How I think about the drug problem

There is something drastically wrong with a society in which 70,000 of its citizens die every year from something they voluntarily do to themselves.

I’m writing of course about the so-called “opioid epidemic”. The very term itself is a distortion of the language: an epidemic is a contagion that comes from without, an organic disease that infects a person without the person asking for it.

The misuse of the word “epidemic” is another example of how human behaviors have been converted into medical problems. The same thing has happened with alcoholism: it is now spoken of as a “disease”, again distorting the older meaning of the word.

In both cases, the traditional understandings of these words don’t seem to square up with the medical models now proposed. Most people, myself included, think of epidemics and diseases as something you would never wish upon yourself. But drug and alcohol deaths result from conscious and willful actions taken by an individual. So lumping these tragedies in with cancer, strokes and heart attacks is taking the medical model too far.

Or put another way, drug and alcohol deaths have some mental or character component for which the medical model is totally ill-prepared to handle. Thus, a medical solution is not going to “cure” the problem.

In writing this, I understand that there may be an underlying genetic or hormonal component to these addictions, so that once a person gets started, he can’t stop. In this sense, the addiction is not “voluntary”, as we ordinarily understand that word. I have spoken to people who have overcome alcoholism, and they tell me that the urge to have a drink becomes overwhelming, despite getting sick, wasting through earnings, ruining close relationships, and so forth. Reasonable thought about the drink is simply impossible.

So of course, the question has to be asked, “Why would anyone continue with a self-destructive behavior?” Why does anyone “need” the sensations induced by drugs or alcohol, especially when they lead to terrible aftereffects?

Trying to answer these questions must take you into the strange byways of the mind, into the netherworld of compulsions, self-destruction and other psychological realms that no one really understands.

This conclusion hit me really hard in a conversation I had with a pastor who was trying to help what he described as a “beautiful young woman, pretty enough to be a model”. She was so addicted to opioids that she had run out of space on her arms to inject herself. Her solution was to pull out her eyeball and put the needle into the space behind. This horrid detail convinced me that thinking of the opioid “epidemic” as a medical problem was going to be of limited value, if not ineffectual altogether.

Can anyone say honestly they would know how to help a person who pulls out an eyeball to give herself a drug injection?

Right now, our culture seems to be oscillating between a largely futile attempt at medical interventions, psychotherapy treatments, and just plain criminal solutions such as jail time. Whole industries have sprung up like mushrooms to “treat” opioid users, who are now suffering from “substance use disorder”, the new, kinder-gentler term for drug addiction. The whole calamity is becoming normal, and a successful growth industry.

I can’t go there. I refuse to accept this dreadful waste of human life. In my next posting, I will advance my own solutions, which will be pragmatic, straightforward, quite harsh in some ways, and quite compassionate in others. Stay tuned.


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