Public shaming of drug addicts - Do you think its a deterant to drug use?

[rexlunae]

Sure it does, which is why drug overdoses has now surpassed all other causes of death.

You libs want to ignore everything.

No. Consult the actual literature. This has been studied.

 

[kmoney]

Do you agree with that? If yes, break it down, would it apply to the doctor that started their scripts and if they chose to take more than described or start adding getting it on the street to fill in to make it to the next prescription?

Do you think doctors should heavily monitor those they give opiates to and when and how do the doctors become the killers?

I like the idea behind it because it's a way of targeting dealers. But I think it would be very difficult to put into practice. You give a couple of the potential problems concerning doctors and prescription medications.

I don't know what you mean by 'heavily monitor' so it's hard to answer that.

 

[ok doser]

I like the idea behind it because it's a way of targeting dealers. But I think it would be very difficult to put into practice. You give a couple of the potential problems concerning doctors and prescription medications.

I don't know what you mean by 'heavily monitor' so it's hard to answer that.

who needs dealers when you've got internet shopping and the mail service? http://theologyonline.com/showthrea...-to-drug-use&p=4918462&viewfull=1#post4918462

 

[kmoney]

Sure it does, when there wasnt a revolving door on crime and needles being handed out to make it easier and it being called a "disease" instead of sin, taking responsibility from the user, there wasnt as much of a problem.

The evidence doesn't support that view, Angel.

https://www.nap.edu/read/4975/chapter/12#217



It seems to me that you're trapped in a paradigm of sin, such that you can't consider other approaches that have much higher success rates. You need to view drug use as a consequence of the fallen state of man, because you are afraid that otherwise, we might not be responsible for our actions. Well, addiction doesn't necessarily respond to moral purity.

I don't think it has to be an either-or issue. Addiction is clearly a factor in the problem and simply throwing someone in jail does nothing to fix it. A medical approach needs to be at least part of the solution. At the same time, if someone gets addicted to a drug through their own choices then making them responsible in some way doesn't seem unreasonable.

 

[rexlunae]

I don't think it has to be an either-or issue. Addiction is clearly a factor in the problem and simply throwing someone in jail does nothing to fix it.

I disagree with that. Shame and criminality is counter-productive, in this case.

A medical approach needs to be at least part of the solution. At the same time, if someone gets addicted to a drug through their own choices then making them responsible in some way doesn't seem unreasonable.

What if they start out taking legal drugs to control pain under a doctor's supervision, and end up hooked and buying illegal drugs because it's cheaper?

The common case for this is not as simple as people just experimenting with drugs.

 

[kmoney]

I disagree with that. Shame and criminality is counter-productive, in this case.



What if they start out taking legal drugs to control pain under a doctor's supervision, and end up hooked and buying illegal drugs because it's cheaper?

The common case for this is not as simple as people just experimenting with drugs.

By talking about their own choices I was leaving out cases where an addiction starts from a legitimate medical prescription.

 

[Angel4Truth]

By talking about their own choices I was leaving out cases where an addiction starts from a legitimate medical prescription.

What if it starts that way, then they get clean, but later go back to it, or abuse their prescription by taking way more than prescribed?

 

[Angel4Truth]

Heroin Overdoses Cause THREE Car Crashes in One NC Town in a Single Week

Heroin overdoses are on the rise in a North Carolina town, three of which caused car crashes in a single week. Police say that intoxicated drivers high on the illegal drug caused three separate crashes in the small city of High Point this past week.

High Point, known as the furniture capital of America, has a serious problem with opiate addiction. The city saw double the number of heroin overdoses in 2016 than in the previous year.

Speaking to the press (via WNCN), Police Captain Michael Kirk said that no one was seriously injured in any of the crashes, but noted that two of the vehicles involved had children on board.

In one crash, officers responding to the scene discovered the driver and co-passenger passed out in the front seats with two children in the back. Leigh Ann Snipes and Justin Earl Faw crashed into the back of a tractor trailer.

In a crash that happened on Monday, 23-year-old David Presnell II overdosed on heroin and crashed his car with his 14-month-old toddler onboard, who was later taken to hospital for treatment.

Snipes and Faw were both charged with child abuse and possession of drug paraphernalia and their children are now in custody of relatives. Meanwhile, Snipes was charged with a DWI, driving with a revoked license, child restraint, and a movement violation.

The police say that the wrecks happen when drug addicts drive to secluded locations to get high, away from their homes, and get into traffic accidents when they try to drive back under the influence of heroin.

Given the spate of heroin overdoses in High Point, the town should really consider changing its name to something else.

 

[Angel4Truth]

I don't think it has to be an either-or issue. Addiction is clearly a factor in the problem and simply throwing someone in jail does nothing to fix it.

yes, it does often fix it, it forces them to get off the drugs and sometimes forces a pregnant woman not to have an addicted baby, by keeping her clean till the life inside her is born, clean. Sometimes too, it gives someone access to someone who will share the gospel with them, or make someone think, while they get clean.

A medical approach needs to be at least part of the solution.

Yes, and you can force rehab in jail, you cannot outside of it.

 

[Angel4Truth]

This horrific body camera footage from an EMT shows what happens during a heroin overdose

 

[Angel4Truth]

Virginia Beach EMS Repeatedly Revive Same Opiate Overdose Victims

VIRGINIA BEACH – It’s a nasal spray that will save your life, and pull you back from the dark depths of an opiate overdose.

The drug is called narcan (or naloxone), and in Virginia Beach, most medical professionals see it as life saver.

However, statistics from Virginia Beach Emergency Medical Services (VBEMS) show in the last ten months 18 people have been revived more than once, on separate occasions.

Repetitive revival is why others seen narcan as an enabler of opiate addiction.

 

[Angel4Truth]

Drug Overdose Immunity and Good Samaritan Laws

Drug overdose death rates have continued to rise, according to the Centers for Disease Control.

More than 52,000Americans died of a drug overdose in 2015, the majority caused by opioids. Since 2010, 30 states have experienced increases in opioid deaths and the increase in deaths from 2014 to 2015 can most likely be attributed to heroin and illicitly manufactured fentanyl.

In 2016 nearly every state enacted legislation addressing the abuse of opioids, including heroin and prescription drugs. Policymakers have sought solutions that will help curb use and overdose by expanding access to treatment, increasing diversion opportunities and funding, modifying penalties, expanding Good Samaritan immunity, and increasing naloxone access.

Access to Naloxone and Immunity

Opioid overdoses can be reversed with the timely administration of a medication called naloxone. Naloxone is a “rescue drug” that has been approved by the FDA and can be administered in a number of ways that make it possible for a lay person to use. The drug has no abuse potential and counteracts the life-threatening effects of an overdose. Seeking professional medical assistance after administering naloxone, however, is important because it is a temporary drug and multiple administrations may be necessary if overdose symptoms return.

Often family and friends are in the best position to administer this lifesaving drug to their loved ones who overdose. Access to naloxone, however, was relatively limited until legislatures provided specific statutory protections for nonmedical professionals to possess and administer naloxone without a prescription. Providing medication to someone other than the at-risk drug user (called third party prescription) was usually prohibited and laws required a doctor-patient relationship to be established before direct prescription. Medical professionals and other interested parties have welcomed these new laws as a way to reduce the toll of the opioid epidemic and alleviate concerns about criminal, civil and professional liability.

New Mexico became the first state to enact legislation to increase access to naloxone in 2001. Forty-seven states and the District of Columbia now have laws providing immunity to medical professionals who prescribe or dispense naloxone or individuals who possess or administer naloxone. The majority of these laws were passed within the last five years and promote the use of naloxone in addition to training and education on recognizing and preventing overdoses

By 2014 it was reported that more than 150,000 lay people had received naloxone information and rescue kits resulting in more than 26,000 reported overdose reversals. Legislation and regulation has also greatly increased access to naloxone for first responders and law enforcement officers.

Immunity for Calling 911 or Seeking Emergency Medical Assistance – Good Samaritan Laws

To encourage people to seek out medical attention for an overdose or for follow-up care after naloxone has been administered, 37 states and the District of Columbia have enacted some form of a Good Samaritan or 911 drug immunity law. These laws generally provide immunity from arrest, charge or prosecution for certain controlled substance possession and paraphernalia offenses when a person who is either experiencing an opiate-related overdose or observing one calls 911 for assistance or seeks medical attention. State laws are also increasingly providing immunity from violations of pretrial, probation or parole conditions and violations of protection or restraining orders.

The scope of what offenses and violations are covered by immunity provisions varies by state. Some states have opted for more restricted immunity while others, like Vermont, have provided immunity from a more expansive list of controlled substance offenses.

These laws often require a caller to have a reasonable belief that someone is experiencing an overdose emergency and is reporting that emergency in good faith. Good faith is often defined to exclude seeking help during the course of the execution of an arrest or a search warrant. Some laws also specify that immunity for covered offenses is not ground for suppression of evidence of other crimes. Other requirements frequently include remaining on scene until help arrives and cooperating with emergency personnel when they arrive.

Diversion, Treatment and Criminal Penalties

Defendants who may not qualify for Good Samaritan immunity as described above may be eligible for entry into a drug diversion program or drug treatment court for defendants identified as having substance abuse or addiction needs. The majority of states provide for such programs statutorily and many other programs have been created by local jurisdictions. States have also increasingly provided funding for these programs.

Related, states have also been expanding other treatment opportunities for justice-involved individuals with substance-related needs. Between 2015 and 2016, more than a quarter of the states funded, authorized or expanded medication-assisted treatment opportunities for people involved in the justice system. Additional information on recent diversion and treatment enactments can be found in the NCSL Pretrial Release Legislation Database or the NCSL State Sentencing and Corrections Database.

In addition to immunity, diversion, and treatment, 18 states have also specifically codified summoning emergency assistance during an overdose as a mitigating factor to be considered at sentencing. Other state actions have included modifying controlled substance penalties. For more information on recent changes to drug sentencing provisions visit NCSL’s Drug Sentencing Trends webpage.

 

[ok doser]

they need to mix narcan with a Disulfiram analog, so that revived overdosers are intolerant to further use

not sure one exists, but it sounds like a good research project

 

[Angel4Truth]

they need to mix narcan with a Disulfiram analog, so that revived overdosers are intolerant to further use

not sure one exists, but it sounds like a good research project

Think about the system being taxed when ems workers are constantly reviving addicts, and other calls to 911 and assistance needs, going to the back burner. Having a heart attack? Too bad, the same addict who was revived 5 times, is getting ems assistance again...

 

[Angel4Truth]

Gov. Wolf to seek another $10 million for naloxone to help reverse overdoses

The governor will ask Pennsylvania lawmakers for more money to help police and first responders buy the overdose antidote also known as Narcan, which can save people who are overdosing on heroin or prescription drugs.

HARRISBURG, Pa. —

Gov. Tom Wolf will ask lawmakers for another $10 million to help save the lives of people overdosing on heroin or prescription drugs.

The Democratic governor said Tuesday that he wants the money to help law enforcement agencies and first responders buy the overdose antidote naloxone.

Grants would be available through the Pennsylvania Commission on Crime and Delinquency. Wolf will make the request in the budget proposal he submits to the Legislature next week for the fiscal year starting July 1.

The money could pay for hundreds of thousands doses of naloxone. Kits can start at $20.

Wolf's administration has worked to make naloxone more available around Pennsylvania and says more than 2,300 opioid overdoses have been reversed by first responders in Pennsylvania since November 2014.

Harrisburg, PA – Today, Governor Tom Wolf announced that his proposed 2017-2018 budget will include $10 million to provide live-saving Naloxone to first responders and law enforcement across the state. The money will be available through the Pennsylvania Commission on Crime and Delinquency.

“Expanding access to Naloxone is crucial in continuing our fight against the opioid epidemic,” said Governor Tom Wolf. “We cannot help our family members, friends, neighbors, and fellow citizens get the treatment they need if they die from an overdose of prescription opioids or heroin. Since November of 2014, more than 2,320 opioid overdoses have been reversed by first responders across Pennsylvania. As this terrible disease continues to devastate our families and communities, we must ensure the widespread access of Naloxone.”

Expanding access to naloxone goes hand-in-hand with the Wolf administration’s “warm-handoff” policy. A warm-handoff is a process in which a person who is identified as having a substance use disorder and/or overdose survivor is transferred from a hospital emergency room or other healthcare provider to a drug treatment provider. Together, Naloxone and the warm-handoff are saving lives across Pennsylvania, and are helping to get those suffering from substance use disorders into treatment, where they can begin their recovery.

“Expanding access to naloxone, a life-saving medication, is critical to giving Pennsylvanians a chance to get the treatment they need,’’ said Attorney General Josh Shapiro. “It’s part of the comprehensive plan we need to fight the heroin and opioid epidemic that is harming so many Pennsylvanians. We need to be merciless with drug dealers, understand addiction is a disease, not a crime, and work with the medical and pharmaceutical communities to help curb the abuse of opioids that is fueling this epidemic.”

“Cops become cops because they want to protect and serve their communities. I can’t think of any greater service than saving someone’s life,” said Pennsylvania Commission on Crime and Delinquency Chairman Charles Ramsey. “It is our duty as government officials to ensure that law enforcement has the tools they need to do their job and that is what naloxone is.”

"The opioid crisis is a public health emergency from which no community is immune. Tackling this challenge involves understanding opioid addiction as a chronic disease that requires prevention, intervention and treatment," said Dr. Valerie Arkoosh, Chair of the Montgomery County Board of Commissioners. "At the same time, you can't get into treatment for your addiction if you die on the streets or in your home as a result of an overdose. That is why making Naloxone available to law enforcement, EMS, hospital workers, pharmacies, schools, and individuals at risk of an overdose is integral to any effective strategy to combat this epidemic."

Do you agree or disagree with tax money being spent on this?

Do you think this miracle drug is assisting in enabling this epidemic?

 

[Angel4Truth]

Tri-State drug overdoses getting worse

HUNTINGTON - If the first three weeks of the year are any example, the number of drug overdoses in the Tri-State is getting worse, possibly much worse, in Cabell County, Boyd County and Lawrence County, Ohio, in 2017.

Two years ago, the Boyd County Emergency Medical Services ambulance crews spent $2,500 on Narcan, a drug which can revive heroin drug overdoses.

That number increased to $12,000 in 2016 and the agency is on track to spend $20,000 for Narcan in 2017, said Tom Adams, executive director of the Boyd County Emergency Medical Services.

Gordon Merry, executive director of the Cabell County Emergency Medical Services, said his crews spent $50,000 on giving doses of Narcan to drug overdose patients in 2016.

"It's getting worse," Merry said Friday. "But there's no end to this. It's becoming a revolving door. That's what's so frustrating. We need to get these people in treatment, and that's not happening."

Each time there's a drug overdose, there's a chance of death, Merry said. His office doesn't track drug overdose deaths, but "we are seeing a bunch of the same people over and over," he said.

The number of drug overdose deaths in Cabell County increased from 70 in 2014 to 102 in 2015, according to Allison C. Adler, director of communications for the West Virginia Department of Health and Human Resources.

Preliminary numbers for 2016 show 98 overdose deaths. Those numbers could increase, Adler said. No figures are available as yet for 2017.

There have been at least seven drug overdose deaths in the past 30 days in Lawrence County, Ohio, according to Prosecuting Attorney Brigham Anderson.

"We've had 54 drug overdoses since Dec. 15," Anderson said. While his office is prosecuting drug dealers, they're seeking drug abuse treatment for low-level, nonviolent offenders.

"We're talking to civic groups," Anderson said. "We're talking to high school and middle school students. This is a community problem. 2017 is starting out horribly."

There have been five drug overdose deaths in Boyd County the first three weeks of January, Adams said.

In Cabell County, EMS has responded to 60 drug overdoses the first three weeks of the year, Merry said.

"It's not getting any better," Merry said. "It's getting worse."

There were 197 suspected drug overdoses in Cabell County the first three months of 2016, according to EMS figures. The number increased to 206 in the second quarter and 350 in the third quarter. In the last three months, the number jumped to 464, he said.

The number of administered doses of Narcan also is on the rise, from 132 the first quarter of 2016 to 318 in the last quarter, Merry said.

"We don't always use Narcan," he said. The first treatment for drug overdoses is to use a bag mask to get abusers breathing regularly.

With the reduction in the number of prescription drugs such as oxycodone, many people are turning to heroin, Anderson said. Heroin also can be cheaper than pills, which have a street value of $1 per milligram.

The big problem is that heroin making its way to the Tri-State is being laced with fentanly and carfentanyl (also used as an elephant tranquilizer), Anderson said.

"When they took an oxycodone, they knew how potent the drug was," he said. "That's not the case with heroin. They're abusing heroin and don't know how potent it is" because the potency can vary from dose to dose.

Lawrence County Emergency Medical Services ambulance crews are seeing a big increase in the number of runs in 2017, said Earl "Buddy" Fry, executive director of the county ambulance district.

There were 664 ambulance runs the first 23 days of 2016 compared to 799 for the same period in 2017.

 

[Angel4Truth]

Infant died of starvation after parents’ overdose deaths, Pennsylvania coroner says

JOHNSTOWN, Pa. — A coroner says a 5-month-old Pennsylvania girl starved to death in her bassinet after her parents died of drug overdoses.

The Cambria County coroner's office said autopsy and toxicology reports confirmed that Summer Chambers died of dehydration and starvation in the home in Kernville, about 60 miles east of Pittsburgh, a few days before Christmas.

Coroner Jeff Lees called the case "heart-wrenching" and ruled the infant's death homicide due to parental neglect.

Lees says toxicology tests indicate that 27-year-old Jaron Chambers and 19-year-old Chelsea Cordaro died of acute fentanyl overdoses. Lees says the woman had four times the lethal range of the drug and the man had 2½ times the lethal range.

Lees says the parents died on or about Dec. 15 and the child probably on Dec. 19 or Dec. 20. The bodies were found Dec. 22.

 

[Angel4Truth]

‘You can tell they’re in pain:’ Hospitals see more infant victims of opioid crisis

YORK, Pa. (WHTM) – We’ve heard the stories about the heroin epidemic, but one of the things that’s not talked enough about are tiny victims who suffer through no fault of their own.

The number of babies born suffering from withdrawal symptoms of heroin and other opioids has skyrocketed. A York County mother of three shared her story to spare other newborns the pain she put hers through.

She has three girls under the age of four; Penelope, Charleigh and Stella.

“She has a mind of her own. She’s so strong-willed, she’s basically me in toddler form,” their mother Jannelle Dissinger said,

The girls are picture perfect. But their mom is admittedly flawed.

“I basically prayed to die every single day because I couldn’t get out and I didn’t know how to get out,” she said.

Not long ago, a much different looking Jannelle walked this earth.

“I woke up, I got high, and that was my life,” she said.

At 20 years old, Jannelle was working at a restaurant and fell in with the wrong crowd.

“I knew it was wrong, but I always thought I’m going to be okay, I wasn’t going to get addicted, I was going to be that one person that was going to be okay,” she said.

First, she tried cocaine – then heroin. She tried rehab, but it didn’t work. Then she got pregnant.

“And I overdosed, and at the point, I was like, I’m done. I can’t do this anymore, so I went to a Suboxone doctor and I never used ever again,” she said.

It was a success, but it was too late. All three babies were born suffering from withdrawal.

“I literally thought that this was going to be my life and they were going to take my kids from me and that was going to be the end of it,” she said.

Which brings us to PinnacleHealth in Harrisburg.

“It’s always been there, but you’re starting to hear about it a little bit more,” said Kaitlyn Palkon, discharge coordinator for PinnacleHealth NICU.

Neonatal Abstinence Syndrome, or NAS, is caused when a pregnant woman takes opioids, causing the baby to experience withdrawal at birth.

“They’re very irritable. They’re very uncomfortable. You can tell they’re in pain,” Palkon said.

Babies can end up hospitalized for three weeks; sometimes three months. Symptoms include tremors, sweating, stiffness, vomiting, and constant crying that can’t be mistaken.

“This cry is very high pitched. I mean, you can be a hundred feet away and hear this cry. It’s very unique. It almost sounds painful, like you think the baby is getting some type of painful procedure,” Palkon said.

Over the past five years, the number of newborns with NAS in the state has gone up. The numbers reflect only those covered by Medicaid but show an increase of about 200 each year. Medical experts use a scale to see if a newborn needs treatment.

“Each withdrawal symptom gets its own number, then we add those numbers up to determine the severity of the withdrawal,” Palkon said.

Most hospitals won’t treat a baby unless they score consistently above an eight, so the data doesn’t represent all babies with NAS. And it’s not just opioids putting babies on the charts.

“Some of the babies who are observed or have significant withdrawal, it’ll be not because the mother is taking any kind of illegal medication, but she’s being properly treated for a chronic condition,” said Dr. Michael Goodstein, a neonatologist at Wellspan Hospital.

Jannelle’s babies withdrew from Suboxone, not heroin. It’s an opioid blocker that suppresses cravings and the feeling of getting high. She calls this the best-case scenario in a worst-case situation.

“There were times, for hours, I’d go in there and I just had to look at her, I couldn’t even hold her,” she said.

What she didn’t know is there’s plenty of help.

“The way we really need to think about this is this is an illness. It’s a disease, and putting a person in jail for a disease is not going to help make that person get better at the end of the day,” Goodstein said.

Today, Jannelle’s girls are healthy, but she still feels guilty for making them suffer.

“I’m their mom. I’m supposed to protect them. I’m not supposed to be the reason that they’re sick, and at the end of the day, as long as I’m a good mom to them, then I’ve come out on top,” she said.

There’s a bill to create a task force to focus on the impact of the opioid crisis on pregnant woman and babies. It’s a large effort by the Center for Children’s Justice.

Jannelle is still on Suboxone to this day. She said she hopes to eventually go off it once her kids are a little older so she can better deal with withdrawal.

So much for sins that dont hurt anyone else.

 

[Angel4Truth]

NH adults say drug abuse is state's biggest problem, according to UNH poll

DURHAM — A new poll from the University of New Hampshire showed that Granite Staters see drug abuse is seen as the most important problem facing the state.

According to the latest Granite State Poll, 44 percent of NH adults said that drug abuse was the biggest problem in New Hampshire. Drug abuse has been seen as the biggest issue facing New Hampshire for more than a year.

Other issues Granite Staters felt were important that followed drug abuse included jobs and the economy at 11 percent, education at 8 percent, healthcare at 5 percent, taxes at 4 percent, and the state budget at 1 percent.

The UNH Survey Center said that 505 NH adults were surveyed by phone between Jan. 31 and Feb. 8, 2017.

The full results of the Granite State Poll can be viewed here.

 

[Angel4Truth]

Judge to addict: No more babies until fit to care for them

ROCHESTER, NY (Democrat and Chronicle) -- Disheartened by the parade of heroin-addicted parents who appeared in her courtroom, a Family Court judge in late December ordered an addict-prostitute to not get pregnant again until she was able to regain custody of her newborn son — the fourth child to be taken from her care because of neglect.

"The testimony in this case clearly established that the mother had little or no prenatal care, that the baby was born prematurely with a positive toxicology for illegal drugs, and that the mother admitted use of illegal drugs during her pregnancy," Family Court Judge Patricia Gallaher wrote in the decision.

Gallaher retired at the end of December, and the 27-page decision reads like a salvo from a judge disturbed and dispirited by what she witnessed as a judge and previously a legal assistant in Family Court. And, she wrote, the epidemic of heroin in the community has led to more severe and frequent cases of parental neglect than in years past.

"This court has seen about a half dozen seemingly 'nice couples' show up as respondents in neglect cases where both are addicted to heroin and literally throwing their lives away — and the lives of their children — in just this year," Gallaher wrote.

The Dec. 27 decision is now over a month old, but is making ripples in legal circles where possible appeals are being weighed. The Monroe County Public Defender's Office represented the mother in the case, identified as Brandy F. in court documents, and may appeal. The New York Civil Liberties Union, or NYCLU, is also considering assisting with an appeal.

"I understand why the judge may have had good intentions here," said KaeLyn Rich, director of the Genesee Valley chapter of the NYCLU. "When it comes to interpreting here, we don’t want to set a precedent that the court has the authority to tell a woman not to get pregnant or a man not to procreate."

Gallaher was a legal clerk to retired Monroe County Family Court Judge Marilyn O'Connor, who issued a similar ruling in 2004 that made national news and led many to applaud O'Connor for the decision. (Conservative Fox talk show host Bill O'Reilly said O'Connor would be secretary of the U.S. Department of Health and Human Services in his "dream cabinet.")

Gallaher mentions O'Connor's decision, calling it "courageous and cutting-edge," but also notes that an appellate court overturned the ruling, deciding that a Family Court judge did not have the authority to order parents to have no more children. That legal dynamic has not changed since 2004, though Gallaher in her ruling implores appellate judges to reconsider the earlier decision.

Four children neglected

In July 2016, Brandy F. gave birth to her son Steven, born at 29 weeks and displaying immediate signs of drug withdrawal. He was in the hospital for 33 days before being released. During the pregnancy, Brandy ingested crack cocaine, methadone and alcohol, according to court testimony. She said she did not know who the father was.

Testimony showed that she "admitted using illegal drugs prior to the actual delivery of this child, resulting in her and the newborn having positive toxicology screens at the hospital for both cocaine and opiates," Gallaher wrote.

Gallaher ordered the baby removed from Brandy's care. Court records also show that another son was born prematurely to Brandy in 2014; the boy was addicted to drugs and "had no identified father." A daughter was taken from her custody in 2011; the girl was also born an addict and "went through medically monitored withdrawal."

Another son was taken from Brandy's care in 2007 and has been living with his maternal grandmother since that time. While in Brandy's care, the boy "was not protected from access to (a) hypodermic needle."

In the ruling, Gallaher said her goal was to allow Brandy to stabilize her life so she could one day have custody of her children.

The children "would most probably rejoice in having (a) mother who was clean, sober and competent, and hopefully even would love them as a mother should love her children," she wrote.

The ruling makes clear that the onus of responsibility is not solely on Brandy. The state's Social Services Law requires that caseworkers "advise eligible needy persons periodically of the availability at public expense of family planning services for the prevention of pregnancy and inquire whether such persons desire to have such services furnished to them."

Gallaher's ruling directs the county caseworkers to offer family planning and contraception to Brandy, as the law allows. Caseworkers can not require family planning or the use of contraception for a client. The services and contraception are provided at no cost.

Gallaher declined to discuss the ruling. Brandy could not be located to discuss the decision.

Retired Judge O'Connor said that the decision from Gallaher, who helped draft the 2004 ruling, shows that many of the same troubling issues she and Gallaher saw in 2004 still exist, and that heroin may be exacerbating the societal problems.

O'Connor said she often encouraged county caseworkers to direct men and women to family planning services, which the county funded, but the county staff seemed loath to do so.

"The law requires it," she said. " ... And they just don't do it."

"The (county social services department) deals with the children coming into their care," she said. "They do not deal with preventing the children coming into their care."

O'Connor said that caseworkers do not have to discuss contraception or family planning with someone who is religiously averse to it, but that too often the county staff seemed disinclined to offer to discuss it with anyone.

"They're not dealing with the reality," she said. "They're simply handling the numbers.

" ... The court is not ordering somebody to get an abortion, to go against their religion, to go against privacy and not have sex," O'Connor said.

But opponents of the ruling claim the 2004 and current decision do just that — dictate to a woman what she can do with her body.

"It really violates the constitutional right (to privacy) and could set a bad precedent," said Rich, of the NYCLU.

Appellate fight

The NYCLU, Planned Parenthood and others opposed O'Connor's 2004 ruling, and the privacy issue was often the crux of their arguments.

"The implications of this condition are far-reaching," the organizations and others wrote in a 2004 brief appealing O'Connor's ruling. "It would permit unprecedented state intrusion into private decisions concerning reproductive health."

While the appellate arguments focused in part on sweeping issues of privacy, the regional appellate court reversed the ruling on much more narrow grounds, basically saying that a Family Court judge did not have the legal autonomy to issue such an order.

The legal obstacles do not appear to have changed in the past 13 years, though the judges on the appellate court have. Gallaher in her decision encourages the appellate judges to take a fresh look at the decision.

"Abandoning your child is endangering the welfare of a child and it is a crime, not a constitutional right," Gallaher wrote.

Gallaher acknowledges that a violation of her order could present a quandary: Just what would a judge do should Brandy get pregnant again? Obviously, a judge would not order an abortion, so jail could be a response, though Gallaher wrote that jail also "is not the intent of this decision."

Instead, she said, she hoped the ruling would force both Brandy and the county to look at the best way to ensure Brandy had no more children until she is fit to care for them.

"Family planning advice a day after a pregnancy has occurred means the advice is only good to prevent the next pregnancy," she wrote.

Agree or disagree with what the judge ruled?