We’re bombarded with the news, every day. Emergency medical services stretched to their limits. County Morgues forced to use refrigerated trucks reserved for mass-disaster events to deal with overflows. Lives ended, families destroyed, entire neighborhoods of dead-eyed zombies, “Walking Dead” characters in your yard, instead of on your TV.
Many shrug their shoulders at the exploding number of overdose deaths. There is a general mentality that a junkie brought his or her death on themselves. That he or she should have been “too smart” to ever pick up that needle. This attitude is fairly common in spite of the staggering number of people who will die from prescription medication overdoses. Prescription drug overdoses will, in fact, claim more people year-to-year than heroin and cocaine overdoses COMBINED. Heroin is a symptom. Addiction is the disease. Addiction is what must be addressed.
At least half of all heroin users, and perhaps as many as 2/3 of them, began their opioid addictions due to having been prescribed opioid pain medications. Most of these folks weren’t looking to get high all the time. They were people who had had surgical procedures in some cases. People who got injured on the job, or on the playing field. They wound up hooked on pain pills, and a lot of them suddenly got cut off their legal medications by a newly-tough FDA regimen. Opioid withdrawal is especially devastating, and a lot of these folks not only were suffering from withdrawals, but also the pain that got them on the pills in the first place. For some of these people, heroin became the way by which existence continued to be possible. Unfortunately, the heroin a lot of these folks bought happened to be spiked with fentanyl, a drug normally used as sedation for surgeries. Fentanyl is cheap to produce, incredibly potent, and quite profitable if sold either as heroin, or as “generic” opioid pain pills. Prince died from a fentanyl overdose, having purchased what he thought were knock-off oxycontin tablets. Many others who were addicted to prescription pain medications have died just as Prince did. People who were functional, with jobs and families. There is no cookie-cutter addict. Fentanyl doesn’t care who you are, who loves you, or what your status is.
Let’s say I buy a new car. I never so much as have an oil change done, and the car breaks down in a couple of years. So I go buy another car, and I treat it the exact same way, and it also breaks down. At what point do we agree that I’m an idiot? Especially when I’ve been told how long my cars will last in most cases if I perform the correct maintenance? My example translates nicely to the way we handle opioid addiction in the United States. In spite of study after study showing us that opioid addiction is NOT the same as alcohol addiction, we continue to run people through AA-style programs. Counseling and cold turkey often work for an alcoholic, but with an opiate addict this methodology is a complete and utter failure. The reason is in our brains; opioid addiction rewires our expectations, our sense of “right” internally. The brain becomes dependent on the “rush” that can only be derived from an opiate. And the brain wants that rush, no matter how many people love us, or support us, or will talk to us all night if we want them to. The average opiate addict is going to relapse repeatedly, because the brain is screaming for something to end the disorder in the mind. And if he or she is fortunate enough to survive another round with opiates, he or she is likely going to again be sent back to counseling that we know does not work, and is not going to work. We don’t have to do it this way. As far back as the 1970s, we were aware that another opiate, methadone, will take care of the screaming brain, while leaving the methadone patient able to function as a productive member of society. Yes, methadone CAN be abused, and some people do abuse it, but most methadone users are looking for some way to really and truly wean themselves from a costly, debilitating, and deadly addiction. And besides, we’ve got something even better in the pipeline now. Suboxone is also an opiate, and it dispenses quite well with the withdrawal problems associated with opiate addiction. What suboxone does NOT lend itself to is abusing it for the “high.” People who abuse suboxone will more often than not trigger the very symptoms of opiate withdrawal, making abuse of the drug a highly unpleasant experience. In the US, relatively few doctors are prescribing either for addiction, because a process one must go through to get certified for prescribing methadone and/or suboxone is time-consuming. It shouldn’t be. We know these things work. It is time for us to arm our practitioners with the correct tools they need to combat the problem we have. Suboxone and methadone can be prescribed, and slowly tapered off under the supervision of a medical professional. The long-term results are very encouraging in places where this has been done; relapses are far fewer, and overdose deaths drop (Portugal, in particular, has a wealth of successful experience with this kind of therapy.) And in the pharmaceutical arsenal beyond opioids themselves are psychedelic drugs, which also seem to have some promise for relief of the symptoms of addiction. Should we not, at long last, at least be trial running some psychedelic therapies? Why on Earth do we continue to do things we know damned good and well aren’t going to work?
Trump has said a few words about the ravages of opioid addiction, but his actions have amounted to nothing thus far. Attorney General Jeffy Beuaregard Sessions seems more interested in filling up private prisons with punk small-time dealers than he does addressing addiction, a “strategy” that has been a spectacular failure each and every time we’ve tried it before. Given our continuous mistakes, and the known successes of others, it’s time we did a little learning. And while we’re at it, let’s do a lot more caring. Addiction is an ailment, like a broken arm is an ailment. If we treated a broken arm the way we treat addiction, we’d dismiss the patient with the broken arm as a moron and offer him a 12-step program to heal up his bones. And he’d be about as likely to have his arm mend that way as an opioid addict is to get off drugs that way.
Don’t you think it’s time we stopped being so damned stupid?