Dr Andrew MacLean Pagon MD PhD的动态

Judging from this chart, there were perhaps 25,000 drugs deaths annually when Nora Volkow became head of the the NIDA in 2003. (There were under 20,000 in 1999, while the Leshner-Volkow drug addiction is a disease-that-can-be-treated model was coming into full swing.) There are currently about 110,000 deaths annually. https://lnkd.in/gza9JR9s Has there been less treatment since 1999-2003? Buprenorphine-Suboxone weren’t in use at the time. They are currently widespread commercially with a minimum of restrictions. Is there something about our drug addiction and death epidemics that is exceeding our ability to treat them? Something about the addiction to and death from drugs seems to be infiltrating America (more so than in Europe). Is this reversible by treatment?

Addiction treatment works, everyone deserves access to it if they so choose, including those in jail. Often in our industry we speak less of prison reform, but reform while incarcerated is directly tied outside success. Effective treatments like methadone and buprenorphine saves lives, reduce overdose deaths, and improve public safety. These life-saving medications are under utilized in the criminal justice system. Only 5% of jails and prisons offer MAT, despite studies showing that providing them can reduce overdose deaths by 60%. Expanding access to these treatments for incarcerated individuals is a critical piece for breaking the cycle of addiction, supporting recovery, and enhancing community health. (https://lnkd.in/ePZmYNf3).

?? A new study shines a light on the availability of addiction treatment in U.S. jails, revealing troubling gaps in care for those with opioid use disorder. Out of 1,028 jails surveyed across the nation, fewer than half (43.8%) offered any form of medication for opioid use disorder, and only 12.8% made them available to all inmates who need them. With two-thirds of incarcerated individuals battling substance use disorder—many with opioid use disorder—this lack of access to life-saving medication in jail is a missed opportunity to provide critical care. While 70.1% of jails offered some form of substance use disorder treatment or recovery support, many cited a shortage of licensed staff as a major barrier to providing opioid medications. Larger jails, those in lower social vulnerability areas, and those near community-based providers were more likely to offer these treatments. Dr. Nora D. Volkow, Director of NIDA, emphasizes the importance of offering addiction treatment in justice settings to break the cycle of addiction and incarceration. "Connecting individuals to addiction treatment while they are incarcerated is crucial to reducing the risk of relapse and overdose, and to helping them achieve long-term recovery." https://lnkd.in/gNABFt7c #AddictionTreatment #OpioidUseDisorder #JailReform #CriminalJustice #SubstanceUseDisorder #Naloxone #RecoverySupport #PublicHealth #HarmReduction

Challenging the Narrative on Drug Criminalization In today’s society, the approach to drug-related offenses raises profound questions about our justice system and public health strategies. The pervasive criminality associated with drugs often overshadows a crucial truth: addiction is a health issue, not simply a criminal one. Current practices, such as roadside drug tests administered by police, do not reliably measure impairment. Instead, these tests contribute to a cycle of traffic charges that criminalize individuals struggling with substance use rather than addressing the root causes of their issues. The implication is clear: our law enforcement often leans towards incarceration rather than rehabilitation, believing that locking someone up is a solution. Yet, we know that prison doesn't effectively resolve addiction. The reality is that the private prison system profits from this cycle, creating a financial incentive to perpetuate incarceration rather than fostering recovery and rehabilitation. This approach overlooks the human aspect of addiction and fails to provide the necessary support to help individuals reclaim their lives. It’s time to shift our focus from punitive measures to compassionate, evidence-based treatment solutions. Acknowledging that addiction is a health issue opens the door to more effective strategies—ones that prioritize rehabilitation over incarceration. Let’s advocate for a justice system that addresses the complexities of addiction with understanding and support rather than criminalization. Together, we can push for policies that recognize the humanity of those affected by drug use and invest in a system that truly promotes healing and recovery. #CriminalJustice #PublicHealth #AddictionRecovery #RehabilitationOverIncarceration #SocialJustice

Today I have 12 years clean from drugs and alcohol. My sobriety has been dethroned by my son (vid attached) and is now the second best thing that has ever happened to me. Usually I take my “how’d ya do it?” AA traditional speech and post it here, but I’m going to do something different this year. I’m going to reveal my true mission. An estimated 2 million Americans are in prison or jail right now. At least one in five of them are locked up for a drug offense, meaning they could be just like me. A much larger number are locked up for non-drug offenses that were caused by addiction. In addition to incarceration, I’ve also been homeless. Just my own experience here, but I don’t think I’ve met a single homeless person who didn’t suffer from addiction. (But please do your own research by getting to know a homeless person, maybe by buying them a meal if you can do so.) In any group, society, or country, the minority ~20% are preyed upon by the majority ~80%. You’ll see this manifest everywhere once you start paying attention to it. Here in America, our drug policies, incentive-based policing, and for-profit/taxpayer-funded prisons keep our bottom 20% as low as dirt. In fact, within 2 years of release from jail or prison, 68% of prisoners find themselves incarcerated again. The only thing I want people to take away is that addiction is a disease, not a choice—meaning if you and I both shot up today, I’d wouldn’t be able to stop myself from shooting up tomorrow. My thoughts and priorities would simply become functionally illogical, reality a little more bent, whereas your worldview would persevere. Please think about this when you think about how we treat addicts and alcoholics. And more importantly, when you see someone visibly struggling with addiction, understand that they’re still just as miraculous as you are. Anyways, I’m so grateful to be here today. I wonder if I even deserve it. Please forgive me for posting about such an uncomfortable topic. It is my karmic duty to spread the message as far as I possibly can. Time to go hug my son. ??

The recent release of a client from a detention facility has brought to light a concerning issue within the treatment center landscape in Charlotte. This individual, who had been arrested for a substance use-related crime, successfully achieved sobriety while incarcerated. However, upon her release, she faced significant barriers in accessing treatment. One sober living facility could not accommodate her until the following day, while another refused entry without prior completion of a treatment program. Most alarmingly, a 30-day treatment program denied her admission due to the absence of drugs in her system. This policy is both unacceptable and counterintuitive. If an individual has recognized their need for help and is actively seeking treatment, it is imperative that they receive the support they need regardless of their current drug use status. Forcing someone to relapse in order to qualify for treatment is unethical and potentially life-threatening. The fact that this client had achieved sobriety in a structured environment, such as a detention facility, demonstrates her commitment to recovery. It is crucial that treatment centers recognize and support individuals who are actively working towards change. The policy of denying admission based on drug use status perpetuates the stigma associated with substance abuse and creates a barrier for those who are seeking help. Treatment centers should instead focus on providing a safe and supportive environment where individuals can receive the necessary care and guidance to address their addiction. It is time for treatment centers in Charlotte to re-evaluate their policies and prioritize the well-being of those they serve. By removing barriers to entry and embracing a harm reduction approach, these facilities can play a vital role in supporting individuals on their recovery journeys. The client's experience highlights the urgent need for systemic changes within the treatment system. It is essential that policies and practices are reviewed and revised to ensure that individuals seeking help are met with compassion, support, and access to the services they need.

There is never a waitlist for a jail cell for someone struggling with addiction. Why, then, is there a waitlist for treatment—or for safe and stable housing? Currently in Canada we’re experiencing the worst overcrowding in jails in history. Instead of addressing the root causes—like untreated addiction, trauma, and homelessness—we’re building more carceral institutions. Meanwhile, the waitlists for inpatient treatment beds and affordable housing continue to grow, leaving countless individuals without the resources they need to recover and rebuild their lives. I personally ended up in and out of jail and prison as a result of unaddressed trauma and the use of substances to cope. After finally managing to get into detox, I would complete it—only to face a 4–6 month wait for a treatment bed. During that time, without the support I desperately needed, I would inadvertently go back to using, repeating the cycle. Unfortunately trafficking became part of that cycle. Addiction is a health issue, not a crime. But when our systems prioritize punishment over healing, we perpetuate harm, particularly for marginalized communities. Indigenous women, for example, are vastly overrepresented in prisons, often as a direct result of systemic barriers to housing, treatment, and other critical resources. We need to shift our priorities: Invest in affordable, supportive housing as a foundation for recovery. Expand access to detox and treatment programs to mitigate long waitlists. Destigmatize addiction and homelessness by framing them as societal challenges, not personal failures. Address systemic inequities that push vulnerable populations into the justice system instead of connecting them with care and housing. Focus on holistic, community-based solutions that promote long-term recovery and reintegration. Building more jail cells is not the answer. Investing in treatment, housing, and community supports is. What kind of society do we want to be: one that offers punishment or one that creates opportunities for healing, stability, and hope? How can we collectively shift the narrative and the priorities? I’d love to hear your thoughts!

So very true. Start with the root causes of these problems and issues, and then put specific dedicated services, including funding into place through designed and structured service plans. This allows for service planning to be reviewed and revised. We don’t need to be maticulous financial managers or accountants to follow,strategic pathways in achieving positive service delivery and great outcomes.

Touche'