Science has proven that substance use disorder is a chronic brain disease that can be managed with medical treatment. It is not a moral failing or a character flaw. But still, only one in 10 Americans with a substance use disorder receives treatment.
Addiction is highly stigmatized, and stigma is fueling the public health crisis, according to Gary Mendell, who leads Shatterproof, a national nonprofit he founded to end the devastation that addiction causes families.
“Everyone’s talking about heroin because that’s what gets eyeballs, when it’s really a prescription drug problem,” Mendell said.
Easton police Chief Tim Shaw agreed. Stamford, where Shaw worked for 28 years before coming to Easton, is home to Purdue Pharma, producer of OxyContin. Shaw was fighting crime on the front lines of the opioid epidemic when it began in the 1990s with the introduction of OxyContin to the market.
The highly addictive 12-hour time-release drug, which wasn’t supposed to be addictive, triggered the opioid crisis when it was introduced in the 1990s, Mendell said.
Doctors were taught in medical school, “Do not prescribe opiates, they are very dangerous,” he said. “That was what it was like prior to 15 years ago.”
Then Purdue Pharma spent hundreds of millions of dollars convincing the health industry that OxyContin, a 12-hour release product, not two-hour, is not addictive, and they believed it, Mendell said.
“I’m not blaming doctors,” he said. “Doctors get into the field and they do what they were taught. Doctors were taught that OxyContin wasn’t addictive. We have to get prescribing habits of doctors under control. We’re talking about cutting down on supply.”
Opioids are so addictive — and so dangerous — because of the way they affect the brain’s pleasure center. They work by attaching to the brain’s receptors and sending signals that block pain, slow breathing, and promote a feeling of calmness. They also flood the brain’s circuits with dopamine — the “feel-good” chemical that sends the brain feedback about rewards — creating a feeling of euphoria.
For the sake of survival, humans brains are naturally wired to repeat behaviors associated with pleasure or reward. So when that reward system is overstimulated by the effects of opioids, the brain remembers that behavior and records it as something that should be repeated without even thinking about it, according to research posted on the Shatterproof website.
Mendell cited the facts:
• In 2015, 33,000 people died of an overdose, of which 20,000 were from prescription drugs and 13,000 from heroin. Of the 13,000 heroin users, 10,500, or 80%, started with prescription pills, he said.
• In 1995, doctors wrote 60 million prescriptions; last year doctors wrote 240 million prescriptions, a fourfold increase. Concurrently, the number of overdoses jumped five and a half times, he said.
“Another statistic, which I use on my slide shows, is the United States is 5% of the world population but we use 80% of the prescription drugs,” Shaw said.