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Monday, June 15, 2020

The Stigma of Addiction

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Sharp spike in mental health and addiction-related crises seen

Ask anyone struggling with drugs or alcohol if they ever dreamed of becoming an alcoholic or drug addict when they were children, and they will emphatically tell you no. Who would?

Yet we treat addiction as if it were nothing but a personal choice – a moral failure. We, as a society, stigmatize people with chemical addictions, and they know it, too.

However, was it really nothing more than a choice?

Maybe he did choose to have a few beers with his friends from time to time when he was younger. Or perhaps she chose to take pain pills after she was injured in an accident. Or perhaps a friend said, “Try this. It will make you feel good or happy or confident or less sad.” And as he realized that he was drinking more and more or her needing more prescriptions for her pain pills, they were sure that they had it under control and could stop whenever they wanted. Everyone believes that.

For some people, their substance use spirals out of control. There are so many factors involved: biological, environmental, societal, cultural, and likely many we do not even realize. Does simply the chronic use of alcohol or opioids or cocaine or even methamphetamine (meth) make somebody bad? Absolutely not!

Both of my parents had significant problems with drugs and alcohol. My father was in and out of rehab for as long as I can remember. My mother could have been the poster child for the song “White Rabbit” by Jefferson Airplane. Both died from complications of their substance use – my father of lung cancer and my mother from alcoholic dementia. Did this make them bad?

My high school buddy, college roommate and lifelong friend hurt his back on the job. The doctor prescribed pain pills. Yes, my dear friend died from an opioid overdose. Was he bad?

Of course not. I grew up surrounded by chemical addictions. I have also studied cocaine and meth for over 40 years in the laboratory and face-to-face with people who struggle with substance use disorders. I did not meet a single man or woman who was deserving of any less respect than you or me.

Nevertheless, many are treated as outcasts who are shunned and looked down upon by society. And as Dr. Nora Volkow, the director of the National Institute on Drug Abuse, recently opined, “Stigma on the part of healthcare providers who tacitly see a patient’s drug or alcohol problem as their own fault leads to substandard care or even to rejecting individuals seeking treatment 1 .”

This seemed incredulous to me at first. How could someone with a clear and present medical problem be turned away by the health-care community?

Yet, I also knew it was true.

I have talked with countless meth users over the past several years, primarily women, due to the paucity of information on women and this insidious drug. When meth is smoked or injected, it produces an almost instantaneous activation of the sympathetic nervous system – producing that “fight or flight” response. Heart rate increases, pupils dilate – all senses are intensified.

It can also take your breath away. I cannot tell you how many women have told me that they had lain on the floor, gasping for breath for what seemed like hours. They thought that they were going to die. But when I asked them why they did not go to the hospital for help, each one to a person told me, “I can’t go to the hospital. They would see the needle marks.”

Even when I tried to reassure them that people working in emergency rooms had seen everything, they persisted. Nothing I said would dissuade them.

As Dr. Volkow so aptly stated, “When people with addiction are stigmatized and rejected, especially by those within health-care, it only contributes to the vicious cycle that entrenches their disease.”

It is imperative that we treat them as well, not as addicts and outcasts, but as people who need our help. We are all God’s children, after all, deserving of treatment, care and love.

It is long past time to stop stigmatizing addiction and to start treating this as the medical condition that it is.

The stress and fear associated with the COVID-19 pandemic will result in unprecedented increases in drug and alcohol use among our friends, our families and others in our communities.

People do not know where to turn. They are isolated and do not know how or where to seek help. Unemployment and furloughs are resulting in financial burdens on top of a plummeting economy. Uninsured and limited access to addiction treatment, healthcare worker stress, family strain and feelings of helplessness in assisting family members, and uncertainty about the future all compound the problem, leading to anxiety, insomnia, isolation, depression and PTSD – all of which can produce increases in alcoholism and drug addiction.

Isolation and economic upheaval caused by COVID-19 are resulting in a sharp spike in mental health and addiction-related crises. The Louisiana Addiction Research Center (LARC) at LSU Health Shreveport is closely monitoring the effects of COVID-19, particularly as they relate to substance use disorders, and is here to help. If you or a loved one are struggling with addiction, the Louisiana Addiction Research Center has compiled a list of resources that can help: www.lsuhs.edu/larc.

References: 1. https://blogs.scientificamerican.com/observations/addressing-the-stigma-that-surrounds-addiction/

Nicholas E. Goeders, PhD, is professor and chair of the Department of Pharmacology, Toxicology & Neuroscience at LSU Health Shreveport and the executive director of the Louisiana Addiction Research Center (LARC).

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