InSite Safe Injections Site Closure

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Homeownertoo
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Re: InSite Safe Injections Site Closure

Post by Homeownertoo »

steven lloyd wrote:
Homeownertoo wrote: BTW, I am dealing with one such person now, a brother, and am painfully aware that there is nothing for him until he reaches that point.


Fortunately, this poster is quite erroneous and incorrect in presuming or suggesting it (“hitting rock bottom”) is a necessary condition for entering a cycle of change.

I am not accustomed to you misreading my postings. I said "hitting rock bottom and/or decided to stop."
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Homeownertoo
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Re: InSite Safe Injections Site Closure

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SL, I won't repeat your last lengthy posting as I'm sure you know what's in it. But a response is in order.

Perhaps you thought I wouldn't notice how you cleverly inserted poverty and crime into a discussion over drug use and addiction. In fact, however, I had said nothing about poverty and crime, and you were (supposedly) responding to my point that effective treatment of addictions begins with a decision and commitment of the addict to escape from his addiction (often arrived at after 'hitting bottom'), at which point intervention may be helpful. Apparently, you think otherwise, however. You apparently think that, via the magic of 'cognitive behavioral methods' and enough tax dollars, you can 'cure' addicts who don't want to be cured or don't think they need to be cured (just a delusion spawned by their environment and marginalization, I guess).

I find it remarkable that you are so eloquent on the alleged failures of other methods (caricatured as "arresting more people, building more jails and start locking everybody up") and so silent on the lengthy record of highly touted bureaucratic interventions. You need only contrast the carnage of President Johnson's liberal-inspired Great Society programs with the relative success of President Clinton's conservative-inspired welfare reforms to begin to ask what went wrong. Or, if you prefer to look closer to home and today, consider the massive failure of the massively expensive interventions in the Downtown Eastside over the past decade.

If your approach accomplished more than the delivery of expensive promises, it would have no shortage of supporters, least of all among taxpayers like me who have tired of funding the ever-widening pipeline of cognitive behavioral (or whatever is the flavor of the month) 'solutions' that seldom, if ever, deliver on their promises of 'pay now or pay a lot more later'. What particularly galls, however, is the caricaturization of any alternative as simply "arresting more people, building more jails and start locking everybody up".
“Certain things cannot be said, certain ideas cannot be expressed, certain policies cannot be proposed.” -- Leftist icon Herbert Marcuse
“Don’t let anybody tell you it’s corporations and businesses create jobs.” -- Hillary Clinton, 25/10/2014
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Bagotricks
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Re: InSite Safe Injections Site Closure

Post by Bagotricks »

old-bushman wrote:I've heard it said that democracy is the worst form of government-except for all the others.
Maybe the same principle applies to insite. Just a thought. Your comments?


Legal, regulated drugs / Prohibition

Which is the lesser evil?

Considering we amplify the problems associated with drug abuse with prohibtion, and create a whole new set of problems ( crime, black market, putting people in jail, breaking up families, criminal records, mistrust/loss of respect for the police ) ASIDE from drug abuse with prohibtion...

Very interesting Old-Bushman.

http://www.leap.cc

Check this out. Cops that think drug use is bad, but the drug war is worse.
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Re: InSite Safe Injections Site Closure

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Seems to me it is clear that some form of intervention targeted at breaking the cycle is needed. I don't agree that Insite is even a marginally partial answer, with or without efforts to increase availability of supportive "housing". Nor do I agree that the rotating door approach of catch and release does any good either. I don't even agree that all of those things in combination as we have developed recently are much more than a very expensive "feel good" exercise, since it only a addresses a small fraction of the demographic involved.

And of course the oft touted cost/benefit THEORIES put forward by Steven are really little more than an attempt to establish an ARGUMENT that "there is another way" ....however vague and philosophical (that will cost much more now but "pay back" somehow in the distant future). That to me is also little more than a "feel good" position too, since it lacks practicality (IMO), missing far too many essential elements of "the real world as it exists", including adequate identification of all the global (as well as unique local) social, criminal, transient, and economic factors involved that continually contribute to the problem(s) that I see as cyclical and self renewing, ...not only on a short term basis but on a generational basis too.

I of course don't know the solution(s), nor does anyone else, because in my view so many of them (piecemeal and largely ineffective on a broad scale though they be)...

....are not so much focused on identifying and attacking the problem(s) in a global way to the long term benefit of ALL those afflicted,...

...but rather feeding the overblown ego's and wallets/purses of those who see it more beneficial to themselves (and their little kingdoms) by NOT wanting the problem(s) approached in such a way that they could actually be solved.

But then, NOT solving them is very good for the economy too... No? And it would also involve "infringing on (some) peoples rights and freedoms" in major ways on a comparatively massive scale.

Edit to add: I sometimes wonder too if all those taxpayer dollars spent acquiring and fixing up buildings in Vancouver for low income housing is really being done so much out of concern about helping people, as much as it is about government (and their close 'friends") getting involved in real estate speculation and acquisition, development, and eventual sale with anticipated profit on the taxpayers dime. Olympic Village ring a bell?

Nab
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steven lloyd
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Re: InSite Safe Injections Site Closure

Post by steven lloyd »

NAB wrote: Seems to me it is clear that some form of intervention targeted at breaking the cycle is needed.


That’s a great idea, but unless it somehow involves blaming and/or punishing the persons and/or groups being targeted it is not going to be a very popular idea. Particularly if tax money is involved and amazing results aren’t realized immediately (funny how people who are trying to lose weight can understand the concept they didn’t get fat overnight, yet we expect interventions to change social conditions to have amazing results overnight)

NAB wrote: And of course the oft touted cost/benefit THEORIES put forward by Steven are really little more than an attempt to establish an ARGUMENT that "there is another way" ....however vague and philosophical (that will cost much more now but "pay back" somehow in the distant future). That to me is also little more than a "feel good" position too, since it lacks practicality (IMO), missing far too many essential elements of "the real world as it exists", including adequate identification of all the global (as well as unique local) social, criminal, transient, and economic factors involved that continually contribute to the problem(s) that I see as cyclical and self renewing, ...not only on a short term basis but on a generational basis too. Nab


:137: I can understand that Al and homey often miss the significant points made in my “argument” given the concentration of their ideological blinders but I have been willing to give you more credit than that Nabs.

I am really at a loss as how to explain to posters who I normally feel are really quite intelligent that the interventions I have been talking about have produced measurable results. Not vague or philosophical or abstract or elusive pay back “somehow” in the distant future intangible ideas, but clearly defined interventions that have had practical, concrete, definable and quantifiable outcomes. Once again (and hopefully only once again), I will say I have been involved with the delivery of programs that provided taxpayers with both immediate and extended savings. I have been involved in collecting and collating research data. These were concrete, tangible, and quantifiable results that were measured at program completion, as well as after one year and after five years from program completion.

In my current position we also measure the effectiveness of different approaches and types of intervention. We don’t use cognitive-behavioural interventions because they are the “flavour of the day” (as homey so naively describes it) approach, but because evidence-based research tells us it is the most effective approach to take – that is, effective based on the fact it actually has a quantifiable impact in changing thinking and behaviour as measured by reduced rates of recidivism.

Unlike our ideologically driven government, we are not waddling around in the dark trying this way and that way. We use real research to measure quantifiable results and we use the evidence from that research to direct our efforts - except as and when we are limited by the government of the day.

Yes, real evidence-driven research has shown us there is another way Nabs, that includes “adequate identification of all the global (as well as unique local) social, criminal, transient, and economic factors involved that continually contribute to the problem(s) that we see as cyclical and self renewing, - not only on a short term basis but on a generational basis”. Unfortunately, ideological prejudices are extremely entrenched and resistant to challenge and as a society we seem more apt to remain adhering to approaches more conservative and fixed to the status quo. We are scared to step out in and follow new direction (long enough to see where it goes) and so we are doomed to continue repeating the same failures and mistakes.

This whole “debate” here, however, is just getting repetitive – and frankly, it is starting to get quite boring. People read what they want to read and block out the part of the message that doesn’t fit with their already determined ideological agenda. Sometimes they even block out material that is consistent with what they believe just because of some choice of wording (eg. “collective” effort – oops, must be talking about socialism and I’m having none of that stuff). If people aren’t even going to take the effort to read what you’re saying (as evidenced by some of the rebuttals) then at some point you just need to drop the issue. Besides, contrary to what some posters believe what we discuss here is not going to have any real impact on new social policy anyway.
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Re: InSite Safe Injections Site Closure

Post by NAB »

I think you missed my point steven, perhaps in your rush to to re-assert your position once again. But I'm too tired tonight to try and flesh it out further at the moment. Perhaps by the time I am ready to do so you will have reviewed my post and spotted it. For it will not be addressed through your philosophy, nor the existing approach(es) (status quo) regardless of what various small scale (in the scheme of things) studies, experiments, and results have produced you deem as meaningful to your argument.

Think about the dilemma a scientist faces when something works in the lab, and he/she tries to upscale and commercialize it on a global scale ;-)

All IMO of course.

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Re: InSite Safe Injections Site Closure

Post by deadscape »

"Their research, the renowned Adverse Childhood Experiences (ACE) Study, looked at the incidence of ten separate categories of painful circumstances – including family violence, parental divorce, drug or alcohol abuse in the family, death of a parent and physical or sexual abuse – in thousands of people. The correlation between these figures and substance abuse later in the subjects’ lives was then calculated. For each adverse childhood experience, or ACE, the risk for the early initiation of substance abuse increased two to four times. Subjects with five or more ACEs had seven to ten times greater risk for substance abuse than those with none." Maté, Gabor, M.D., In The Realm of Hungry Ghosts: Close Encounters with Addictions (Knopf Canada, Toronto, 2008) 193

I would hardly call addiction a choice.
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steven lloyd
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Re: InSite Safe Injections Site Closure

Post by steven lloyd »

deadscape wrote: I would hardly call addiction a choice.

Of course it is. Didn't you know? Every addict begins that path by waking up one day and saying "You know what?" "I think I want to make a conscious choice to give all my power away today and become a drug addict." "Really, I think even from a very young age I knew I always wanted to be a drug addict." "That's why I chose to be born into a life of poverty, despair and abuse." "I certainly wouldn't want to be as happy, smart and successful as all those people who judge me."
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Re: InSite Safe Injections Site Closure

Post by deadscape »

You make it sound like you've never made a dumb decision. That's all it takes.
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steven lloyd
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Re: InSite Safe Injections Site Closure

Post by steven lloyd »

deadscape wrote: You make it sound like you've never made a dumb decision.

:137: You did recognize my "over the top" and plainly obvious use of sarcasm, right ?
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Re: InSite Safe Injections Site Closure

Post by Captain Awesome »

The topic of addiction and choices is interesting.
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steven lloyd
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Re: InSite Safe Injections Site Closure

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Captain Awesome wrote: The topic of addiction and choices is interesting.


Indeed it is, and not nearly as simplistic as some would like to presume. In fact, the nature of addiction and addictive behaviour is quite complex and there is a huge amount of research material on the subject. I’m not going to tell you I know all about it. In spite of being educated and trained in the field and having more than fifteen years of direct experience working with addicts in one capacity or another, I’m not going to presume I have it all figured out like some here who are more than ready to finalize their opinions on the subject (in spite of knowing next to nothing about it).

Drug addiction can and does happen to anybody – from those who are marginalized and hopeless to doctors and stockbrokers (although the incidence rate is much higher among the former group). As far as addiction and choice goes, however, I can tell you with a reasonable amount of certainty that no one decides (ie. makes the choice) to become a drug addict. No one decides to give their power of choice away to some substance that will obsess and overcome their lives and control every decision they make from that point forward. No little kid grows up thinking “when I grow up I’m going to be a dirty, diseased and open-soured drug addict living in the alleys of east Vancouver with no home, no friends and no hope to live”. No, this issue is clearly not as simple as a matter of choice. It is so easy for people to make judgement though, isn’t it?
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Re: InSite Safe Injections Site Closure

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No one decides to give their power of choice away to some substance that will obsess and overcome their lives and control every decision they make from that point forward. No little kid grows up thinking “when I grow up I’m going to be a dirty, diseased and open-soured drug addict living in the alleys of east Vancouver with no home, no friends and no hope to live”.


Nope, no one really does it. Though some people choose to quit when they find themselves on the road to self destruction, and some people are unable to do so. Is it really a choice when some people can easily make it by quitting and for some people it's nearly impossible due to lack of character or weak will? May be it's an easy choice for some people and nearly impossible for others. I've been addicted myself to nicotine, and for me it was a bit of an effort. And for others it's damn impossible to do for whatever reason. Or do you still count it as choice even if it requires tremendous effort and basically changing who you are at the moment?
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steven lloyd
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Re: InSite Safe Injections Site Closure

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Captain Awesome wrote: Nope, no one really does it. Though some people choose to quit when they find themselves on the road to self destruction, and some people are unable to do so. Is it really a choice when some people can easily make it by quitting and for some people it's nearly impossible due to lack of character or weak will? May be it's an easy choice for some people and nearly impossible for others. I've been addicted myself to nicotine, and for me it was a bit of an effort. And for others it's damn impossible to do for whatever reason. Or do you still count it as choice even if it requires tremendous effort and basically changing who you are at the moment?


Good questions Captain, and clearly demonstrating an appreciation for how simple this question is not. It’s interesting you brought up the nicotine thing. That is one highly addictive drug and one I had an extremely hard time breaking free of (many failed attempts but never giving up on the idea of quitting). As you might have discovered in your attempts at quitting, there was more than just the withdrawal from the physical addiction (said to last from 24 to 36 hours) to overcome.

Again, when you look at the questions you’ve asked it should be clear there is no easy explanation to a very complex issue. The most favoured model of addiction theory right now is the biopsychosocial model. And if you’re thinking we’re just gonna include everything because we don’t know what the hell we’re talking about I wouldn’t blame you. Bottom line is though that the factors from each of these areas affect the propensity for addiction and addictive behaviour and all have to be taken into consideration when working with people with addiction issues. You say that for you it was “a bit of an effort” to break free from the addiction to nicotine (Do you think you are really free? What would happen if you had a puff?), and yet acknowledge it might be nearly impossible for others. Do you really think it is a matter of will (ie. that you had more will than them?), or is it possible that other subtle factors (bio-psycho-social) might have an impact?

In your last question you asked “do you still count it as choice even if it requires tremendous effort and basically changing who you are at the moment?” Choice often requires tremendous effort and basically changing who you are at the moment. Look at our Olympic athletes. At some point each of them decided they were going to excel at their chosen sport and change who they were. That is the power of choice. It involves making many decisions on a day to day basis (eg. no beer, run 10k instead), but these decisions are also dependent on a belief system (eg. “I can do it, I am worth it”). Using cognitive-behavioural techniques, this is where we try to create change in people who have become marginalized (for reasons much more complex tan saying “it is their fault”) and try to give them back that power of choice.
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Let's look at the athletes (they're hot topic right now). Do you need to be born special to be an athlete? Somewhat. After all, you do have to be relatively healthy, you have to have parent who would recognize your gift in early age and push you in the right directions. Then you have to make a choice to exercise regularly, you a have to make a choice to eat healthy and push yourself everyday to achieve more. So, when you're getting that gold medal in Vancouver, did you make a choice to become a champion? Not really, cause half kids don't even dream about it. But the thousands of smaller choices you made everyday - one more lap, one more swing, so on - did it for you.

Now let's look at the problem of addiction.

Are there any circumstances that make you more likely to get involved with drugs? God yes. You can be born in a poor family, you can be born on the wrong part of town, you father might be an abusive jerk that drove you out of your home onto the streets where you mixed up with some dirty kids that one day asked "Yo, you know what will make you feel better?". So you might try some. You might try some more, you might start trying them every few days until you're full blown addict to the point when you've completely given up on your future and focused only on your habit, your career is ruined, you have no place to live because you've got kicked out, nobody will hire you because you're a dirty stinky fella, and you now steal money as a way of surviving and feeding your ugly habit.

Now. Did you make a choice to become a low life addict living on the street that very first time when you've decided to try drugs? Nope. In fact, if people knew that this will happen to them, none of them would ever go down that road. But all these little choices that you made everyday - to keep injecting yourself, to keep falling down, to keep being in poverty and addiction and not to change anything - these were your choices not to do any changes, would you say? Do we count all these everyday choices one makes as a big giant choice to become what you've become?

On one hand, I laugh at people who present these ideas that all homeless people with habits living on the streets have a choice to one day clean up, get a job, and become a contributing member of a society. I'm sorry, I've only met ONE person who actually did it, and it was a tremendous, enormous effort on his part. When you get to that stage, the cards are already dealt, you have a *bleep* hand, and your chances for success are incredibly low. But was it their choice to live on the streets while turning remaining brain tissue into mush with crystal meth? All these little decisions that their made through out their life were theirs, after all.

But you're right. Complex issue to say the least. And like many other things in life, not exactly a black-white situation, but many many gray areas and half tones.
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