Why CARA Is a Failure and How Recovery Advocates Were Duped

On Wednesday, the Comprehensive Addiction and Recovery Act (CARA) passed the Senate 92-2 and was sent to President Obama’s desk. Advocacy groups lit up social media with praise for the bi-partisan legislation which expands Naloxone training for first responders, provides more funding for buprenorphine for people with opiate disorders, and grants some meager funds to find alternatives to incarceration.

While the bill offers up a few good solutions, it’s far more of a failure than a success.

1) The Senate version of the bill called for a mandated prescription drug monitoring program (PMP). The House rejected it after doctors and pharmacists lobbied that it would be burdensome. The final language just suggests that doctors and pharmacists use it. “Suggests” has not worked when it comes to public policy and addiction treatment issues.

2) Case in point. CARA calls for over $900 million to go towards expanded buprenorphine for individuals with opiate misuse disorders. It does not address the key flaw regarding buprenorphine, which I have been writing about for years. Buprenorphine has proven to be effective when combined with weekly therapy sessions and weekly drug screening. The Drug Abuse Treatment Act of 2000 introduced buprenorphine to America and despite the trials and evidence, merely suggested it be accompanied with therapy and drug screens rather than required it. As a result, buprenorphine has been less effective in America than in other countries and has gotten a bad reputation in some treatment programs and 12-step rooms because it is viewed as swapping one drug for another. Without a requirement for drug screens and counseling, it isn’t medication assisted therapy. It’s just medication.

3) The $1.1 billion bill has little funding. This is a political trick. Pass the bill. Get applauded by people in recovery, family members and advocates. Congress will now go on break for the next seven weeks and everyone’s attention will turn elsewhere for the rest of the summer. Advocates will calm down. Then Congress will return after Labor Day. At that point, schools will be back in session, the NFL will be on TV, and the Presidential election will be in full swing. Voting on funding for CARA will most likely be buried. Even if CARA does not get funding, 92 Senators in June and 400 House members in March voted in favor of it. One third of those Senators and all of the House members are up for reelection this fall. Even without funding the bill, they can all claim that they voted for CARA and that they really, truly, deeply care about addiction.

Maybe (hopefully) I’m wrong about the third point and Congress will somehow find the $1.1 billion to make it work. Even so, it would still fail on points one and two.

In Defense of Teachers, Muslims and Cops

I try to limit my writing to subjects that I have an obvious expertise in (addiction, recovery, military, education, criminal justice, public policy) or intense interest (comics, baseball). I’m concerned enough about the current public discourse regarding teachers, Muslims, and cops that I’m going to write about them, but only within a very limited framework. I do not know what the fixes are for these problems; rather, I am just offering up a few of my viewpoints and experiences. A quick background on me: politically, I’m a centrist. I’m a registered independent voter. Family members, friends and students of mine that are conservative view me as a liberal while liberals often express a frustration with some of my conservative viewpoints.


I taught high school English from 2006 to 2009. My mother was a high school English teacher for 31 years. My grandmother taught English in the 1930s and my great grandmother taught every subject in a K-12 school house in a small farming community about 50 miles outside of Minneapolis, Minnesota. Teaching is not only in my blood and a way of life, but a deep, enduring passion. I have tried to encourage a number of my high school and college students over the years to pursue a career in teaching, and I’m thrilled when I hear them talk about their students when they “got” the lesson or hear a story about how a kid made them laugh.

Over the last dozen years, I have read (at least what seems to be) at least one story a week on NJ.com about teachers who are accused or convicted of having sex with their students. I did a quick google search, and it appears that teachers make the news more for having sex with their students than anything else. It’s distressing, and I have had more than a few people in my personal life ask me about the “teacher-student sex problem.” While I am always distressed to hear about these stories, I think it is neither an epidemic nor endemic of the teaching profession. There is a tiny percentage of teachers that do this, but because of the “if it bleeds it leads” mindset, this is what we hear about. On top of this, Governor Christie has continually demonized teachers (along with police officers and other public workers) since he took office. Attacking the teachers’ union made for popular soundbites and youtube vidoes, both of which increased Christie’s popularity during his first term. Partly (I’m quite sure but can’t prove) because of the negative publicity and Christie’s attacks, the number of young people who report wanting to become a teacher has gone down.


Each time there has been a mass shooting the last couple of years and before we find out who pulled the trigger, an old friend of mine asks me if I think it is either a “rural white Christian who feels economically and culturally left behind or a radical Muslim with foreign ties.” It’s an awful question, but it seems to me that liberals hope it’s the white Christian while conservatives want it to be the radical Muslim (the whole business of hoping it’s someone from (or not from) a particular group is ugly, and each side ultimately tends to use it as a talking point to push their world view or limited political agenda). Again, I don’t know what the fixes are for addressing the grievances of either group, but it seems to me that Muslims in America are constantly asked to answer for the heinous crimes of a tiny percentage of 1% of American Muslims.

I have served in the military with Muslims; just like members of every other religion or race, a couple were great soldiers, some were good, most were ok and a few were sub-par. I’ve had dozens of Muslim students over the years (both at Essex County College and Rutgers), and I found them to almost always be polite, studious, punctual and usually a bit quieter than my other students. Unless they discussed a particular issue involving their faith, I could not tell that they were Muslim through their writing. A former colleague of mine at the Rutgers Newark Counseling Center is Muslim, and he is a prime example of a wonderful American: calm, smart, wise, kind, humorous and hardworking. He is also a Cowboy fan, which caused me to ask him when we met, “Wait…you are a Cowboy fan? How do you reconcile that with being a psychologist, a Muslim and a teacher of young people?”  He grew up with many of the same cultural experiences I did (trading lunch items in school, cartoons on weekday afternoons). He invited me to observe services in a mosque, and I took a number of my recovery students there on a few separate occasions. I felt welcome and safe there every time (just as I have felt when I have gone to Catholic, Protestant,  Baptist, or Jewish services with friends). Rany Jazayerli is a dermatologist from middle America who is a life-long Kansas City Royals fan. I have been reading his work with Rob Neyer, at Baseball Prospectus, at Grantland, at Five Thirty Eight, and on his own site for almost 20 years. He is a married father of three and a Muslim.

Not every Muslim I know has been an ideal American citizen though. I have also worked with Muslims in jails and rehabs. Some of them drove drunk, sold drugs, stole from family members and engaged in a variety of other drug related crimes. Like people of every other race, religion, and class in America. (When I was working in Thailand, Muslim leaders despairingly talked to me about the drug use among their young people and how it was devastating their families. They expressed the same sadness, fear and powerlessness that I’ve heard from Americans the last dozen years)

Cops, State Troopers, and Other Law Enforcement Officers

I started writing this piece before Alton Sterling and Philoton Castillo were shot this week. In their immediate aftermath, I wrote this: “The number of cops that engage in excessive violence (and in even fewer instances, murder) are a tiny percentage of law enforcement overall. My fear is the legitimate grievance regarding the higher statistical likelihood of black people being searched, arrested, beaten or shot will continue to be used to ascribe all law enforcement with racism and evil. The sadness and anger felt by Americans will be fueled by the echo chamber in which it seems that most of us live and end up motivating some deranged individuals to attack police officers, which in turn will further drive a wedge in society. And it will probably be captured on camera.” I wrote that a few hours before the five police officers were killed in Dallas on July 7th.

I have two friends that are cops. One is a guy I served with in the Army from 1997 to 2001. His father was a State Trooper and from everything I heard from other troopers in the NJ Army National Guard, a wonderful man with great sense of humor. My buddy is a married father of three and an easy going sergeant. Over the years, he changed his views on drug arrests. When he was younger, he was quick to arrest and charge people with simple possession. As he aged, he realized that it was a numbers game and that it was detrimental to the people he was arresting and not a good use of his time (that said, he takes a very strong stance on driving while under the influence of any substance). I met my other friend in college in 1996. We went to Rutgers together. He was a Maryland State Trooper for a few years before transferring to a municipal force in NJ. He has been in law enforcement since 2004. He joined to protect people and catch bad guys. On the morning of July 8th, he left home to go to work. His wife cried and begged him to be safe and make it home. His two children watched this interaction. Because we are so close, we’ve talked about drug problems and drug arrests for years. Long before the Good Samaritan Law was passed in NJ, he understood that drug users do better with treatment than incarceration, and at lower costs to society. He has taken people to the hospital and referred them to treatment for years. And it has gone completely unnoticed and unreported.

In April, I watched one of my former students from Elizabeth High School graduate from the Maryland State Trooper Academy. The Colonel of the Troopers was there, and in his speech to the graduates he said everything that one would want to hear. I’m going to quote him from memory as best I can:

We are a paramilitary force with specialized training. You must remember that we are not a military force. We are not going out there to engage the enemy, but rather be part of the community and protect society. If you use excessive force, we will get rid of you very quickly. Please watch your words and actions at all times – do not be one of those troopers who give all of us a bad name. Do not be discouraged by what a few bad officers do that causes a media frenzy.

My former student is a young man (25) of color. He has been assigned to a barracks in Baltimore. Unlike my buddies from the Army and college, I worry about my student. I’m not just concerned about the usual work, but I’m afraid that someone will take a shot at him because he’s in law enforcement. He has been on my mind throughout much of the last few days.

At the start of June, I gave a keynote speech at the NJ Juvenile Justice Officer Convention. I talked about a variety of illegal and prescription drugs, as well as criminal justice reform and other public policy issues. I also talked about the failure of D.A.R.E., and how not only does it not work, but kids that go through D.A.R.E programs are more likely to use and abuse drugs. Afterwards, I spoke with dozens of cops, both in person and via email. Some of them were D.A.R.E officers. They asked me to see that data on their ineffectual programs and then for advice on what they could do better. Many of them expressed frustrations within their units, schools or communities. It seemed that all of them cared a great deal about the work they do.

I have been hired by other law enforcement groups for trainings or to engage in group or individual counseling sessions. I always ask why they become cops. Usual answers include “it’s the family business” and “good benefits” and sometimes “a cop saved my life.” By far though, the most common answer is this: “I want to catch bad guys.” I then ask them if they joined for any of these reasons:

Possibility of getting killed. Lots of paperwork. Long shifts. Nights, weekend and holiday work. Dealing with the worst people. Working with old and broken equipment. Bosses who are out of touch. Pressure to make arrests. Investigating sex crimes.

Of course no one entered law enforcement to deal with those problems, but they are part of the job. It’s a rhetorical question and one of my bonding and teaching strategies. Add to these problems the shift in public perception about cops – many feel unappreciated, blamed and attacked. Morale is low. The data on cops and troopers is pretty clear. They have more sleep problems, higher rates of first marriage divorce, higher rates of alcohol abuse, higher rates of stress, a high likelihood of PTSD, higher suicide rates, and shorter life expectancy. I tell them that their job might be killing them (much like how military jobs and child welfare workers jobs cause them to have all kinds of personal and health problems). This is a point that I must emphasize strongly – there are some jobs that we ask people to do that are detrimental to their physical and mental health, as well as the well-being of their families. Again, the data on this is clear.

One unit I work with focuses on sex crimes. What they deal with and see is beyond horrible. Someone will work in that unit for at least 3 years, but many work in it 10 or more. They see thousands of horrendous pictures of sexual acts committed against 6 month olds, toddlers and small children. And it’s not a bad day at work. They see this every day. For years. It does a number on them. It effects their families. These officers often don’t take sick days or vacations, because time is of the essence and any time off to them means “bad guys are doing bad things.” And they are haunted by the images of those bad things. I am thankful for the work they do and feel a sense of desperation to help them.

When military members came home from Vietnam, they not only had to deal with physical injuries and psychic wounds, but a hostile public that sometimes spat at them and called them baby killers. The burnt out and disillusioned Vietnam Veteran was so common that he became an American archtype, and we can all think of books and movies and TV shows where they are represented. The perception of the military and veterans changed after Gulf War I concluded in 1991, and soldiers (and marines and airmen and sailors) came home to yellow ribbons, parades and thanks. This respect for servicemembers and veterans has continued through 2016. I don’t know how it flipped (nor can I find a reasonable theory on it), but law enforcement needs and deserves a similar public perception change.

From what I’ve learned about the Dallas Chief of Police, he seems to be the ideal type of individual to help address the problems of modern policing and current perception in America. Even before the recent and well publicized problems between the black community and police blew up on the American radar (one might argue that it entered the national dialogue with Ferguson in 2014), Chief Brown had been working on engaging the community and training his officers to use restraint. A veteran of over 30 years, his son killed a police officer and was then killed by another cop shortly after Mr. Brown became the Chief in 2011. He’s also black, which is particularly significant and potentially impactful because of the level of distrust between many members of the black community and law enforcement.

The Importance of Language and How We Say Things

All of this written, I don’t have policy proposals to deal with teacher-student sex, Muslims who shoot people in America or the rampant fear that other Americans have towards Muslims, how to fix the disparity of arrests and violence against black Americans by law enforcement, nor how to improve the perception of the vast number of cops who try so hard to do the right thing all the time. What is obvious and painful to behold is that teachers, Muslims and cops are all being maligned for the actions of a few deranged individuals that share a profession or religion with them.

I’m an Orwellian. That means that precise language is extremely important to me and that I try to avoid understatement, exaggeration, hyperbole, and inflammatory language. I am so disappointed and frustrated by the words I hear people use to argue their positions. People threaten, curse, yell, exaggerate statistics, and misstate facts to make their points. People on both the right and left, conservatives and liberals, Republicans and Democrats, are guilty of this. We surround ourselves with people that think and speak like us and choose to read media that reinforces our opinions. We get fired up on social media by the latest outrage and unfriend those that have a different viewpoint.

President Obama spoke at the Rutgers graduation this year, and he criticized the administration, faculty and student body for pressuring Secretary Rice to not speak at the 2014 graduation.

I don’t think that’s how democracy works best, when we’re not even willing to listen to each other. If you disagree with somebody, bring them in and ask them tough questions. Hold their feet to the fire, make them defend their positions. … Don’t be scared to take somebody on. Don’t feel like you got to shut your ears off because you’re too fragile and somebody might offend your sensibilities. Go at them if they’re not making any sense.

A number of liberal writers said he was wrong, and that Rutgers community was justified in denying Secretary Rice a chance to speak. I strenuously agree with the words of President Obama. We need to be able to talk to and more importantly, listen to each other. If you are a conservative, ask yourself if you have any liberal friends or liberal views. If you are a liberal, do you have any conservative friends or conservative views. Do you talk in specifics or generalizations? Are you in a constant state of rage and agitation? Can you have a conversation without getting nasty or raising your voice? These are points I implore you to consider and questions to ask yourselves.