The state of Addiction Medicine in the greater part of the developed world (with the glaring exception of North America, ESPECIALLY THE US which is well behind its friends in the West, for the most part) is moving in all directions.

There are fighters in every corner of this orange Hexagon waiting to tell you you’re cured now.

Cured now cause you’ve wept on your knees enough.

Cured now — with the caveat to keep taking the medication assistance from drugs like Buprenorphine and Methadone, or you’re cured now because you’ve completed the 12 steps and have a sponsor.

We’re all cured now somehow.

Except that we are all (mostly) not.

Medications cost upwards of $500 a month, and only if you’re one of the lucky ones who gets access to these life-saving meds.

Methadone clinics are exclusively in big city ghettos, where nurses and psychology majors sitting behind old schoolhouse desks quite literally hold their patients lives in their hands.

Some experts say only when you’ve admitted deep down that you’re a wretched fiend and admitted same to “God as you understand Him” are you cured now.

There’s a pill if you’re a dope head (heroin/opioid user) called Buprenorphine (or more so these days, just Suboxone), and a cherry flavored Methadone clinic ball-and-chain that you’re free to become dependent on as well.

There’s rehab.

There are 12-steps tacked to walls in worn rooms.

There’s Bill and the Big Book.

There are uncaring Suboxone doctors in innumerable clinics — in every big city in the US — who are there for you — there for you just so long as you keep coughing up $200+/month to be in their esteemed presence for 10–15 minutes, you’re cured now.

See, we’re all cured now, but if we are not, it’s not because we may live in a rural area where the nearest medicine-based treatment clinics are at least 400 miles round trip.

It’s not because we don’t have an NA meeting in our hometown (even if we wanted one) — because: “Not In My Back Yard!”

“NIMBY” say the small town city councilmen and women to Bupe Rx’ing doctors — never you mind that crooked croaker who will write anyone who comes in a script for 90 Ritalin 20’s/mo (“Just to start with honey. We’ll see you in a good month, and if you’re ‘symptoms’ aren’t any better, we’ll try 120/mo.”)

And never mind the croaker on the other end of town who will write anyone a script of Roxy 30’s just so long as you went to the same high school.

NEVER YOU MIND THE ROOT CAUSES!

“We will not be having Suboxone in our perfect little town, those doctors are the real problem,” say the authority figures.

“A methadone clinic!?”

They’ll gasp if you even mention it — mention it while writhing on the floor in pain: and that’s pain you’re most certainly going to go do something illegal about in T-minus 10 minutes without some Fucking Proven Treatment Options.

“NIMBY” they’ll all shout at the city council meetings.

“Don’t you see?” (And with every minor “Suboxone possession” story placed on the front page of your local small-town paper — domestic abuse stories, page three, thank you — it’s almost hard to blame them. ‘Almost’ being the operative word there.)

But it’s clear we’re not all cured now, sure as there’ll be another minor drug possession story in the headlines on A1 this week.

Sure as the mother with a daughter who “died from Suboxone!” will shout “NIMBY” at the next council meeting.

We are not all cured now.

No.

We’re all fighting each other and price—gouging each other into oblivion.

But a medication assisted treatment option within — even say…60 miles of your hometown — one that takes insurance, or (God forbid) “Medicaid,” and allows the town addicts to lead normalish lives…“NIMBY!”

But that is what we’ve all agreed upon, right?

That addiction is a chronic disease, and the most imperative part here: that medication-assisted treatment has the best outcomes, scientifically speaking?

Then why in the name of your Fucking Higher Power don’t any pharmacies within 120 miles of me even carry Buprenorphine-containing medications?

Why do people keep dying from overdoses when this week’s mule returns from Chicago (or Detroit, or Dallas or: insert your nearest urban area _______ <—- here) with $10 packs of dope marked up to $40?

Why is our small-town jail so overcrowded that we’re letting serial drunk drivers out to make room?

Why does every 10th person you see have the chills when it’s 90 Fucking Degrees Outside?

Why?

I’ll tell you why:

Because we are not all cured now.

Not a God Damned One of us.

Even the ones going to church AA meetings as if their lives depend on it. (And their lives do, that’s the kicker…and another post)

No, sorry but we’re nowhere fucking close to cured now.

We’re all here suffering, while you’re all there murmuring quietly about the dangers of Suboxone or Methadone (‘done, admittedly, is the more dangerous of the two – respiratory-depression-OD wise anyway).

We’re all up, awake all hours of the night, doing B&E’s on long-established and respected local businesses that can’t withstand another loss, — We’re all still up, all of us, doing all sorts of crazy shit to feed our habits — while you’re all tucked in sweetly, with visions of normalcy dancing about in your head.

We’re all out there selling those 120 Ritalin we get, and for $10 a piece (!) to get some dope, “let’s see, that’s… . 120 X 10, . . hmm, carry the one and… holy shit: $1200.00 USD.”

That’ll get you started.

Where’d you think all the speed addicts came from anyway?

No, we are most certainly NOT all cured now.

Now we coexist — in a hellhole for those afflicted – a nice space where you can all look down your noses for those who are not.

Now we barely make it through the month.

He’s not going to make it through the day, and she’s got a week if she’s lucky (. . .and. . . I swear. . .didn’t I just hear, that she’s 4-months along?)

(Oh, and by the way, he’s most certainly one of your sons, and she, one of your daughters.)

But keep screaming about the scourge of Buprenorphine and Methadone.

We’ll all still be here, well…only some of us, sadly, when you finally get your heads out of your asses and decide science is real.

When you decide diseases are real and we’re not all cured now.

Here we’ll be, (only most of us, tragically) waiting for our chance to be welcomed back into the human race.

Waiting for the day when addiction really is treated — at the city council meetings, in our homes, on the town square, in your heads, in the Fucking Drunk Tank at the overcrowded county jail — like a disease.

When it’s finally looked upon with some empathy

You know empathy, right?

It’s what you feel when you see someone with MS struggling to walk for Just One More Day.

Addiction is a treatable disease, like Multiple Sclerosis (MS) is (an unpredictable, often disabling and terrible) disease, both who’s symptoms can be treated with science, medication, etc.

That is what the town Doctors say now, no?

Well, then why the Fuck can’t I fill a Rx for medication that can treat my symptoms within a 200-mile radius of home?

Oh, that’s right, because we’re all cured now.

I nearly forgot.

Just a few more judges hand down a few more outlandish sentences + a few more suboxone possession stories on A1 at the local news stand near you, shit. . . we’ll have this thing licked.

Let’s keep up the good work, all.