Pre-Existing Conditions? Whose Pray Tell?

by Mark A. Rogers on 5 January, 2010

in BioPsychosocial Health,BioPsychoSocial Mental Health

DEA rips NYC-funded handbook on heroin

‘Step-by-step instruction on how to inject a poison,’ drug agent says

NEW YORK – A New York City-funded guidebook for heroin users offers information on how to prepare drugs carefully and care for veins to avoid infection.

However, the state’s top official with the Drug Enforcement Administration said the “Take Charge Take Care” guide was disturbing.

DEA special agent-in-charge John Gilbride said the handout was a “step-by-step instruction on how to inject a poison.”

The city’s Department of Health and Mental Hygiene printed about 70,000 copies and a top official says the goal is to promote health and save lives.

More information on this story is found at http://www.msnbc.msn.com/id/34706732/ns/us_news-life/?GT1=43001

The front cover of the heroin user's guide book, "Take Charge Take Care," published by the New York City Department of Health and Mental Hygiene. (CBS)

Given my training and experience, I have seen many innovative and utilitarian approaches to promote health and save lives, especially in mental hygiene. But when I read this story I must confess I just could not get my mind fully around the magnitude of issues and challenges this guidebook offers heroin users for preparing drugs carefully and of course their veins so they can avoid infection. At a foundational level, this whole matter gives me great pause and is in milder terms unsettling, and then in a radical sense surreal.

My hope is that those of you who read this post will follow the link back to this article and reflect for yourself on this topic. This whole topic and what it addresses, the methodology and intervention it promotes both informatively and instructively raises so many concerns and questions for me. Common sense seems not to have prevailed from a practical and practitioner clinical and forensic vantage point on so many fronts and so many levels here.

How does a mayor such as Bloomberg rationalize his math here when on one front he wants guns banned because people may at a minimum get hurt and maximally become fatalities while on the other hand indirectly promotes (assists) in the drug trade of heroin and maybe even reluctantly in a veiled sense accepts “learned helplessness” with shutting down the drug trade of heroin and rehabilitation of consumers consumption of this insidious drug?

Is this city like I hear often from my colleagues in Chicago and even in the affluent suburbs surrounding it tired of picking up people of all ages and socioeconomic stratum who are (a) addicts, or worse yet (b) dead people in all kinds of habitats? I frickin’ hope so! When I was working with this milieu I sure the hell was!

How is the utilitarianism of this intervention (without all the “junk science” of political dogmatism and biopsychosocial medical and mental hygiene) illustrative of excellent clinical and forensic critical thinking skills regarding rehabilitating or ideally promoting in a preventative front complete abstinence from such a drug? Of course I know the lingo “teaching those who already use the drug how to use the drug saves lives and does not promote or teach gateway vulnerables or the untapped constituency of lost souls that this “human factors” resource is their “handler” for “handling it” when consuming this narcotic cocktail. This whole technical-craft versus street-craft thingy like so many other ones begs me asking this simple question: “Are you all on frickin’ drugs!!??

Is this intervention, I wonder, the great Harry Houdini (1874 – 1926) reincarnated again as an escape artist and not a a psychic who is supposed to influence all facets of magic in America and become celebrated as the world’s greatest escape artist? I worry too that this intervention somehow seems to be rising from humble beginnings in hopes of becoming a renowned magician and illusionist. And this all begs me (again in my signatory fashion) to ask the question: For Whom? For whom may this serve?

If we pretend this heroin thingy isn’t a problem then will this intervention help make it seem even more obvious it isn’t or even ceases to be (for holdout doubters) a problem?

But I hear you naysayers out there saying to me I’m jaded, worse yet become cynical, even given myself up to “compassion fatigue.” In my courser bouts of fending of the voices of my “multiples” and muting their primary drive retorts, “compassion, my ass!” and their street-craft logic: “where’s the compassion when some junkie mugs our law abiding  lambs in our flocks to score? or “where’s the compassion when our innocent babies are born addicted because of their junkie mothers who have their New York City guidebook,”Take Charge, Take Care” again begs me asking the question: Why not contact Welcome to IdiotGuides.com to market this “human factors” addition with a glitzy marketing title such as “The Complete Idiot’s Guide to Heroin”?

So I suppose I can see the upside of this intervention as I work my way through the cognitive maze of this logic, right? This is a great idea to give them a 16-page guide informatively and instructively on how to shoot up, right? Of course this guide is multiculturally and a gender-based approach which are “politically correct,” right? And of course this guide is multiethnically and ethnographically sensitive to readability issues such as language and syntax with regard to readers, right?

Well then. I can just see it now. They can use this guide to keep them warm while they lay in a comma for a while on the frozen sidewalks, frozen ground in their sleeping bags and cardboard shanties under the el tracks, in sitting positions in the seats on the subways, the cold floors in drug houses, over air vents, on church steps or in Penn Station, or even in Central Park’s Ramble’s section, right?

As I said a coupla minutes ago, this whole technical-craft versus street-craft thingy like so many other ones begs me asking this simple question: “Are you all on frickin’ drugs!!??



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