Breaking Drug Dependency
For decades, the war on drugs has been a staple of American federal policy intended to combat substance abuse. Yet today we see America in the midst of one of the largest drug crises in its history.
More than 2 million people in the U.S. currently abuse opioids. The issue has rightfully taken center stage in the theater of public health politics for months, but frustratingly for those affected, impactful change has yet to be enacted. Much of this has to do with the anachronistic views many policymakers hold regarding addiction.
We need strong, consistent efforts to spread awareness of the biological and psychological realities of drug dependency.
Thankfully, the now-common phrase “opioid epidemic” hints to the beginning of a shift in public perspective in the right direction. The use of “epidemic” implies that we are finally seeing addiction as it is should be viewed: as a disease. Previously, the impression was that weakness of character or will were blamed for drug addiction, and strengthening these traits were all that was required to pull one out of dependency.
Decades of evidence points to the contrary. Addiction is a disorder composed of drastic and fundamental changes to the brain’s circuitry system.
Treatment should not involve detoxification alone — a common practice today — as this is merely treating the symptom while ignoring the underlying cause. Addiction must be addressed as a chronic disease.
Once someone is dependent on opioids, their reward circuitry is permanently altered and must receive treatment addressing this change. Mouse studies have shown that even a single dose of an addictive drug can create lasting rewiring between brain regions.
A useful equivalent when considering treatment options for recovering addicts are type two diabetes patients; we cannot completely “cure” their disease, but we can effectively manage it with proper long-term care.
Medications are one such form of care that have recently gained traction for the treatment of opioid use disorders. Some of these, such as methadone, target the same receptors in the brain that opioids do, thus relieving cravings without inducing powerful sedative or euphoric effects.
Treatment centers around America utilizing these drugs have seen many of their patients successfully regain control of their lives.
Further treatments on the horizon include “vaccinations” that reduce the psychoactivity of the drug, or that quickly dismantle the culprit molecule before it can exert its effects.
Equally important to more informed treatment approaches are efforts aimed at mitigating the environmental factors driving addiction. Insufficient social support systems and stressful or dangerous surroundings during childhood can greatly increase an individual’s susceptibility to developing a dependency upon trying an addictive drug.
Evidence shows that negative reinforcement (punishment) has less power in disincentivizing addictive behaviors than positive reinforcement (reward). Drug addiction operates partially through a form positive reinforcement as many of these substances activate reward circuitry upon their use. This in turn incentivizes the brain to continue to seek the drug out.
Providing small, immediate rewards for sobriety can serve as a replacement reward system and provides the brain with the best chances of beating relapse. Recent trials have shown remarkable improvements in abstinence when addicts are provided with small vouchers for food or entertainment upon proof of sobriety in a urine test.
Modest sums of money diverted to these sorts of programs could decrease the substantial costs of repeated detoxification and overdose treatments on the healthcare system.
Funding strict penalization policies for addicts has been proven to not work. It is time to support victims of this crisis instead of continuing the current neglect. A culture shift is absolutely necessary.
In recent decades, society has successfully begun to respect alcoholism through an understanding that its victims often need a strong, lifelong support system to keep clean.
The stigma once associated with the disease is diminishing. Why must addiction to opiates and other drugs of abuse be viewed differently?