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.
Lorne Cross, MD is a healthcare professional from Portland, Oregon, who specializes in Addiction Medicine. It’s no secret that the United States is facing an opioid crisis. There are more lives lost to overdose deaths each year than were lost in the entire Vietnam War, and new data shows that opioids now kill more people each year than breast cancer. Understanding and treating the opioid crisis is of utmost importance to this country, and Dr. Cross has chosen to specialize in Addiction Medicine and focus all of his professional attention on this critical problem.
As the Medical Director of the Willamette Valley Treatment Center, Dr. Cross is the leader of a team that provides Medication Assisted Treatment to patients with Opioid Use Disorder. Lorne Cross, MD also serves as the Medical Director of a new Opioid Treatment Program in the Yamhill County Jail. Focusing on the treatment of opiate addiction, rather than punishment, can help to prevent relapse, decrease the rate of overdose deaths, and help to lower recidivism in the jail population, putting inmates on the right path upon release. Giving patients a path to recovery ultimately sets them up for more success in their futures.
Dr. Cross is hopeful as he looks into the future of treatment opportunities for opiate addiction. He sees the expansion of treatment into jails and prisons as a necessary step towards treating the opioid crisis and preventing unnecessary overdose deaths. Treating addiction with a rehabilitative approach is one of the best ways to reach out to those who truly need it most.
Senior Medical School Class Officer
Scholastic Honors Program Graduate
John Philip Sousa Award 1988
Years' Experience in Healthcare
Years Serving as a Major in the U.S. Army Reserve
Published Research Articles
From the time he was a child, Lorne Cross, MD was always fascinated by medicine and the natural sciences. By the time he reached college he knew he wanted to attend medical school and pursue his medical degree. He graduated in the top third of his class from Loma Linda University School of Medicine and completed his medicine internship and his anesthesiology residency at Loma Linda University Medical Center. Loma Linda University is a coeducational health sciences university located in California. He is also a Magna Cum Laude graduate of the Scholastic Honors Program at Southwestern Adventist College, where he earned his Bachelor of Science in Biology. Southwestern Adventist College is a small college, with an undergraduate enrollment of around 800 students, located in Texas.
Outside of work, Lorne Cross, MD likes to maintain an active and healthy lifestyle. He is an avid cyclist and bicycle racer, while actively pursuing many other sports. Outside of spending time exercising, he also loves to travel to new locations and spend time with his two teenage children and family.