Tuesday, April 1, 2014

Let's change the way we view addiction




Catherine was a 13-year-old in a middle class family, when she used Oxycontin for the first time at a party. Her friends took prescription drugs, and she thought it was the way to socialize. Within weeks, she was dependent on Oxycontin and spent years stealing and borrowing to feed her habit. Eventually, she moved to heroin — it was cheap and easy to obtain. For years she used heroin, falling deeper and deeper into an addictive spiral. Fortunately, after years of drug addiction she found the strength to get help. She has been sober for 10 years and is now raising two children. 

Not everyone’s story ends this way. 

Today we face a tragic and unprecedented health care epidemic fueled from the rapid rise of addiction to powerful narcotics, which are plentiful and highly addictive. This health crisis stems from the medicine itself. And, regrettably, we have been here before. Heroin itself was legally sold on the market briefly in the early 1900s as a cough suppressant until it was outlawed as addiction became widespread. We have recreated this tragedy with oral narcotics 100 years later. And, it may get worse with the recent approval of an even more powerful narcotic, Zohydro. The abuse of these prescription drugs has skyrocketed over the past 15 years and has precipitated a crisis of opiate and heroin addiction among young people throughout our Commonwealth. According to national survey data, in Massachusetts 9.6 percent of our citizens age 12 and older were either dependent on or abused drugs or alcohol. That figure was 23.4 percent for 18-to-25 year olds. 

Hundreds have died of heroin overdose deaths in Massachusetts since November. This is only the tip of a very large and destructive iceberg growing out of sight in many of our communities. 

Massachusetts has often been a leader in treating addiction problems in the past, but we are overwhelmed with the rapid rise and huge scale of this epidemic. Why?

We are failing to treat this crisis with the urgency and mobilization of resources it needs, because as a Commonwealth, we are still not seeing this tragic epidemic for what it truly is. Addiction is a public health issue, but still carries the stigma of many of our outdated prejudices. Too many of us still view addiction as a character flaw, or a moral failing, or a failure that stems from poor parenting or poor values. These old attitudes borne over generations die hard, and exhibit themselves in subtle but obstructive ways. Because addiction is a health issue, it is just as if someone has diabetes, heart disease or suffers from cancer. The stigma of addiction traps us in antiquated thinking and prejudice, preventing us from radically changing our approach to prevent further destruction. 

Our “old way” of thinking about addiction is costing us too much.

Families struggle to find where their loved ones can get treatment and are oftentimes denied access by insurance.

County jails are full of youths with minor non-violent drug offenses often related to their addiction, yet they are held at a huge cost to the Commonwealth, without getting the proper treatment they need while incarcerated.

We do not have enough beds in our treatment facilities of all types across the Commonwealth.
Current medical practice is often inconsistent regarding replacement drug therapy versus full rehabilitation, often leading to confusion and ineffective treatment. 

Insurance coverage presents too many barriers to proper rehabilitation and often interferes with the much needed continuity of treatment, sending our young ones back into a cycle of using and addiction.

We must have widespread re-education of physicians on pain control and proper use of narcotics. 

We need to dramatically increase our efforts to educate our students and encourage discussion in our communities on the dangers of prescription drugs and heroin.

We need political leaders who will aggressively push the FDA and the pharmaceutical industry to develop and approve safer drugs that are much less addictive. We must say no to the FDA on Zohydro.

The ability to stop this tragic epidemic is within our means. But, it must start with removing the stigma. Changing our approach virtually pays for itself, and can save the lives of so many of our fellow citizens. We need a call to arms. Strong leadership from our political leaders is necessary to lead us to this new understanding, and away from the old attitudes which are holding us back. When we recognize this tragic disease for what it is — a preventable health problem — we will be able to put the pieces together to truly change the world for tens of thousands of families in our Commonwealth.

Joe Avellone is a Democratic candidate for governor. Steve Tolman is president of the Massachusetts AFL-CIO.

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