The top health story of 2018 according to WebMD was the opioid addiction crisis. This crisis is not only a health crisis but a legal crisis too. Opioid addiction creates a huge black market for purveyors of all variety of opioids, including heroin. The addiction also causes many addicts to commit crimes so that they are able to fund their habit. But most tragic of all is the number of people who are dying from opioid overdoses. In 2017, the most recent year for which the statistics are available, 47,600 people died in the U.S. from an opioid overdose. Tragically, over half of those deaths were among people 25-44 years of age. Opioid deaths surpass the number of people who died in a fatal car accident in 2017 by almost 10,000. To put this in perspective, every 11 minutes, someone dies of an opioid overdose.
Why is our health and legal system doing such a poor job of addressing this crisis? Perhaps we are putting too much blame on the addict. To the credit of justice reform efforts across the country, including some in Orange County, laws are being written that seek to address the addiction rather than criminalize it. But perhaps we need to turn our thinking 180 degrees. No one plans on getting hooked on opioids. Sometimes it is chronic physical pain that brings a person to the dark path of addiction, often leading to addiction to street drugs such as heroin when the prescriptions are no longer available. This is often the story we hear.
Yet, there is another pain that leads people to addiction—emotional/psychological pain. In our “pull yourself up by your bootstraps” nation, we often consider those who become addicted because they are in emotional pain to be weak and consider the addiction to be their own fault. How helpful is that? Not very. The truth is many people turn to these drugs in response to very painful life experiences, whether it be the lingering effects of PTSD, childhood trauma, or any number of experiences that affect the person so profoundly that they cannot shake the pain of it. Not everyone will turn to drugs to ease painful experiences, but some people are simply more susceptible, whether that is due to personality factors, lack of resources, or even a lack of imagination.
Opioids trigger reward circuits in the brain. As one user described it, “It’s like being hugged by Jesus.” When people in emotional pain experience this, they want to chase that feeling and thing taking more opioids can give it to them. But what happens for many opioid users is that the brain rewires with each successive use. That initial feeling of euphoria is never experienced again but the user continues to seek it, leading to addiction. As the brain has now been altered by the drug, the addict finds it increasingly difficult to cope with everyday life without the drug. The addict no longer feels the high of the drug, but only takes it to avoid the low that comes when the drug wears off. It is a vicious and tragic circle.
If the addict tries to stop, the physical dependency on the drug rears its ugly head. The withdrawal can last for weeks and for many, it feels like they are dying. The body is begging for more of the drug and many yield to the urge. Relapse in itself becomes a dangerous proposition. Because the addict’s tolerance for the drug diminishes during withdrawal, taking the same amount of the drug during a relapse can cause death.
If this country doesn’t figure out how to effectively treat this addiction, the addicts will continue to steal so they can get their next dose from the drug dealer, and our jails will continue to fill up with users and dealers. As the experts weigh in on how to treat this crisis, it is clear that there is no consensus. Most treatment centers still follow the abstinence model. But abstinence is not supported by medical research as effective. More effective are treatment medications that decrease the cravings without producing the high. This protocol requires a long-term commitment, which may not be affordable or convenient. But some believe we need to go deeper than these surface remedies. Dr. Gabor Mate, an addiction expert in Canada, has had much success in treating addicts by recognizing the underlying emotional pain that causes the addiction in the first place, and treating that pain. As he has put it, “The question is not why the addiction, but why the pain.”
This is a complex subject which is far from resolved. One thing seems certain: We are not solving the opioid crisis in this country. Perhaps we first need to stop blaming and punishing and start practicing more empathy towards the addict. Orange County criminal defense attorney William Weinberg understands this. When he receives a client whose crime is driven by an underlying addiction, he utilizes all available laws to get the client treated, not punished.
Attorney William Weinberg has been defending those accused of drug crimes or crimes motivated by drug addiction for over 25 years. He is available for a free consultation to discuss your options. Mr. Weinberg may be reached at his Irvine office at 949-474-8008 or by email at bill@williamweinberg.com.