Right when I was about to start grad school, I had to draw a line in the sand with a friend I had grown up with, although we had not hung out socially until that summer. One night he left some drugs in my friend’s car (we did not know he had them). I could see the two paths of my life literally diverging. I chose to save myself. I told him that I would not return them. I told him that he was a good person, but I couldn’t be around that stuff. He said “Okay, bye Kara.” That stung. I didn’t hear anything from him for a long time.
The next summer, the night before I was leaving for my first clinical, I get a text “What are you up to tonight? I don’t feel like cooking. You pick the place, I’ll pay.” I remember thinking “I thought you hated me??” Well, we got dinner. He told me he was 4 days sober. Off everything! Except cigarettes. He said, “You know, I have money… I could buy drugs, but I would rather take you out for dinner.” I honestly did not realize how severe his addiction was until that evening. It was eye opening to listen to him. And of course, I had to drive to CO for 2 months the next morning.
Being friends with him has changed me as a person. The heartbreak, the hope, the disappointment, the letting go, the smile that isn’t quite carefree, because you know it could change at any moment. I have a better, though certainly not full, understanding of mercy. He is doing better now, but I don’t think his mind will ever be 100% again.
I really don’t know what the answer is, but I appreciate delving further into research to find compassionate and effective options to help both individuals and society.
I just quickly want to say, before I finish listening, that I very much appreciate an episode in my life that's not about NY politics, Columbia and Harvard, or Tulsi Gabbard's latest crazy pronouncement.
Just wanted to share something made me smile. I was listening to this episode and texted my boyfriend that I was listening to a really interesting episode of Pantsuit Politics and asked if he wanted to listen to it. He said “Yes, I love Pantsuit!” He’s not a regular listener but he has really enjoyed several of the Spicy Lives. They’ve made for grand opportunities to pause the episode to talk about things. Also I love that he always calls you “Pants!” As in “Let’s listen to Pants” 😂
I appreciated the conversation here. An extended family member overdosed on edible marijuana several years ago that landed the person in the hospital. Now the stuff is legal or at least socially acceptable, I’ve learned that little research has been done on serious side effects or even permanent damage. Some people dismiss marijuana as no big deal but it caused havoc in our extended family. Users cannot always see how their choices to use either causes unpredictable behavior or makes it worse for their family.
This is what scares me so much. Marijuana is not harmless, but I am a middle-aged woman and sound "hysterical" when I mention it. But I have seen so much damage to families, and now that edibles are easy to obtain, we often have children ending up in the hospital because they didn't realize what they were eating. People say, "it's not as bad as alcohol." Well, that may be true, but it's not saying much.
Deborah, right before I read your comment, I read a very critical one on Instagram about how we should have differentiated between types of drugs in the discussion. And certainly there are differences -- "drug" means so many things. But your comment illustrates how difficult it is to make generalizations in any direction. There is always some degree of risk.
Thank you for this episode. It is SO valuable. No one wants to be an addict. My husband is in recovery and has been for many years. His sobriety was shaky when we met, and he relapsed not long after we were married. It took me several years to understand the family disease aspect and the CRAFT approach helped me find my feet as a partner to a very good man with life threatening opioid use disorder.
When he was in active addiction, initially, we lived in Texas and our insurance did very little. His providers stigmatized and minimized his struggle. I did not fully understand he was in active addiction and took a job in Connecticut as this was going on. I believe moving saved his life. The day I realized he needed inpatient treatment was two days before he and I flew to Connecticut (I'd moved ahead of him). We drove straight to an inpatient treatment center. It was literally the first day we had insurance through my Connecticut job. Had we still been on our health plan through his Texas job treatment would have been cost prohibitive. I still get chills when I think about the providence of how all of that played out.
Access to care, medically assisted treatment, 12-step programs, all the therapy, for him, for me and for us are scaffolding needed to keep my husband healthy. The stigma of addiction still shadows some parts of his journey, but living in New England we've found a much more supportive community than we had previously. He has had one lapse, and that is one thing I wish the episode had talked about a bit. Being in recovery is not without missteps. People lapse/ relapse. It is consequential, and if they survive the lapse/ relapse, it is not hopeless. All is not lost.
My husband's life has been saved by having all of the pieces of the puzzle of helping someone with substance use disorder available to him along with the privilege of being a middle class white man who had parents who kept sending him to treatment when he was young and who survived accidents and overdoses before his feet found enough stability for him to choose sobriety. I don't take that for granted. This episode highlights so many gaps, and I fear we've further away from closing them as we watch the current political climate destroy public health systems. I hope a reckoning is coming.
Thank you, Erin. I'm so glad that you and your husband have found support when so many gaps exist. I have browser tabs open to learn more about the CRAFT approach.
I so appreciated this conversation. 3 years ago today (the 22nd) my sister-in-law died suddenly. In the aftermath of her death, we discovered that she had been ordering what she thought was Xanax from an online ‘pharmacy’ and the last batch was tainted with fentanyl. She had been complaining of not feeling well for about 2 weeks and had even gone to the ER, but no one did a drug screen that might have saved her life. I have so many complicated feelings around the conversations about drug use, but I truly believe the more we can have discussions like these, the more progress we can make.
Over the course of learning what had been going on, we (my husband and I are both medical professionals) were shocked to discover how simple it is to order from these online ‘pharmacies’ with the click of a button and a credit card number to be delivered to your home through the US mail. You don’t need connections or dark alleys, just a simple search on google.
Wow reading the comments here have added a whole other layer to the conversation which also gave me a lot to think about. I’m in San Francisco and gosh it feels like this is intractable. I’m hopeful for Lurie (new mayor) but he’s got a lot to confront and a major budget deficit to contend with at the same time.
I truly hope we can make a real dent with both more shelters AND more treatment programs 🙏 grateful for organizations like City Hope that show up day in and day out to do this hard work (https://www.cityhopesf.org)
I totally agree about the comments adding new layers! And I so appreciate organizations like this that are trying not to leave anyone behind in any respect.
I’ve been thinking about this basically my whole life having watched my brother (16 years older than me) struggling with addiction and mental illness, cycling in and out of homelessness, jail, half-way houses, and prison. He’s been clean now for almost 2 years, and out of prison for 1 year. Still hard to shake the feeling that he’s been here before and not made it; still have no answers about what we can do in our communities, states, and nation. Still hoping we can find an answer-or, more likely, multiple answers. Absolutely appreciate this conversation.
I’m fascinated by the required testing/sobriety methods mentioned in the episode. I immediately wonder about logistics. I’ve had friends go through drug classes/testing for dui diversion, and they had to drive all the way across town for their check ins. I wonder how you implement something like that without making people miss work or otherwise make it difficult to comply. Access to help and resources is important. When I was a CASA, part of our training was that sometimes for seemingly belligerent children, or non compliant parents, it wasn’t a won’t but a can’t. I had kids come back into care because parents couldn’t find work with a record but they knew how to have income selling drugs. I witnessed parents who wanted to take the classes, go to the appointments, etc but were stymied by the lack of dependable transportation, or they were newly (sometimes forcibly due to incarceration) sober, and barely functioning. We can’t just say “don’t do drugs”. Compassion isn’t a downfall. And yet, we have to look out for those in the community who don’t want to/can’t be around active addiction. It’s definitely not simple. And not solvable in a catchy campaign slogan level.
We have an ex-employee who was diagnosed with schizophrenia and bipolar disorder in his 20’s. He lacks family support and tried to get meds through county resources. He didn’t like the way the meds made him feel and needed continual adjustments - but it was SO hard to get a ride up to the county office and feel heard by his doctors. He was trying SO hard and it was heart wrenching to witness. We tried to partner with his case worker to help support, but ran into red tape.
He eventually stopped them and self medicated to cope and has been unhoused for several years now. He stays around our stores and we see him often. The elements have been hard on his body, but his sweet spirit is still there.
Such a hard, hard problem that I wish we as community would see belongs to ALL of us.
I really appreciate him highlight the idea that people have the right to NOT be around people who abuse drugs. Many people find themselves in need of public housing because at one point they had to leave a home that was made unsafe or intolerable by an addict or a person who abuses drugs (parent or spouse). Those people and their famileis deserve a safe living environment. Abusing drugs or alcohol does not make people "bad," but it does make them unpredictable and that can be very stressful and scary to be around, even if the user is not violent.
I think there is a big difference between using drugs for personal enjoyment and abusing drugs to the point of physical dependency. In my experience, when that physical dependency takes hold, a person and their ability to make decisions for themselves can be lost. I don't know if lifelong, total sobriety is possible or appropriate for every addict, but required treatment may offer an opportunity to determine what that person needs/wants and not what their addiction needs/wants.
This is true, but it’s not always apple to apples. I think it is important to consider who/what you are safeguarding: the addicted person or the addictive behavior. When you love someone in the throes of addiction, this is a hard distinction to make. You’d do anything to protect and provide for the person because you care deeply about them and you are so scare of what will happen if you don’t. You don’t want to inflict any tension or hardship because you are afraid of harming them, but then you have to remember that being permissive allows them to continue harming themselves. It truly is a compassion trap. I really appreciate Dr. Humphreys’ acknowledgement of this struggle.
Beth I so appreciate you initiating the conversation about the US tendency to oscillate between extremes. It is one of our fundamental flaws. I’d add lack of humility as another.
I so appreciated his comment about having direct conversations with people about “learning to live with” people you disagree with or have issues with in order to make positive change.
I’ve been trying to get a grasp on how we got to this place of not only being staunchly anti something but also insisting LOUDLY, that everyone else be equally anti that thing or else they must be completely evil. Certainly I do think there are places where there is not a lot of nuance between good and evil, but I think those are rare. IMHO what drives the difference in perception between good/evil or right/wrong is actually differences in experiences, struggles, community needs, culture, etc, and our inability or unwillingness to understand those differences and instead shortcut ourselves into whatever quick, easy explanation vindicates our feelings about the other. That’s why I love the PP approach to these convos. Maybe we’ve always been like this and social media is just shoving it in our faces, but I hope we can get past it so we can collectively work towards true lasting change.
My husband and I were just talking about this tendency to swing between extremes. I think it's part of human nature to overcorrect; it's hard to hit a bullseye when you're scared or desperate.
I think Americans seem particularly bad at it because we have so many resources to throw at problems. It's like we're at the craps table and when one person wins on black a couple times, we become convinced to put all our collective chips on black. It's all black and no one feels safe enough to try red, until we lose enough times and then put everything on red.
I remember reading somewhere that in the 1970s when world governments were worried about overpopulation, it was thought that we had only enough resources to tackle the problem from one of two directions: either drastically decrease births rates, or drastically increase food production. We couldn't do both. But, of course we have done both. China did more of one approach, and our scientists here in America did more of the other, and here we are now with more than double the population and less starvation throughout the world. Things still suck, but they suck less than expected! Maybe the lesson here is that all countries overcorrect, we just have to rely on each other to split the difference?
Very much appreciated this conversation. I live in Vancouver and this is a huge conundrum for BC as a whole right now but especially Vancouver and Victoria (where my parents live) where communities must grapple with what to do next. Hearing conversations like this help me form my thoughts as a citizen when elections come around and competing platforms and policies abound.
Not to be a broken record with my Louise Penny love, but I have found the discussion of drug use and trafficking in her books from Canada to be so valuable. Fiction can really put you in a new space!
Ah, this was such a good and challenging episode. I volunteer at a local women's shelter, and often find myself struggling with the fact that some of our guests really need to be in a sober living type of space where they are being made to take their mental health meds, but that a lot of them don't want that. I also struggle because I know that nobody can be forced into recovery and that at the end of the day, long-term sobriety usually occurs when the person with an addiction wants to be sober. And yet, clearly, what we are doing isn't working! This interview gave me a lot to think about.
Also, I just wanted to add that I won the DARE essay contest in 6th grade at my school and then went on to marry an alcoholic and used alcohol as a coping mechanism and drank way. too. much. for many years. 😆 (My husband has been sober for 6 years now, and we are both doing great!)
I've never been so eager to click on a PP episode! Thank you, Beth, for exploring this topic and introducing us to Keith Humphrey's work in this area.
I'd like listeners to have a little more context than what a study in the limited timespan of 2020-24 can provide. I moved to Seattle in 2012 and over the years experienced the city moving towards the policies that Keith described. George Floyd's brutal murder wasn't the catalyst, but the opportunity.
Pre-covid era, I participated in community forums and local Democrat meetings where I met advocates who were pushing for harm reduction that could extend as far as the free drugs Keith mentioned in the BC area. I met and talked with former residents of and workers in homeless shelters, and several cops who knew those shelters, who told me of the dangerous conditions in these places, many of which traced to the unregulated presence of drugs. I've experienced how low-barrier shelters (ones that allow drug use) not only destroy neighborhoods, but also put their residents and drug users drawn to the dealers in the shelters in serious danger. In recent years I've learned how the city's housing-over-treatment approach has led to drug users who weren't capable of living on their own being left to die in low-barrier housing (if they were lucky enough to get housing) or in Seattle's unmanaged green belts. Advocates for "safe" drug use and housing first got Seattle to where it is today, with drug deaths and drug-related crime going up over the past five years while the same were going down in other regions of the country. Floyd's death was the excuse to get these permissive policies over the line, not the cause.
Yes, it's true that deregulation policies that went into effect during and after 2020 accelerated the problem. But Seattle already had majority low-barrier shelters, a focus on housing over treatment, and a small but robust advocacy for the right of drug users to continue using. A city - a region - does not become what the PNW has become overnight. That takes intention.
What I realized while listening to your conversation with Keith is that many of my neighbors, people in the community who didn't go to the same forums and meetings as I did, weren't and aren't aware of this pot we'd all been slowly boiling in. Seattle is a place full of compassionate, intelligent, well-meaning people who want the best for their community. They were told that harm reduction (no matter the form) and housing before treatment were best practices, so they backed those policies. They voted and donated and repeated the advocates' talking points. They did what they thought was right.
Now that organizations like We Heart Seattle are trying to get folks off the street and into treatment, connected with family who can help them on the road to recovery, into high-barrier housing and away from users, there are so many entrenched advocates fighting them on all those fronts that my neighbors are understandably confused. I've been to meetings at City Hall where advocates vociferously oppose family reunion; I'd seen the same advocates in my neighborhood arguing against treatment and reunification. And my neighbors were just as likely, or even more likely, to listen to the drug use advocates as those encouraging treatment. That's just what the social structure of Seattle (and of the PNW at large) has conditioned them to do.
That's why I left the PNW. I was tired of fighting the uphill battle virtually alone in my neighborhood. I admire those who stay and keep fighting the good fight, but I just couldn't take the stress anymore. Keith's work is important for my neighbors, those who use, those who don't, and those who want to have a life beyond using. I hope leaders across the PNW, and across the country, take such research seriously. It's very hard, but we must work towards helping people to get off these drugs, for their own sake and for the sake of our communities.
I really appreciate you taking time to share all of this perspective with us, and it rings so true to me that people are trying to do what they are persuaded is good and right for their neighbors. This is why I loved Keith's research. I could easily see myself voting for all of these initiatives enthusiastically.
I grew up in Olympia and watched it change the older I got (I’m in the Tacoma area now). I still have friends who live in Oly and it sounds like it’s starting to get better but phew - it seems like it really went off the rails there for a while.
The comments about Portugal not being the US really struck me. For better or for worse, we do not have the connections that most other countries do. We can definitely learn from other countries, but we cannot wholesale adopt what they do - in all kinds of realms - and expect it to work
Only a couple minutes into the interview. This Portlander has never once heard or considered the concept that drug use is a right. It was definitely not a part of the campaign to decriminalize all drug use.
Thanks for the comment because I was wondering. I'm in San Jose, which tends to be a liberal city but not a progressive city. We're never cutting edge on policy. We leave that to our neighbor to the north (San Francisco). I heard him mention SF early on, and I was gobsmacked by learning that many there considered drug use a right. It kind of tracks based on other things I've heard from people who spend more time in the city than I do. It also now makes perfect sense that the city recalled its DA. I'm liberal enough to want to decriminalize, but of course "hey, do fentanyl with your friends!" crosses a great big ol' line for me.
Years ago I read the book “Chasing the Scream: The First and Last Days of the War on Drugs” and it really blew my mind. It traces the history of the war on drugs (including the devastating fact that Joe Arpaio is basically a disciple of the main dude who engineered the war on drugs 😩). It also really book really drills down on how the approach really fails a lot of people. The author explained how there are basically always people using drugs that are just fine (only 10% of users are actually addicted per some UN group) and that drug policy really hurts that minority greatly. It does a good job showing how narrowing the market through prohibition leads to more potent options being utilized. It also just creates more people considered criminals, and the stigma and consequences of that definitely do not help make more a constructive situation for someone who is struggling with drug addiction.
The book truly blew my mind at the time. My job was literally to analyze stuff for the police to determine if it was an illegal drug. We were often navigating updated laws as more things became illegal. As a naive, sheltered, try-hard, I certainly had a lot of black and white attitudes about drugs and especially once I started my career, I suppose I felt a bit defensive. The book came to me in during an intense phase of my life where many black and white perspectives I had got busted up. I was being primed for nuance shortly before finding the show (I just realized that!). Thank you for this very thoughtful and informative episode!
To the point of the comment further down about the goals of policy not working, it’s hard to see any good intent in the way the war on drugs was designed. This one seems to get exactly what it wants- the cruelty was often the point- need I mention Sheriff Arpaio again?
I’d really like to hear more about how often policy design utterly fails its goals. The Portland decriminalization was doomed from the start. People voted for it not just because punitive measures fail sick people, but because it came with a BOATLOAD of money for services, but then the services and the decriminalization went into effect on the same day! And despite all that money we still don’t have anywhere close to adequate services because we couldn’t possibly hire and build the facilities to climb from the bottom of the states for mental health access to the top. We botched this so badly no one will touch it with a 10-foot pole for decades.
On top of bad policy our referendums lead to voters want the government to hear them so badly that they often vote for laws they know are poorly written and won’t achieve its aims “knowing” lawmakers will fix it down the road. (New city council structure, anyone? We went from a 5 person body to 12!)
I really appreciate your comments. I am from PDX as well, now living in Bend, and I voted for the decriminalization for the very reasons you laid out - criminalizing people doesn’t seem to help and it came with a bunch of money for services. Then last year I heard an OPB episode where they talked about how the drug overdose problem in Portland exploded after the bill passed and I remember thinking…hmm, we knew this was a complex problem when we voted but this is even more complex than any of us knew and the impacts aren’t all what we anticipated. Voting on policies like this feels like a massive catch 22 for the general voter population with no real win. But I’m not sure what the alternative is.
Right? What I heard (and still support) was that locking people up for addiction was not the answer. Fining people for addiction was not the answer. Why were we (and why have we sadly returned to) criminalizing addiction? I don’t know the answer, but I suspect what was hinted at in the episode, that it’s more nuanced, and constantly swinging from all to nothing is not helping anything. We need both/and.
Right when I was about to start grad school, I had to draw a line in the sand with a friend I had grown up with, although we had not hung out socially until that summer. One night he left some drugs in my friend’s car (we did not know he had them). I could see the two paths of my life literally diverging. I chose to save myself. I told him that I would not return them. I told him that he was a good person, but I couldn’t be around that stuff. He said “Okay, bye Kara.” That stung. I didn’t hear anything from him for a long time.
The next summer, the night before I was leaving for my first clinical, I get a text “What are you up to tonight? I don’t feel like cooking. You pick the place, I’ll pay.” I remember thinking “I thought you hated me??” Well, we got dinner. He told me he was 4 days sober. Off everything! Except cigarettes. He said, “You know, I have money… I could buy drugs, but I would rather take you out for dinner.” I honestly did not realize how severe his addiction was until that evening. It was eye opening to listen to him. And of course, I had to drive to CO for 2 months the next morning.
Being friends with him has changed me as a person. The heartbreak, the hope, the disappointment, the letting go, the smile that isn’t quite carefree, because you know it could change at any moment. I have a better, though certainly not full, understanding of mercy. He is doing better now, but I don’t think his mind will ever be 100% again.
I really don’t know what the answer is, but I appreciate delving further into research to find compassionate and effective options to help both individuals and society.
I just quickly want to say, before I finish listening, that I very much appreciate an episode in my life that's not about NY politics, Columbia and Harvard, or Tulsi Gabbard's latest crazy pronouncement.
I'm really happy to hear this. It's a balancing act for sure!
I really liked this episode! It’s got all the nuance I love about PP! Thanks Beth!!
So glad to hear it!
Just wanted to share something made me smile. I was listening to this episode and texted my boyfriend that I was listening to a really interesting episode of Pantsuit Politics and asked if he wanted to listen to it. He said “Yes, I love Pantsuit!” He’s not a regular listener but he has really enjoyed several of the Spicy Lives. They’ve made for grand opportunities to pause the episode to talk about things. Also I love that he always calls you “Pants!” As in “Let’s listen to Pants” 😂
This really makes me smile, too, Christina. Thank you both!
I appreciated the conversation here. An extended family member overdosed on edible marijuana several years ago that landed the person in the hospital. Now the stuff is legal or at least socially acceptable, I’ve learned that little research has been done on serious side effects or even permanent damage. Some people dismiss marijuana as no big deal but it caused havoc in our extended family. Users cannot always see how their choices to use either causes unpredictable behavior or makes it worse for their family.
This is what scares me so much. Marijuana is not harmless, but I am a middle-aged woman and sound "hysterical" when I mention it. But I have seen so much damage to families, and now that edibles are easy to obtain, we often have children ending up in the hospital because they didn't realize what they were eating. People say, "it's not as bad as alcohol." Well, that may be true, but it's not saying much.
Deborah, right before I read your comment, I read a very critical one on Instagram about how we should have differentiated between types of drugs in the discussion. And certainly there are differences -- "drug" means so many things. But your comment illustrates how difficult it is to make generalizations in any direction. There is always some degree of risk.
Thank you for this episode. It is SO valuable. No one wants to be an addict. My husband is in recovery and has been for many years. His sobriety was shaky when we met, and he relapsed not long after we were married. It took me several years to understand the family disease aspect and the CRAFT approach helped me find my feet as a partner to a very good man with life threatening opioid use disorder.
When he was in active addiction, initially, we lived in Texas and our insurance did very little. His providers stigmatized and minimized his struggle. I did not fully understand he was in active addiction and took a job in Connecticut as this was going on. I believe moving saved his life. The day I realized he needed inpatient treatment was two days before he and I flew to Connecticut (I'd moved ahead of him). We drove straight to an inpatient treatment center. It was literally the first day we had insurance through my Connecticut job. Had we still been on our health plan through his Texas job treatment would have been cost prohibitive. I still get chills when I think about the providence of how all of that played out.
Access to care, medically assisted treatment, 12-step programs, all the therapy, for him, for me and for us are scaffolding needed to keep my husband healthy. The stigma of addiction still shadows some parts of his journey, but living in New England we've found a much more supportive community than we had previously. He has had one lapse, and that is one thing I wish the episode had talked about a bit. Being in recovery is not without missteps. People lapse/ relapse. It is consequential, and if they survive the lapse/ relapse, it is not hopeless. All is not lost.
My husband's life has been saved by having all of the pieces of the puzzle of helping someone with substance use disorder available to him along with the privilege of being a middle class white man who had parents who kept sending him to treatment when he was young and who survived accidents and overdoses before his feet found enough stability for him to choose sobriety. I don't take that for granted. This episode highlights so many gaps, and I fear we've further away from closing them as we watch the current political climate destroy public health systems. I hope a reckoning is coming.
Thank you, Erin. I'm so glad that you and your husband have found support when so many gaps exist. I have browser tabs open to learn more about the CRAFT approach.
Thank you for sharing.
I so appreciated this conversation. 3 years ago today (the 22nd) my sister-in-law died suddenly. In the aftermath of her death, we discovered that she had been ordering what she thought was Xanax from an online ‘pharmacy’ and the last batch was tainted with fentanyl. She had been complaining of not feeling well for about 2 weeks and had even gone to the ER, but no one did a drug screen that might have saved her life. I have so many complicated feelings around the conversations about drug use, but I truly believe the more we can have discussions like these, the more progress we can make.
Over the course of learning what had been going on, we (my husband and I are both medical professionals) were shocked to discover how simple it is to order from these online ‘pharmacies’ with the click of a button and a credit card number to be delivered to your home through the US mail. You don’t need connections or dark alleys, just a simple search on google.
Rachel, this breaks my heart, and you sharing it is such a public service. Thank you.
Wow reading the comments here have added a whole other layer to the conversation which also gave me a lot to think about. I’m in San Francisco and gosh it feels like this is intractable. I’m hopeful for Lurie (new mayor) but he’s got a lot to confront and a major budget deficit to contend with at the same time.
I truly hope we can make a real dent with both more shelters AND more treatment programs 🙏 grateful for organizations like City Hope that show up day in and day out to do this hard work (https://www.cityhopesf.org)
I totally agree about the comments adding new layers! And I so appreciate organizations like this that are trying not to leave anyone behind in any respect.
I’ve been thinking about this basically my whole life having watched my brother (16 years older than me) struggling with addiction and mental illness, cycling in and out of homelessness, jail, half-way houses, and prison. He’s been clean now for almost 2 years, and out of prison for 1 year. Still hard to shake the feeling that he’s been here before and not made it; still have no answers about what we can do in our communities, states, and nation. Still hoping we can find an answer-or, more likely, multiple answers. Absolutely appreciate this conversation.
I truly hope he makes it.
I’m fascinated by the required testing/sobriety methods mentioned in the episode. I immediately wonder about logistics. I’ve had friends go through drug classes/testing for dui diversion, and they had to drive all the way across town for their check ins. I wonder how you implement something like that without making people miss work or otherwise make it difficult to comply. Access to help and resources is important. When I was a CASA, part of our training was that sometimes for seemingly belligerent children, or non compliant parents, it wasn’t a won’t but a can’t. I had kids come back into care because parents couldn’t find work with a record but they knew how to have income selling drugs. I witnessed parents who wanted to take the classes, go to the appointments, etc but were stymied by the lack of dependable transportation, or they were newly (sometimes forcibly due to incarceration) sober, and barely functioning. We can’t just say “don’t do drugs”. Compassion isn’t a downfall. And yet, we have to look out for those in the community who don’t want to/can’t be around active addiction. It’s definitely not simple. And not solvable in a catchy campaign slogan level.
Thanks to you and Jess for adding to the conversation here. You're right -- nothing is simple.
We have an ex-employee who was diagnosed with schizophrenia and bipolar disorder in his 20’s. He lacks family support and tried to get meds through county resources. He didn’t like the way the meds made him feel and needed continual adjustments - but it was SO hard to get a ride up to the county office and feel heard by his doctors. He was trying SO hard and it was heart wrenching to witness. We tried to partner with his case worker to help support, but ran into red tape.
He eventually stopped them and self medicated to cope and has been unhoused for several years now. He stays around our stores and we see him often. The elements have been hard on his body, but his sweet spirit is still there.
Such a hard, hard problem that I wish we as community would see belongs to ALL of us.
I really appreciate him highlight the idea that people have the right to NOT be around people who abuse drugs. Many people find themselves in need of public housing because at one point they had to leave a home that was made unsafe or intolerable by an addict or a person who abuses drugs (parent or spouse). Those people and their famileis deserve a safe living environment. Abusing drugs or alcohol does not make people "bad," but it does make them unpredictable and that can be very stressful and scary to be around, even if the user is not violent.
I think there is a big difference between using drugs for personal enjoyment and abusing drugs to the point of physical dependency. In my experience, when that physical dependency takes hold, a person and their ability to make decisions for themselves can be lost. I don't know if lifelong, total sobriety is possible or appropriate for every addict, but required treatment may offer an opportunity to determine what that person needs/wants and not what their addiction needs/wants.
It's so hard when safety for one person means a lack of safety for another.
This is true, but it’s not always apple to apples. I think it is important to consider who/what you are safeguarding: the addicted person or the addictive behavior. When you love someone in the throes of addiction, this is a hard distinction to make. You’d do anything to protect and provide for the person because you care deeply about them and you are so scare of what will happen if you don’t. You don’t want to inflict any tension or hardship because you are afraid of harming them, but then you have to remember that being permissive allows them to continue harming themselves. It truly is a compassion trap. I really appreciate Dr. Humphreys’ acknowledgement of this struggle.
Beth I so appreciate you initiating the conversation about the US tendency to oscillate between extremes. It is one of our fundamental flaws. I’d add lack of humility as another.
I so appreciated his comment about having direct conversations with people about “learning to live with” people you disagree with or have issues with in order to make positive change.
I’ve been trying to get a grasp on how we got to this place of not only being staunchly anti something but also insisting LOUDLY, that everyone else be equally anti that thing or else they must be completely evil. Certainly I do think there are places where there is not a lot of nuance between good and evil, but I think those are rare. IMHO what drives the difference in perception between good/evil or right/wrong is actually differences in experiences, struggles, community needs, culture, etc, and our inability or unwillingness to understand those differences and instead shortcut ourselves into whatever quick, easy explanation vindicates our feelings about the other. That’s why I love the PP approach to these convos. Maybe we’ve always been like this and social media is just shoving it in our faces, but I hope we can get past it so we can collectively work towards true lasting change.
My husband and I were just talking about this tendency to swing between extremes. I think it's part of human nature to overcorrect; it's hard to hit a bullseye when you're scared or desperate.
I think Americans seem particularly bad at it because we have so many resources to throw at problems. It's like we're at the craps table and when one person wins on black a couple times, we become convinced to put all our collective chips on black. It's all black and no one feels safe enough to try red, until we lose enough times and then put everything on red.
I remember reading somewhere that in the 1970s when world governments were worried about overpopulation, it was thought that we had only enough resources to tackle the problem from one of two directions: either drastically decrease births rates, or drastically increase food production. We couldn't do both. But, of course we have done both. China did more of one approach, and our scientists here in America did more of the other, and here we are now with more than double the population and less starvation throughout the world. Things still suck, but they suck less than expected! Maybe the lesson here is that all countries overcorrect, we just have to rely on each other to split the difference?
I'm trying to work on this in myself by really looking for where the holes are and where the merits are across the spectrum of opinions.
Very much appreciated this conversation. I live in Vancouver and this is a huge conundrum for BC as a whole right now but especially Vancouver and Victoria (where my parents live) where communities must grapple with what to do next. Hearing conversations like this help me form my thoughts as a citizen when elections come around and competing platforms and policies abound.
Not to be a broken record with my Louise Penny love, but I have found the discussion of drug use and trafficking in her books from Canada to be so valuable. Fiction can really put you in a new space!
Ah, this was such a good and challenging episode. I volunteer at a local women's shelter, and often find myself struggling with the fact that some of our guests really need to be in a sober living type of space where they are being made to take their mental health meds, but that a lot of them don't want that. I also struggle because I know that nobody can be forced into recovery and that at the end of the day, long-term sobriety usually occurs when the person with an addiction wants to be sober. And yet, clearly, what we are doing isn't working! This interview gave me a lot to think about.
Also, I just wanted to add that I won the DARE essay contest in 6th grade at my school and then went on to marry an alcoholic and used alcohol as a coping mechanism and drank way. too. much. for many years. 😆 (My husband has been sober for 6 years now, and we are both doing great!)
Thank you for volunteering and for sharing so vulnerably here. I'm so glad that you and your husband are thriving.
Congrats to both you and your husband. I know it is a difficult journey.
I've never been so eager to click on a PP episode! Thank you, Beth, for exploring this topic and introducing us to Keith Humphrey's work in this area.
I'd like listeners to have a little more context than what a study in the limited timespan of 2020-24 can provide. I moved to Seattle in 2012 and over the years experienced the city moving towards the policies that Keith described. George Floyd's brutal murder wasn't the catalyst, but the opportunity.
Pre-covid era, I participated in community forums and local Democrat meetings where I met advocates who were pushing for harm reduction that could extend as far as the free drugs Keith mentioned in the BC area. I met and talked with former residents of and workers in homeless shelters, and several cops who knew those shelters, who told me of the dangerous conditions in these places, many of which traced to the unregulated presence of drugs. I've experienced how low-barrier shelters (ones that allow drug use) not only destroy neighborhoods, but also put their residents and drug users drawn to the dealers in the shelters in serious danger. In recent years I've learned how the city's housing-over-treatment approach has led to drug users who weren't capable of living on their own being left to die in low-barrier housing (if they were lucky enough to get housing) or in Seattle's unmanaged green belts. Advocates for "safe" drug use and housing first got Seattle to where it is today, with drug deaths and drug-related crime going up over the past five years while the same were going down in other regions of the country. Floyd's death was the excuse to get these permissive policies over the line, not the cause.
Yes, it's true that deregulation policies that went into effect during and after 2020 accelerated the problem. But Seattle already had majority low-barrier shelters, a focus on housing over treatment, and a small but robust advocacy for the right of drug users to continue using. A city - a region - does not become what the PNW has become overnight. That takes intention.
What I realized while listening to your conversation with Keith is that many of my neighbors, people in the community who didn't go to the same forums and meetings as I did, weren't and aren't aware of this pot we'd all been slowly boiling in. Seattle is a place full of compassionate, intelligent, well-meaning people who want the best for their community. They were told that harm reduction (no matter the form) and housing before treatment were best practices, so they backed those policies. They voted and donated and repeated the advocates' talking points. They did what they thought was right.
Now that organizations like We Heart Seattle are trying to get folks off the street and into treatment, connected with family who can help them on the road to recovery, into high-barrier housing and away from users, there are so many entrenched advocates fighting them on all those fronts that my neighbors are understandably confused. I've been to meetings at City Hall where advocates vociferously oppose family reunion; I'd seen the same advocates in my neighborhood arguing against treatment and reunification. And my neighbors were just as likely, or even more likely, to listen to the drug use advocates as those encouraging treatment. That's just what the social structure of Seattle (and of the PNW at large) has conditioned them to do.
That's why I left the PNW. I was tired of fighting the uphill battle virtually alone in my neighborhood. I admire those who stay and keep fighting the good fight, but I just couldn't take the stress anymore. Keith's work is important for my neighbors, those who use, those who don't, and those who want to have a life beyond using. I hope leaders across the PNW, and across the country, take such research seriously. It's very hard, but we must work towards helping people to get off these drugs, for their own sake and for the sake of our communities.
I really appreciate you taking time to share all of this perspective with us, and it rings so true to me that people are trying to do what they are persuaded is good and right for their neighbors. This is why I loved Keith's research. I could easily see myself voting for all of these initiatives enthusiastically.
Your comment reflects my experience living in Olympia, WA as well. It's really sad and such a difficult situation.
I grew up in Olympia and watched it change the older I got (I’m in the Tacoma area now). I still have friends who live in Oly and it sounds like it’s starting to get better but phew - it seems like it really went off the rails there for a while.
The comments about Portugal not being the US really struck me. For better or for worse, we do not have the connections that most other countries do. We can definitely learn from other countries, but we cannot wholesale adopt what they do - in all kinds of realms - and expect it to work
Only a couple minutes into the interview. This Portlander has never once heard or considered the concept that drug use is a right. It was definitely not a part of the campaign to decriminalize all drug use.
Thanks for the comment because I was wondering. I'm in San Jose, which tends to be a liberal city but not a progressive city. We're never cutting edge on policy. We leave that to our neighbor to the north (San Francisco). I heard him mention SF early on, and I was gobsmacked by learning that many there considered drug use a right. It kind of tracks based on other things I've heard from people who spend more time in the city than I do. It also now makes perfect sense that the city recalled its DA. I'm liberal enough to want to decriminalize, but of course "hey, do fentanyl with your friends!" crosses a great big ol' line for me.
Years ago I read the book “Chasing the Scream: The First and Last Days of the War on Drugs” and it really blew my mind. It traces the history of the war on drugs (including the devastating fact that Joe Arpaio is basically a disciple of the main dude who engineered the war on drugs 😩). It also really book really drills down on how the approach really fails a lot of people. The author explained how there are basically always people using drugs that are just fine (only 10% of users are actually addicted per some UN group) and that drug policy really hurts that minority greatly. It does a good job showing how narrowing the market through prohibition leads to more potent options being utilized. It also just creates more people considered criminals, and the stigma and consequences of that definitely do not help make more a constructive situation for someone who is struggling with drug addiction.
The book truly blew my mind at the time. My job was literally to analyze stuff for the police to determine if it was an illegal drug. We were often navigating updated laws as more things became illegal. As a naive, sheltered, try-hard, I certainly had a lot of black and white attitudes about drugs and especially once I started my career, I suppose I felt a bit defensive. The book came to me in during an intense phase of my life where many black and white perspectives I had got busted up. I was being primed for nuance shortly before finding the show (I just realized that!). Thank you for this very thoughtful and informative episode!
To the point of the comment further down about the goals of policy not working, it’s hard to see any good intent in the way the war on drugs was designed. This one seems to get exactly what it wants- the cruelty was often the point- need I mention Sheriff Arpaio again?
I’d really like to hear more about how often policy design utterly fails its goals. The Portland decriminalization was doomed from the start. People voted for it not just because punitive measures fail sick people, but because it came with a BOATLOAD of money for services, but then the services and the decriminalization went into effect on the same day! And despite all that money we still don’t have anywhere close to adequate services because we couldn’t possibly hire and build the facilities to climb from the bottom of the states for mental health access to the top. We botched this so badly no one will touch it with a 10-foot pole for decades.
On top of bad policy our referendums lead to voters want the government to hear them so badly that they often vote for laws they know are poorly written and won’t achieve its aims “knowing” lawmakers will fix it down the road. (New city council structure, anyone? We went from a 5 person body to 12!)
I really appreciate your comments. I am from PDX as well, now living in Bend, and I voted for the decriminalization for the very reasons you laid out - criminalizing people doesn’t seem to help and it came with a bunch of money for services. Then last year I heard an OPB episode where they talked about how the drug overdose problem in Portland exploded after the bill passed and I remember thinking…hmm, we knew this was a complex problem when we voted but this is even more complex than any of us knew and the impacts aren’t all what we anticipated. Voting on policies like this feels like a massive catch 22 for the general voter population with no real win. But I’m not sure what the alternative is.
I love this question about policy design failing the goals -- that's a perfect way to describe what's happened in so many contexts.
Right? What I heard (and still support) was that locking people up for addiction was not the answer. Fining people for addiction was not the answer. Why were we (and why have we sadly returned to) criminalizing addiction? I don’t know the answer, but I suspect what was hinted at in the episode, that it’s more nuanced, and constantly swinging from all to nothing is not helping anything. We need both/and.