Heroin users are not disposable

I respect Bob Hunter. I appreciate his ability to call things as he sees them, and as he said in a recent editorial, he formulates his opinions based on what he believes rather than whether it fits into a particular ideology. However, he is not always right. In his editorial in the Aug. 1 edition of the Mail Tribune, he stated: “But I have my doubts about providing an endless, and expensive, supply of the antidote naloxone to the heroin user who overdoses again and again and again.”

Who do you imagine these heroin users to be? They are our kids! The largest age group for heroin overdoses in America is 25-34 years old. Four out of five recent heroin users started on prescription opioids. The prescriptions were written by health care providers in excess of what was required, and the drugs became a gateway to heroin for a half million young people across the nation. That may not have been the story 50 years ago, when our stereotypes of addicts were formed, but that is the case today.

The editorial implies that those caught up in the throes of addition should eventually be allowed to die if they can’t just “get it together.” Tell that to the mother of the heroin addict who sees her child relapse over and over, with genuine attempts at sobriety, hoping that the next close call will be the last. Or to any of those addicted to alcohol, cigarettes or gambling, who relapsed repeatedly, only to finally crawl out of the abyss after one too many close calls, thankful that someone offered them a hand up.

It is the nature of those with substance use disorder to episodically return to misuse. This is a brain disease we need to better understand so we can treat it effectively and with compassion. Who reading this doesn’t know someone taking too many pills, or who is using a substance repeatedly despite personal harms? This problem touches us all.

The good news is, we have very effective treatments for opioid addiction. Buprenorphine (Suboxone) and methadone are medications that can be prescribed in controlled settings and generally allow individuals to return to a life without misuse. However, those treatments are often inappropriately stigmatized as “replacing one drug with another.” An understanding of brain chemistry and decades of experience suggest otherwise.

We are fortunate to have access in our community to effective treatments for opioid use disorder. Let's create systems of care within Jackson County that link individuals who have a non-fatal overdose to effective treatments. Let’s get smart about understanding, recognizing and treating addiction, rather than presenting addicts as disposable human beings.

— Jim Shames, M.D., is medical director for Jackson County Health and Human Services.

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