Heroin use in the United States has increased dramatically in the past 10 years. It is more available, purer and cheaper than ever, and it is frequently tainted with potentially lethal substances like fentanyl.
Well over 10,000 Americans will have died from heroin this year. Most Drug Enforcement Agency field division officials rank it as the No. 1 drug threat their populations face.
Winning a “War on Heroin” will require a multidisciplinary strategy and public-private partnerships. Here are just 11 of the essential elements:
1. Define the use of heroin as evidence that an individual is “unable to care for self,” a trigger that should satisfy the requirements for involuntary hospitalization in all 50 states. This would end the unwise pattern of treating heroin users in emergency rooms and then releasing them to use, again, just hours later.
2. Publicize, promote and vastly expand a family member’s right (which already exists in most states) to petition a court to involuntary-hospitalize a loved one in danger from opiate abuse.
3. Allow courts to impose involuntary hospitalizations, rather than jail terms, on heroin users, with substantial periods of involuntary outpatient treatment (including random drug screening) following their release. Fail a drug test or refuse one, and you go back to the hospital.
4. Create a wall — financial, physical or both — that makes drug traffic across our borders less attractive. The financial wall could include penalties levied on governments that pollute our population with drugs that flow from their territories into ours. The physical wall could include bricks and mortar, and it could also include our assertion that we have the right to patrol past our borders if a country cannot or will not police its own.
5. Reinvigorate the community mental health system across America and ensure that it includes crisis teams that can, with good reason, reach out — invited or not — to provide help to opiate abusers.
6. Educate young people, starting in grade school, to the fact that heroin and other substances will weaken them and their country, and that using such substances shows a lack of character.
7. Encourage public schools to randomly test students for heroin, send users home and provide instructions to their parents for getting their kids help.
8. Fund faith-based anti-heroin initiatives as part of a preventive health strategy. Drugs destroy personal autonomy and integrity. Faith builds both.
9. Deploy known technologies to fight opiate addiction, including the use of Vivitrol, an injectable medication that makes it a lot harder to get high on heroin.
10. Help physicians identify and treat underlying psychiatric illnesses like depression and attention deficit disorder that, left untreated, can make the use of opiates, including heroin, more attractive.
11. Jumpstart recovery with a job. Heroin saps motivation. Putting recent users (who must test negative for drugs) back to work building America’s infrastructure would be some of the best medicine they could ever get.
The epidemic of heroin abuse and dependence in America will end when America decides it must. Now, with a president-elect who values independence of mind so highly, we can (and should) resolve to win it back for every American.
Keith Ablow, MD is a psychiatrist, and was host of the nationally-syndicated "Dr. Keith Ablow Show." He is a former member of the Fox News Medical A Team.