Today's depressing Massachusetts statistic

Does not start as a 'chemical issue.'
But it sure becomes one quite fast....

Where we live has a particular geomancy that lends it self to this--a particular lifestyle, rhythm, etc.

This isn't really about programs--there are plenty.
This isn't about Narcan....we have enough to administer to the same person 5 times in a week.

"Soul work" (Cornell West regarding American politics)) is what this dialogue needs...

you cant buy a bag of heroin anymore without running the very real risk that its cut with fentanyl or carfentanil

which, btw, is one of the things that happens when you have prohibition.

i've heard that even pills are being faked now? idk how true that is, i've distanced myself from that world, but that used to be the 'safe haven' of opiates because you knew what you were getting. of course, this was usually to avoid being ripped off, not to avoid having your shit cut with fentanyl and ODing or nodding off while driving and crashing.

I am deeply concerned with how the state of Massachusetts is addressing this opioid crisis. Let me clear that when we say it is an epidemic I am somewhat confused as the concept of epidemics are that there are contagions that are spread among humans causing grave illness and sometimes death. AIDS was an epidemic. The opioid crisis is not an epidemic unless one wishes to consider the contagion bad thinking and bad ideas. One of the bad ideas is that Harm reduction (HR) has so permeated the government that those who question it are marginalized or ignored in the drug policy dialogue. An example of this is the initiative of Boston HealthCare for the Homeless’ safe injection facility (SIF). A program last night at BU School of Medicine was all HR all the time, there was no place at the table for a dissenting view.
The ever expanding policy of HR that includes “no wrong door” has resulted in the deterioration of neighborhood around Boston Medical Center. Active drug use, overdoses, drug dealing, assaults, thefts, zombies pushing baby carriages seeking K2 or ‘pins or anything to dull their feelings and most recently major crime ( a shooting and death) are relatively new to this area and I don’t think that we can use “the island closed” any more as an excuse.
We have flooded the streets with medication assisted treatments, access to clean needles, alcohol swabs, Chore Boy to facilitate smoking of your drug of choice, cotton and cookers, Narcan and the only results that one can see are more overdoses and repeat admissions (sometimes every week) to the “No wrong Door” spin cycle of detox. The persons were are supposed to be serving have no motivation to stop using. Most people stop using drugs when they have a reason to stop. Pregnancy is a great motivator and often time’s jail too is a motivator. A safe site provides no motives for one to consider giving up drugs. Avoidance of death is not a motive as evidenced in the recent statement to me from a patient, “I have been Narcan’d 17 time…” When consequences are removed from our actions the very concept of human agency evaporates (skin in the game). This is what has happened with the well-meaning idea of HR which has now become an ideology; life has become meaningless and therefore a vacuum in which people bounce between boredom and oblivion. Just take a look at our own little Hamsterdam At mass Ave and Albany St. There is nothing to hope for, nothing to fear.

^{( when the state and Mayor Walsh closed the Long Island Bridge )}

The graph shows shocking results; very discouraging on its own.

More data is helpful, as always, because without it, false conclusions can be made.

I'd like to see other states' data compared to the national average. Unfortunately, the source data are voluminous and difficult to parse.

I have long believed that there is far too much emphasis on prescriptions causing the heroin problem. Sure, when Oxycontin first came out, 20+ years ago, some weaned off it with heroin. Today, I'm told that doctors must fill out all kinds of DEA paperwork to prescribe it and prescriptions are rare. I think it's more of the traditional peer pressure "try this" than anything begun with a prescription.

Long an opponent of legalization in my youth, I reluctantly support it now. Tax, regulate and limit the purity and additives. Dedicate the tax money to treatment. The courts do nothing when arrests are made anyway.

Politicians don't want to touch this one. They'll talk about treatment programs, NARCAN, law enforcement, other ways of treating the symptom. They'll talk about "keeping drugs out of our community". It's a typical approach to danger and risk: believing that it originates only from outside ("build a wall"). I spoke to a politician who was running for office this November, someone who seemed brighter than average and who had worked with substance abuse issues, and asked him what he would do about the contribution of prescription pharmaceuticals to the addiction problem: for example, look at sales practices, incentives, etc. He seemed utterly gobsmacked at the question. It's hard to check an "epidemic", or whatever you want to call it, if you fail to at least seriously examine something that's contributing to it.