New Methods of Drug Addiction Treatment Needed

The effects of drug addiction are far-reaching, both on the addicted and on those around them. The costs to society are enormous; the cost to individuals is devastating, both to the addict and to their families and loved ones. The reasons for addiction are unclear. The result is abundantly evident.

Specific addictions create adverse health conditions, some more pronounced than others. Most drugs, including alcohol damage the liver and can lead to cirrhosis or cancer. Amphetamines and opiates both cause long-lasting changes in the brain that may be impossible to overcome. Methamphetamine in particular is noted for the obvious damage to the teeth due in part to repression of saliva production and the acidification of the mouth. Part of the severe tooth damage seen in meth addiction may also be due to the tendency of the addict to grind his teeth subconsciously as a result of the high state of agitation and tension experienced while under its influence.All addictions can result in accidental injury or death both from overdose and from engaging in risky behavior due to impaired judgment. Heart, lungs and vascular systems can all be adversely affected by addictive drug use and result in long-term disability and death.

The effects of addiction on the immune system are not well understood. It is evident, however, that drug addiction plays a part in the transmission of such debilitating diseases as HIV-AIDS, Hepatitis C and more recently, MRSA. Intravenous drug use and the sharing of needles increase the possibility of exposure to these blood-born pathogens and to infections due to unsterile needle use. Impaired thought processes and the overwhelming craving for the drug of choice prevent the addict from appreciating and acting upon the need for caution and sterility. Methamphetamine use in particular carries with it behaviors related to sexual compulsion leading to unprotected and risky sexual behaviors and the risk of sexually-transmitted disease.

It matters little if the drug of choice is an illicit compound or a prescription medication. In fact, there are many instances of full-blown addiction to substances which appear to have no physically-addictive properties. An addiction appears then to be first a psychological disorder and secondarily a physically addictive disorder. Unfortunately, our over-emphasis on the addictive qualities of certain substances has obscured the issue of psychological indicators in substance abuse and has ultimately limited the ability of physicians to prescribe adequate pain relief to patients who need it most. Oddly, the fact that patients prescribed high levels of addictive drugs for pain management seldom develop addiction to the substance shows there is, apparently, no underlying psychological anomaly to predispose toward the addictive behavior in the many cases of users who are not abusers.

The psychological effects of addiction are both well-known and poorly understood. There may well be a psychological pre-disposition of some individuals to drug abuse including alcohol. Current research is discovering that the patterns of abnormality in both psychiatric illness and drug addiction are in many cases the same, leaving open the question as to whether a genetic brain abnormality may predispose the individual to one or both. It is well-documented that persons with diagnosed psychiatric illness are overly-represented among the drug abusing population. This fact is the reason some mental health and substance abuse systems have begun to treat patients as being dually-diagnosed for both conditions and to integrate treatment programs to address both problems. Unfortunately, change is slow to come in entrenched treatment models. In the past, treatment was withheld for psychiatric disorders until substance abuse was under control and that model is still the majority policy in treatment. Withholding psychiatric treatment prevents all but the psychologically most healthy from overcoming the addiction and assures drug addiction treatment will grow exponentially in the foreseeable future with limited success.

Government assistance and insurance payment is almost non-existent for dual diagnostic models, although it is becoming more prevalent. Of course, only a small percentage of drug abuse patients are covered by employment-based or private insurance and even partial public funding tends to concentrate on populations that can pay at least part of the cost. Public efforts at keeping costs down now insure an ever-increasing future cost as the same poorly-treated indigent patients are treated again and again with the same ineffective methods.

The strictly physical result of drug addiction is insidious and progressive. Addicts tend to forego nutrition in favor of drugs or alcohol, thus depriving their bodies of vital nutrients. The onset of disease from such deprivation is slow and may not be evident to even the attending physician as he is trained to look for pathological causes of disease.

The healthy human body usually carries a reserve of important vitamins and minerals if the mother was sufficiently healthy and well-fed before birth. The nature of nutrition is that these reserves are replaced via the diet in the normal individual. A person's capacity to utilize these nutrients is optimal in children and young adults but decreases with age. Drug addiction usually manifests in adolescence. Therefore, the effects of nutritional deprivation often do not appear until the addicted individual approaches thirty and beyond.

As these individuals are often among the homeless population, providing them with barely adequate nutrition is not enough: replacing years of lost nutrients to remedial level requires remedial dosages. Soup kitchens and food banks do the best they can do with donated goods and cant hope to provide balanced nutrition to their target populations. Providing the remedial dosages of vitamins, minerals and amino acids needed to nourish both the body and the brain of an addict is impossible, given the current model. Disease that results due to inadequate reserves of nutrients adds another cost, that of costly medical care for chronic disease, to the societal cost of caring for drug addicts.

Studies show that the majority of addicted individuals eventually end up homeless for varying periods of time. As society struggles to solve the problem of homelessness, a major underlying cause-addiction-is inadequately treated. In such as scenario, costs can only continue to rise or society can absolve itself of responsibility for its less-fortunate citizens.

Unfortunately, the latter seems to be what society is doing as they do not see the relationship between good mental health and addiction. The amount of self-control and will power an individual has personally has absolutely nothing to do with that possessed by others. The moral judgments placed against the addicted may reflect anger at the true costs to society, but such judgments do nothing to solve the problem. And solve the problem we must as we have managed to do very little to solve the problems of addiction even though we have spent billions of tax dollars and incarcerated millions in the name of the 'War on Drugs'.

Obviously, we must come up with better methods to address the problem of drug addiction. An effective program is going to require a complete overhaul of existing systems and treatment modalities. A comprehensive, humane and systematic approach will have a large initial outlay of tax dollars and will be a hard sell both to politicians and the public. Long-term, a system of adequate mental health care, effective drug treatment and supportive follow-up care including adequate access to housing, food , medical care and job training should reduce 'drug war' costs commeasurably and pay for itself in the long run.