Over 60,000 Americans died from drug addiction in 2017, mostly from overdoses caused by illegal drugs such as heroin, cocaine, methadone, and methamphetamine. Yet while much of the spotlight is on the illegal drugs coursing the streets of America, there is a potentially more sinister villain at the center of all of this: misused medication.
Awareness on the dangers of prescription drug addiction has risen extensively, but so has the rate at which they cause deaths. A lot must be done to understand that addiction is addiction, and drug abuse is drug abuse – regardless of who is abusing what drug, in what neighborhood, with what capital.
There is an unbelievable amount of stigma around addiction, and all addicts must struggle with it. But stereotyping and misinformation has framed the issue of addiction around illegal drugs and criminal behavior. But that’s not what addiction is. It is not a consequence of character, or a moral weakness. It is a diagnosable brain disease with severe mental and physical consequences, and a long and difficult treatment process. But like many other diseases, it can be treated, and managed despite its chronic nature.
But nothing will change in the long term without a societal shift in perspective. To truly solve our addiction crisis, we must understand addiction as a disease, and mitigate the factors that develop it. In America, one such factor is the over-prescription and overconsumption of prescription drugs, and the near-ubiquitous American diagnosis and perception of pain.
Drugs Are Drugs: A History
Prescription drugs are prescription-only for the fact that they play a role in causing addiction, since they can be abused to do more than treat a medical condition. Our relationship to these drugs goes back as far as the 1800s, when pharmaceutics began utilizing and effectively marketing opium and opium-derivatives as painkillers and soothing medicine, causing addiction and overdose deaths.
On the scientific and developmentary front, new medicines hit the market and almost immediately became subject to stringent regulation, including tranquilizers as medication, amphetamines, and barbiturates. An unsettling trend sets in across households as housewives abuse the drugs for self-medication, and soldiers get addicted while in combat tours overseas. Synthetic opiates hit the market, more powerful and potent than their natural counterparts.
Since then, many changes have occurred in both the pharmaceutical industry and in law. Government agencies like the FDA have largely squashed the quackery and snake oil salesmanship that openly promoted dangerous and highly addictive drugs as child-friendly medicine, while many drugs that at the time were available over-the-counter are now considered illegal drugs even in personal possession without a medical license, including cocaine, heroin, and morphine.
In the 50s, the Durham Humphrey Amendment set up a clear legal distinction between prescription and over-the-counter medicine, while the government began crackdowns on the smuggling and distribution of narcotics, and the manufacture of both natural and synthetic addictive medicines. Non-addictive medicines, including aspirin and acetaminophens, are exempt from this. Yet despite these efforts, advertisements for addictive medicines as being generally safe continued. Drug addiction created the industry of drug treatment, and rehab clinics started opening across the country starting in the 60s.
The 60s, 70s and 80s saw an explosion in the use of cocaine and marijuana, through South America. Yet while illegal drugs were on the rise and started the panic that sparked the War on Drugs and led to skyrocketing rates of mass incarceration, a rise in prescription drug advertising and a growth in both the perception of pain and pain-related lifestyle illnesses meant Americans started being prescribed more and more prescription medication – including opioids like Oxycontin and Percocet, and benzodiazepines like Xanax and Valium.
Doctors were incentivized to sell patients more drugs than they needed, and profit became an additional motive behind the primary driving factor in America’s lurking addiction to prescription medication – a war on pain. Yet what many doctors did not know was that their efforts to combat pain would later unfold in extremely dangerous ways.
How Medicine Can Kill
Opioids slow down breathing, to the point of respiratory failure, paralysis, and death. Adderall and other amphetamines cause heart issues and can lead to long-term brain damage and stroke. Benzodiazepines can kill through sedation.
Understanding the dangers of addictive substances – regardless of what purpose they serve – is important for solving the drug issue. We need alternatives to addictive medicine, especially in cases where said medicine may not be a good treatment tool to begin with.
America And Pain
It is no coincidence that the United States is going through an opioid crisis at the same rate that perceived pain is on the rise. Not only do Americans claim to feel more pain more often than people in less developed countries across the world, but the rate at which that trend has been growing is relative to the rate at which opioid consumption has increased.
Whether one caused the other, or whether they are both in a tangled relationship, is up to more research to decide. But the facts are that beyond a flawed perception of pain, the American healthcare system still has a flawed perception of pain management. Doctors are too quick to prescribe addictive medication or expensive surgery for injuries, while putting patients through a battery of unnecessary tests further driving up their medical bills. Despite the costs associated with American healthcare, it is often no better or even worse than the healthcare in other developed nations, where doctors are far less likely to prescribe painkillers of any kind, going so far as to teach patients instead to cope with the pain, and work through it as part of a healing process instead of putting them on a slippery slope towards illegal drugs.
Americans are not just reluctant to explore and live with their pain, but they are also at greater risk for chronic pain than others. The decades-old obesity issue does more than increase the American waistline, it also leads to more cases of chronic pain caused by joint stress, arthritis, diabetes, and inflammation.
More Than Just Opioids
Painkillers are not the only kind of addictive prescription drug on the rise. Anti-anxiety medication is in spot number two, as benzodiazepines like Xanax cause overdose deaths to grow, accompanied by an ever-increasing number of patients struggling with anxiety disorders. Amphetamines are also overprescribed – Americans consume more Adderall than any other nation on Earth.
This is not to say that medication and treatment are important in tackling anxiety disorders, chronic pain, and ADHD. Many Americans struggle with mental and physical health issues that are debilitating and rely on medication to get out of bed in the morning and function as human beings. Yet there must be safer alternatives in our healthcare than opiates and stimulants. Billions are spent producing and selling pharmaceutical answers, while therapeutic treatments and mental health facilities are understaffed and underappreciated.
If you’re struggling with an addiction due to a pre-existing medical condition, get help. Your diagnosis does not excuse addiction no matter if it’s to “legal” or illegal drugs, and the two can make each other worse. Addiction treatment today emphasizes the unique nature of each case, and how important it is to treat all underlying issues, rather than focusing on the superficial symptoms.