A few days ago, we met Miki MacDonald, a family nurse practitioner at St. Joe’s Internal Medicine. She talked about how loved ones can support those in their life with a substance use disorder. One thing she touched on was the “why” — why does this happen to some people and not others? There is a genetic theory; upbringing could contribute; social norms are a factor; and traumatic experiences could play a role. The bottom line is that there might be many explanations for why someone turns to opiates.
Vivek Kumar is an assistant professor at the Jackson Laboratory where he uses mouse genetics to study behavior and behavioral abnormalities, including addiction, ADHD and depression. Kumar wrote an informative OpEd recently on how we should use science to understand addiction. He is clear about one thing: Addiction is a chronic illness. He compares addiction with two other chronic illnesses: diabetes and hypertension.
Roughly 40 percent to 60 percent of addicts will stay clean 12 months after entering treatment. Similarly, 30 percent to 70 percent of diabetes and hypertension patients will experience reoccurrence of symptoms within a year of treatment onset.
However, the key difference is how this is perceived. In the case of diabetes and hypertension, the fact that treatment suppressed symptoms is considered a success, even if the symptoms reoccur. But with addiction, the reoccurrence of symptoms is seen as a sign that the treatment has failed.
Finally, there is a massive discrepancy in access to treatment. Imagine if insulin treatment for diabetics were abruptly stopped because of a state mandate, if diabetics had to drive two hours to receive a shot of insulin, or if their treatment facility suddenly shut down. This is exactly what addicts are experiencing in Maine. Furthermore, many insurance companies cover acute detox and stabilization but provide limited or no long-term treatment options for this chronic condition.
Addiction is a chronic illness, with genetic, environmental and social aspects that are similar in scope to illnesses such as diabetes or hypertension. Why should one be treated as a social and moral failure while the other is a medical issue? As the neurobiology and medical communities make very clear, addiction is a chronic disease, and its treatment needs to mirror that of other chronic diseases.
We hope you take a few moments and read this article. We thank Kumar and all the folks at Jackson Laboratory working on such important issues and changing the way we think about things around us.