There are three loaves of bread sticking out of a paper bag in the passenger seat of the car.  I recognized them from the bakery on Park Street where people pick up fresh long loaves of the crusty pan de agua (water) bread hot out of the ovens when the shop opens at six.  It is now eleven on this brisk November day and the bread is cold. We pulled the young man who bought them out of the parked car and laid him down on the pavement in the apartment building’s isolated rear lot. Now a woman screams when she recognizes the man. People come out of the back door of the building.  The older onlookers try to shield the children’s view. We work the man for thirty minutes and then five more on the short trip to the hospital, but the straight line on the monitor never changes.

“He cut them down in droves–the corpse fires burned on, night and day, no end in sight.” – The Illiad -Homer (Robert Fagles translation).

In 2017, for a powerpoint presentation on the opioid epidemic, I made a slide that showed a graph of annual nationwide fatal ODs (about 15,000) from when I started as a paramedic in Hartford in 1995 to 2016, when the number had reached 65,000 a year.  I put a picture of myself at each stage.  Now four years later the annual death toll has reached 100,000.  

I went from being a medic who told my patients to just say no to drugs or they would end up dead or in jail to being an advocate for harm reduction (community naloxone, needle exchange, safe consumption sites) to now being adamant that the only way out of this is to end the war on drugs through decriminalization and regulation of a safe medicinal supply of opioids.  Clearly what we have been doing is not working and the problem continues to get worse.

Nearly everyone recognizes that this is a public health...

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In my experience many if not most lawyers advise clients facing an either way charge to elect trial at the crown court.  Of course not every defendant can afford the fees involved and many others just want to get the process over and done with as quickly as possible but nevertheless it is instructive to compare the...

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Many will remember the report of a series of stabbings in Birmingham in September 2020 – Jacob Billington sadly died, killed at random and seven others were seriously injured in the course of other random attacks across the city centre area and a man was arrested in subsequent days, prosecuted for murder and a number of serious woundings.  Yesterday, Zephaniah McLeod was sentenced for manslaughter at Birmingham Crown Court to (at least) 21yrs in prison for these offences and it’s obvious from victim impact statements how much carnage has been inflicted on the lives not only of the victims, but their families who are still looking for answers as to what happened and why.

Having handed down a lengthy prison term, the judge also stated Mr McLeod will be detained at Ashworth (high security) hospital “for as long as is necessary” and I thought a short-post to explain this sentence may be useful.  It’s almost certain (although not made explicit in media coverage) that he has been sentenced under s45A of the Mental Health...

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Those of you who have read this blog since it began will know how Ive often bemoaned the fact that we keep reading and hearing the same things said over and over again in cycles which last over a decade.  When the Bradley Review (a wider ranging review of mental health and criminal justice, 2009) it was widely lauded and well received, quite rightly – but it many respects it just repeated much of what we already knew from the Reed Review (1992) and indeed from the Percy Review (1957).  They each had slightly different reason and focus, but ended up saying many of the same things about mental health and criminal justice.  Of course, we have also had review of the Mental Health Act specifically, the Richardson Review (1997) and more recently the Wessely Review (2018) which were not criminal justice centric, but touched upon those issues.

This week, a new Joint Thematic Inspection has been published by Her Majesty’s Inspectorate of Probation, jointly endorsed by other inspectors for policing, CPS and prisons as well as the Care...

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This week we have seen the shocking events of the terrorism incident in Liverpool. The national threat level has been raised after two attacks in the last month. It is a timely reminder that this threat never goes away and all our eyes and ears are vital. I do not know anything more about the facts of the incident in Liverpool but what we are increasingly seeing is lone actors moving from self-radicalisation to attack. This can be much harder to detect and so, as we attend calls and jobs and move around as ordinary citizens, we need to be vigilant. We have a key role in gathering intelligence.

Last month I got to see around 1400 of you at the roadshows. I hope you enjoyed the event and learned a little and shared some of your views. Personally I found this round of roadshows to have been the best. Great questions from you all and some brilliant stands at the Expo. If you missed it you can find out more on Newsbeat. Thank you to all those who made the roadshows possible and everyone who came.  

We...

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With Kenneth Clarke on his first appearance before the Justice Select Committee 25/7/2010 we saw what was below that "I`m a fair chap" image; " He was not fussed about competitive tendering (“we have enough lawyers” and there is “no lack of people wanting to come in”). “I haven’t made that many policy decisions yet”, he concluded." Further comment is available here. He was proud to tell the media that in that first austerity budget of the Coalition...

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“You’re covering the city,” dispatch says to us, when we clear Saint Francis after an early morning cardiac arrest. 

We park on Albany Avenue. The sun isn’t up yet, but the black birds are stirring.  We’re on for another ten hours.  By midday, we’ll have twenty ambulances on, but right now it is only us.  The others are calls-an asthma on Martin Street, a diabetic on South Whitney, and two early dialysis runs.  Another ambulance is at the base doing a crew change.  The rest sit parked in neat rows in the cavernous garage, waiting for their crews, still asleep, to rise and slowly make their way back in.

The avenue is quiet.  A cop sits across the way waiting like us.   From Park Street where the coffee at Cubanitos is being put on to brew and the days bread just starting to come out of the oven north to the Bloomfield line, where early workers are trodding to the bus stop along Blue Hills Avenue; from Prospect Ave where the governor sleeps in mansion East to Interstate 91 that runs along the...

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(This is an excerpt from a fictional work-in-progress.)

Frank Anastacio walked out of the brick building with a small paper bag in his hand. His work boots trudged forward, each step taking him deeper into a world he no longer wanted to live in.

The autopsy report said she had died of asphyxia from tying the bed sheet around her neck and jumping off the top bunk of her cell. EMS had transported her to the hospital and the run form said they had briefly restored a heartbeat, but the coroner told him that her brain had died within minutes. He tried to get out of his mind the thought of his daughter kicking the air, fighting against the sheet. He wondered if she might have regretted it at the last second, or had her despair been so deep that nothing mattered?

The last time he saw her, he’d had to talk to her through glass. She’d cried and said she was ashamed. She said that, no matter what, she loved him. He had to know that.

“We’re going to get through it,” he had told her. “We’re going to get...

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