Pre-Existing Conditions? Whose Pray Tell?

by Kwewu on 5 th Jan 2010

in BioPsychoSocial Health, BioPsychoSocial Mental Hygiene

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)

Now every once in a while (regardless of my clinical and forensic psychology training and practical experiences) a news byte or two comes out of no where to (1) blind side me; and then (2) make me question whether I should be laughing or I should be hurling.

Just such an instance has surfaced with the news byte about a New York City-funded guidebook for heroin users offering them information on how to prepare drugs carefully and care for their veins to avoid infection.

And of course it comes as no surprise to me that the state’s top official with the DEA rips NYC for this handbook on heroin.

John Gilbride, DEA special agent in charge, contends that the Take Charge Take Care guide is disturbing and is a “step-by-step instruction on how to inject a poison.” With no disrespect intended to this professional, I am left only thinking of one intuitive response to this matter at hand. Ya think?

It is reported that the city’s Department of Health and Mental Hygiene printed about 700,000 copies and in kind that a top official says the goal is to promote health and save lives. Really?  Where do they find these people?

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

First let me underscore given my clinical training and practical experiences, and secondarily being mentored by an esteemed senior executive and administrator in hospital administration who happened to be my father as well—I have seen many innovative and utilitarian approaches to promote health and save lives; particularly in my chosen trade craft in mental hygiene.

In a radical sense, I can only offer up one adjective to capture my range of sentiments for this story, which of course is nothing less than surreal.

But when I read this story, I must confess to you all, I just couldn’t get my mind fully around the magnitude of issues and challenges that 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.

But don’t take my assessment of this situation at face value. I hope you’ll all take some time to follow the preceding link back to this article and reflect for yourself on the magnitude of this topic. For me this issue and especially what it asserts to address, the methodology and intervention it promotes (both informatively and instructively) raises so many concerns and questions. Common sense seems not to have prevailed from (a) practicality and (b) practitioner clinical and forensic professional and ethical vantage points on so many fronts and so many levels.

How does a mayor such as the likes of  Bloomberg rationalize his math here, when on one front he asserts that 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 (as I hear often from my colleagues in Chicago proper, 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 on 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 others begs me asking this simple question: “Are you all on frickin’ drugs”!!??

Is this intervention, I wonder, the great Harry Houdini (1874 – 1926) himself reincarnated again as an escape artist, and not a psychic who is supposed to influence all facets of magic in America, who when it’s all said and done definitively becomes celebrated as the world’s greatest escape artist?

I worry too that this intervention somehow seems to be rising from humble beginnings (as did Houdini) in hopes of becoming  too a renowned magician and illusionist. And this all begs me (again in my signatory fashion of conducting myself interpersonally) 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?

Why not sell on Welcome to IdiotGuides.com this New York City-funded guidebook (aka “human factors edition”) “The Complete Idiot’s Guide to Heroin” as another user volume for purchase on the website?

But I hear you naysayers out there saying to me that I’m jaded; worse yet that I have become cynical, maybe even given myself over to “compassion fatigue.”

Well then, I add this to the task at hand.

My satirical wit reframes this compassion fatigue something like this. My bouts of fending off the voices of my “multiples” and my efforts at muting these voice’s primary drive retorts “compassion, my ass!” Or their street-craft logic “where’s the compassion when some junkie mugs our law abiding lambs in our flocks to score?” Or even more sardonic yet, “where’s the compassion when our innocent babies are born addicted because their junkie mothers have their New York City-funded guidebook Take Charge, Take Care to guide them through the birthing process while they use 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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Tagged as: Bloomberg, DEA, heroin, NYC

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