Opioid, Schmopioid

If you intentionally crash your car into a tree, don’t call me for a tow.  If you deliberately set fire to your own house, don’t ask me to put it out.  And if you overdose on opioids, don’t expect me to come to your rescue.

Come to think of it, opioids aren’t even in the same moral category as the car and the house.  Opioids are worse.  For all I know, it may be legal to burn your house down.  And, depending on where it is, crashing your car into a tree may be legal too.  Opioids, by contrast, are against the law.  Libertarians like me may want to make drugs legal, but my side lost that argument.  And, legal or not, using opioids is just plain stupid.  Compared to an opioid user, a man who punches himself in the face looks smart.

That's why I roll my eyes and change the channel when hectored about this so-called epidemic.  If you want to talk about an epidemic, talk about zika or bird flu.  Opioid addiction comes from a decision, not a virus.  No mosquito can infect you with opioid addiction, and you don't need antibacterial soap to avoid catching it.  To speak of it as an epidemic and to speak of addicts as victims is to stack the rhetorical deck for the view that addictions and overdoses are diseases rather than choices.

And that brings us to Middletown, Ohio, a grimy post-industrial burg in the heart of the opioid heartland.  Middletown is so afflicted with opioid addicts that it’s on track to spend ten percent of its budget on Narcan, a drug that first-responders administer when called to the scene of an opioid overdose.  A city councilman there, fretting over the unsustainable burden on the public fisc, has proposed that the city’s EMTs simply ignore 911 calls from any overdosing addict who has already received Narcan from the city twice before.  Three strikes, says his proposal, and you’re out.  The very suggestion has, of course, prompted a tsunami of hate mail from people with lots of tattoos.

That councilman gets a loud amen from me.  You want to pay EMTs to drop everything and come the rescue of repeat overdoses just as they do with heart attacks, strokes, and other ills that flesh is heir to?  Not with my tax money you don't.  If you want to help an addict who OD's, help him yourself.  Keep public emergency services out of it.  And if my cold-hearted attitude means that more opioid users die, my answer is a big, fat so what?  If they don’t want to die, they shouldn’t abuse opioids.  If an addict doesn't care about his own life, why should I?

Spare me your sanctimonious flubarb about how every life is precious.  Precious to whom?  Those sentimental memes on Facebook are wrong; the death of some drug-addled wretch does not make all of us poorer.  In fact, it probably has the opposite effect on everyone but the dead addict's mother.  The only exceptions are the truly innocent, such as the toddlers we’ve been reading about lately who ingest colorful pills that their monstrous parents leave lying around.  Send the baby an ambulance by all means, and send me the bill.  But the addict?  He made his own bed.  Let him lie, or die, in it.

Judgmental, you say?  You betcha.  Our society needs to be more judgmental.  Your indulgence of the opioid addict makes the problem worse.  It is because of people like you that there are so many people like him.  Telling the addict he's a jerk and turning your back on him, as I do, discourages not only him, but also any sober but temptable people who might be in earshot.  Your alternative, which is to coddle the addict and pay for his care, is no disincentive at all.

You who tell us we have a duty to rescue every user, you who say we should give him a government program and pay a regiment of social workers for his benefit, you are the same people who portray the addict’s drug use as something other than a conscious decision.  That portrayal assumes the addict to be less than free and, therefore, less than human.  I, in my callousness, have more respect for his humanity than you do.  In my moral universe, the addict is a free man who made a choice.  In yours, he's little better than one of B.F. Skinner’s pigeons, conditioned by chemicals and responding to bodily humors.  For me, his own sovereign responsibility for his every act is an unshakeable moral axiom.  For you, his blamelessness is the only axiom, an axiom that denies any code of morality and leaves room only for sentimentality.  In my view, he might overcome his woes by sheer will, as only Man can do.  In yours, he can never be more than a clever primate.  Talk of "sheer will" just makes you laugh.

Don’t go calling this "tough love."  I do not love addicts.  The issue with opioid addiction, as with gambling, alcohol, and all the other addictions on our spoiled culture's ever-lengthening list, is one not of love but of respect.  If you tell people they're sick and need a pill, then that's how they will live.  If you keep treating addictions as epidemics, and you keep calling addicts victims, then be ready for a lot more "epidemics" and a lot more "victims."

Save our EMTs for real victims of real diseases.

If you intentionally crash your car into a tree, don’t call me for a tow.  If you deliberately set fire to your own house, don’t ask me to put it out.  And if you overdose on opioids, don’t expect me to come to your rescue.

Come to think of it, opioids aren’t even in the same moral category as the car and the house.  Opioids are worse.  For all I know, it may be legal to burn your house down.  And, depending on where it is, crashing your car into a tree may be legal too.  Opioids, by contrast, are against the law.  Libertarians like me may want to make drugs legal, but my side lost that argument.  And, legal or not, using opioids is just plain stupid.  Compared to an opioid user, a man who punches himself in the face looks smart.

That's why I roll my eyes and change the channel when hectored about this so-called epidemic.  If you want to talk about an epidemic, talk about zika or bird flu.  Opioid addiction comes from a decision, not a virus.  No mosquito can infect you with opioid addiction, and you don't need antibacterial soap to avoid catching it.  To speak of it as an epidemic and to speak of addicts as victims is to stack the rhetorical deck for the view that addictions and overdoses are diseases rather than choices.

And that brings us to Middletown, Ohio, a grimy post-industrial burg in the heart of the opioid heartland.  Middletown is so afflicted with opioid addicts that it’s on track to spend ten percent of its budget on Narcan, a drug that first-responders administer when called to the scene of an opioid overdose.  A city councilman there, fretting over the unsustainable burden on the public fisc, has proposed that the city’s EMTs simply ignore 911 calls from any overdosing addict who has already received Narcan from the city twice before.  Three strikes, says his proposal, and you’re out.  The very suggestion has, of course, prompted a tsunami of hate mail from people with lots of tattoos.

That councilman gets a loud amen from me.  You want to pay EMTs to drop everything and come the rescue of repeat overdoses just as they do with heart attacks, strokes, and other ills that flesh is heir to?  Not with my tax money you don't.  If you want to help an addict who OD's, help him yourself.  Keep public emergency services out of it.  And if my cold-hearted attitude means that more opioid users die, my answer is a big, fat so what?  If they don’t want to die, they shouldn’t abuse opioids.  If an addict doesn't care about his own life, why should I?

Spare me your sanctimonious flubarb about how every life is precious.  Precious to whom?  Those sentimental memes on Facebook are wrong; the death of some drug-addled wretch does not make all of us poorer.  In fact, it probably has the opposite effect on everyone but the dead addict's mother.  The only exceptions are the truly innocent, such as the toddlers we’ve been reading about lately who ingest colorful pills that their monstrous parents leave lying around.  Send the baby an ambulance by all means, and send me the bill.  But the addict?  He made his own bed.  Let him lie, or die, in it.

Judgmental, you say?  You betcha.  Our society needs to be more judgmental.  Your indulgence of the opioid addict makes the problem worse.  It is because of people like you that there are so many people like him.  Telling the addict he's a jerk and turning your back on him, as I do, discourages not only him, but also any sober but temptable people who might be in earshot.  Your alternative, which is to coddle the addict and pay for his care, is no disincentive at all.

You who tell us we have a duty to rescue every user, you who say we should give him a government program and pay a regiment of social workers for his benefit, you are the same people who portray the addict’s drug use as something other than a conscious decision.  That portrayal assumes the addict to be less than free and, therefore, less than human.  I, in my callousness, have more respect for his humanity than you do.  In my moral universe, the addict is a free man who made a choice.  In yours, he's little better than one of B.F. Skinner’s pigeons, conditioned by chemicals and responding to bodily humors.  For me, his own sovereign responsibility for his every act is an unshakeable moral axiom.  For you, his blamelessness is the only axiom, an axiom that denies any code of morality and leaves room only for sentimentality.  In my view, he might overcome his woes by sheer will, as only Man can do.  In yours, he can never be more than a clever primate.  Talk of "sheer will" just makes you laugh.

Don’t go calling this "tough love."  I do not love addicts.  The issue with opioid addiction, as with gambling, alcohol, and all the other addictions on our spoiled culture's ever-lengthening list, is one not of love but of respect.  If you tell people they're sick and need a pill, then that's how they will live.  If you keep treating addictions as epidemics, and you keep calling addicts victims, then be ready for a lot more "epidemics" and a lot more "victims."

Save our EMTs for real victims of real diseases.

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