About 91 Americans are expected to die today and every day from opioid overdoses. Over 300,000 have died since the year 2000, surpassing vehicle accidents as the leading cause of unintentional deaths. The economic toll is estimated to be a staggering $78.5 billion per year nationwide.
Most people know someone who has battled addiction. They may have been in an accident or needed surgery. To ease their pain, their doctor prescribed opioids. Those prescriptions were appropriate and entirely legal.
Opioids reduce pain and give intense feelings of happiness. Many people’s brain chemistry causes them to crave this “high” and they become dependent on these drugs. When their prescriptions run out, the cravings don’t stop.
Addiction is a medical condition, not a moral failure. President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis emphasized that addiction is “a chronic brain disease.”
Addiction changes the way people’s brains function, causing their brains to need opiates in order to function normally. The absence of opiates causes brain abnormalities that trigger withdrawal, with physical symptoms such as anxiety, vomiting, cramps, diarrhea, and tremors.
The pain of withdrawal can be unbearable. One person described it as though “every bone in your body hurts. You get hot and cold sweats. It is 90 degrees out here, but you’d be freezing with goose bumps. There is no middle ground.”
To avoid these withdrawal symptoms, many people living with addiction shop for a doctor who will give them another prescription. If that fails, they often resort to buying opioids on the street. This is extremely dangerous because these street drugs often contain Fentanyl, which is cheaper and more deadly than other drugs.
The tragic toll of this epidemic extends beyond those who die from overdoses. Grandparents and foster parents take on the burden of raising the children of those who have become addicted to or died from opioid use.
In addition, there is a troubling increase in the number of children whose mothers take opioids during pregnancy. These innocent babies suffer the terrors of withdrawal after they are born. As a result, many of them experience physical and mental difficulties throughout their lives.
Other epidemics are treated as public health crises with government and private sector support for research to find appropriate treatment and prevention protocols. Unfortunately, we have not made the same commitment to prevent and treat addiction.
Despite the solid evidence that addiction is a disease, there remain those who believe opioid addiction is a moral failure and should be punished with jail time. Certainly, we need to go hard against those who are bringing large shipments of this poison across our borders and into our neighborhoods. These drug dealers belong in prison.
However, imposing severe sentences for people with opioid addiction is both cruel and dangerous. We wouldn’t lock someone up for having pneumonia. So, why would we incarcerate someone with the disease of addiction?
While incarcerated, people living with addiction go through withdrawal without proper medical supervision. It is extremely painful and doesn’t do anything to treat their underlying disease.
Incarceration cannot reverse the neurobiological abnormalities of the addicted brain. In fact, putting people battling opioid addiction in jail rather than in treatment programs can lead to more opioid-related deaths.
Tolerance for the drug is reduced while in jail, but the person’s addiction remains. Upon release, if he or she succumbs to his or her brain’s cravings, the “usual” dose may cause an overdose, which could cause the person to die due to having a lowered tolerance. Continuing to follow the “punishment not treatment” course will only continue the devastation of the opioid epidemic.
Instead, here are some important steps that will help end this opioid epidemic:
- Partner with pharmaceutical companies and research hospitals to develop non-addictive painkillers and new ways to treat addiction and overdoses.
- Prosecute major drug trafficking organizations that ship large amounts of illicit synthetic drugs into our country and communities. Currently only 14 percent of federal prisoners convicted of drug crimes were major traffickers. That means we spend millions locking up the 86 percent, who are small fish.
- Fully enforce the federal law that requires insurance companies to provide the same benefits for mental health and substance use diagnoses as they do for other medical conditions. When they refuse to pay for these services, patients end up in costly jail beds where their addiction is not treated.
- Reverse health care policies that perversely provide incentives for prescribing opioids, while limiting payments for non-addictive treatments for pain, as well as addiction treatment and medication-assisted treatment.
- Change outdated laws and regulations that make it harder for people living with addiction to get medication-assisted treatment. This includes eliminating the cap on the number of patients a health-care provider can treat. It also includes changing regulations that make it harder for patients to access new longer-acting recovery drugs that are less prone to be diverted and help with adherence.
- Establish drug courts that support evidence-based treatment interventions in every federal judicial district. As the commission reported, drug courts are “working in our states and can work in our federal system to help treat those who need it and lower the federal prison population…. Drug Courts are known to be significantly more effective than incarceration…”
These are concrete steps that will provide help to millions of Americans fighting addiction. It is truly a matter of life and death.
Newt Gingrich is an adviser to Advocates for Opioid Recovery.