The frustration and expense of treating addictions

Julia O’Malley’s recent pieces about the cost and price of addiction clearly struck a chord with me given the amount of years I’ve labored in the field of human services.

My memories of working with addicts stretch back to the late sixties and early seventies when I worked in a hospital in Brooklyn making extra money by pulling a second shift in the ER. Heroin addicts would come in with virtually no vital signs, we’d shoot some Narcan into them and, in an amazingly brief span of time, they would wake up. Almost inevitably, their first question was, “Where’s my stash?”

They knew that if it had been found, it had been flushed away. It was our little way of trying to prevent seeing the same addict in for an overdose twice in one night. When they realized their stash was gone, all thoughts of thanking us for saving their lives fled. Instead, we were treated to rants that made Mel Gibson’s phone calls sound like Sunday sermons.

Since then, I’ve had the sad misfortune of dealing with people addicted to everything from alcohol to cocaine to crystal meth and back again. I’ve had parents who skin popped the drugs, mainlined the drugs, snorted the drugs and ingested them in ways too ugly to describe. They did all this, as did the young lady Julia chronicled, despite knowing with some certainty that it would cause them to lose their children – maybe permanently.

Addiction changes how you view life. It changes your priorities. It causes you to justify the most unjustifiable behavior because nothing else matters but the next hit and the next high. I’ve had parents sit in front of me totally wasted while telling me how this would be the last high, that from now on their children would take first place in their lives, that they were tired of living this way.

They meant those words in the instant they said them. Then the high would wear off and suddenly nothing mattered again except that next hit.

People who have never dealt with an addicted friend or family member cannot begin to comprehend how much support is needed for an addict to make the right choice when the urge hits. They view getting high as simply a sign of weak character, indicating someone who should simply be locked away because they obviously don’t want to be sober. But jails aren’t a solution. Not only are they significantly more expensive for taxpayers than treatment programs, but they often offer no way for the addict to learn the skills needed to at least try to break the cycle. Given what we know about how many times the same people cycle back through the criminal justice system because of their addiction, and given how expensive we know that option is compared to treatment, you’d think it would only make sense to send these people back through multiple treatment programs rather than jail.

At least in treatment there is the possibility that this time it will take, that this time the addict will emerge with the skills and support system needed to keep the devil at bay.

Unfortunately, when it comes to politicians having the courage to point this out to their constituents, they usually wimp out in favor of looking “tough” on drugs. “Lock’em up and throw away the key” is the stance that wins elections in America. What rarely works is getting people to understand that prison is not only prohibitively expensive but most often an exercise in futility when dealing with addicts.

I understand the frustration that comes from watching someone re-enter a treatment program for the fifth, sixth and tenth time. I firmly believe that kids should not be held hostage to their parents’ addictions and inability to stay sober despite treatment. If the parents can’t sober up for their kids within the first year of state custody, parental rights should be terminated and the children given a chance for a healthy life in an adoptive home.

But when you are looking at the best bang for our tax bucks in treating addicts, the math is simple. Jail is expensive and rarely works. Treatment programs are cheaper and have a better success rate. 

You shouldn’t need a calculator to figure that equation out.