Heroin 2016

If a pundit had predicted back in the 90s that one of the main concerns for New Hampshire primary voters in 2016 would be heroin addiction, the pundit would’ve been dismissed as batty. Even if Nostradamus had been resurrected from the grave, he wouldn’t have made such a prediction. Yet, New Hampshire is dealing with a heroin addiction epidemic, and it’s not just New Hampshire.

Here are a few numbers from a New York Times article:

Heroin-related deaths jumped 39 percent from 2012 to 2013, and the longer-term trends are equally disturbing: from 2002 to 2013, the rate of heroin-related overdose deaths nearly quadrupled, according to the Centers for Disease Control and Prevention.

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90% Of First-Time Heroin Users Are White

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75% Of Heroin Addicts Used Prescription Opioids Before Turning to Heroin

Since this is election season, candidates are taking notice. Chris Christie gave an inspirational speech about a friend who died from opiate addiction. Jeb Bush will present a policy proposal to deal with heroin addiction. Hillary Clinton has spoken to the subject. All the candidates will address this issue as they prepare for the New Hampshire primary. I just hope it’s not forgotten after the smoke clears in New Hampshire, or after the election and the new President moves on to easier priorities.

Heroin addiction is not an easy issue to deal with. Addiction is not something that we can attack and defeat, like the early war on drugs. As a nation, we can create more services, better services, but it also takes follow up after the initial treatment. Recovery management entails actions over the long term to strengthen recovery. Old ideas about addiction must be destroyed.

If people continue to think of addiction as simply the result of poverty and ignorance, it’ll make progress difficult. There are many reasons why people start using heroin, or other opiates that lead to heroin. The boredom of poverty is one reason, as is ignorance, but plenty of heroin addicts are neither poor nor ignorant. The heroin addict might become poor after starting the heroin, and the addict might act ignorantly, but poverty and ignorance weren’t necessarily the reasons for using.

Some people start using prescription opiates for legitimate reasons and become addicted to them. Once addicted to opiates, the person begins seeing more than one doctor because their prescription runs out, and then they get caught by the system and cut-off from the prescribed opiates. The opiate addict then goes to the street to buy opiates, and this is where they’re talked into using heroin. The heroin dealer will surely ease the person’s fear of needles by informing the opiate addict that using heroin by a needle is not necessary, there are other routes of intake. Often, neither the  pharmacist nor the prescribing physician will deal with the addiction. The addict is dismissed from care for not following directions, sometimes with a haughty sneer of indignation and condemnation.

Some people, usually young people, start using to experiment, to fit in a group, just for pleasure. Those who have a biological predisposition to addiction will usually quickly become addicted. In order to address the problem of addiction effectively, a multifaceted approach is necessary. There must be education and prevention efforts – community education, more education given to health care professionals and teachers. There must be quality treatment providers. There must be resources in the community to help addicts adjust and remain abstinent over the long term.

But most of all, the way people think about addiction must change. Condemnation and shame aren’t effective – each individual is different and has to receive individualized care – jailing users doesn’t help addicts or society – addiction is a health care problem, a chronic brain disease – it can happen to people from all walks of life.