KEVIN LEININGER: Is opioid abuse an ‘addiction’? Apparently not, which may be part of the problem

Allen County has a needle exchange program similar to this one in Austin, Ind. (AP photo)
John Crawford
Kevin Leininger

After Fort Wayne and Allen County governments joined the wave of lawsuits against the makers and distributors late last year, County Commissioner Nelson Peters said he didn’t want to minimize the need for personal responsibility but justified seeking legal relief because “It’s not fair to the taxpayers to support a problem that may have been caused by the manufacturers.”

A report released Wednesday by the Community Research Institute at Purdue University Fort Wayne places the direct and indirect cost of opioid abuse in Allen County at $1.1 billion since 2003. But for all its chilling statistics and worthwhile recommendations, the report also reflects society’s unfortunate tendency to redefine a problem in search of a solution.

Is “the stigma, shame or judgment associated with” drug use “a barrier to seeking treatment and recovery (that) isolates people from family, friends, neighbors and the larger community when they may need help the most”? I don’t don’t doubt the experts who helped craft the study, but its embrace of terminology recommended by the Office of National Drug Control Policy masks both the severity of the problem and the ability of individuals to avoid becoming statistics.

“Abuse. Addiction. Overdose. Junkie. Clean. Dirty. Habit. These have all been terms used to refer to people using and misusing substances in the past 50 years,” the study notes. “However, medical and mental health professionals are moving away from these words and reclassifying how we talk about drug use to reduce stigma and make it person-first. Hence “addict” becomes “person with substance abuse disorder,” “clean” becomes “abstinent” and “dirty” becomes “actively using.”

Notice the not-so-subtle shift: While a word like “addict” places blame on the individual, changing an addiction to a possibly unavaiodable medical or psychological “disorder” absolves responsibility. If use of kinder, gentler terminology could solve the problem, all well and good. But, obviously, it’s not that simple — especially if individuals using drugs get the idea they have no power to control the outcome.

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City Councilman John Crawford was the guest on my “Fort Report” TV show last week, and as a Republican mayoral candidate next year he intends to focus on four key points, including opioid abuse. A physician, Crawford agrees with many of the report’s recommendations, especially the need for more treatment options, including those that use drugs such as Methadone to wean users from opioids. “Thirty years ago doctors were villains (because they didn’t prescribe more pain medication). Now prescriptions are going down but deaths are going up,” he said.

Why? We can debate that, he said, but “personal responsibility is 100 percent (important).”

Is addiction really a disease? Perhaps. But it usually is also a disease that, in the beginning at least, is subject to some degree of willpower. Smoking, remember, has been linked to lung cancer since at least 1950, and the U.S. Surgeon General made the connection official in 1964. People willingly continued to smoke nevertheless, but that didn’t protect the tobacco industry from a $206 billion settlement with 46 states in 1998.

The point here is not to blame or vilify drug users but to point out that neither addiction nor recovery can be totally passive. The cure to this crisis must be a joint effort not only among service providers, but between those providers and “persons with a substance abuse disorder” who actually want to cooperate in their own recovery.

The study, interestingly, acknowledged the need for both external and internal effort even as it talked about the dangers of stigma. “Some African-American pastors or lay faith leaders,” it stated, “fail to see (opioid use) as a medical condition but rather as a moral failing that can or should be solved through prayer alone rather than prayer and faith being part of a larger treatment and recovery plan.”

Exactly. Not either-or, but personal responsibility and corporate concern — and maybe even divine intervention. Otherwise, this effort really will require a miracle to succeed.

This column is the commentary of the writer and does not necessarily reflect the views or opinions of The News-Sentinel. Email Kevin Leininger at kleininger@news-sentinel.com or call him at 461-8355.


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