As long as there have been drugs, there have been people who abuse them. While addiction itself is timeless, different drugs do come in and out of fashion.

There is little question that we are now living in an era of painkiller addiction. This epidemic has several possible causes, but its effects are unquestionably devastating. Dr. Eric D. Collins, the chief physician of the renowned Silver Hill Hospital, explained the crisis on Thursday in The Hill: “The number of overdose deaths in the U.S. due to opioids, which include heroin and prescription pain relievers such as morphine, oxycodone, and hydrocodone, quadrupled between 1999 and 2011.”

The overuse of prescription painkillers funnels people toward heroin when they become unable to afford pills. While street drugs such as heroin may seem more dangerous due to being illegal, the truth is that overdoses of all opiates kill people indiscriminately.

Before 1980, prescriptions for opiates were written far more selectively than they are today. How did so many Americans get hooked on legal pills? Dr. Collins explains:

[P]rescriptions for opioid pain relievers have increased dramatically as a result of several factors: the efforts of a small group of specialized pain physicians, who argued that individuals with chronic pain deserved more access to the powerful analgesia provided by opioids (despite a lack of evidence that opioids provide good analgesia for chronic non-cancer pain), the argument, now discredited, that opioids almost never produce addiction when used to treat pain, the transformation of American medicine into a volume business with shorter and shorter doctor-patient visits that typically lead to a prescription rather than a longer discussion about alternative ways to manage pain, and the efforts of pharmaceutical companies to encourage opioid prescribing [….]

Addicts will go to extreme lengths to secure the drugs they need. One common tactic is “doctor shopping,” in which users secure prescriptions from multiple clinicians. This is typically accomplished by keeping doctors in the dark about the full scope of their drug-seeking.

Dr. Collins is therefore advocating for a better system of information sharing among doctors, via “prescription drug monitoring programs” (PDMPs). Other approaches are also being explored around the country. Many police departments are attempting to treat addicts less like criminals and more like people who need help; the police chief of Gloucester, Massachusetts was recently quoted on his desire to “change the fundamental way we deal with addicts and recognize it as a disease and not a crime, in and of itself, that deserves punishment.”

It is remarkable to see the criminal justice system increasingly address addiction using the “disease model” long prevalent in medicine, instead of their traditional punitive approach. While that may represent progress, the reality is that millions of addicts will continue going to any lengths for their fix, irrespective of public understanding of their condition. Until the addicted person accepts real help, they and their loved ones will continue to suffer.

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