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(SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities.

 

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This popular claim lacks evidence and leads to poor policy.

The notion that drug addiction is a brain disease has become axiomatic. Around the globe aspiring health professionals treating substance abuse are indoctrinated with this belief, especially after the idea became popular in the 1990s. Its popularity extends far beyond the hallowed halls of academia. Both the May 1997 Time and the September 2017 National Geographic magazines were dedicated to the brain science of addiction. Numerous other popular magazines have run similar cover stories over the past two decades.

But after 20 years of research, one of us (Hart) saw that paradigm yielding dismal results. Meanwhile, behavioral research on outcomes after providing both animals and humans with attractive alternatives to drugs has yielded positive results regarding effective treatments, despite the lack of mainstream attention.

Despite this seemingly solid scientific consensus, there are virtually no data in humans indicating that addiction is a disease of the brain in the way that, for instance, Huntington’s or Parkinson’s are diseases of the brain. The existing paradigm is based on intuition and political necessity, not on data and useful clinical results. Yet the diseased-brain perspective has outsized influence on research funding and direction, as well as on how drug use and addiction are viewed around the globe. This situation contributes to unrealistic, costly, and harmful drug policies: If the problem is a person’s neurobiological state after exposure to a drug, then either the drug must be eradicated from society through law enforcement or an individual’s brain must be treated. In such a myopic approach, the socioeconomic and societal factors that contribute to drug addiction are considered a footnote in research, clinical practices, and policy, despite their apparent importance. (see also DRR: Dealing With Addiction)

For complete Research Paper go to American Scientist – Is Drug Addiction a Brain Disease?  

Cocaine’s effects on the heart can cause both immediate emergencies, such as a heart attack, and long-term damage.

Cocaine’s effects on the heart can cause both immediate emergencies, such as a heart attack, and long-term damage.

Regular, long-term cocaine use significantly increases the risk of heart disease. For people with pre-existing heart health problems, even short-term cocaine use may elevate the risk. These risks include…

Coronary artery disease

Higher blood pressure

Damage to the structure of the heart

Heart arrhythmias

Chest pain

Congestive heart failure

Heart attack and stroke

For complete article

In recent decades the range and patterns of opioids used for extra-medical purposes have changed. The use of pharmaceutical opioids exceeds the use of heroin. In 2017, 63 percent of opioid deaths were attributed exclusively to pharmaceutical opioids, 28 percent to illicit opioids and 8 percent to both illicit and pharmaceutical opioids (aged 15-64 years).

The objective of this report was to estimate the social costs arising from extra-medical opioid use in Australia for the financial year 2015/16. Due to data limitations in most cases we only estimated the costs occurring in this 12-month period. For example, on-going care of chronic conditions was not included. The exceptions to this were for certain harms which occurred in 2015/16 but which had longer-term ramifications, for example premature deaths, where discounted streams of future costs (lost economic activity and lost contributions to household chores) and partially offsetting savings (future health expenditure ’avoided’ by premature deaths) were estimated. The authors also included the long-term costs of road traffic accidents, as were the expected future costs of opioid attributable imprisonment for those sentenced in 2015/16.

For complete report go to APO - Quantifying the social costs of pharmaceutical opioid misuse

Policy Reflection – Dalgarno Institute: The misuse of OST (Opioid Substitute Treatments) or MAT (Medically Assisted Treatments) or any other pharmaceutical displacement mechanism that does not have a sunset clause to usage, will continue to be a major contributor to both morbidity and mortality. This can either occur over a longer time simply due to the toxic nature of persistent opioid use on the human biological unit; or short term, by direct  misuse of the legal opioid for ‘recreational’ or self-harming purposes, by either the client or their network. 

This growing issue continues to be overlooked or deliberately discounted by certain sectors. Which means that this, arguably well-meaning, but poorly implemented ‘harm reduction’ mechanism continues to add to the drug using cohort and the increasing harms this ‘pairing’ collectively bring. 

The net result of a no-exit, perpetual use of opioids, whether licit or illicit, only causes harm, the very thing the policy pillar was supposed to reduce.

If sunset clauses and exit strategies are not harnessed to these chemical mechanisms, then we will only see these harms grow, along with an ever-burgeoning pressure and cost to the health-care system. This is not best practice health care, and no longer rates as a positive ‘net community benefit’ economic rationale either

Reducing drug use is the primary objective of the National Drug Strategy, and in both its intent and specifics does not promote, or we would argue, condone this policy and people failing measure.

Drug use exiting recovery is not only possible, but consistently achieved when actively facilitated in its best practice format too. 

We will leave you with a very provocative quote (now 14 years old) but perhaps even more relevant today? A statement that could have only been published then, but with the  ‘cancel culture outrage’ in play at present, may well be ignored now and for the very reasons it confronts.

“The medical profession and the addicted community have a complex, symbiotic, mutually dependent relationship that does none of us any good. Basically, they pretend to be ill and we pretend to treat them. And thousands of public employees make a good living out of it. Prescribing for opiate addicts is like throwing petrol on a fire; pointless, counterproductive, stupid, self-defeating. And yet we keep doing it.”

Dr Phil Peverley, PULSE, 22 June 2006

As of January 7, 2020, a total of 2558 hospitalized patients with nonfatal cases and 60 patients with fatal cases of e-cigarette, or vaping, product use–associated lung injury (EVALI) had been reported to the Centers for Disease Control and Prevention (CDC).

CONCLUSIONS: Chronic conditions, including cardiac and respiratory diseases and mental health conditions, were common among hospitalized patients with EVALI.

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