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Listen to Science? Since When?

Updated: Aug 13, 2023

Editor’s Note: Today’s post comes from contributing editor Brooks Hudson, a PhD student in history at Southern Illinois University.

Every day, on television or doom-scrolling through Twitter, some Democratic Party official rails against Trump for ignoring “science” and putting the country at risk by his failure to “listen to the scientists.” It is true. Though, to be fair, Trump has never claimed to respect science or made any pretense that it would influence his policy decisions. Conversely, since the coronavirus outbreak, Biden has really hammered home the “public health” message. His campaign’s website, in a bullet point filler section, pledges that, if elected, the Biden administration will “ensure public health decisions are made by public health professions and not politicians.” Don’t take this seriously. 

Whether we should take it seriously or not, the constant barrage of “listen to scientists” has struck a chord with me, though not in the way they intended. In fact, it has heightened my awareness of how policy is utterly divorced from science. The primary reason for thinking that Biden is bluffing with the whole “public health over politics” shtick is that, if taken literally, it would mean overhauling sectors of the economy and reforming and reshaping various government agencies. In American politics it would be nothing short of revolutionary, and revolution, as we remember from the primary, was the opposite of Biden’s message of normalcy and not rocking the boat. While the feasibility of either political party “trusting public health officials” is basically nil, it is interesting to consider hypothetical changes made by public health officials, practices and policies flagged or simply ended. There is some low-hanging fruit (things evicting an elderly woman in brutal health during a pandemic seems like a good one). Or evicting anyone, especially people recovering from the virus, for mistaken medical debt

Health care workers applaud Michael Flor upon his release from Swedish Issaquah last month Pushing the wheelchair is Dr. Anne Lipke, Flor’s critical care doctor. (Ken Lambert / The Seattle Times)

The same applies to $10,984 COVID tests and $1.1 million medical bills being handed off as the patient is being wheeled out to their vehicle. Intellectual property should not be a higher priority that supersedes questions over who lives and dies. 

The coronavirus has transformed country, and exacerbated all the underlying issues of mental health that were plaguing the country before the pandemic. Mental health and drug policy are their own special nightmare. The depth of the crisis is revealed in a study the Centers for Disease Control and Prevention released in August, which was based on an extensive mental health survey of Americans in late June. Glenn Greenwald covered the study for The Intercept:

For those incarcerated, conventional medical ideas are just thrown out. Take for instance, the “brain-disease” model of addiction, described as a “chronic relapsing brain disorder that, like diabetes and heart disease, is caused by a combination of behavioral forces.” This definition is accepted by “the National Institutes on Drug Abuse, the American Medical Association and The Diagnostic and Statistical Manual of Mental Disorders,” which “is the final authority on psychiatric conditions that qualify for insurance reimbursement.” Even though “relapse” is a predictable and likely outcome of addiction, our prosecutors and law enforcement officials have decided to ignore the consensus, and no laws have been enacted to address it. The people that used to beat prisoners with mental illness hundreds of years ago actually were keeping with standards and beliefs of the time. In fact, punishing someone for demonic possession is as warranted as punishing someone for relapsing; it is an knee-jerk idiotic reaction, without medical research backing it, whose remaining justification relies on punishment for its own sake.

Looking at individual cases can be even more revealing. When someone has a serious drug problem, the general assumption is that drugs were the cause. In most cases, drug misuse is a symptom of deeper issues. Pro Publica recently profiled a woman, Ricki Dahlin, serving time at Hiland Mountain Correctional Center in Anchorage, Alaska. While the piece notes a substantial portion of women residing in that prison had stories not that dissimilar to Dahlin (above), who was arrested for stealing a vehicle and possessing a firearm along with a gram of heroin in 2016, the brief overview of Dahlin’s life makes clear that heroin was a symptom of a lifetime of physical and sexual abuse: 

“Born premature and diagnosed with a fetal alcohol spectrum disorder, Dahlin said she was sexually abused as a girl. She remembers letting her mind go blank when the man would begin to touch her. ‘Blacking out,’ she calls it.

By age 13, Dahlin was drinking and using drugs. When she began to date, some of those boys and men hurt her too, she said.

‘A lot of people look at us as just drug addicts or junkies, ‘You know, they deserve to be in jail.’ Well it goes deeper than that,’ Dahlin said. ‘We’re broken. We’re trying to fix ourselves.'”

From Dahlin’s perspective “it’s the law that hasn’t held up its end of the bargain.” Before the Pro Publica reporter arrived, Dahlin had been punished with solitary confinement for relapsing while housed in the facility. A lot of countries and most human rights organizations understand solitary confinement to be torture, primarily because it is. After being sexually abused as a child and physically abused through her adolescence, the state picks up where Dahlin’s abusers left off, punishing her for an illness and then recommending some light torture when she relapsed. While the criminal justice system and law enforcement officials pretend they know how to deal with substance use disorders, in truth they ignore all evidence and require extreme adherence to abstinence-based programs, not because they are the best methods for treating addiction, but because they are cheap.

Abstinence-only programs often exacerbate mental illness, as the Boston Globe documented in Debra Silvestri’s case. A mother of three, Silvestri committed suicide, fearing she would be sentence to probation violation: 

“Debra Silvestri slipped into the women’s bathroom at the district courthouse, pulling a plastic bag full of sedatives and antidepressants from her purse. Her lawyer had just told her the judge was thinking of sending her to a women’s prison because a court-ordered test showed she had been drinking.

For more than a year, the 55-year-old mother of three had come nearly every week to the Lowell Drug Court, a requirement of her probation following a 2012 drunken driving arrest. It was supposed to be a compassionate alternative for addicts such as Silvestri, a place that steered them away from jail and toward treatment.

But Silvestri had other problems that made drug court painful for her. She had struggled for years with schizophrenia and bipolar disorder, once cutting her wrists and wandering the streets of Tewksbury, knocking on neighbors’ doors in the middle of the night.

Yet, court officials rarely asked Silvestri about her mental health. Instead, they focused on making sure she attended AA meetings, took random drug tests, and breathed into a machine that can detect alcohol use. Her life had turned into a succession of court-ordered deadlines that made her so anxious her hair had started falling out in clumps.

‘I can’t take it anymore,’ Silvestri often told family members.”

This nexus between drugs as a public health responsibility and a law enforcement issue remains unsolved. Maybe an upside of the coronavirus is that it undermined a lot of the stated justifications for enforcing drugs laws. Typically, the argument for drug enforcement is that it’s meant to ensure “public health” and safety. If we assume that to be true, arresting people in the middle of a pandemic for drug possession and exposing them to more people betrays the claims of “public health and safety.” Then there was the police raid in Louisville, Kentucky, where police murdered Breonna Taylor after executing a no-knock warrant for some tangential relationship to drugs through her ex-boyfriend who lives ten lives away. Sometimes we don’t need public health officials to think through this problem. Why execute no-knock warrants in the middle of the night? Wait until the morning. More generally though, even if she had drugs, who cares? Had they retrieved drugs, what would it have effectively done? Nothing.

While my expectation is that we will address these issues soon, there is little room to be optimistic.

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