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Addiction: The most misunderstood disease that’s killing Americans

Washington Attorney General Bob Ferguson, second from left, talks to reporters in September in Seattle, as he stands near a chart detailing the increase of admissions for opioid addiction treatment in Washington state. Ferguson said the state and the city of Seattle are filing lawsuits against several makers of opioids, including Purdue Pharma, seeking to recoup costs incurred by government when the drugs, which many officials blame for a national addiction crisis, are abused.
Washington Attorney General Bob Ferguson, second from left, talks to reporters in September in Seattle, as he stands near a chart detailing the increase of admissions for opioid addiction treatment in Washington state. Ferguson said the state and the city of Seattle are filing lawsuits against several makers of opioids, including Purdue Pharma, seeking to recoup costs incurred by government when the drugs, which many officials blame for a national addiction crisis, are abused. AP

Today, more than 175 Americans die of addiction each day — that’s one person every eight minutes.

According to the U.S. Centers for Disease Control (CDC), even this jarring number may not account for all addiction-related deaths. Many deaths from abscesses, infections, pancreatitis, liver disease and suicide may stem from addiction, but aren’t reported as such.

A CDC spokesperson says that deaths from addiction may represent “an iceberg” with only the tip showing. Soon, American deaths from addiction will surpass those from the previous most devastating plague in our history, the Spanish Flu epidemic of 1918-1920. Officials as diverse as Presidents Obama and Trump have called the addiction crisis a “scourge,” “epidemic,” and “public health emergency.”

The addiction pestilence came to us largely from the pharmaceutical industry, which gained approval of highly addictive opiate-based drugs in the 1990s, and promoted them as safe and non-addictive remedies for pain.

According to a 2017 Harvard study, marketing tactics were “aggressive,” “fraudulent,” “misleading” and contained “statistical falsehoods.”

Opiate pill consumption in the U.S. skyrocketed. By 2012, 258 million prescriptions were written in our nation — enough for every American over 18 to have a bottle. Enough pills to last for weeks often were prescribed for minor injuries, “just in case” the pain returned. Ordinary people became addicted, and then, when pills became too expensive or hard to obtain, they turned to heroin.

Heroin is chemically identical to opiate pain pills. The American Society for Addiction Medicine finds that 94 percent of people who seek treatment for heroin addiction began their drug use with pain pills.

Do you think you’d recognize the typical heroin user? He’s male, but only by a slight percentage. Many addicted persons are female. Furthermore, according to the prestigious Journal of the American Medical Association, users are young, mostly Caucasian, represent all professions and occupations, and most do not come from dysfunctional backgrounds.

In recent years, brain imaging techniques have allowed researchers to “see” inside the human brain, and the results are startling. Simplistically, the brain tissue of addicted persons shows that the limbic system (sometimes called the brain’s “reward center”) and memory areas become almost super-charged, and the frontal cortex — seat of judgment, inhibitions and the ability to foresee consequences — goes nearly dormant.

Drug-seeking becomes hard-wired, and is seen and experienced as essential to survival by these addicted brains. Behavior is then altered, bringing conflict, crimes, betrayals, manipulations and angst to families and society. It’s easy to see these negative behaviors as just the product of poor moral character, when really they stem from brain-based compulsions.

What can we do, now that the addiction epidemic is upon us?

Many American communities have started with the premise that “help ought to be more available than heroin.”

Police, sheriffs and city councils are turning police and fire stations into “safe havens” for addicted people to ask for help. Drugs are collected for disposal only, and criminal charges are held in abeyance as long as substance abusers go to treatment.

Jails host “recovery circles,” and emergency rooms bring in recovering addicts as “recovery coaches” for overdose cases. Sentencing reforms mean that counties and states charge only dealers, not individual users, with felonies. The president has established a high-profile commission to combat the opioid menace, and new laws and guidelines are limiting prescriptions. We have an enormous challenge, and it will take money, patience, scientific research, seeing others with new eyes, and love to resolve it.

Dr. Michele S. Gerber retired from the Hanford Site in 2011 after a long career in World War II and Cold War history. In retirement, she has turned her attention to the study of addiction science. She will present “Understanding the Addiction Epidemic” as part of the Community Lecture Series at the Richland Library, October 19 at 7 PM.

This story was originally published October 14, 2017 at 2:01 PM with the headline "Addiction: The most misunderstood disease that’s killing Americans."

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