Recently, heroin addiction has gained attention beyond the usual remedies of harsh law enforcement and occasional drug treatment ("The new face of Md.'s fight against heroin," Feb. 26).
In the last few years, the Drug Enforcement Agency has increased restrictions on opiate prescriptions. These policy changes have made it more difficult for patients to get adequate pain relief. Overall, the DEA efforts have caused more prescription drug users (not necessarily addicts) to turn to heroin.
In particular, addicts find heroin appealing since its black market price is now cheaper than that of prescription opiates. In the U.S., the 16,500 prescription drug overdose deaths from opiates decreased only marginally between 2010 and 2013, while heroin overdose deaths soared from about 3,000 to more than 8,000 over the same period.
Using heroin to treat pain or an addiction to opiates is much more dangerous than obtaining prescription drugs through legal channels. It should be obvious the DEA's restrictions on prescription use are counterproductive to the goal of reducing harm from prescription drugs.
An alternative approach is suggested by an animal experiment. The experimenter puts a rat into a bare cage with little stimuli and provides two bottles: one contains only water and the other water mixed with an opioid. The rat will usually choose to drink from the opioid-laced bottle and eventually fatally overdose. However, if a rat is put initially in a stimulating environment, it will usually drink little or nothing from the opioid-laced bottle and be well adjusted.
This experiment suggests that our present approach — sentencing addicts to prison (like putting an addicted rat in a bare cage) is mostly counterproductive. A prison sentence (or even drug court) often results in loss of job or reduced ability to hold or find a job. Starting addicts down this path reduces the chance they will ever return to a normal productive life.
Portugal presents an encouraging example. They are using a buprenorphine-naloxone maintenance approach together with the decriminalization of small amounts of formerly illegal drugs. Buprenorphine-naloxone maximally reduces craving for opiates, and side effects are usually mild. Funding for the criminal justice system can be reduced while increasing resources for finding employment for the addict. This positive model should be implemented in the U.S. for both heroin addicts and people who become addicted to prescription drugs.
Kevin S. Fansler, Havre de Grace