Heroin Coverage Doesn’t Go Far Enough

The reality is no one knows “how to get off heroin,” if that is defined as the final product of a treatment that has proven, predictable efficacy in creating long-term remission from opioid use disorders (“How to Get Off Heroin: An inadequate system takes on an epidemic,” Jan. 12-18, 2017). The obfuscating and confusing title and juxtaposed subtitle of this piece, however, are valid metaphors for the abysmal state of addiction treatment services, and yes, the system is severely impaired. But this piece lost credibility by fostering an impression that there was going to be new, specialized, or unique information to give struggling addicts. Nope, didn’t happen. However, not to digress …

Let’s view the treatment options. Okay, we have medication-assisted therapies like buprenorphine and methadone. Sure, they work — but only to suspend cravings and begin turning people away from the harrowing addiction lifestyle they desperately must restructure. These medications, and most of the programs and physicians that administer them, do very little or nothing to steer people away from alcohol, marijuana, sedative, or cocaine abuse, nor the cravings for these replacement addictions. They are also not wrap-around, integrated treatment modalities, but the people who run them may feel they are doing enough. Indeed, the mantra of harm reduction and the imperative of reducing opioid-related deaths has permitted this sort of fractionated service. The real work of recovery is then left for someone else to carry out — someone who has, or cares to spend, the money needed to carry out long-term recovery practices. And how about inpatient and residential treatment programs? Yeah, they’re wonderful, many of them, located in posh settings, staffed by well-paid, energetic counselors, and offer holistic treatments galore. They have great success rates — until people are discharged home after a couple weeks or a month to their job, family, financial, legal or other stressors. Discharge plans from these programs are typically garbage. And when clients fail, they themselves are invariably blamed. And let’s not forget the simple matter of lack of availability of a broad range of treatment services, not the least of which is to ensure continuity of care.

What a mess. We have a long way to go and we need nothing less than a proverbial Marshall Plan to get real headway in rescuing the hundreds of thousands who suffer from devastating addictive disorders, and in achieving better success than the lackluster 30-50 percent recovery rates (probably optimistic) common to our treatment systems. It may take quite a while to wrap our heads around this reality as a nation; addiction, astonishingly in this day, remains highly stigmatized.

— Greg Merens,


Get Serious

Now the Valley Advocate has it’s own version of alternative facts? The real purveyor of sexism isn’t genital-mutilating, “adulteress”-stoning Islam! No, the real purveyor of sexism is the Super Bowl, so says “Have an Alty Super Bowl, Everybody!” (Feb. 2-8, 2017). And Martin, Brown, Rice and Garner, each of whom were arguably in the commission of a criminal act when they met their ends, were “guilty until proven innocent?” Which somehow has an implication for “racism in Heaven” in Holland’s piece (“Racisim in Heaven: Nick Cave at MASS MoCA,” Feb. 2-8, 2017)? Come on, Valley Advocate. Apply the same standards of behavior to everyone, instead of favoring the out-group of the moment. You’re supposed to be journalists, not propagandists.

Trump is a sexist pig. So is the Grand Imam of al-Azhar, Ahmed el-Tayeb, the highest Sunni authority. Face the facts, and report them.

— Kathy S. Grey,