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Prescription Drug Addiction: A Medical Condition, Not A Moral Failure

April 24, 2012 By PaulHeroux

Close to Home

Prescription drug abuse and addiction is prevalent in America yet it lurks in the shadows. We don’t like to talk about it because of the stigma associated with it. But if you are still reading this, you probably know someone close to you it has affected. This is an issue that is near and dear to me and my family.

Both of my parents own pharmacies (my father’s is in Attleboro and mother’s is in Plainville). Both have had their share of robberies from persons suffering from drug addiction. In September 2010, there was a well publicized case of a 17 year old boy found nearly comatose in the ceiling of Plainville Prescription Center. That is my mother’s store, and it wasn’t the first break-in she or my father has experienced.

A few weeks ago, an old friend recently succumbed to a long fight with mental illness and she intentionally overdosed on pain killers – mental illness is a serious risk factor for drug abuse. Another person close to my family, who has long suffered from back pain, also became a victim to pain killers, which many people fall victim to. He is currently in residential rehab with the full support of his family. Prescription drug addiction affects men and women, young and old, employed and unemployed, and those suffering from mental illness and those who don’t. In short, no group is immune.

While I have never even had so much as a drink of alcohol in my life, (it may be hard to believe but it’s true) before you question the type of people I surround myself with, facts are important and sometimes a wake-up call to the judgmental. Consider that in 2007, nearly 28,000 Americans died from unintentional drug poisoning, and of these, nearly 12,000 involved prescription pain relievers. Prescription drug abuse surged 400 percent from 2000-2010.

Drug addiction is a problem that can originate with chronic mental illness or legitimate physical or psychological pain. Drug addiction is a medical issue, not a moral one. Drug dealing, however, is a different issue, and to be clear, a serious crime. Some people think abuse or addiction are moral issues, some a criminal issue and others a medical issue. There is a difference between use, abuse, and addiction.

A Brain’s Cheap Thrills

Drug use and non-addictive abuse are cheap thrills for your brain’s dopamine receptors (think of dopamine as the neurotransmitter in your brain that allows you to experience pleasure; without it, no pleasure). However, when abuse becomes addiction, we are talking about a physically altered brain. The brain becomes incapable of producing dopamine, or the pleasure receptors in the brain become incapable of receiving enough dopamine. The only way for some individuals to feel any pleasure, or no pain, is through excessive use of drugs. While drug experimentation may be a moral issue or an issue of poor judgement, drug addiction is more than a moral issue. In fact, I would not describe it as a moral issue at all. It becomes a physical one and one that is the equivalent of a hawk sinking its talons into prey.

Addiction is not something that someone can just snap out of.

One recent study found that over two-thirds of people who who used illicit drugs for the first time in one recent year began by using prescription drugs medically. In 2009, the number of first-time, non-medical users of psychotherapeutics (prescription opioid pain relievers, tranquilizers, sedatives, and stimulants) was about the same as the number of first-time marijuana users. Prescription drugs are the second-most abused category of drugs in the United States, following marijuana, which usually has much less serious consequences than prescription drug abuse and dependence.

There is clearly a need for effective measures to prevent prescription drug abuse and addiction. The recent initiative in Attleboro, to give back unused prescription drugs, made me first think of gun buy-back programs. Gun buy-back programs were attempts by local police to allow citizens to sell their guns to police as a way to decrease the number of guns in a community. The hope was that it would decrease gun crime. Gun buy-back programs were a failure; they did not reduce gun violence or illegal carrying. I wonder if this program will have similar outcomes. I hope not. I don’t see the harm that can be done by such a program, and there is reason to believe that the dynamics of abusing guns and prescription drugs are very different.

An Opportunity and Obligation in Massachusetts

If we look at the base-rate of prescription drug abuse in our community and other communities not doing this initiative, then compare rates of prescription drug abuse after this initiative has been implemented, and compare it to the pre-post rates where this has not been done, we can have some sense of whether or not this initiative helped decrease prescription drug abuse. This is a thumbnail sketch of a research design and there are a lot more details that need to be considered.

The point is that when we measure something correctly, we can then have the evidence that we need to make a case for or against something.

Measurement for public policy my seem like an academic exercise. It may seem needless when someone has the proverbial “commonsense” – which is often what people claim to have when they don’t have facts to offer. But I think that such measures are a way to get to the fact of the matter and push good policy. And real commonsense dictates that evidence based on a measurement of the real world is far superior to speculation or no evidence at all.

Ryan

The person who broke into my mother’s store in 2010, Ryan, had people around him who care and a criminal justice system that recognized his unique needs. He has received treatment, tough love, sanctions and he is doing much better now. Let’s hope he stays that way.

Paul Heroux has a Bachelor’s in Psychology and Neuroscience from USC, a Master’s in Public Administration from the Harvard School of Government, and a Master’s in Criminology from the University of Pennsylvania, and worked for a jail and prison for 4 years. Paul can be reached at PaulHeroux.MPA@gmail.com.

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Filed Under: User Tagged With: attleboro, crime, criminalization-of-mental-illness, drug-policy, drugs, mental-illness, plainville, prescription-drugs, tough-on-crime

Comments

  1. pogo says

    April 24, 2012 at 9:42 pm

    …national in scope and people can find the nearest Prescription Drug Take Back location here.

    Thank you for your thoughtful post. If I could provide a complementary, but different view…we now have a legal drug problem. I don’t have the time to unpeel the many layers of that statement in my comment.

    While abuse of prescription drugs may start with stealing from the medicine cabinet, addicts acquire the bulk of their pills from Pill Mills and Dr. Shopping, often selling the opiate pills and buying the cheaper cousin: heroin. Given the high volume of these legal drugs diverted to the black market, one would think that the manufactures of these drugs is reaping a “wholesaler’s profit” from this illicit diversion. At the least, there ought to be a big tax on them, so they no longer can profit from death.

    • pogo says

      April 24, 2012 at 9:43 pm

      try here: https://www.deadiversion.usdoj.gov/NTBI/NTBI-PUB.pub;jsessionid=2B443119E13C26A50E25B54178FC0D26?_flowExecutionKey=_c346DB610-2D05-2593-E578-F6C9E2DBDFE5_k2CDAF563-A501-049F-42D7-40C25D192751

    • lodger says

      April 25, 2012 at 9:33 am

      Evidently you don’t suffer from severe pain which can only be reduced by prescription medication. Seems around BMG it’s always the “evil” corporations reaping profits from nefarious activities who are to blame for any problems. Its not the drug addict who is to blame…it’s big pharma. (or gun manufacturers, not the shooter, or casinos, not the gambler).

      Ask someone who suffers from degenerative spinal arthritis if they feel these companies are evil. You can’t imagine the relief which results from overcoming such pain with the medication they manufacture. I wish you good health.

      • pogo says

        April 25, 2012 at 10:35 pm

        …and you seem to want to read more into my comments than is warranted. First, opiate pain medication is warranted for chronic intense pain caused by such things as degenerative spinal arthritis, as well as end of life comfort. That was the original–and still remains–to legal labeling intent with the new generation of pain meds were introduce in the mid 1990s.

        But that market was not enough for Oxycontin maker Purdue Pharma, who eventually pledge guilty and paid a mere $750 million fine for lying to doctors, saying it was safe for normal pain medication…resulting in widespread diversion of the drug. First stolen from family medicine cabinets, a foolish mistake that a generation ago would result in valium abuse. But today’s raid on the medicine cabinet nabs synthetic heroin. A foolish mistake that know ends in life-ending addiction. And once addicted, the habit is feed by pill mills and weak controls on Dr. shopping. And among those who profit from the pill mills and Dr. shopping are the drug companies that make these legal opiates.

        It is this behavior by an irresponsible pain medication industry–who turn a blind eye to the adverse social impact of the products they make–that threaten the availability of your needed medication.

        Thank you for wishing me good health. As I’ve said, I wish you relief. But since the introduction of powerful opiate pain meds, fatal overdose of opiates (including heroin) has skyrocketed. And unless the makers of these meds limit the distribution to those truly in need, your relief may be impeded.

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