Opioid Crisis: What People Say vs. What Research Says

“Addiction is bad people doing bad things.”

“Addicts use drugs for pleasure.”

“Addiction is a choice.”

  • Brain studies reveal that addiction compromises brain structures including the basal ganglia, extended amygdala, and prefrontal cortex.
    – Nora D. Volkow, M.D., George F. Koob, Ph.D., and A. Thomas McLellan, Ph.D., Neurobiologic Advances from the Brain Disease Model of AddictionNew England Journal of Medicine, 2016
  • “People suffering from addictions are not morally weak; they suffer a disease that has compromised something that the rest of us take for granted: the ability to exert will and follow through with it.”
    – Nora Volkow, M.D., Can the Science of Addiction Help Reduce Stigma? Advances in Addiction & Recovery, Fall 2015

“Lock ’em up. That’ll serve ’em right. That’ll cure ’em.”

  • The primary symptom of the illness of addiction is persistence in use despite negative consequences – including persistence despite the punishing, negative consequences of jail, prison, loss of custody of children, loss of one’s job, license to drive, license to practice a profession…
  • For those with opioid addiction in the criminal justice population, maintenance medication can reduce rates of re-incarceration by 20% or more.
    – Larney et al., Effect of prison-based opioid substitution treatment and post-release retention in treatment on risk of re-incarceration, Addiction, 2011
  • Treatment is up to 7 times cheaper than incarceration.
    NIDA, “Is drug addiction treatment worth its costs?”, 2018

“Abstinence treats addiction.”

“Abstinence from opioids treats opioid addiction.”

“People with addiction need to go to rehab.”

“Drugs cause addiction.”

“Big Pharma and prescription pain pills are to blame for the opioid crisis.”

“Doctors are to blame for the opioid crisis.”

“Prescription pain pills are a gateway to heroin addiction.”

“Overdose deaths are skyrocketing.”

  • The spike in opioid-related deaths is presumed to be caused, not by prescription pain pills, but by inadvertent overdose through street supplies of heroin poisoned with illegally-made fentanyl and its analogues.
    Opioid Data Analysis, Centers for Disease Control, 2017

“If we declare war on opioids, we’ll solve the opioid problem.”

“Medication trades one addiction for another. Because methadone and buprenorphine are opioids, giving them to opioid ‘addicts’ substitutes one addiction for another.”

“Babies are born addicted.”

“Opioid addiction is the biggest problem facing America today.”

  • Marijuana overdose deaths: 0 (Source)
  • Terrorism-related deaths, U.S. citizens, overseas and domestic: 32 (2014: Source)
  • Prescription opioid drug-related deaths: 16,000 (2015: Source)
  • Opioid-related deaths: 35,000 (2015: Source)
  • Gun-related deaths: 35,000 (2014: Source)
  • Drug overdose deaths: 64,000 (Provisional, January 2017: Source)
  • Alcohol-related deaths: 88,000 (2015: Source)
  • Obesity-related deaths: 300,000 (Source)
  • Tobacco-related deaths: 480,000 (Source)

Oh, wait. Breaking news. Not 70s heroin? Not 80s crack cocaine? Not 2010s opioids anymore? Meth again?

Wait, not meth? Benzos?

  • “It would be a tragedy if measures to target overprescribing and overuse of opioids diverted people from one class of life-threatening drugs to another.”
    – Lembke et al., Our Other Prescription Drug Problem, New England Journal of Medicince, 2/22/18

“Deciding to use substances like tobacco, alcohol, marijuana or heroin
does not make people less human. It reflects the fact that they are
human.”
– Hakique Virani, M.D., People use drugs, get over it, CBC Radio-Canada, 2017

“The iron law of drug prohibition is that the more intense the law enforcement, the more potent the drugs will become.”
– Richard Cowan, National Review, 1986, Wikipedia

Last updated 3/8/18

Image: iStock

. . . . .

I will be giving a talk entitled “Opioid Epidemic? What Are the Facts?” for the Lifelong Learning Institute at Virginia Tech on Tuesday, March, 13, 2018, 3:15 – 4:30 PM, at Warm Hearth Village Center in Blacksburg, Virginia. The event is free and open to the public.

More information about the talk is here and here.

A follow-up discussion meeting will be held on Wednesday, April 25, 6:00 – 8:00 PM, in the Community Room at the Blacksburg Library, 200 Miller Street, Blacksburg, Virginia.

The views expressed are mine alone and do not necessarily reflect the positions of my employers, co-workers, clients, family members or friends. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Question Criminalizing a Medical Illness
Talk on the Opioid Crisis in Blacksburg, VA, March 13, 2018

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