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Recovery in the News
Editorial
Addiction is not a moral issue
The Patriot Ledger
November 19, 2007
‘Heroin is killing our kids.’’ This has been the headline on the South Shore and in the Northeast for too long!
Opiates are the leading drug problem in the Northeast and it is the only region in the country where this is so.
Providing Narcan to an addict is a tool, it is an emergency measure to treat an overdose for themselves or someone else. No addict wants to be given Narcan.
Working in the field of addiction at Boston Medical Center, I have yet to see a person who was still responsive hear the word ‘‘Narcan’’ uttered and not try to flee the situation. When Narcan is administered, it displaces the opiate from the receptor in the brain, making the person physically ill, and reverses the respiratory depression that causes the overdose.
When someone is addicted to opiates they spend their day trying to keep from becoming sick. Over time, their body has developed a tolerance and without the opiate they are ‘‘dope sick’’ and with the opiate they feel ‘‘normal.’’ It is a vicious cycle that many struggle with day in and day out.
So, we say: Just stop, go to detox, put the drug down and get on with your life. Why do we need Narcan, and why do we care what happens to people who make a conscious decision to use opiates and potentially overdose and die?
Because addiction is a disease, it is a brain disease and we need to treat it much like we do other chronic diseases. We arm diabetics with sliding scale insulin, perform repeated limb amputations, we give chemo to the lung cancer patient who goes outside and smokes cigarettes between treatments, we resuscitate the obese, hypertensive, cardiac patient and perform open heart surgery multiple times, we treat the alcoholics’ GI bleeding, and cirrhosis.
But we continue to treat the patient struggling with opiate dependence differently believing that because they are ‘‘addicted,’’ they made the choice to be ‘‘addicted.’’ The obese patient, the uncontrolled diabetic, the cardiac patient and the alcoholic, they have a disease much like the addict; it is a chronic disease and it affects the brain. Science has proven this and yet society continues to look at it differently.
Initial drug use is voluntary, however once addiction develops this control is disrupted and it is no longer a choice to use, it is now a chronic relapsing disease caused by prolonged effects of drugs on the brain.
Prevention, education and treatment are all critical components in the process, but what about those already addicted and not at the stage of change where they are willing to put down that cigarette, go on that diet, exercise or stop using drugs? Do we forget them and move on? No, we meet them where they are at in their stages of change, providing them with tools, education, treatment and support. We meet people where they are at and hope over time they will move forward and get the treatment they need for their disease.
Time is critical when someone overdoses, and having Narcan available for that immediate response before medical help is sought can be the difference between life and death.
It is critical to view addiction as a brain disease and understand the brain has been altered and this drives the behavior of addiction. Therefore, treatment is required to deal with the altered brain including addressing behavior and the social components of the illness. The management of a chronic disease is lifelong; it is a chronic illness for which there is no cure.
We need to help folks change their behavior, and move forward in their recovery process but this takes time, lots of hard work and commitment. Changing behavior is not an easy task for anyone. How many stick to their New Year’s resolution and stop smoking, stop drinking, eat healthier or exercise? It’s not easy.
Providing Narcan to addicts or others for emergency measures will save lives! Addicts are not going to use because they know there is some Narcan in their pocket. Giving them Narcan will not replace treatment but it will give them a tool to treat their disease should they need it until such time that they are willing and able to engage in treatment. It saves lives!
Heroin is killing our kids, it’s impacting our community, and we need to make a commitment to use whatever tools and resources we have in treating this disease!
‘‘How many deaths will it take til too many have died?’’ Peter, Paul, and Mary.
Colleen LaBelle, RN, is the nurse program manager for the office-based opioid treatment program at Boston Medical Center. She lives in Hanover.
© Copyright 2007 The Patriot Ledger