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Carter: Myths about addiction persist

For the past week, I’ve had a piece of paper sitting on my desk next to my keyboard that I keep glancing at and re-reading. It’s a letter to the editor about the opioid crisis. It’s an anonymous letter, and the writer also notes that he or she has sent it to every daily newspaper in America. The Times has a clear policy about not publishing anonymous or mass letters, but this particular letter struck a chord.

Of course, the current opioid crisis is a problem almost everywhere in our country, including Carroll. More than 115 Americans die every day after overdosing on opioids. Last year in Carroll County, 49 people died of a drug overdose, most of those related to prescription opioids, heroin or its powerful synthetic cousin fentanyl. Already through the first two months of 2018, there have been 17 overdose deaths in the county, according to the latest data from the Carroll County Sheriff’s Office.

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So I feel compelled to share a few portions of this letter, lightly edited for grammar, for the same reasons the mysterious author chose to write it: To spark a conversation.

The person writes: “It is tragic to see the number of family members left behind to mourn, after the death of a loved one, due to an opioid drug overdose. We must have sympathy for these family members, but can the same be said for the ones who chose to take chances with their lives?

“The reality is that the current loss of life, due to opioid drug overdoses, and drug abuse in general, is the modern-day implementation of ‘Darwin’s Theory of Natural Selection.’ When a member of the species is too uninformed about the dangers of certain actions (taking addictive drugs) or too weak to resist the temptation, then their death eliminates them from the gene pool. Taking addictive drugs is no different than playing Russian Roulette. Both are dangerous. The persons involved in either of these activities know it is dangerous, and too often, the results are the same – death.

“ … Nothing I’ve written above is ‘profound,’ but maybe the comparison of drug abuse to Russian Roulette will ring true with some person watching their family member or friend spiral downward due to drug abuse. Maybe that comparison will prompt them to finally do something to intervene.”

Certainly, the comparison of drug abuse and Russian Roulette is an apt one. The anonymous author’s last statement, the importance of family members and friends attempting to intervene is also fair. How many who have lost someone close to them due to drug abuse have wondered whether they should’ve said or done something sooner? I’d bet there are more than a few. But it’s also fair to assume most parents and friends are doing everything in their power to help those they know are struggling with addiction.

The problem with this letter is that the author simplifies the issue of addiction, as it seems many have. It’s easy to dismiss someone who chooses to use drugs like heroin as “uninformed” or “weak,” or to callously refer to their death as “chlorination of the gene pool,” but that’s not what is at the heart of the current crisis.

First, there needs to be a better understanding of addiction itself. Science shows that people who suffer from addiction are not necessarily morally flawed or weak-minded, as was once believed. Rather, research indicates that biological and environmental factors contribute to addiction and it may actually be a genetic variation that contributes to developing substance use disorders.

This would explain why research has shown that about 23 percent of people who try heroin once will become addicted because of its powerful effects on the pleasure centers of the brain. But what about the other 77 percent? It’s the same reason someone can smoke a cigarette once or twice and never feel the urge to do it again, whereas some people smoke once and become lifelong tobacco users.

Once the brain of someone who is prone to addiction is triggered, however, it becomes difficult for them to turn back, as chemical and physical changes to the brain render the addict helpless to their need to seek that “high” again and again, even though they know the risks. If you listen to recovering drug abusers, many will tell you they’d rather die than continue living life addicted.

We also know that the reason for the current crisis dates back to the overprescribing of prescription opioids that began in the 1990s, with assurances from the pharmaceutical companies that they weren’t addictive. According to recent data from the National Institute on Drug Abuse, roughly one-fifth to nearly one-third of people prescribed opioids for chronic pain misuse them. Only a small percent who misuse prescription drugs will transition to heroin, but among heroin users, roughly 80 percent misused prescription drugs first.

How many stories have we heard during this current epidemic of young people who were prescribed Oxycontin because of a legitimate injury, only to eventually turn to heroin use once the prescription ran out?

Heck, I can recall about eight to 10 years ago when I was experiencing some nerve pain in my hand. I went to an urgent care and was given a hand brace and a 30-day supply of Oxy. I used the hand brace for two or three days before the pain subsided. The pain was never so great that I needed to use the Oxy and I got rid of it. I wonder what might’ve happened for someone with a lesser pain tolerance than I had? Does that make them weak-minded? If as a result they developed an addiction, eventually turned to heroin and OD’d, does that make their death a cleansing of the gene pool? All because they went to a doctor when their hand hurt? I think not.

The anonymous writer concludes their letter with the telling of “The Starfish Story.” Essentially, a man spots a young boy picking up starfish and throwing them back into the ocean. The boy says, “The surf is up and the tide is going out. If I don’t throw them back, they’ll die.” The man posits there are miles of beach, hundreds of starfish and that the young boy can’t possibly make a difference. Smiling, the boy picks up another starfish and tosses it into the ocean. “Made a difference for that one.”

While the writer’s take on addiction and the opioid epidemic is different from my own, I think the starfish story is a good anecdote for a lot of troubles we face in society. A reminder we can all make an individual difference, no matter how small. Regarding addiction and the opioid epidemic, that difference can simply be letting go of these misbegotten beliefs about addiction.

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