As a person personally and professionally involved in changing the conversation about substance use disorders and the opioid epidemic now taking the lives of so many, I was deeply disappointed in the HBO documentary, “Heroin: Cape Cod, USA,” which aired on December 28, 2015. Since HBO has produced many documentaries with Dr. Nora Volkow: http://www.hbo.com/addiction/understanding_addiction/12_pleasure_pathway.html educating us about addiction as a brain disease, I was shocked they would produce a portrayal that only focused on the problem and offered no solutions.
As defined, a documentary is supposed to give us the facts about a specific event or person. This documentary did point out one fact: those who suffer from the disease of opioid addiction can come from affluent homes and neighborhoods – but that’s all it did! No other facts were offered about opioid substance use disorder or the treatment of this brain disease. It was just another television expose’ focusing on the negative drama of the illness. At the end of the program it gave less than three minutes to one young woman who was experiencing a successful recovery without giving any specifics about her treatment except to say she was attending Narcotics Anonymous meetings. The remaining 60 minutes of the program focused on the devastation of the illness for the other young people. No solutions or pathways for recovery were ever offered. This kind of programming is what keeps us focused on the wreckage of the illness, and fuels the stigma, shame, and ignorance about the disease instead of focusing on the solutions and hope of recovery.
Some solutions to consider: As seen in the documentary, opioid addiction can happen quickly and is gripping. Many people can benefit from treatment that involves the use of the medications methadone, Suboxone, and naltrexone as be part of a multi-faceted, long-term treatment often needed for opioid addiction. Research shows that these drugs used as medication-assisted treatment (MAT) are most effective in preventing relapse when they are part of a treatment protocol – not the stand alone treatment. This is where the system failed my son, Aaron. If he would have had services along with MAT, i.e., recovery coaching, therapy and job and housing support he would have had a much greater chance of surviving. Long-term treatment means anything between 90 days to three years; it needs to be individualized. There is no cookie-cutter treatment for opioid substance use disorder.
Supporting the Comprehensive Addiction and Recovery Act of 2016 (CARA) and enforcing the Mental Health Parity and Addiction Equity Act of 2008 will help provide the long-term recovery support so desperately needed with opioid addiction. The CARA Committee has not yet formally announced the hearing or witnesses. It is great to know there are now 68 bipartisan cosponsors in the House and 21 in Senate, with Vermont Senator Leahy the most recent to sign on. And the Committee may now vote on the legislation as early as the first week in February. When we were advocating on the Hill for CARA following the Unite to Face Addiction rally the last October (www.facingaddiction.org), we were told not to be disappointed if CARA was not funded in 2016. But it’s beginning to look like that might be more of a possibility now than we thought in October. You can read the latest update on the progress on the enforcement of Parity Act here: http://www.thenationalcouncil.org/capitol-connector/2016/01/new-parity-bill-aims-to-hold-insurers-accountable-for-behavioral-health-coverage/
Yes, opioid use disorder combined with other substance use disorders is costing this country 600+ billion dollars in health care costs and lost work productivity. But, according to several conservative estimates, every dollar invested in substance use treatment programs yields a return of between $4 and $7 in reduced drug-related crime, criminal justice costs, and theft. When savings related to healthcare are included, total savings can exceed costs by a ratio of 12 to 1.[i] Major savings to the individual and to society also stem from fewer interpersonal conflicts; greater workplace productivity; and fewer drug-related accidents, including overdoses and deaths.
Saving the lives of those who are affected by this disease will only happen when the general public gets angry enough to demand that the people who suffer from these disorders deserve the same medical treatment and compassion as anyone suffering from a chronic illness. Let’s care about these very, very ill people enough to have a conversation about what needs to be done to help them instead focusing on the symptoms of their illness and calling it a documentary.
[i] “Principles of Drug Addiction Treatment: A Research Based Guide (Third Edition),” December 2012.