The May 12 article As pill mills fade away, heroin fills the void highlights a predictable trend in drug use, the result of America’s penchant to focus on one drug or another rather than the disease of addiction. The steps that Florida has taken to control the misuse of prescription drugs have been important and, to some extent, successful in reducing such misuse. But they have done little to address the larger issue of risky substance use and addiction.
Addiction is a complex brain disease that frequently involves multiple substances including nicotine, alcohol, illicit and controlled prescription drugs and, perhaps, other compulsive behaviors. At least 16 percent of the population has this disease — that’s 40 million people, more than those affected by heart conditions (27 million), diabetes (26 million) or cancer (19 million).
Another 80 million people, while not addicted, use addictive substances in ways that threaten public health and safety. More than half of those with this disease also are risky users of more than one substance, and about one in five have addiction involving multiple substances. It makes no sense to only treat one manifestation — such as addiction involving pain meds — since it may well be replaced by addiction involving another drug such as heroin.
Instead we must address the disease broadly to avoid a costly game of whack-a-mole, where we clamp down on addiction involving one drug only to see the problem reemerge in the form of another.
Susan E. Foster, vice president and director, Division of Policy Research and Analysis, The National Center on Addiction and Substance Abuse,
Columbia University, New York