Expert in addiction says prevention is most effective cure for opioid epidemic
There is a lot of attention paid to opioid addiction treatment, Dr. Richard Blondell told an audience at the City Church Generation Center in Batavia today, but not enough effort is given to preventing addiction in the first place.
"The bottom line of this opioid epidemic is we cannot treat our way out of this epidemic," Blondell said. "We cannot incarcerate out of this epidemic. We can't legislate our way out of this epidemic. What we really have to do is prevention."
Blondell is vice chair of addiction medicine and a professor in the Department of Family Medicine at SUNY Buffalo. He spoke today at a workshop for faith leaders sponsored by the Genesee-Orleans-Wyoming Opioid Task Force.
Drawing on science, history and statistics, Blondell made the case that it's very difficult to successfully treat somebody for opioid addiction; therefore, to end the current epidemic, society needs to produce fewer addicts.
That begins with doctors, he said but includes families and individuals who need to be more aware and better educated about addiction and prevention.
The causes of addiction are both genetic and environmental, Blondell said.
About 10 percent of the population is genetically susceptible to opioid addiction. Those people, when exposed to opioids, usually through prescription medication, are much likely to become addicts.
The addiction for them is a disease.
An addict has about a 5 percent chance of dying in any given year.
"The average life expectancy of a heroin addict is about 10 years, most are gone in 20," Blondell said.
Much of the blame for the opioid epidemic can be placed on Arthur M. Sackler, a medical marketing executive in the 1950s who, among other things, introduced the world to Valium, the first multimillion drug.
"It didn't treat anything actually," Bondell said. "Even though Valium was the number one prescribed drug in the country it was not clear what disease it treated."
The Sackler family went on to own Perdue Pharma, the company that introduced OxyContin.
That pain pill was sold to doctors as non-addictive if used for pain.
Then the insurance companies got involved, Blondell said. They stopped funding pain-management regimes, which could cost thousands of dollars but were effective, in favor of prescription pain medications. And if doctors didn't prescribe enough pain pills, they would get low patient satisfaction scores from patients who said, "he didn't do anything for my pain."
Doctors started prescribing opioid-based pain medications "like skittles," Blondell said.
Patients who become addicted to pain pills often, usually, turn to heroin, which is cheaper and easier to get. About 75 percent of heroin addicts started with a prescription to either the addict himself or to a friend or family member.
There are two types of treatment for addicts, neither high success rates -- counseling or medication.
In counseling, an addict receives psychological therapy, or they might live in a home and where they can learn adult life skills but if they are physically addicted, brain condition related to addiction is not treated. That is where medication, such as methadone, come in.
Blondell said all treatment methods should continue but that isn't the final answer on the epidemic. We've never treated our way out of an epidemic, he said.
People who say addiction is a choice really don't understand opioid addiction, Blondell said.
Everybody is addicted to something. Addiction is essential to survival. We're all addicted, for example, to water.
But what substances, such as illicit drugs and alcohol do, is trick the brain into thinking that substance is a higher priority than other addictions, such as food.
"So people say to me, this is a behavior," Blondell said. "It's not really a mental illness or it's not a disease. It's not a disorder. It's really just a behavioral problem. To which my question is, what organ in the body produces behavior? Is it the kidneys? Is it the liver? No, it's the brain. So it's the brain that produces the behavior that we see and pass judgment on."
If we're going to end the epidemic, Blondell said, doctors need to be more cautious and judicious in when and how they prescribe pain medications. Patients who receive them need to be better educated about taking the prescribed amount for only a short period of time. Parents need to ensure they control the distribution of pain medication to their teen children, and ensure they actually take them when dispensed so they're not hoarded so five or six can be taken at a time. Everybody needs to be better educated about the nature of addiction and how to avoid it.
The last sentence says it all.
Capitalism at it's best. The pharmaceutical companies have been shown (busted?) time and time again to be THE most prolific and deadly drug pushers on earth. A conspiracy "theory" that even the ny times was compelled to acknowledge. While many, many pharmaceutical companies and their human components have been busted for pushing their dopes on unsuspecting victims, at least one was busted just recently for conspiring to profit further on the addiction of its victims by offering other drugs to "help" those victims to get unhooked. While knowingly continuing to get and keep users hooked. Check here:
Usually corporate pigs who are busted for illegalities get off scott free with deals that involve fines for the corporations. Even when their behavior results in thousands or millions of deaths. Such fines are viewed as simply a cost of doing business, and very seldom approach the value gained through their criminality. All while our corrupted system of injustice concentrates on "getting" users and addicted "dealers" off the street. Hey, it all creates "jobs." "Crime is functional."
Such conspirators need to be imprisoned and their companies dismantled. Little dealers have their assets confiscated. Why not corporations? Oh yeah, capitalism.
Thanks for posting this Howard. It is a topic that is not addressed enough, and one we all need to be better educated about.
While I agree with Daniel Norstrand's views on this, I would not want to see the discussion morph into Us vs. Them or Left vs. Right. This opiate crisis is effecting us all. It could happen to any of us. Only with better education (thanks Dr. Blondell) can we start understanding what the problem is and work to bring an end to the epidemic.
The "1 percent" have rigged our system Scott. The opioid/dope business is a perfect storm for them as it creates jobs for doctors, nurses, EMTs, hospitals, police, jailers/jails, counselors, mortitians, cemeteries, headstone makers/carvers, reporters/media, priests/pastors, DAs, lawyers, street urchins, etc., etc., etc. All moving money around which is taxed on most all transactions. The tax money belongs to the 1% also because they have queered our government entities with the influence they buy. All of this is also a huge distraction from the many other important topics we should be concerned about. Making our lives, our country, and our planet much less than they should be, and much, much less than they could be.
There are plenty of 1%ers on both sides of the aisle, hence the blurred lines between the aisles at the top. I don't know how it could be anything other than us vs them. They allow/promote this situation as they do our insane war mongering, our support and alliances with some of the world's most egregious regimes, while undermining democracies. Our life expectancy has actually declined for the 1st time in our history. THEY are drunk with power and pseudo prestige that THEY will never relinquish without a fight. Be it in the courts, ballot booths (which they have also queered), or in the streets. That is why they want our guns and want to militarize our police. Also why they want to feminize our men, suck our young undeveloped minds into their militarism, criminalize and otherwise compromise those who don't adoringly conform.
Thrown in the towel Howard? LOL
Scott good to see some level heads on this topic, Education is key in ending this, Unfortunately, many more will die before any light is seen at the end of the tunnel.