Addiction is classified as a mental illness by the American Psychiatric Association and viewing it as such has a profound effect on the treatment of those suffering from this epidemic. When it comes to prescription pills and opioids, viewing addiction as a mental illness helps to eliminate the stigma surrounding this disease, making it infinitely easier for victims to seek and receive help. In many areas, opioid addiction is seen as a plague, and the community almost shuns anyone who falls prey to it. This only forces addicts deeper into the hole of chemical dependence and further down the spiral of depression. Merely changing the way we look at opioid addiction could be one of the keys to eradicating it once and for all. When addiction is viewed as a mental illness, it becomes obvious that those suffering should have access to proven medications, access to care in the emergency room and the cost of treatment covered by health insurance.
Only 10 percent of those with a substance use disorder receive specialty treatment for their addiction, according to the 2016 surgeon general’s report. This is because, in many cases, local treatment options don’t exist, or they’re unaffordable and have long waiting periods.
Imagine that someone suffering from heart disease was only able to get access to treatment 10 percent of the time. Ninety percent of Americans would have to suffer and even die from the disease, a condition that can be treated with medication and a doctor’s care. Someone suffering from heart disease could walk into an emergency room or doctor’s office only to be told they don’t have the necessary means to treat them, or that they don’t accept patients with their condition. Imagine having a heart attack and then being told you have to wait months before receiving treatment for your illness. A public health emergency would quickly be declared, and legislation would be demanded to close these gaps in coverage. While this seems a dramatic comparison, it’s the reality of drug addiction, and year after year overdose deaths break records.
The combination of stigma and misconceptions surrounding addiction are the main reason for the barrier to receiving treatment. Addiction is seen mainly as a moral failing; addicts choose to be addicted. Someone with diabetes or lung cancer does not decide to become sick, even though those conditions are often caused by a choice made by the sick party.
Addiction and dependence on a substance begin in the brain. Addicts feel as if their drug of choice is comforting, providing their mind with the inner peace they so desperately crave. This is one of the defining traits that makes opioid addiction a mental illness. Even with physical side effects and withdrawals, addiction is primarily a psychological process. There should be no stigma surrounding addiction, just as there shouldn’t be one regarding any form of mental illness. Those with depression or bipolar disorder are not subjected to the same subhuman treatment that addicts are. There is no reason that we can’t identify and sympathize with our fellow human beings, just because they have fallen prey to their own mental illnesses and developed an addiction to a specific substance. It is no different from the dependence on caffeine that some coffee drinkers are guilty of or addiction to cigarettes.
The most effective medications for opioid addiction are buprenorphine and methadone. These medications lessen the rate of all-cause mortality by half or more among opioid addiction patients and do a better job of keeping patients in treatment compared to non-medication approaches. With any other disease, preventing access to medication that halved death rates and proved more effective than any other type of treatment would be immoral and unethical. But with addiction, many people question the use of medication for treatment. It’s often seen as replacing one drug addiction with another. Because addiction isn’t seen as a mental illness, people dispute the simple fact that medication is used to treat illnesses.
Modern health care still does not do enough for the mentally ill, much less victims of addiction. The stigma and misconceptions run as deep as the American health care institutions. Many addicts will be turned away for treatment, after having been prescribed the very medicine they have grown addicted to.
Under federal law, health care providers must attend special courses to be able to prescribe buprenorphine. Forty-seven percent of counties in the U.S., 72 percent in the most rural counties, have no physicians that are certified to prescribe buprenorphine. Nationwide, only 5 percent of doctors can prescribe the medication. The vast majority of emergency rooms do very little, or nothing, to treat addiction. Only one state prison system offers the three medications that treat addiction. Many health insurers refuse to cover the cost of these medications. After recent reforms forced Medicaid to boost their reimbursement rates for addiction treatment, there was an increase in the number of people receiving treatment and a decrease in the number of ER visits for opioid use disorder.
Fixing the opioid crisis is not something that will happen overnight, but the first step is changing the way we view addiction and addicts.