Last month, I presented “The History of Marijuana Policy in the United States” on a national webinar for the National Association of Alcohol and Drug Abuse Counselors (NAADAC). You can find the link to watch it for free here. The webinar is about 90 minutes long. It was well received, and I posted the participant ratings of it here. A number of people sent in questions, and I spent a little bit of time this evening answering them. I’ve listed them here for your benefit (enjoyment?).

Q: Are the statistics presented similar in other countries that have decriminalization or legalization of marijuana (ie: Holland, Canada)?

A: Canada has very similar rates to the United States when it comes to marijuana use and abuse. Holland has lower rates of use and abuse than the United States. When Holland lowered the legal age to 16 and allowed for easier access, rates of use and abuse increased.

Q: Alaska’s new legalization of marijuana will be interesting as marijuana has been a privacy issue for generations in Alaska. It appears (though research is HIGHLY needed) that the attitude in Alaska has historically been positive toward marijuana is a personal decision/issue. Thoughts?

A: I can’t speak with any authority on the culture in Alaska. I drove to Alaska after I graduated from Rutgers in 2001, and I spent the month of August there. From reading and talking with hundreds of people, I learned that Alaska attracts a lot of people from the lower 48 that are highly individualistic and less interested in rules and regulations than the average US citizen. That would seem to jibe with the thoughts behind this question, but again, I am not certain.

Q: Did the studies regarding marijuana’s effects on the lungs/respiratory system address whether the issues were because of marijuana or the act of smoking?

A: Both. There are chemicals in marijuana which are damaging to the lungs. Smoking, of course, is bad for them as well. There needs to be a lot more research done on vaping (for e-cigs too), but most researchers tend to agree that both marijuana and smoking are bad for the respiratory system.

Q: How do we debunk the myths associated with marijuana while at the same time promote responsibility and acknowledge that marijuana has benefits?

A: It depends upon what myths you are asking about. Some myths state that marijuana is comparable to heroin and causes people to instantly go crazy and attack people. Other myths report that marijuana is not addictive and doesn’t cause physical dependence. All of those aforementioned myths are wrong.

I’m wary of a person, company or institution that wants to promote “responsible marijuana use.” Does anyone talk about responsible tobacco use? I know that there are lots of PSA’s and programs that promote responsible alcohol use, but that is an attempt to address the widespread binge drinking culture that is rampant among younger people and that also leads to drunk driving. I think that the idea of promoting responsible marijuana use suggests that many people use it irresponsibly or even dangerously.

Q: Why is recreational use of marijuana considered abuse?

A: Partly because “recreational use” has a wide range of definitions, depending upon who is using the term. Some people define recreational use as once every two weeks. Another person may define it as smoking after dinner every day at 6 pm. A third may say that they recreationally smoke whenever they are not working.

Q: How long does marijuana will stay in someone’s system?

A: If you are asking about how long will marijuana metabolites appear in someone’s urine sample, it depends upon how long someone has been using it, how strong their marijuana was, how often they smoked and their individual physiology. That answer is most likely anywhere from 2 to 90 days.

Something a little more daunting…THC attaches to fat in the body. White blood cells are made of fat. The neuron walls in the brain are also made of fat. It can take FAR longer for the THC that has attached to fat, especially in the neurons, to leave the body. It won’t be detected in a urine screen, but it will affect the body.

Q: Can nanogram levels go up and down without new use?

A: Only down. The half-life of marijuana is about a week in most people, but because of our different physiologies and variation within the species, it can probably range from 2 to 10 days.

If you test someone and her nanogram levels went up from a previous test, she used. Unequivocally.

Q: It is clear that Americans continue to be uninformed as to the real risks to our children and our society that will increase as we continue to legalize marijuana as both medicine and recreational use. As mental health professionals, we need to decide what we are going to do to educate the public in our communities, and our political leaders, to keep this from continuing. Positions statements are not enough – we must carry the message to the public or accept the consequences that we know will only get worse. Are we going to take any meaningful action?

A: Kevin Sabet and SAM are doing an excellent job about presenting information about marijuana and providing policy suggestions.

These are fascinating and scary times: some states have made marijuana completely legal, others have allowed for medical use only, a few have decriminalized it , while many other states continue to make the use and possession of marijuana a criminal offense. Over the next several years, we will be able to collect and observe how the use and abuse of marijuana has been affected by the varying policies. We will also see if there are real tax benefits, or if marijuana is revenue negative. We will see if marijuana legalization leads to less arrests, more arrests or similar rates of arrest (you might be wondering why legalization would lead to more arrests – well, there may be more driving while under the influence and we might see an increase in use among people under 21, which is still illegal). We will also see if it does anything to address the fact that minorities get disproportionately arrested for marijuana possession.

I am on the record as being in favor of decriminalization and against both legalization and criminalization. I have suggested to the powers that be in several states that they should not change their policies for the next few years and just watch what happens in different states. I am hopeful that we will have a sound grasp of these issues by 2020.

Q: Does the move of marijuana from schedule I to schedule II impact the international drug treaties which in my opinion will always be a reason for federal government to continue to keep marijuana illegal at that, the federal level?

A: Just to be clear, marijuana is still a DEA schedule I drug. It is there along with heroin and MDMA (ecstasy). Schedule I drugs are considered highly addictive and without any medical value. I have suggested that marijuana should be moved to schedule II in order to allow for true medical research so that we can determine if marijuana is helpful for people with cancer, AIDS, glaucoma and/or serious chronic pain.

I would guess that it would have little to no impact on our international drug policy. Take that last sentence with a grain of salt though, as that is not an area of my expertise.

Q: What would be a good resource to monitor Colorado’s impact of legal marijuana use?

A: SAM will provide balanced data, but their opinions will probably skew against legalization. The CATO institute is a libertarian think tank serves as an interesting counterpoint. I also believe that the New York Times will continue to do an excellent job reporting on this issue. While it is my newspaper of record, I disagree with the editorial board’s pro-legalization stance.

Paul Ressler’s son, Corey, died on July 14, 2010 of a drug overdose. He spent the next year both grieving and trying to find a way to make a difference in the lives of people who had problems with substance abuse. I met Paul in the summer of 2011 when he showed up to his first meeting as a new appointee to the Governor’s Council on Alcoholism and Drug Abuse (GCADA). After the meeting, I walked over and grabbed his hand and introduced myself (Paul is blind). He told me about his son and how he wanted to “make a difference and save lives.” I recognized the rare fire that burns in people who want to implement change.

Paul told me he also cared about veterans. I asked him why. He responded that he had been a combat medic in Vietnam (it’s one of the most meaningful jobs in the military that I can think of). I told Paul that a blind, Vietnam combat medic who lost his son to a drug overdose could be a powerful advocate in the fight for better public policy, improved treatment and maybe even insurance reform. Paul responded, “Whatever I can do Frank. Whatever I can do.”

Within a year, the NJ Heroin and Opiate Task Force was formed. Neil Van Ess, the Chairman of the GCADA, appointed me as the Chairman of the Task Force, Eric Arauz as the Vice-Chair and Paul as one of the other members. We held hearings around the state and listened to testimony from the parents of dead kids and a few people who fought their way into recovery. After the last session in October of 2012, we got down to the business of writing our report.

Also that October, Governor Christie vetoed the Good Samaritan Law. It was a law that had been enacted in other states in order to save lives. There is evidence that shows that 70% of people who died from an overdose and were found alone were actually not alone at the time of their overdose. People flee the scene and don’t call for help because they don’t want to get arrested. The Good Samaritan Law would have saved lives and all it would have cost was to not charge someone with drug possession that called for help. Governor Christie vetoed it because he said that drug dealers would use it to avoid getting in trouble.

Paul went public and denounced the Governor. It was a bold move, because this was pre-bridge, still-national-rising-star Governor Christie. Paul didn’t care. He said the Governor was wrong. He wanted the Task Force to officially support the Good Samaritan Law, but he couldn’t sway a few members who didn’t want to publicly oppose the Governor. Along with a number of other advocates (including Patty DiRenzo from South Jersey), Paul raised hell for the next six months. On May 2, 2013, Governor Christie announced that he was doing something that he rarely does – “I’ve changed my mind.” He signed the Good Samaritan Law and the Overdose Prevention Act into law. Paul was there when the Governor signed it.

Meanwhile, the Task Force report was repeatedly stalled, changed and blocked. Politics. The delay made the front page of the Bergen Record with the brutal title: In the Fight Against Heroin, Help Stalls While Frustration Grows in Trenton. Paul continually argued that the report should be released immediately, regardless of the political fall out (behind closed doors, he even gave me an earful on a couple of occasions). Eventually, the report was released on March 17, 2014.

Paul is on the board of Daytop-NJ. He was trained by NCADD-NJ to do advocacy work. He donates his time and money to the cause. He makes phone calls. He shows up to events all over the state. He speaks his mind without fear – “I don’t care what happens to me Frank…no one can do anything to me. I lost my son and I’m blind.”

This fall, Paul founded the Overdose Prevention Agency Corporation. It is a non-profit that conducts free trainings on how to administer Narcan to someone who has overdosed. The corporation also supplies free kits of Narcan to people that attend the training. It’s a big deal (it is supported through donations, so consider giving). Paul has continued to deliver on his words that he told me when we first met: “I want to make a difference and save lives.”

You have Paul. You do. Thank you.

Back in August, I wrote about how I left a dream job working at the Rutgers Counseling Centers and overseeing the Rutgers Recovery House. I mentioned that there were several new prospects that I was pursuing, including rejoining the United States Army (USA Today ran a nice article about me as well). I am now ready to unveil another one of those opportunities: late last summer, I was hired to be the Executive Director of College Recovery. We are a new business (that has ties to a large, successful and ethical treatment program in California) that has a Sober Living Component as well as a NJ DMHAS-licensed Substance Abuse Treatment Center.

College Recovery (click here for the treatment website) is treatment program that provides individual and group counseling to people with alcohol and/or drug problems and people with co-occurring disorders. We treat people at a variety of levels: Partial Hospitalization (PHP – 20 hours a week), Intensive Outpatient (IOP – 9 hours) and Outpatient (OP – 1 to 8.5 hours a week). We are less than a mile from the Rutgers campus and only a few blocks from the New Brunswick train station. We are located in a brand new, green (eco-friendly) building in downtown New Brunswick just a block away from City Hall and the Courthouse. Our population age range is 18 to 29, although we will take older individuals when they make sense. The key requirement (after the diagnoses) is that they are in college (or just wiped out of college and plan to go back within one semester). Soon, we will be licensed to offer individual and group treatment (both IOP and OP) for people with mental health disorders and/or eating disorders.

Those close to me know about my affinity for supergroups (Cream, the Traveling Wilbury’s, the Avengers, Giffen’s Justice League, the 2006 Swedish Hockey Team, the 2012 NJ Opiate Task Force, Temple of the Dog, the special case unit in The Wire, etc…). Within a week of being hired, I put together an all-star team of treatment experts.

Dr. Louis Baxter is our consulting medical director. He is the past president of the American Society of Addiction Medicine (ASAM). He served with me on the aforementioned Task Force and is nationally known for his expertise in medication assisted therapies (MAT’s). Joe Buttler is the clinical director and comes to us with over 40 years of experience in the field. Joe is known throughout the state for his expertise in training clinicians, especially running internship programs. Jass Pelland is the compliance officer and has 30 years of experience on the front lines. She has an absolute expertise in quality assurance and regulations. There are a few other well known figures and experts that I’m in discussions with about joining our team. I’ve hired a number of clinicians that I’ve worked with in other places, as well as a handful of my former students. They are young, bright, motivated and extremely coachable. It’s a great team. I’m both thrilled and proud of it.

At College Recovery, we do monitored urine screens. In addition to traditional groups like gender groups, relapse prevention and multi-family groups, we offer a guided mediation group and multiple yoga classes each week. We encourage exercise and take people to the gym. We take students to 3+ 12-step meetings a week and offer 2+ social activities a week as well. Being outside of Rutgers is a wonderful fit, as there are 40 students in recovery housing and 60 young alumni that live nearby, so there are over 100 young people in recovery that understand the unique issues facing college students who don’t drink or drug. This provides an immediate social circle, set of role models and potential sponsors that are not available to young people in early recovery anywhere else.

We also offer supportive housing (click here for that website). The brand new building has 20 beds, live-in staff and is located a block behind the Rutgers Student Center on the College Avenue Campus. Residents must submit to a breathalyzer in the morning and night, follow a curfew and be enrolled in some kind of treatment (obviously our treatment program is an easy fit, but they can choose to go to another program if they want). Getting sober at a young age is tough, and doing so on a college campus provides an even more difficult set of challenges. We are providing supportive housing, treatment, exposure to positive peers and role models, and perhaps most significantly, fun activities throughout the week and on every Friday and Saturday night. If people don’t find new ways of having fun, they aren’t going to stay sober.

So, I’m doing what I’ve done for over a dozen years (with my students in Japan, the residents at Integrity House, the residents at Earth House, my students at Elizabeth High School and my Rutgers Recovery House members)….I take them for late night, high caloric foods and on brutally long, surprisingly cold hikes.

“My concern is the Marlboro-ization or Budweiser-ization of marijuana,” said Ethan Nadelmann, executive director of the Drug Policy Alliance. “That’s not what I’m fighting for.” This quote it taken from an article on NBCnew.com that discusses, among other things, how the alcohol and tobacco industries warily view marijuana as both a threat and an opportunity. One thing everyone agrees on is that Big Pot is here to stay.

Mr. Nadelmann has been a pawn for the wrong side and it seems like only now is he beginning to realize that the same marketing whizzes that got America hooked on Starbucks will churn out several new generations of ardent marijuana users. He should look up the term unintended consequences. The most irritating part about this is that multiple people told him this is exactly what would happen.

Back in late September, Caitlyn Kovacs, a Rutgers sophomore died after drinking at a Delta Kappa Epsilon party. I wrote a piece in the immediate aftermath calling for colleges and universities around the country to shut down fraternities and sororities. I wrote about the rampant alcohol and drug problems associated with Greek life, high rates of sexual assaults, racism, sexism, academic cheating and the overall negativity they bring to campus life (to date, it has been the most read piece I’ve written for this site). Members and alumni of the Greek system were outraged and responded in droves. Several stated that I had jumped to conclusions and that maybe she didn’t die because of alcohol or maybe she hadn’t been served alcohol at Delta Kappa Epsilon. Recently, the Middlesex County Prosecutor announced that the county coroner determined that she died from “acute ethanol toxicity.” Caitlyn was 19 years old. She died drinking at a fraternity. Those are indisputable facts.

In the last six weeks, there have been several more fraternity and sorority related disasters. I list several of them below. This piece concludes with a number of scholarly articles that provide data that backs up my assertions and adds weight to the problems I’ve enumerated.

The Tiger Inn Eating Club at Princeton University (Eating Clubs are the equivalent of Greek Life at a few Ivy League schools) is currently under investigation by local authorities because a photo of a sex act was electronically distributed (there is a wide range of possibilities of what happened, but clearly, someone’s privacy was violated). On Tuesday night, someone spray painted “Rape Haven” on the walls of their entrance. I’m not a supporter of the destruction of public or private property, but someone apparently feels very strongly that the Tiger Inn Eating Club is a Rape Haven.

Today, West Virginia University announced that is was suspending all frats and sororities after an 18 year old was found unconscious and not breathing in a WVU frat (he died a few days later). One week earlier, 19 pledges got involved in a street brawl. I know that I am going to seemingly malign a whole state here, but seriously, you know that an institution has gotten out of hand when it is banned in West Virginia.

In September, Clemson University suspended all frats after the death of a teenage pledge.

Last month, Phi Kappa Psi was suspended at Brown University (a great, world class school) after two students reported they were given date rape drugs and one of them claimed she was sexually assaulted later that evening.

In just a few paragraphs, I’ve detailed several anecdotal examples that include deaths, dangerous drinking, fighting, drugging and sexual assaults. Two weeks ago, the New York Times published an article about the high cost of Greek life. While it doesn’t cover the destruction of drinking, drugging, date rape and death, it does paint a further negative portrait of Greek life. Pledges and members of sororities are often asked to spend a lot of money on fees, parties, clothes and other events each semesters.

Here are a number of scholarly articles and/or studies about Fraternities and their relationship to binge drinking and sexual assaults (thanks to Tess Krakoff for conducting this research).

Fraternity membership and binge drinking by Jeff DeSimone
• Social fraternity and sorority membership relationship with binge drinking incidence and frequency among 18–24 year old full-time 4-year college students who participated in the 1995 National College Health Risk Behavior Survey.
• The main activity with which fraternities are associated is alcohol use.
• Data confirm that fraternity members drink more intensively than do non-members. In the NCHRBS, past month binge drinking, defined as consuming at least five alcoholic beverages within a few hours, was reported by 69% of fraternity members as compared with 42% of non-members.

High-Risk Drinking Among College Fraternity Members: A National Perspective
• Extensive profile of drinking behaviors and predictors of drinking among 3406 members of one national college fraternity, distributed across 98 chapters in 32 states.
• Multiple indexes of alcohol consumption measured frequency, quantity, estimated blood alcohol concentration levels (BACs), and related problems.
• Among all members, 97% were drinkers, 86% binge drinkers, and 64% frequent binge drinkers.
• Drinkers had an average BAC of 0.10, reaching at least 0.08 on an average of 6 days.
• These fraternity members appear to be heavier drinkers than previously studied fraternity samples, perhaps because they were more representative and forthright.

‘Liquor before beer, you’re in the clear’: binge drinking and other risk behaviours among fraternity/sorority members and their non-Greek peers
• Respondents who binged were significantly more likely to be male and belong to a fraternity/sorority.
• Fraternity bingers were significantly more likely to engage in physical fights ( p < 0.05) than non-Greek male bingers.
• Sorority bingers were significantly more likely to be injured ( p < 0.01), drive under the influence of alcohol (DUI) ( p < 0.001), be sexually victimised ( p < 0.01) and engage in unwanted sex ( p < 0.05) than non-Greek female bingers.
• Fraternity members who binged frequently (≥3 times in 2 weeks) were significantly more likely to DUI ( p < 0.01) and engage in unprotected sex ( p < 0.05) than were those who binged intermittently.
• Sorority members who binged frequently were significantly more likely to DUI ( p < 0.05) than were those who binged intermittently.

Fraternity and Sorority Members and Alcohol and Other Drug Use
• A report by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) notes the disturbing consequences of drinking on campus each year: 1,700 college student deaths from alcohol-related causes; more than 500,000 unintentional injuries; more than 600,000 assaults; and more than 70,000 cases of sexual assault and acquaintance rape.
• Fraternities and sororities are among the key groups that foster this culture of drinking on campus.
• Given the high rates of heavy drinking in fraternities and sororities and the role they take in promoting frequent and heavy alcohol consumption on campus, college and university prevention efforts should target these social societies.

Study Ties Binge Drinking To Fraternity House Life

• This 1995 study was written about in the New York Times. You can read it here (things haven’t changed in 19 years).

Living in a fraternity or sorority house is by far the strongest indicator of binge drinking in college, a new study by the Harvard School of Public Health reports.

• 86% of fraternity residents and 80% of sorority women are binge drinkers
This compares with 45 percent of men not affiliated with fraternities and 36 percent of women

Our friend Pat died last week. He was 30 years old. Yesterday, I went to Pat’s funeral in the suburbs of Philadelphia. There were at least 200 people there, most of them in their 20’s and 30’s. It was very somber, even by a funeral’s standard.

Pat got sober as a young man. He went to Rutgers and lived in Recovery Housing. I met him in 2005. I was finishing up my masters in social work and he was a rowdy undergraduate full of zest and life. He was close friends with a number of guys that I eventually became quite tight with. Pat was a strong member of the recovery community and he was extremely welcoming and supportive of newcomers. He was the RA of the Recovery House during the 2007-08 school year (which was the year before I was hired to oversee the program). Pat was never my student or my client. I was never responsible for him. We were both just members of the Rutgers Recovery Community who felt a strong sense of gratitude and dedication to the Recovery House. Eventually we became friends.

Pat shared his experience with me as a RA and made some suggestions for improving the program. He played in our Alumni-Student softball games, sang at Karaoke with his friends, and spoke with current students about the importance of academics and internships. He shared his time and experience.

In the past 18 months, I went to Costa Rica with Pat for a bachelor party, was in a wedding party with him and attended two other weddings together of mutual friends. He enjoyed smoking cigars on the beach, fine dinners, a good joke and dancing like a lunatic. I knew him. After 9+ years of sobriety, Pat relapsed. I’m not going to get into details, but I’ll say this:

1) He stopped doing what he used to do in order to stay sober

2) His close friends were upset and concerned

3) Pat made a series of poor choices and his life got increasingly worse

4) People talked to him and he wouldn’t hear it

5) He cut people off

6) He put together about two weeks of sobriety this fall. Our friends visited him and told me, “It was nice to have my friend back.”

7) A month later he was dead.

One of my closest friends called me on Tuesday night and told me the news. I felt sad because Pat was my friend. I felt bad because Pat was an alumnus of the Rutgers Recovery program. I felt frustrated because Pat had once turned his life around. I felt awful for his closest friends. I felt devastated for his family, especially his parents.

I lost my friend Fraser in September of 2002. I had tried for several years to get him sober. His death was the final event that put me on the path of my life’s work. Both Rutgers and myself have written about it. Pat’s death reminded me of Fraser again and all the feelings that I went through in the aftermath. I sent out an email to his closest friends:

I am so sorry for your loss. I know this pain all too well. I just wanted to share my experience with you all in the hope that it might be of some help.

(1) Write down everything you can about Pat. Things he said, things you did together, jokes played, things that pissed you off and little gestures. Your mind will be flooded with memories over the next two weeks, and then they will slowly fade. You will never remember him as well as you do right now. Write it down. Also…it will help you grieve.
(2) I was angry at Fraser for dying and then I would feel bad about being angry at my dead friend. It was confusing. It took me a while to reconcile all of those feelings. It is ok and natural for you to be angry at Pat.
(3) There was nothing you could do to help. Do not blame yourselves in any way or carry that burden. You were all good examples and good friends to him.
(4) Double up on your coping mechanisms, whether they be therapy, AA, exercise, yoga, meditation, hanging out with friends, hiking, etc….Do this for a number of weeks.
(5) You have the right to talk with who you want about this, and you can also tell people that you are sad and just need some space. I found that I talked about it a lot with a couple of close friends, shared about it at every meeting I went to and discussed it in therapy. But I didn’t have it in me to talk to everyone. Some people just pissed me off or didn’t “get it.”
(6) Remember that his family’s pain is worse than yours. Writing a letter to them about how much he meant to you, as well as some funny/good stories will be valued more than you can possibly know.

At the service, I told his parents about GRASP (Grief After Substance Passing). Since 2012, I either get a letter, email or phone call from at least one parent of a young person who died from substance abuse each week. The pain a parent experiences when their child dies is indescribable and immeasurable. There are no words or deeds of comfort.

I watched my friends at the service. I watched them look at pictures, talk to each other, cry in their spouses’ arms and try to make sense that this happened. “I keep waiting for him to pop out of the next room and say it was all a joke,” one friend told me. It happened so fast and seems so unreal. I wish I could take away their pain. All I can do is share my experience and be there for them.

___________________________________________________________________

We are going to create a scholarship for students in recovery in Pat’s memory. If you want to be a part of that scholarship, you can contact me. If you just want to donate in Pat’s memory, you can mail a check to Rutgers ADAP, c/o Lisa Laitman, 17 Senior Street, New Brunswick, NJ, 08901.

I’m strongly against both marijuana criminalization and legalization. Criminalization is costly, leads to a crowded criminal justice system and mars the records of otherwise upstanding citizens. Legalization is costly, leads to more cops, more use, more hospitalizations and more treatment episodes.

Decriminalization does not encourage new users but also keeps the criminal justice system clear (so cops can do real police work and citizens don’t have to explain a marijuana arrest when they were 26).

It’s great news out of NYC: click here

On Tuesday morning I received a call from a former colleague of mine that a young man was caught drinking on the job. My colleague knew that the young man, George*, was a former student of mine and that he had once been sober for about two years.

I was able to get in touch with George and explain to him that the jig was up. “Everyone at your job knows that you have a drinking problem,” I told him. I explained that he should go to treatment and that he could keep his job and that I would help him through this. He agreed to call several detoxes. Within 15 minutes, he had an appointment at a quality program in Central New Jersey for Wednesday morning.

The medical staff at the detox unit took his vital signs. His resting pulse was 101 and his blood pressure was 140/100 (he is 25 years old). He admitted to drinking for the last 72 hours and that he usually drinks 13 out of 14 days (his pattern for the last several months). The medical professionals and the substance abuse counselors all agreed that he needed to be admitted to the detox.

Here is a word by word copy of our text conversation from Wednesday morning (reprinted here with his permission):

George: I’ve been admitted.

Me: Great. Keep me posted on your progress and let me know when they begin discharge planning.

George: Correction. I was denied. I’m under “doc” review from my insurance company.

Me: WHAT?!? If they don’t pay for it make sure that doctor gives you written reasons why and a referral/rec for other treatment.

George: Okay..like, I’ve drank for 72 hours straight, my pulse is 101, BP is 140/100 and they fuckin deny it. How is that possible? Alcohol is one of two detoxes that you can die from.

Me: Let’s try Sunrise detox or Bergen Pines.

George: It’s my insurance saying no.

Me: Ah…it’s the insurance. Right. Of course.

George: Yessir. The clinician is really pushing for me to be accepted.

Me: Who is your insurance company and what kind of insurance is it?

George: HBCBS and advantage EPO. I’m being referred to an ambulatory detox.

Me: Are you going to go there?

George: Probably not. I don’t see how I’m not going to drink at night. My pulse is 116 now. The doctor told me to go to a GP and have him prescribe me a benzo and detox at home.

Me: That is outrageous. Who is the doctor reviewing your file for the insurance company.

George: Dr. Pigvomit**.

Me: Ok. We are going after him and that company. Fill out this form when you get a chance – NJ State Insurance Complaint Form

George: Will do. This detox is admitting me.

Me: Ah, great news.

George: They said irrelevant to what the insurance doctor says, I’m in and not responsible for all payment if the insurance company says no.

Me: Wow. Great great news. I’ll have to contact them and thank them.

My student has been there for 36 hours now and is doing fine. We are going to file a complaint against the insurance company and I’ll take this story to the press. Sadly, this is all too common. If you have a story like this or know someone who does, please fill out this form: NJ Insurance Complaint Form and please tell your story to the press.

* George is not his real name. I’ve changed it for this article.

** Pigvomit is not the Dr.’s real name.

Excellent article about addiction, overdose, treatment, medication assistance therapy, PMP’s and Narcan from the September 8, 2014 The New Yorker: click here

Halloween fell on a Friday night this year and college towns around the country were overrun with parties and alcohol-fueled hospitalizations. New Brunswick’s police force, EMT’s and hospitals were overwhelmed: click here.

A Natural Fix for ADHD from last Sunday’s New York Times.

I’m in favor of punishment and consequences, but after people have served their time, I think they should be allowed to move forward. Today Californians will vote on reclassifying some crimes from felonies to misdemeanors in an attempt to make it easier for ex-offenders to find jobs. This excellent piece appeared on 538.com: click here.

This guy is very sharp. He does an excellent job explaining why medication should be a part of some treatment and recovery regimens. My only disagreement is that I think needle exchange programs are a little better than he makes them out to be. Read the interview from The Fix.com here: one man’s war on treatment.

From Forbes: What 20 Years of Research Has Taught Us About the Chronic Effects of Marijuana.

For Addiction Treatment Professionals: sexual misconduct on the job.

More marijuana facts: What the Marijuana Industry Doesn’t Want You To Know

My favorite, current-sitting, NJ politician, Senator Joe Vitale, appeared at Rutgers in late October and spoke at an Overdose Vigil. His 21 bills that address education, prevention, treatment and recovery are a fantastic way to address the opiate epidemic. While Governor Christie gets headlines for saying things, Senator Vitale quietly works towards getting big things done. Read about it: Overdose Vigil at Rutgers.

* I post most of these on the Facebook page when they are published, as well as a number of other articles that I don’t discuss on this site.

A recent article in The Nation described my well-discussed theme about how locking up people with alcohol and drug problems is a waste of money, poor public policy and inhumane. I’ve written about how we should educate prisoners and what books and articles people should read in order to learn more about criminal justice policy. One of my favorite facts is this: in NJ, it costs about $55,000 to incarcerate someone and about $12,000 to treat them in drug court (and drug court gets better results).

I am a fourth generation English teacher and a second generation college professor. For a time, I considered getting a PhD in English in order to pursue a career as a Professor of Shakespeare. Alas, my life took a different direction (that has worked out very well). I still read widely and go to the theater a few times a month. Last summer, I went to see Our Country’s Good at the Guthrie Theater in Minneapolis with my mother’s cousin Anne and her husband Phil.

The play is set in Australia in the 1790’s. The English penal colony has just been set up and the Governor, Captain Phillips, has encouraged 2nd Lieutenant Ralph Clark to work with the prisoners and put on a play for the entertainment of the entire colony. A number of the officers are disgusted by this and have threatened to mutiny. The prisoners are looked on as less than human (some of them are serving seven year terms for stealing food because they were hungry). There is an incredible scene at the beginning of Act II in which Captain Phillips advises Lt. Clark to continue with the play, despite the protests of the other officers.

Phillips: If you break conventions, it’s inevitable you make enemies, Lieutenant. This play irritates them.
Ralph: Yes and I —
Phillips: Socrates irritated the state of Athens and was put to death for it.
Ralph: Sir —
Phillips: Would you want a world without Socrates?
Ralph: Sir —
Philips: In the Meno, one of Plato’s great dialogues, Socrates demonstrates that a slave boy can learn the principles of geometry as well as a gentleman.
Ralph: Ah —
Phillips: In other words, he shows that human beings have an intelligence which has nothing to do with the circumstances into which they are born.

Ralph: Sir —

Phillips: Sit down, Lieutenant. It is a matter of reminding the slave of what he knows, of his own intelligence. And by intelligence you may read goodness, talent, the innate qualities of human beings.

Ralph: I see — Sir

Phillips: When he treats the slave boy as a rational human being, the boy becomes one, he loses his fear, and he becomes a competent mathematician. A little more encouragement and he might become an extraordinary mathematician. Who knows? You must see your actors in that light…..How do we know what humanity lies hidden under the rags and filth of a mangled life?

How do we indeed? Americans love the story of a life redeemed. The bad boy (or girl) turned good. We are nation of second chances and third acts. We need to take this approach with those that have a substance abuse problem.