Addiction Confusion

I want to see us make progress in reducing the number of overdose fatalities. Knowing these heart-wrenching deaths are preventable, I have made it my mission to study the research and understand the science well enough to be an effective advocate, to promote the interventions proven to save lives elsewhere.  

It’s frustrating though. Needed reform is not all that complicated, but there are so many barriers.

I do know that our lawmakers hold the cards.  And I’ve realized, sadly, that some of those in power simply don’t care. They may pretend to care, paying lip service to the overdose epidemic being a priority. But without follow-up initiatives, or the allocation of sufficient resources, their words ring hollow. I can’t get my mind around their indifference, but I guess it’s the same as not caring about other sources of human suffering be it poverty, racism, or other injustices people endure. There are legislators who do care—the humanists who want to make a difference, but whose efforts are too often misguided, disjointed, or compromised by misunderstanding, either theirs or that of their constituents.

Mistruths hurt. Some hit the rumor mill and go viral. For example: You can overdose by touching fentanyl. Without any substantiation, this myth risks legislation that will misdirect resources and impede timely response to those in need.  Then there are beliefs that run counter to years of scientific data but are nonetheless unshakable. Harm reduction enables drug use is a case in point, one that thwarts our cause year after year.

Healthy debate is a good thing and different perspectives enhance decision-making outcomes, but only when scientific facts—substantiated with consistent results—are not subject to opinions. The facts are the facts. They are the foundation on which progress is made.   

With any other public health threat of this magnitude we would be beholden to the research scientists, grateful for those who devote resources accordingly, and united in our commitment to stamp out the source of the alarming loss of life. But with rising overdose deaths, we are less sure. There’s no doubt that our confusion stems from the notion that addiction is a crime. In fact, the war on drugs—fueled by those who assign blame to the afflicted—continues to cause unspeakable harm, overshadowing efforts to address addiction with compassion and medical expertise.

But I’ve learned that there are other factors that compel us to reject the science, and unwittingly promote confusion.

I posted my most recent op-ed on social media. It was about the overreaction to recent prescription drug guidelines that, since implementation, managed to victimize chronic pain sufferers while not making a difference in the number of overdose deaths. One person commented that she disagreed with me, contending that most addiction started with prescription drugs and then said, “You’d understand if you lost a child.”  

What do you say to that? (1) I did lose a child; or (2) Mathematical modeling conducted by research experts, and corroborated by the nation’s leading science and medical analysts, project the effect of prescription drugs on the number of overdose deaths over the next five years to be modest?  

Would facts matter?

I am not second guessing any individual, but maybe some parents whose child died of an overdose feel it saves face if the addiction started with prescription drugs. I know in some cases it did, but I also know these cases are in the minority and that the onset of addiction among recipients of prescribed medication, those without previous drug use, is less than 1 percent. But regardless, it’s the “saving face” part that is heart-breaking. Because it’s easy to understand. After all, we’ve been conditioned to think of addiction as a moral failure. And our instincts to protect our children, even in death, are powerful.

Last year, I posted an article I wrote on the underlying cause of addiction and its importance in effective treatment. One parent responded by saying that he didn’t agree, a stance that he’s entitled to. (You don’t put yourself out there expecting all readers to concur.) In elaborating, he said he’d already suffered the loss of a child and couldn’t bear the additional burden of thinking that something in childhood had been a factor and could lie at his feet. I felt badly for him and we had a thoughtful exchange.

But these and similar experiences reveal the emotional overlays that complicate our view of addiction. And the irony is this: It isn’t just those who don’t care and whose harsh judgement renders all drug users undeserving; but on the opposite end of the spectrum are those who do care and who love or have loved a person suffering with addiction, and who, on top of their struggles and losses, harbor shame.  Why? Because we live in a society that doesn’t get it.

We are so conflicted that we can’t even agree on what addiction is, much less what causes it.  It’s no wonder then that we limp along with initiatives and legislation that don’t target the problem and too often cause further suffering for those who need help.

There has been much written about whether addiction is a moral failing or a disease. I think some subscribe to the notion of ‘disease’ simply because any terminology that precludes its being seen as a character flaw is automatically embraced. While addiction is recognized as a medical condition and is defined as such throughout the medical world, it is not really a disease in any classic sense. It is a symptom, maybe. But in acknowledging this, we have to be careful not to throw it into moralizing and, in turn, undermine the understanding that is crucial for meaningful treatment.

I don’t know all the answers. But I know that Changing the Narrative is important.  And we can all play a role in that, as clarified by this thoughtful network of reporters, researchers, academics, and advocates who are dedicated to accurate, humane, and science-based information. Take a look.