PROGRESSIVE OREGON AT THE BOTTOM: NEW FUNDING FOR FAILED SYSTEMS PREDICTS MORE DRUG DEATHS

Betraying voters, Measure 110 is hijacked to fund failed systems with cronyism employment – not new treatment approaches – ensuring a worsening public health threat already at the worst nationally

by Clark Miller

Published February 11, 2022

Oregon’s potential sea change citizen initiative measure to decriminalize drug use and create effective treatment services was set up to betray voters before any votes were cast, finished off in stacked, closed-door meetings within weeks of passage. That’s detailed and explained here.  

That betrayal and its lethal effects are increasingly evident in early reports of outcomes, and in disingenuous attempts by protectors of failed systems they are beneficiaries of, along with compliant media, to hide the hijacking of the measure’s intent – an intent by voters to create for the first time substance use treatment in Oregon that is effective. 

Headline

PORTLAND, Ore. (KOIN) — Oregon ranks second in the country for substance use disorder, according to new numbers from a survey from the Substance Abuse and Mental Health Services Administration.

These numbers were given to KOIN 6 News by Oregon Recovers, and they compare 2020 to 2019. According to the survey, nearly one in five Oregonians struggle with addiction.

The state also fell to 50th in access to treatment with 18% of Oregonians needing but not receiving treatment.

“The state also fell to 50th in access to treatment with 18% of Oregonians needing but not receiving treatment.”

That’s a critically important revelation that you won’t often see in other reports – other reports in which the term “access to treatment” is constructed falsely as representing a lack of services that are available for Oregonians who could and would otherwise engage in them. 

Instead, as we’ll see, Oregonians impacted by problem opioid and other drug use are avoiding, choosing to not access, the failed decades-old, invalidated systems that have never helped them, that continue to ensure that Oregon remains at the bottom for providing effective, evidence-based treatments for the potentially lethal condition of compulsive substance use. 

Oregon ranks first in the country for both opioid misuse and methamphetamine misuse rate, the survey stated. Meth usage skyrocketed during the same time period examined, seeing a 53% increase from 2019, according to the survey.

State officials said between 2019 and 2020, alcohol-related deaths had increased 73% and drug overdoses had increased 39%.

That’s not good. And was predictable, based on any consideration of Oregon’s grossly inadequate programs and malfeasant abdication of responsibility to develop and provide effective behavioral health services to its citizens. 

Oregon is poised to dramatically expand an addiction treatment system that already consumes millions of dollars each year with no clear results.

– Rachel Alexander and Saphara Harrell, Salem Reporter

And from the State’s analysis of effectiveness of the $2.3 billion in public funds spent over the 2017 – 2019 biennium on mental health and substance use services, that is, on treatment depended on by vulnerable Oregonians trapped in increasingly lethal drug and mental health epidemics – 

6.1 SUMMARY OF FINDINGS

In the 2017-19 biennium, OHA will publicly spend $2.3 billion in behavioral health services, with 81% allocated to mental health ($1.9B) and 19% spent on substance abuse treatment services ($430M).

No reliable outcomes exist on the effectiveness of treatment, or how well the services worked to reduce clinical symptoms and enhance quality of life.

No reliable treatment outcomes exist for youth or adult offenders who receive SUD treatment in prison (DOC), in facility (OYA), or in the community once released, other than counts of services. Therefore, it is unknown what effect treatment has on criminal justice outcomes, including recidivism.

And what about “access to treatment”? 

Turns out that, as in other states and nationally, access to opioid substitution treatment (OST) – the dispensing of addictive, diverted opioids by prescription – has been increasing steadily over past years and decades. And there’s no evidence provided that individuals seeking outpatient substance use treatment are unable to become enrolled. 

Instead, evidence points to unfilled capacity in programs and Oregonians choosing to decline the fake “treatment” systems, even paying a fine to avoid an initial screening for services under Measure 110 provisions. 

From a Willamette Week report this year – 

Many law enforcement officials opposed Measure 110 two years ago, warning of dire consequences if it passed.

In response to such concerns, the measure included a provision for police to write tickets for drug possession rather than make arrests. The idea was that those cited for possession could avoid a fine by calling a phone number on their ticket; that connection would open a gateway to evaluation and services—and get up to $100 of their fine waived.

Data collected by the Oregon Judicial Department from February 2021 through Dec. 31, however, shows that avenue has not worked. Police wrote 1,826 tickets last year for hard drugs (nearly two-thirds for meth) but few—only 55 for the whole year—prompted users to telephone the number for services. (The Oregonian first reported sparse use of the hotline last year.)

That is, Oregonians cited for drug possession and likely to have encountered mandated or voluntary “treatment” in Oregon previously understand that there is nothing in the services offered them in those sham treatment programs that is remotely beneficial to them for the problem of compulsive substance use. 

Their consumer-wise choice to avoid bogus programs that provide no benefit is consistent with reports like this

The Salvation Army is closing its only Oregon drug and alcohol rehabilitation center for men. 

The Adult Rehabilitation Center in Northeast Portland offers men a free six-month drug and alcohol rehab program, including housing and work connection services. 

After more than 100 years it will be closing its doors in late September, affecting 72 employees. 

The program has become less sustainable due to competition from similar programs now being covered by the Affordable Care Act, said Major Nancy Dihle, divisonal commander for the Salvation Army’s Cascade division. 

“What that [the Affordable Care Act] does is give people access to programs at a much lower cost and a lower amount of time in-house, and so that’s affected our ability to sustain the program,” Dihle said. 

The ARC facility has capacity for about 120 men. Dihle said it’s currently serving 56. 

That appears to represent excess supply of services, not unmet demand, excess supply also consistent with Oregon’s largest provider of behavioral health services requiring a bailout last year due to insufficient revenues. 

Here’s what we know

Oregon, with unused capacity for traditional substance use treatment, or “treatment as usual” (more on that below), is among the worst states in the nation for problem substance users using those services, let alone benefitting from them, and among the worst for problem use of some substances.

Under a managed care system with demonstrated aversion to use of evidence based practices, instead use of public funds for invalidated or never-validated services, “treatment” consists of historical approaches that predict at best no benefit or harm including group therapy; programmed, coerced, or mandated participation in the religious subcultures AA and NA; belief in the invalidated and relapse-predicting disease model of “addiction”; addiction medicine; and a workforce of “addiction professionals” unqualified to treat any complex behavioral health condition, let alone the potentially life-threatening, complex behavioral symptom of underlying psychic distress – compulsive substance use.

The compulsive substance use driving increasingly lethal epidemics is generally rooted in retained effects and distortions of early trauma or ACE, is a complex condition requiring for effective treatment understanding and mastery of use of components from psychology, developmental sciences, mental health, interpersonal functioning, psychotherapy, and psychosocial analysis and treatment planning.

In Oregon, the “stakeholders” and consultants interviewed in media reports, placed on state commissions and committees to provide guidance on substance use treatment, and preferentially hired into the failed treatment systems – No, I am not making this up – are individuals without meaningful education, training, experience or capacity in any of those required areas of competence, nor with capacity to understand or think critically about research bearing on the nature of addiction and its effective treatment. Instead, they are individuals placed in positions to continue to guide Oregon’s failed, lethal approach to substance use treatment by virtue of their being “in recovery”, that is having allegiance and connection to organizations and social networks largely tied together by shared history of problem substance use and participation and identification with the religious subcultures AA and NA. It is as if the state of Oregon would have, by now, formed its scientific and policy advisory committees for use of public funds and resources to respond to the COVID pandemic by populating those committees with individuals with “long Covid”, constructing them as qualified to guide public health response by virtue of having the condition of long Covid. They are, after all, in “long term recovery” from that condition, long Covid, making them experts able to advise and guide state policy on treatment approaches. Right? 

What? You haven’t read anything like that in the news articles you’ve seen? Surely Oregon’s and America’s journalists and watchdog press are investigating and publishing about distortions and discrepancies for a state with remarkably failed lethal outcomes for substance use treatment,  branded as the progressive ideal of creating effective treatment. Let’s take a look.

And here is what is mass messaged to Oregonians

by beneficiaries  of Oregon’s  failed systems (“stakeholders”) and compliant media –

In this piece, a tragic death is spun to promote the view that lack of access to existing treatment programs is the barrier to Oregonians getting effective treatment, and that the woman’s death was due to that barrier. But it wasn’t. She died, according to the story, in a medically managed detoxification facility where she would have been provided medical care for life-threatening withdrawal symptoms and taken to emergency care if needed. That’s how it works, and that’s the highest level of care for acute substance use and withdrawal. That level of care would have been provided at an Emergency Department as needed, and once stable and safe, any patient would be provided a plan, with family or other supports, to stay safe until able to access outpatient or residential treatment. But that’s not the problem. 

The problem isn’t lack of access to those programs, it’s access to them

Traditional and existing outpatient treatment for substance use (treatment as usual, or TAU) in Oregon and elsewhere is not treatment at all and provides no benefit, for reasons explained here. It is a lethal parody of itself. “Rehab”, or residential treatment, predicts the same lack of benefit and for the same reasons, but is more expensive, constituting a criminal scam as effectively outlined in this documentary –

Meanwhile, as reported, Oregon’s governor, perhaps advised by medical staff from the sham treatment program Hazelden, (featured in the trailer, above, for The Business of Recovery) is meeting with groups to decide how to give more money to existing, failed systems, to treatment as usual, to the systems that have been failing Oregonians over past decades, the governor’s office helped in that task of determining effective use of public funds for the complex, potentially lethal behavior of compulsive substance use by groups like Oregon Recovers, composed of individuals not remotely qualified or capable of forming meaningful thoughts about the nature of addiction or its evidence-based treatment.  

Here are some of the team players ensuring that Measure 110 funds get to existing, failed programs – 

Announcement featuring Oregon public figures

The recovery community individuals and organizations are highly competent at something else: protecting, including in closed-door meetings with Oregon legislators, access of members of their organization to cronyism employment in Oregon’s sham addiction treatment industries.

Some of those employed, with public funds, are “peer support specialists”, their paid employment predicting perpetuation of worsening substance use epidemics, as explained here, and here.

How’s that going these days, the work of paid peers promoted as effective and important by “recovery leaders” (former drug users who have worked to ensure Measure 110 funds continue to fund failed systems that provide cronyism employment to other members of their “recovery community”) ? Not so well, as reported by NPR. So many of these addiction treatment professionals are returning to problem drug use themselves, that their positions are unfilled. Who could have predicted that?

Several organizations contacted by NPR said the number of people relapsing, anecdotally anyway, has skyrocketed.

In fact, some groups say they’re having trouble finding enough peer counselors because so many are back using.

“The relapse numbers have gone up so much,” says Elly Staas with the 4th Dimension Recovery Center in Portland.

Here’s another piece of journalism, on Measure 110 implementation, from Willamette Week –

Hurst presented his dismal news on drug deaths as the state races to implement Measure 110, the 2020 ballot measure that forced two major policy shifts. It decriminalized the possession for personal use of many hard drugs, including heroin, meth, cocaine and some opioids. Measure 110 also shifted funding from Oregon’s cannabis taxes—well over $100 million a year—to fund new referral and treatment services for substance use disorder.

The piece starts with a lie, that Measure 110 funds will go to “new ” treatments for compulsive substance use. There has been no discussion or recognition of need to begin funding evidence-based treatments versus existing treatment as usual, and the treatment as usual that will be funded is not treatment at all, as explained above in this post, and elsewhere, instead are the failed programs and approaches driving lethal substance use epidemics and killing Oregonians. 

Comments by those “recovery leader” stakeholders, like Tera Hurst of Oregon Health Justice Recovery Alliance consistently point to an agenda of ensuring and increasing public funds used to continue to preferentially hire members of her “recovery community” into the treatment as usual that Oregonians are avoiding, that provides no benefit for substance use, but benefit to beneficiaries of entitlement employment.

  “There are so many centers across our state that don’t just need investments, they’ve been starved,” she says.

The federal National Survey on Drug Use and Health for 2020, released last month, paints a grim picture for Oregon. As a state, we are second in the nation, behind only Montana, in terms of the percentage of people with a substance use disorder and ranked dead last in terms of access to treatment.

Measure 110 is supposed to change both of those indicators for the better. But the toll that meth and fentanyl are taking on the state is making it challenging for supporters to demonstrate the benefits of Oregon’s first-in-the-nation decriminalization effort.

No. It is not making it “challenging”, it is making it far easier to attract at-risk users to treatment they would perceive as potentially beneficial and see evidence of  that, when the alternative to effective treatment and change is – for many users – daily risk of death by overdose. 

Use your head. Oregonians are reasonably delining the criminal treatment scams this reporter constructs as “treatment” because they know better. They’ve been there and know that “treatment” in Oregon is a parody of itself. 

Remember? They’re not buying it, not signing up for even a screening for referral to services, instead willing to pay a $100 fine. 

Many law enforcement officials opposed Measure 110 two years ago, warning of dire consequences if it passed.

In response to such concerns, the measure included a provision for police to write tickets for drug possession rather than make arrests. The idea was that those cited for possession could avoid a fine by calling a phone number on their ticket; that connection would open a gateway to evaluation and services—and get up to $100 of their fine waived.

Data collected by the Oregon Judicial Department from February 2021 through Dec. 31, however, shows that avenue has not worked. Police wrote 1,826 tickets last year for hard drugs (nearly two-thirds for meth) but few—only 55 for the whole year—prompted users to telephone the number for services. (The Oregonian first reported sparse use of the hotline last year.)

By the way, how was that process supposed to work? As discussed in detail here, clinical provisions of Measure 110 required that a mental health professional – someone with actual training and competence in working with substance users to instill confidence for change, motivate them to access real (evidence-based) treatment, and support them in finding that treatment – would provide the initial assessments. 

In closed-door meetings within weeks of Measure 110 passing, “recovery leaders” working with state legislators eliminated that requirement in order to provide additional employment for members of their “recovery community”, like “peer specialists“. Those individuals have no competence or ability to accurately assess for severity and nature of a substance use problem, let alone the underlying mental health and psychosocial conditions, or  to work with substance users to support confidence for change and motivation for treatment. Instead, they are compelled to and paid to get screened individuals involved with the religious subcultures AA and NA, participation in which predicts failure (return to problem substance use) at 90 to 95 percent. 

So far, Oregonians with problem substance use are declining the screenings and avoiding the “treatment” they know from experience is not beneficial, like sitting in a group and hearing others “share their stories”. And the peer specialists paid with public healthcare funds and in any case entirely unqualified to provide such assessments seem to be unavailable due to relapse, as noted above in this post. A “hiccup” in the recovery community’s system of substance use treatment

Tera Hurst, executive director of the Oregon Health Justice Recovery Alliance (and no relation to the medical examiner), says voters signaled they wanted an explicit shift away from treating people with substance use disorders as criminals and to instead direct energy and money toward treatment.

She says it’s unsurprising that citations are not driving drug users to seek help. She and other advocates did not expect they would. Even arrests rarely motivated users to seek treatment, they say—most go only when they are ready.

If there was no expectation for the citations and screenings to lead to treatment engagement, why did Hurst provide a rationale for having members of her “recovery community” provide the screenings and displace competent mental health professionals? 

“Most only go when they are ready” sounds close to the invalidated  folklore of NA and AA religious subcultures and “recovery” – something Hurst would be familiar with – used as rationale for failed outcomes: the need to “hit rock bottom” and the “denial”. It’s the deficits of the users that lead them to avoid our treatments, not the fact that those “treatments” have no treatment value and have been failing them for decades. We just need more money for those failed programs

How much more reason to be ready than facing risk of overdose daily? 

Maybe this – having some confidence that the sham, failed treatment programs Hurst and others want to fund and that failed you in the past now have alternatives, treatments that are evidence-based, that is, effective. There’s no indication that type of change is happening or being considered, and substance users know it. 

Advocates of Measure 110 say it will take time for the benefits to become apparent, as was the case in Portugal, which decriminalized hard drugs in 2001 and saw its overdose death rate plummet-—but only after services were in place.

Translation: 

We need funds for more of the same

What same? 

Oregon is poised to dramatically expand an addiction treatment system that already consumes millions of dollars each year with no clear results.

– Rachel Alexander and Saphara Harrell, Salem Reporter

What else are we to understand from America’s watchdog, investigative press including this remarkable piece from National Public Radio and OPB? 

Read the full piece, it’s well worth your time for the insight it provides – insight about how America’s media consistently perform to perpetuate lethal epidemics. 

With a notable exception, each of the persons interviewed and presented as having some expertise in and capacity to understand compulsive substance use and its treatment, to guide public policy and use of public funds for that potentially lethal condition, is identified as being “in long term recovery” and being capable of forming understandings and positions on evidence-based treatment for “addictionby virtue of having experienced problem substance use

We’ve seen what that means and how it works, including that those individuals are not by any means qualified to form meaningful thoughts or positions about those issues. Not remotely. 

The one exception in this piece of journalism are the comments of Dr. Reginald Richardson, director of the state Alcohol and Drug Policy Commission, who tells NPR, 

“We’ve got significant trouble in terms of workforce, having the right people, qualified people and enough people to provide services to folks who struggle with addiction,”

That’s an extremely generous way of describing one of the key factors preventing Oregon’s treatment programs from becoming effective and evidence-based: the workforce is essentially comprised of individuals not remotely qualified to provide real treatment for any behavioral health condition, let alone the complex, increasingly potentally leathal condition of problem substance use

One of those individuals who became a substance use treatment and public health expert – an authoritative source for journalists writing about lethal epidemics –  by virtue of being “in long term recovery” pr0vided comments that are telling,  would have foretold the doomed hijacking of Measure 110 to only perpetuate failed treatment, to perpetuate harm. 

She “made my voice loud and clear”, that “we need to have resources for the people that are just getting those citations”.

The resources are those that she offers and knows with certainty, as an expert, are central and critical forms of substance use treatment: participation in meetings of the religious subcultures AA and NA, participation in which exposes vulnerable Oregonians to bizarre  principles and prescriptions established as counter-therapeutic and as resulting in return to problem substance use at a failure rate of 90 to 95 percent. Participation that forms the core of what constitutes treatment as usual for addiction in Oregon. 

Due to that expertise and certain knowledge, she’s been appointed to one of the state’s implementation committees for Measure 110. 

She runs a program in Portland to provide access to what is euphemistically reported as a “place to hold recovery meetings”, that is, harm-predicting meetings of the religious subcultures AA or NA. 

And she “says she hopes new [Measure 110] resources eventually help her turn Miracles, now mostly a place to hold recovery meetings, into Portland’s first full-scale treatment facility tailored to people of color.” It seems there must be a very good chance of that happening, with state implementation groups populated by Oregon Heatlh Authority with other members of her “recovery community” – individuals undistracted by and unable to assess what could possibly constitute evidence-based treatment for problem substance use, and united in their loyalty, as acolytes, in those religious subcultures. 

She “says she has yet to see anyone come in to one of Miracles’ thrice daily recovery meetings because of a possession citation and health screening under the new decriminalization policy.”

She doesn’t understand why Oregonians trapped in substance use epidemics, needing alternatives to the sham treatment programs that have failed them, would not want to sit in meetings of her recovery community’s religious subculture, as if that constituted treatment of some type, as if the program she wants to build and will likely get Measure 110 funds for, incorporating those meetings and other harm-predicting elements of treatment as usual, are not experienced by substance users for what they are – a waste of their time and betrayal of their trust in professional help. 

She is no less confused about that than any of the other “stakeholders” working to perpetuate Oregon’s lethal treatment approaches. 

The analogy is worth repeating. 

In Oregon, the “stakeholders” and consultants interviewed in media reports, placed on state commissions and committees to provide guidance on substance use treatment, and preferentially hired into the failed treatment systems – No, I am not making this up – are individuals without meaningful education, training, experience or capacity in any of those required areas of competence, nor with capacity to understand or think critically about research bearing on the nature of addiction and its effective treatment. Instead, they are individuals placed in positions to continue to guide Oregon’s failed, lethal approach to substance use treatment by virtue of their being “in recovery”, that is having allegiance and connection to organizations and social networks largely tied together by shared history of problem substance use and participation and identification with the religious subcultures AA and NA.

By analogy, it is as if the state of Oregon would have, by now, formed its scientific and policy advisory committees for use of public funds and resources to respond to the COVID pandemic by populating those committees with individuals with “long Covid”, constructing them as qualified to guide public health response by virtue of having the condition of long Covid. They are, after all, in “long term recovery” from that condition, long Covid, making them experts able to advise and guide state policy on treatment approaches. Right? 

But to make the analogy closer, more accurate, more apt: 

The health experts who became experts by virtue of having long COVID would be participating members of a religious subculture and identify as such, as individuals with long COVID and in “long term recovery”

They would be instilled with beliefs that the bizarre prescriptions of that religious subculture constitute treatment despite failure rates of 90 to 95 percent and be compelled to instill those beliefs in anyone else with long COVID including the belief that active participation in the religious subculture is necessary for their “recovery”. 

Those beliefs and compulsions would be supported in policy implementation by Oregon health care authorities and would make perfect sense to America’s watchdog and investigative press. 

They would be successful in promoting use of public funds to pay “peer supports” to, as their primary task, ensure to the greatest extent possible that individuals with long COVID are transported and participate in meetings of the religious subculture. 

At those religious subculture meetings serving as effective “recovery meetings”, the compulsive use of tobacco (smoking of cigarettes’) would be normalized, socially reinforced, often encouraged.

 

Ha Ha ! Funny, right? Funny in its absurdity.

But not really funny at all. 

Pathological. Lethal. 

Criminal.  

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.”

– Pierre Bourdieu  Outline of a Theory of Practice (1972)

In Bourdieu’s Theory of Practice, heterodoxy is dissent, challenge to what “goes without saying” – the accepted, constructed doxa, “knowledge”, reality, that goes without saying precisely because it “comes without saying”, without real scrutiny, untested, unquestioned. The function of doxa is not knowledge or truth or promotion of the collective good, but to protect and serve the interests of those with the power, the cultural capital, to create it.

Why A Critical Discourse?

Because an uncontrolled epidemic of desperate and deadly use of pain-numbing opioid drugs is just the most visible of America’s lethal crises of drug misuse, suicide, depression, of obesity and sickness, of social illness. Because the matrix of health experts and institutions constructed and identified by mass media as trusted authorities – publicly funded and entrusted to protect public health – instead collude to fabricate false assurances like those that created an opioid crisis, while promising medical cures that never come and can never come, while epidemics worsen. Because the “journalists” responsible for protecting public well-being have failed to fight for truth, traded that duty away for their careers, their abdication and cowardice rewarded daily in corporate news offices, attempts to expose that failure and their fabrications punished.

Open, critical examination, exposure, and deconstruction of their lethal matrix of fabrications is a matter of survival, is cure for mass illness and crisis, demands of us a critical discourse.

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.

Pierre Bourdieu - Outline of a Theory of Practice 1972

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