I’m glad you brought up both those points. My own indirect experience with someone who was a heroin addict and tried these type of programs mirror that many of the programs need more going on than just being distribution centers staffed by nurse ratchet-like figures, and often they can devolve into that. Our initial optimism in these programs faded quickly. The overall problem being there is so much variation in the programs on a larger scale, state by state, with problems that develop with each link in the chain because of variation in the execution of the programs at each treatment clinic (some of the hole in the wall urban locations better labeled outposts) and sometimes inconsistency even at the same place depending on the staffing for the day. The ground game and implementation is lacking and/or confusing for addicts and families of addicts to navigate without even more stress in a stressful time.
I think these programs have great promise, but I worry advocates for them have fought hard for them to exist so much that in order to combat naysayers and people who frankly could care less about the plight of addicts, to secure funding, to keep the boat aloft, they advocate the programs as if they have no flaws. They are great programs, but the rollout, information deficits, and way these programs are juggled even within a given states system makes me concerned for their long term adoption.
That said, I hope they continue to develop, but I would rather see a slow but improving body of knowledge and protocol, uniform programs and methodologies, be created than the patchwork of paperwork, addicts falling through the cracks, and throwing stuff at a wall to see what sticks. I empathize with those who run the programs now, since the above can’t happen without funding, and to get funding, you don’t want to say their are flaws, so there is not a good play to make. It is just a bad situation all around. Here is to hoping PSH death sheds some light on the problem in a way the death of a young reckless actor would not have, or been shrugged off.
