I have a reason why I do it.  I do it because I want my home group to know if I am present or absent.  (Unless I am travelling, I am present.  I have been present at my home group for almost every meeting for the past 25 years).

I apologize if this offends you-but twelve step groups and meetings are easy to disappear from.  It is too easy to sit in the back, be invisible, and stop attending.  That is not what I want from my recovery.  I want to be right in the middle of the pack, present and accounted for, at every meeting that I attend.

I want to act like my life depends on my recovery, because it does.

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When I was young, I learned to swim at a crowded public swimming pool.  The lifeguards used “the buddy system” for our safety in the pool.  Everyone in the pool had to have a “buddy”- someone who we stayed with at all times in the pool.  When the lifeguard blew the whistle, we were supposed to check on our buddy, and make a lot of noise if we couldn’t find them.  Between the times of whistle checks, if our buddy was in trouble, we were supposed to make a lot of noise.

We took some responsibility for the welfare of our buddies.  We did that in the swimming pool.  We do that in my family.  I try to do that in my recovery, too.  If someone is floundering, I try to help.  If I am floundering, I want someone to call the lifeguard (my sponsor, my wife, anyone).

I sometimes wish that we took Roll Call at meetings.

With Love,
The Recovering Urchin

 

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I Don’t Know

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Once a month I get a haircut.  The woman who cuts my hair (let’s call her “G”) likes to say “you know nothing”.

(In the interest of full disclosure, G is married to my sponsor, and is in recovery herself).  She shares with me something that her sponsor shared with her- “you know nothing!”. I thought that was so harsh the first time I heard it.  It turns out that she was right.

When I am in the moment, I convince myself that I know what is best for me.  But my experience teaches me otherwise. I’ll give you an example. I was interviewing for a job about a year ago.  I thought I was the best candidate, but I didn’t get the job. I was devastated.

A couple of months ago, that company was on CNN, for some really bad stuff.   I’m glad I didn’t get the job.

Last year, I was certain that I wanted that job.  Now I’m delighted that I didn’t get it.

Sometimes I don’t know what is best for me.

As G likes to say, I know nothing.

With Love,
The Recovering Urchin

 

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I Need Help

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I heard someone say at a meeting that three of the most spiritual things she had learned
were:


I need help
I was wrong
I don’t know

I certainly need help. I need help staying sober. I have had that demonstrated to me again and again. At the end of my active alcoholism, I tried to quit drinking, once and for all (I mean it this time!) four different times. Four different times I stopped temporarily.

The first time I stopped, I lasted about a week. The last time I stopped, I couldn’t make it through 24 hours. When I was finally introduced to Alcoholics Anonymous, a gentleman shared his story, and explained to me what worked for him (the Twelve Steps). He also explained to me that he attended AA meetings frequently, and that meeting attendance helped him to stay sober.

I listened to him, I followed his advice, and I haven’t had a drink or a drug since that date. That was May 2, 1990.

Frequent attendance at AA meetings helps me to stay sober. I need the experience, strength and hope that I find at every AA meeting.


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I need help with more than only the “not drinking”. I need help and direction in how I live my life. I wrote an essay entitled “Role Models”. I have four role models, and they show me how to live through their actions. They show me how to be the best father, husband, son, employee, and member of AA that I can be. They show me because they are the best parents, spouses, employees, and sober people that I know.

They truly are role models.


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When I was young, I remember saying “I can do it myself”. That may have been an acceptable strategy when I was a toddler, but it doesn’t work for me anymore. I have no problem asking for help with car maintenace, lawn mowing, income tax preparation, or medical advice. But for some reason, I sometimes think it is a good idea to “go it alone” on really important things. In the book Twelve Steps and Twelve Traditions, there is a passage that states “It is worth noting that people of very high spiritual development almost always insist on checking with friends or spiritual advisers the guidance they feel they have received from God”.

If people of very high spiritual development can ask for help, why can’t I?

With Love,
The Recovering Urchin

 

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