Pills and needles: Addiction in your Neighborhood
For many of us, when we think of intravenous heroin use a stereotypical image of a “junkie” comes to mind. Reality tells us this is simply no longer true. Sure, there are people who use heroin who would fit into that image, but there are also hundreds of thousands of other people who use heroin who look like you. They live in our neighborhood and have jobs. I used to think there was a chasm between opiate pill use and shooting heroin. Actually, it’s just a hop (opiate for pain prescribed by a doctor), skip (doctor shopping then buying pills on the street), and a jump to intravenous heroin use. Increased awareness and treatment breakthroughs in HIV treatment may have had an unintended consequence of lessening the fear of IV drug use. The young people coming of age today have a different view of the disease than those who grew up in the 80s and 90s. Heroin is cheaper and readily available, so once physical dependence sets in and a tolerance level develops, people shift fairly easily from pills to needles.
Heroin use has skyrocketed in recent years. Nationally, heroin use increased by 79% from 2007 to 2012, according to the federal government’s National Survey on Drug Use and Health. Statistics about the increase in use are not nearly as shocking as the number of people who are dying by overdose. Philip Seymour Hoffman’s death by accidental overdose spurred on an existing conversation about the heroin epidemic bringing it into the mainstream population. A recent Washington Post article pointed out that Hoffman’s death was one of approximately 100 deaths by overdose that day. One hundred people are dying each day by overdose. It deserves repeating and leads to inevitable questions such as why aren’t we doing more? Let’s back up and start with: why aren’t more people even talking about this? I would speculate that one of the reasons is the moral judgment lingering around issues of addiction. Even though we know much about the brain and have evidence to support the fact that addiction is a disease, many still attach a “they get what they deserve” attitude to people who die by overdose. Speculations in the Post article also suggest that, because addiction remains stigmatized people are isolated in pockets, and, as a result, are not galvanizing as a group to take action. Positive developments are occurring such as the Prescription Monitoring Program to prevent doctor shopping which allows for earlier intervention and treatment. Whether you are in recovery or in need of treatment, another powerful way to de-stigmatize the disease of addiction is to come forward. Stereotypes fall away when a problem affects someone we know.