California prisoner release – Is Sheriff Baca’s fear justified?

The notion of releasing some 40,000 California prisoners to relieve overcrowding is milling around Sacramento and now, the Supreme Court. Okay, it’s more than a notion, it’s a law, but it’s being held up for the moment, so let’s see what happens.

The prisoners being discussed would be the lowest risk inmates, and as you know from reading some past articles on here, I’m in full support of treatment instead of incarceration. But guess what?! The CA officers’ union, and many other public-safety agency’s are opposed.

Less than an hour ago, I heard LA Sheriff Lee Baca talk about not wanting “these [drug users and thieves] out on the street unsupervised under any circumstances.” The question is, is Mr. Baca’s viewpoint justified?

The law, drugs, and incarceration

Now I understand the notion that when people break the law, especially by hurting others, they need to be reprimanded. It’s how we keep people in line (to some extent) an how we keep the dangerous ones away from the rest of society. But it’s Baca’s general problem with low-risk drug users and thieves that has me worried.

First of all, more than 50% of the U.S. population has experimented with drugs (when marijuana is included). This would, technically, qualify a whole lot of Americans as “drug-users.” In fact, both this President and our last one were drug users at some point in their lives, and I’m pretty sure that a cursory examination of any law enforcement force would reveal quite a few ex-drug users. Still, less than 10% of Americans develop real drug-use problems, and that’s more likely the population Baca was referring to.

Given the fact that approximately 20% of our prison population is incarcerated for drug-related offenses alone, I think it’s time Mr. Baca reevaluated his thinking. These people did nothing wrong except for use drugs, which are illegal, therefore landing them in jail. Their danger to society is, at most, their reduced productivity.

Add to that the 10%-20% who are in jail for drug-addiction-related property-crime, and you start seeing the reason behind our prison population explosion. When it comes to this category of criminal, I see Mr. Baca’s point, to some extent – These prisoners did hurt someone, by stealing their stuff. Still, I believe that if our goal is to stop their stealing, not imprison our citizens, than drug-addiction treatment, not incarceration, is the way to go.

How do we fix the drug-use prison problem?

One of the arguments against the imminent release I heard today was the economic downturn and the fact that “even doctors can’t get a job right now, so these criminals will just go back to what they know best, committing crime.” Well guess what again?! I have a solution!!!

Let’s release the prisoners, but then increase the capacity in drug treatment facilities and other transition settings. This will create jobs, even for those lowly unemployed M.D.s, and will get a good portion of the released inmates the kind of supervision they really need, the kind that could actually turn their lives around.

Social services, job training, and education are all in dire need of funding, and they could actually make our state better by reducing crime through means aside from incarceration. This reduction in crime will save us money by allowing the legal system to focus on dangerous criminals, the ones that inflict violent crime, though I have a feeling that some of those will be helped in the process.

Just an idea, but I think it’s a good one. I’d love to hear your take on this…

Alcohol, benzos, and opiates – Withdrawal that might kill you

Along with teaching and telling stories, part of my goal here at All About Addiction is to get important information out to those who can benefit from it.

Most drug users who quit drug use “cold turkey” have to go through withdrawal of some sort. Withdrawal is never comfortable, but sometimes it can actually be dangerous. The list below outlines some drugs that should NEVER be quit suddenly without medical supervision. This is the reason why some rehab treatment is preceded by a medical detox period lasting anywhere from 2 days to a week or more.

Which withdrawals can actually kill?

  1. Alcohol – Yes, after long term use, withdrawal from alcohol can kill. Alcohol withdrawal syndrome can take on mild, moderate, or severe forms. If while withdrawing from alcohol a person develops a fever, extreme nausea, diarrhea, or DT (delirium tremens), they need to be rushed to see a doctor as soon as possible. In fact, alcohol withdrawal after heavy, chronic use is best managed under the care of a doctor or a professional medical detox unit. By using medications that relieve withdrawal symptoms, these professionals can essentially eliminate any of these risks.
  2. Benzodiazepines – Benzos were introduced as a replacement to barbiturates that were causing common overdose cases, many of which resulted in death. Nevertheless, withdrawal from extended use of benzodiaepines can kill. Whether Xanax (alprazolam), Ativan (lorazepam), Valium (diazepam) or other variations, long term use of Benzodiazepines requires medical supervision to be completed successfully with minimal side-effects and risk to the patient. Normally, the withdrawal process is managed by slowly reducing the dose and transferring the patient from a slow acting, to a long acting, form of the drug. Still, full resolution of benzodiazepine withdrawal syndrome can take up to 6 months (or even longer).
  3. Opiates – Many people are surprised to learn that in most cases, withdrawal from many opiates is not deadly. Still there are some very important exceptions. Methadone, a long-acting opiate often prescribed as a replacement for heroin can cause death during withdrawal if it’s consumed in high enough doses for a long enough period. The debate of whether the state should be prescribing something like this should be saved for a later date. It is one of the better ways of getting people off of heroin, though obviously, all it does is replace dependence on one substance with another, more manageable one. Also, some of the recently popular methods of rapid-detox from heroin addiction can themselves cause death, and many other negative side-effects. Overall, I would recommend checking in with a physician and conducting opiate withdrawal in a controlled setting. Withdrawal under Suboxone or Subutex can be far less horrific.

Much of the danger in withdrawal from all of these drugs has to do with the body’s response to the extreme changes in the chemical processes going on in the brain and the rest of the body. Alcohol, Benzos, and Opiates interference with the GABA system, the body’s most common downregulator.

Withdrawal from these drugs is like trying to turn the heat up in a cold house with a broken thermostat and an out of control heater – It won’t always lead to disaster, but it’s a bad idea.

The withdrawal danger summary

That’s pretty much it. “Cold Turkey” withdrawal from cocaine, marijuana, crystal meth, ecstasy, GHB (never mix GHB with alcohol though!!!), and many other recreationally used drugs will not lead to death in the vast majority of cases. While it may make you uncomfortable, and you may feel moody, constipated, dehydrated, hungry or nauseous, and a whole slew of other symptoms, the chances of someone actually dying from withdrawal are very small.

If you have any more specific questions regarding your case though, don’t shy from asking me!