Addiction is an issue which crosses racial, gender, socioeconomic, and other imaginable societal lines. During my time in Cleveland, I interacted with individuals struggling with addiction from all different walks of life. There were those who came to mind instantly: homeless men who lost everything and women forced into prostitution in order to support their habit, but there were also persons that hit much closer to home. Suburban moms would pull up in their minivans and swap out needles at the syringe exchange van. People not much older than I am, who grew up in stable, wealthy families would be in therapy to receive prescriptions for ongoing medically assisted treatment. One of the men who entered into drug court had a Master’s degree and went in less than two years from successfully owning his own business to living out of his car and being homeless. It is easy to cast a blanket over all addicts and define them by their drug of choice, to believe that all of their addictions were born out of their poverty or poor choices, but it is only when you’re able to sit down and talk with them that you begin to realize that there is no one path to addiction. Oftentimes our perception that addiction stems from poverty needs to be reversed, it is far more common for addiction to lead to poverty or make it that much more difficult to escape. More importantly, not only is there no one path to addiction but there is also no one path to recovery and sobriety.
My internship provided me the opportunity to see addiction throughout all of its phases. I was able to interact with clients at the syringe exchange van who were actively struggling with their illness and wanting to get clean but lacking the resources to do so. I saw the dramatic difference between the miserable looking clients in the detox ward at Stella Maris, a chemical dependency treatment center, and their healthy looking counterparts who had been sober for weeks and months in Stella’s residential facility and were working tirelessly to get their lives back on track. Similarly to Stella, I witnessed individuals in drug court who came to treatment through legal force in order to avoid punishment. Although drug court participants go through similar treatment to those who came to the decision to get clean on their own, they have the added layer of accountability through the courts as a crutch, if they need it, and as a looming threat of legal action, if they continue their ways. I was able to sit in on sessions with a psychiatrist, Dr. Streem, who would provide his patients with their medically assisted treatment prescriptions for Suboxone in order to help them fight cravings that linger despite years of sobriety. Through it all, I saw that a battle with addiction is a lifelong struggle. Individuals may be sober for years and addiction may appear far in the rearview of their life, but it is always with them. Addiction is a disease that sticks with persons for a lifetime, and relapses can occur no matter how many years of sobriety they have, which is why support from groups like Alcoholics Anonymous, Narcotics Anonymous, Heroin Anonymous, and practicing the twelve steps from the Big Book are important in maintaining sobriety.
A large portion of today’s heroin addicts began through use of prescription pills, many of them from legitimate prescriptions for injuries or pain after surgeries. The man with a Master’s degree in drug court hurt his back lifting weights and was given a short term prescription of OxyContin to deal with the pain. He developed an opiate addiction shortly thereafter. Increasing governmental oversight and scrutiny forced doctors to begin cutting back on prescriptions and those who had grown dependent were not offered any assistance for dealing with the fact that they had been receiving long term opioid prescriptions and were then totally cut off. They had no other alternative than to obtain their previously prescribed drugs through illegal means or try to reach sobriety on their own, which can be a herculean task. Ultimately, street drugs like heroin, which are almost chemically identical to prescribed opioids, became cheaper alternatives to often difficult to obtain and expensive illegal prescription drugs. This was the option the man in drug court took.
Many people don’t see the far reaching impacts of opioid addiction and its costs to society. People think of addicts costing money by going to the emergency room to be resuscitated after an overdose or being revived by law enforcement with Narcan, a drug that reverses opioid overdoses, but they fail to see the bigger picture. They don’t think about the abscesses caused by injecting with dirty, used syringes or the heart valve infections they contract that require open-heart valve replacement surgery. They don’t realize that individuals infected with HIV, which is highly transmissible in the IV drug using community, are guaranteed funding for medication they cannot afford by Ryan White legislation, regardless of how the HIV was contracted. The cost of this HIV medication is $3,000 per month for the rest of a person’s life. Moreover, addicts out of work have no taxable revenue and are potentially on other forms of government assistance. A large portion of these costs will be paid for by the taxpayers, so it is troubling when people are hesitant to put money into programs that aim to aid addicts in their journey to sobriety rather than punish them for their addiction. We, unfortunately, appear to be more reactionary and punitive than preemptive and curative when it comes to dealing with addiction, although the situation is slowly getting better.
The vast majority of people have a preconceived idea of what heroin addicts look like—degenerates who steal from and abandon their families, can’t control themselves, and lack the moral fortitude to kick their habit. It can be easy to look down upon addicts when viewing them from afar. On the surface individuals battling addiction are, for the most part, burdensome to society, potential risks to others, and overall unpleasant to deal with. It can be tempting to try to keep them away from society, to lock them up, and to let them to deal with their issues on their own. However, these archaic methods of dealing with addiction have failed society for decades. It is time to look at those battling addiction as individuals suffering with a disease in need of treatment. When we begin to put a face and a story with an addict and view them as fellow humans, not just crime statistics on the news, we see just how present the issue is and how quickly it can become a part of our lives.