dummies' dilemma

i'm taking a break from my ongoing rant about just what is so infuriating about the "heroin for dummies" debate (a bunch of people got upset that their tax money went to a booklet illustrating safer injection practices for heroin), to spend some time on the subject of hypocrisy and double standards.........in the context of "heroin for dummies" :)

i went to the dentist earlier this week, and while waiting for the doctor to come brutalize my molar (seriously, it took 2 shots and still hurt!), perused an issue of rachael ray's magazine, 'everyday.'  flipping through it, i came across this illustration (click image to enlarge) on how to play the holidays' "lively celebrations" right..... or should i say, BOOZING FOR DUMMIES!  DUN DUN DUN!

any other day, i would have been delighted to see this.  harm reduction at its finest.  rachael ray isn't making you go out and booze, but she's looking out for you if you do.  "eat food throughout." "order your drinks wisely." "avoid these traps."  piece of valuable knowledge.  dispelled myth.  useful tidbit to keep in mind.  you win!  you are not sleepy-eyed (rachael ray for hung the eff over?) at the thanksgiving table.  but this just so happened to occur the day after a bunch of glib news anchor types made a mockery of the same concept in relation to heroin, and the internet chimed in.  the level of hypocrisy just blows my mind -- how does harm reduction spark such controversy when we're talking about one thing, but get a jazzy full page feature when it's another??

(much) more after the jump.

i can't help but think that some soccer mom protesting the merits of 'take charge, take care' in the youtube comments section picked up her copy of rachael ray that morning, and got a chuckle out of the cartoon, or maybe even an fyi to share.  maybe the lady on cnn even has a subscription.  one of her most asinine comments still rings in my ears: "use with someone else?  sounds like recruiting a friend. [sneer]"  wait, what's that, rachael ray?  "step 2, phone a few friends to join you"?  for shame, ray.  (by the way, i don't know why rachael ray wants you to call your friends, but the heroin booklet states right underneath, "if you're alone and something goes wrong, no one can help."  sounds more like pragmatism than trying to corrupt your children to me.)  the same goes for the rest of the heroin overdose prevention tips: "know your tolerance."  "don't mix drugs."  sounds a lot like the rachael ray tips, no?  and safer-use advice from rachael (flat mixers, no straws, etc.) fall into a category of "things to make the drug that's already in your hands less dangerous" -- much like advice to use new syringes and prepare drugs carefully.  i could go on with the parallels (they're both marvelous pieces of graphic art!), but they're probably pretty obvious.

so why do we applaud harm reduction when it refers to something we're comfortable with, but condemn it when it refers to something we're not?  where does the contingency behind the sentiment come from?  the desire to keep yourself and others from harm shouldn't be conditional on whether or not you think the behavior is "right" - the important thing is that the behavior is dangerous, but can be made less so -- and chances are, your notion of "right" is skewed and incompletely informed anyhow.  as far as your brain can tell, a drug is a drug is a drug -- making it squirt dopamine (what makes a drug feel good) through opioid pathways isn't inherently worse or better than an alcohol-induced squirt (this is a great paper on how all drugs converge on the same dopamine squirts/feeling good in the end.)  the brain doesn't judge how it got the dopamine boost -- but people do, and so does the law.  but i don't buy arguments like "well there shouldn't be any heroin addicts in the first place," because that's wishful thinking, and you'd never dream of taking away people's seatbelts because you're opposed to reckless driving.  and i don't think it makes sense for some arbitrary and controversial DEA scheduling scheme to determine who deserves to know how to keep from wrecking themselves and who doesn't.  if miraculously alcohol got scheduled as an illegal drug tomorrow..... would "toasts of the town" be the new scandalous "how-to guide for doing horrible things and making upstanding citizens pay for it?"  there is no reason for alcohol (or those rx painkiller bottles in the cabinet for that matter) to be "right," or righter than heroin anyway.  alcohol is a dangerous drug, you can overdose and die, you're a nuisance and a danger to others under the influence, and its abuse results in addiction.  legal status does not exempt alcohol from giving you the same brain disorder other drugs do, and bringing on the same consequences.  granted, in rachael ray's case, the worst consequence is having to take two advil in the morning, but considering that part of what makes up a hangover is withdrawal, i think it's safe to say that differences in severity of consequences don't prevent them from being similar in concept.  and yet, rachael ray acknowledges people are going to booze over the holidays, without judgment, and she should be lauded for helping them minimize the dangers associated with it.  why, then, isn't the new york department of health being lauded for acknowledging that the city's heroin addicts are going to shoot heroin, and helping them minimize the dangers associated with it?

as for the financial aspect, sure, no one is unwillingly footing the bill for rachael ray's advice, while taxpayers are funding the heroin booklets.  but think about it in context -- people addicted to heroin can't will themselves not to be.  they're not going to stop using, and doing so unsafely if that's all they know or have access to.  the nature of their disorder is for them to keep taking the drug, and disapproval, marginalization, and looking the other way certainly won't stop them from manifesting symptoms of their disease (compulsive drug-seeking) ...and if done unsafely, developing the nasty medical and social consequences that will ultimately be a burden to you.  it's like spending the 42 cents to mail page 32 of 'everyday' to a friend, versus dealing with their vomit and drunken idiocy the next night (or rachael ray's worst-case scenario: sleepy eyes at the dinner table.)

anyway, this point of view has been expressed more extensively and eloquently elsewhere on the internet.  i just wanted to point out the irony of coming across these two pieces of harm reduction within 2 days of each other, and express how astonished i am at how differently they were received, and how selectively people seem to apply the principles, for no reason that's clear to me.  so can we collectively flip to page 33 of this debate, and consider that allowing others to avoid unintended harm doesn't depend on your opinion of what they're doing?