Gubernatorial candidate Joe Avellone recently posted an article titled, "Removing the Stigma of Substance Abuse." I would like to thank Mr. Avellone for addressing this topic. As a registered nurse in the community I am familiar with the prevalence of substance abuse here in our town of Tewksbury, in neighboring towns, and in the city of Lowell. There is no delicate way to state that the numbers are staggering. Heroin has become more available and affordable than many realize. One cannot pick up a local newspaper without reading about an increase in heroin use, a number of heroin overdoses, or an arrest for heroin distribution. So, what can we do to stop it? There is no quick and easy answer, but awareness is a reasonable place to start.
Victory in the war against illicit drug use will never be ours if we cannot let go of common misconceptions. There is an immense gap between scientific evidence and public perception. Research has repeatedly shown that the brain of an addict differs significantly from that of someone who is not addicted. After learning about brain activity in addicted individuals, I feel confident in assuring you that drug addiction is a chronic, relapsing disease. Scientific evidence has shown it is a brain disorder. Therefore, those choosing to view the drug-addicted as immoral, as worthless, as pathetic should reconsider the parallels between drug addiction and other common chronic diseases. It is important to note that ongoing research is addressing the cause of addiction before the drug abuse begins. One theory is a lack of receptors in the brain. While those of us in the medical field await a solid explanation as to how the brain of the addict differs before the drug abuse occurs, I would like to suggest we get a grasp on our desire to pass judgment. Let’s say that future research shows that drug use is entirely by choice, that no anatomical or physiological factor drives the brain to seek the effects of drugs before the addiction is in effect. For the sake of my argument let’s say taking the first pill, the first intravenous injection, is entirely a conscious and willing decision. Once the person who is prone to addiction uses drugs, the process of dependence begins as does the chronic, relapsing disease called drug addiction. This is the person who becomes worthless in our society, who many believe does not deserve treatment. Many believe the person who chose to use drugs should be dismissed because of that choice. If you are among those who feel this way ask yourself these questions: Does the diabetic who had a less than healthful diet and a lack of exercise in his past deserve treatment? Does the stroke victim who made unhealthy diet choices and who failed to control her blood pressure by choice deserve treatment? Does the man who could be found daily at the local doughnut shop who now suffers cardiac disease deserve treatment? What about the cigarette smoker or someone who exceeds the speed limit and causes an accident? Each and every one of us has made poor choices. This we have in common with some of those suffering chronic disease. This we have in common with drug addicts.
The war against drug abuse will only be won if lawmakers, clinicians, and members of the community band together. We must recognize the availability of heroin. Heroin is in the hallways at school. Heroin is outside in parking lots and on street corners. Heroin is at the mall. It is in public places of recreation. It is at parties attended by the young and the mature. It is around; and, it is cheap. It can take no more than $5 to get high on heroin. So, be aware that it is around. Talk to your children about it; and be honest with them. Tell them heroin is around. Tell them it might feel good. And, please, tell them that just one use could lead to their sudden death.
We cannot ignore the role of prescription medication addiction and its connection to heroin use. Medications like Vicodin and OxyContin should be prescribed for days at a time. It is preferable to ask patients to make frequent refills than to saturate the community with an excess of opiates. Prescribers have to be diligent in addiction education and patients have to take responsibility for reporting suspected dependence to their providers. It is important to understand just how easily a brain can become addicted to prescribed medication. It is just as important to understand that the addicted brain needs the drug. When the prescription runs out, the brain still needs the drug and this is where the behavioral symptoms that lead to misconceptions come into play. This is where the addict becomes desperate to find pills, perhaps stealing them or stealing to buy them illegally. These pills are very expensive. OxyContin can cost as much as $1 per milligram on the street. This addiction can rapidly drain a bank account. When the brain that needs OxyContin can no longer get it, it finds the abundantly available heroin. Again, the person referenced here is suffering from a chronic disease and some of the observable symptoms are behavioral.
Mr. Avellone suggests that we alter our approach to substance abuse from that of a criminal issue to that of a public health issue. While I advocate for the rights of those addicted, I do believe that criminal activity is just that regardless of the circumstances behind it; and drug addiction most certainly places the public at risk. I am, however, suggesting that those in our state and local government can choose to play a part in the fight against substance abuse by managing resources. I love Joe Avellone’s proposal to create an Office of Recovery which could oversee rehabilitation in Massachusetts, making it more available to those in need. Another article would be needed to tackle the likelihood of recovery; sadly, relapse is common. This is an area in dire need for more research.
This war requires an attack on all fronts. We need more research, more rehabilitation opportunities, more education, more awareness, more responsible prescribing. If you have been prescribed medications with addictive properties, keep them in a secure place and properly dispose of remaining pills. Please accept that no one has immunity to this disease; and no one can predict what injuries or hardships the future might hold.
I care for babies born addicted to the drugs used by their mothers, often this drug is heroin. If I had a nickel for every time someone has asked me, “how can a mother do that to her baby?” I would be a wealthy woman. Please hear me here: The mother to whom is referred does not do this to her baby, her disease does. Future research might demonstrate that these babies will grow to be teens or adults who are prone to the same addiction. Who will be blamed when that happens?
I plead with those in positions to contribute to ending the epidemic of substance abuse to correct misconceptions and education yourselves on the realities of this disease. Thank you to Joe Avellone. I hope your pursuit in this war continues; and I hope that you find the support you will need.
A passionate supporter in this fight,
Kristine Naughton-Chapman RN