May 26, 2016

Addiction to narcotic pain pills like opioids is much in the news. It should be. In a series of lectures titled “The Addictive Brain” Professor Thad Polk of the University of Michigan tells us that “Addiction is a modern-day epidemic. More than 500 people die every hour as a result of an addiction-related disease or an overdose, and addiction is estimated to cost the United States more than 600 billion dollars every year in health-care costs, lost productivity, and crime. Families are destroyed, careers are lost, and lives are wasted.”

While addiction is a problem, society’s response to the problem is often equally problematic. Here is an excerpt from a U.S. News and World Report article titled “Painful Shadow of Prince’s Death” by Lloyd Sederer, the chief medical officer of the New York State Office of Mental Health.

“When someone like Prince or Philip Seymour Hoffman or Michael Jackson needs painkillers, there are doctors for hire or high-end drug dealers who deliver. But when everyday folks, on limited incomes, crave the opioid analgesia to transiently depart from physical and psychic pain, they can turn to Imodium or find a street corner dealer who is peddling heroin. The supply of these and many other drugs of abuse is seemingly endless: It has been for centuries, and there is no evidence that it will dry up in the future, despite whatever futile wars on drugs we have waged.

“In recorded history nearly every society and culture on this earth has employed intoxicants. People use drugs, and they find ways to get them if the getting gets tough, including using impure and toxic substitutes. What seems to be missing from policy analyses is the recognition of how effective these drugs are, which is why they endure and survive despite extravagant campaigns against them. Remember Prohibition in the U.S.? Other than spawn speakeasies and the mob, what did that constitutional amendment accomplish?

“The unwavering attention to consequences and control not only has been vastly ineffective, it has overshadowed attention to the reward aspects of drug use, both legal and illegal. Opioids and other intoxicants like alcohol, tobacco and stimulants establish hegemony over our brain reward superhighways. They pirate the brain’s reward system, as National Institute on Drug Abuse director Dr. Nora Volkow has said. They satiate our wish for bliss and powerfully alleviate mental and bodily pain. They satisfy our emotional hunger, chill out our gloom, deliver some semblance of peace, bridge the void of human disconnectedness and quiet the throbbing, debilitating pain in our backs, necks and joints. These are the needs that won’t go quietly away, to which we can’t simply “say no.” Asserting and lamenting the consequences of drug use and abuse, including dependence, withdrawal and death, seems to be an automatic response from most everyone I talk with. But a focus on these negatives has had no discernable effect on diminishing their use. We must do better than that. The drug epidemic keeps growing, as does the body count.

“So what is there, other than pills and needles, to meet human psychic and physical needs, and reward cravings? We need more than parroting their consequences and futile control efforts to succeed in changing addictive behaviors. The answers ahead may be found in neurocircuitry and electrophysiology, eastern yogic practices, religion, art, culture, family, community, nutrition and what we have yet to learn. Those are areas where we need to turn our attention and give respect to the power of what psychoactive substances can do – in order to see legal and illegal drugs take a backseat in this century’s news clippings.”

At the risk of greatly oversimplifying what Dr. Sederer is saying, I would note that spiritual practice is a potential partial answer to addictive behavior. Thus, I close by sharing this prayer from the Episcopalian Book of Common Prayer:

“O blessed Lord, you ministered to all who came to you; Look with compassion upon all who through addiction have lost their health and freedom. Restore to them the assurance of your unfailing mercy; remove from them the fears that beset them; strengthen them in their work of their recovery; and to those who care for them, give patient understanding and persevering love. Amen.”

Peace,

Jim H.