In the US Revolutionary War, from 1775-1783 there were 50,000 US casualties. In the Vietnam War (1955-75), there were 211,454 US casualties, while the Iraqi War, from 2003-2011 resulted in 36,710 deaths and the Afghanistan War, from 2001 to the present resulted in 20,904 deaths (US Military Casualties of War, en.wikipedia.org). Over 40,000 women each year die of breast cancer (Jemal et al. Cancer statistics, 2008. CA Cancer J Clin. 2008 Mar-Apr.). That’s a lot of mothers, fathers, wives, husbands. Statistics like that grab us. We’re willing to invest in cancer research and treatment. We honor our military dead. Yet in 2015 alone, more than 52,000 people died of a drug overdose according to the CDC (Center for Disease Control). Of those 52.000 deaths, 61% involved an opiate. Between 2001 and 2014, per the National Center for Health Statistics of the CDC, over 250,000 people have died of prescription drug overdoses. Yet, unless one of them happens to be your son, brother, daughter, best friend, wife, those deaths are largely ignored.
We can distance ourselves from those deaths because “it’s their fault.” After all, “they’re drug addicts.” You don’t see fundraisers for drug addiction treatment or parades to celebrate recovery from drug addiction, at least not very often. Yet, we’ve lost more people to drug deaths (not just heroin, but also prescription drugs) over the last 15 years than we did in the Iraqi and Afghanistan Wars combined, or in the Revolutionary War, and we lost more people in 2015 to drug overdoses than we did to breast cancer. What a tremendous waste.
This is a treatable disease.
Why aren’t people getting treatment? Only a very small percentage of people with addiction are in treatment. There are several reasons. For one, there aren’t enough treatment resources, and there aren’t enough people who specialize in treating addiction, particularly in rural areas. There is still a lot of stigma and misunderstanding People with addiction are told that they are simply weak-willed, that they could stop if they only wanted to, and they buy into that. They are hopeless and defeated, and they believe that treatment won’t work. Nothing could be further from the truth. Addiction is a disease of the brain, a disordered brain. Once a person is in the throes of an addiction, free will is not operating anymore. As with any disease, people who have been ill for a long time, people who grew up in families rife with addiction, need more intense treatment over a longer period. It’s not easy to find that. It may be expensive.
I listened to an interesting webinar today, presented by the American Society of Addiction Medicine on what the Surgeon General’s Report, Facing Addiction in America, means to clinicians treating addiction. Dr. Thomas McLellan of the Treatment Research Institute was one of the speakers. He points out that 94% of addictions start between the ages of 12 and 25. So that means that we probably aren’t starting treatment early enough. Addiction related deaths account for 74% of deaths in the 12-25-year-old age group.
Physicians have a role in this abysmal statistic as well. I can say that because I am one. We have been too quick to prescribe opiates and not good enough at monitoring our patient’s use of them. I think, however, that we are getting a little better at understanding when and how to use opiates, when to not use them, and alternative treatments for pain. However, what I still find infuriating is the negative attitude that many physicians have towards patients with addiction, even patients who are in medication-assisted treatment. I thought we learned better in medical school. You don’t let your personal biases interfere with your treatment of the patient. I’m afraid we’ve lost that concept in the medical profession.
Unfortunately, addiction is like cancer. If treated early and aggressively, the patient can be saved. But if treated too late, some people won’t make it. I would be willing to bet that someone in your inner circle is struggling with addiction. Open your eyes. Get them into treatment if possible.
And remember, if people don’t have health insurance, they don’t have access to treatment.
You can read the Surgeon General’s report at addiction.surgeongeneral.gov.