A study by Princeton economists Anne Case and Angus Deaton published in 2015 found that the death rate among white Americans has risen for the first time in decades, a phenomenon linked to this crisis. Political analysts think that the election of Donald Trump was partly driven by this population, who feel helpless and hopeless in the face of mounting odds. The woman who found that opioids helped her face the intolerable is now sober, but “now, without them, she was a poor woman in a poor town with a swollen right foot from a 10-hour shift and a new key tag from Narcotics Anonymous that said ‘Clean and Serene for Eighteen months.’”

Women have been particularly hard hit by this epidemic. Across America, they are dying more often, and at younger ages, than ever before. This is especially true for white women—death rates for blacks and Hispanics are continuing to fall. There has been a 400 per cent increase in overdose deaths among middle-aged white females from 1994 to 2014.

Some experts believe that women’s use of alcohol and drugs, while still not as extensive as men’s, has increased in the past several decades as social taboos have lessened. Alcohol is seen as an acceptable and legal substance, and a doctor prescribes drugs, at least initially. What could be more legitimate? Others point to the greater reluctance of doctors to prescribe Hormone Replacement Therapy (HRT) after studies linked it to serious side effects. This has caused some women to search for other ways to cope with their symptoms. Stanford University professor Beth Darnall, who specializes in pain psychology research, says, “When women go through menopause, there are big changes with pain, anxiety and depression . . .. Opioids, taken long term, reduce the level of hormones in the body. This can lead to a greater sensitivity to pain. And it can feed into this dose-escalation cycle.”

No one denies that this is a national crisis—more Americans are now dying each year from addiction than died of AIDS at the height of the epidemic. There is little agreement, however, on how to meet it. While methadone and Suboxone have been proven to be helpful treatments, safer and more controllable than street drugs, many clinics do not offer them. Programs that have been set up to deal with drug emergencies are now facing defunding as Congress threatens to repeal the ACA (Affordable Care Act).

Health-care policy experts, meanwhile, continue to see addiction as a physical disease rather than a complex bio-psycho-social issue with multiple causes—all of which need to be addressed if we are going to fight it successfully. Rehab centers, which often focus on detox, are often ill equipped to tackle the broader issues, releasing their clients to the same toxic environment that created the conditions that led the addict to use in the first place. Many who overdose have been through rehabs multiple times before they finally succumb.

Most addicts don’t recover after their first rehab, and those who do recover usually make multiple efforts before succeeding. While relapse rates are discouraging (they range from 50 per cent to 90 per cent), addicts have no choice but to keep trying. It’s been said, “there are no good heroin stories.” Continued use of opiates, especially when combined with anti-anxiety agents and alcohol (as so many women do) is a death sentence.

Adding to the problem, drug abusers are often condemned by their families and communities. Treating addiction as a moral failing is not only misguided, it is dangerous. Feeling blamed can cause an addict to become even more discouraged and hopeless, and in her weakened state, more likely to keep using. While it is important to give victims a sense of agency and responsibility for their recovery, it is important not to treat them as if the problem is entirely their fault.

No one decides to become a drug addict. There are multiple factors that contribute to each victim’s story, and we are all complicit in creating a culture in which too many people feel as if their chances for a good life are passing them by, while windows onto the lives of the lucky few are constantly available in the media and the Internet.

Not enough is being done to address this issue. Only when it moves to the top on the agenda, as it has been in some states like New York and Maryland, will progress be made, and a national program is imperative. If you or someone you know is abusing drugs, do what you can to be supportive and urge them to seek treatment. The NCADD (The National Council on Alcoholism and Drug Dependence) has information and resources that can help. If treatment options are scarce in your community, pressure officials to change this. Recovery will be slow and difficult, and for many addicts, it may already be too late.

REFERENCES

“Inside a Killer Epidemic,” The New York Times, January 6, 2017    

“Drug Deaths in America Are Rising Faster Than Ever,” The New York Times, June 5, 2017

“Opioids and Anti-Anxiety Medication Are Killing White American Women,” The Washington Post, August 31, 2016   

“The Lonely Road of Staying Clean,” The Washington Post, December 30, 2016

“An Addiction Crisis Along the Backbone of America,” The Washington Post, December 30, 2016 

“An Opioid Epidemic Is What Happens When Pain Is Treated Only With Pills,” The Washington Post, December 23, 2016