The story of Garrett Brown offers a window into addiction.
Sometimes, those closest to the person suffering don’t know about their friend or family member’s disease. Oftentimes, the person suffering from an addiction doesn’t acknowledge it or recognize it for what it is. Instead of a disease, addiction is all too often viewed as a behavior that can simply be changed.
But the inability to control one’s behavior is part of addiction’s very definition. It’s a serious and complex medical condition that needs to be treated as such.
As BDN editor Erin Rhoda writes in a story she reported for more than two years, Brown had contact with the criminal justice system throughout his teenage years and into his early 20s. He overdosed more than once, coming into contact with the health care system. Yet, he was never connected with treatment appropriate for the chronic disease from which he suffered.
Although more than 2,500 people sought treatment in 2014 for a heroin addiction, that number is far lower than the number of people who actually needed it. The Maine Office of Substance Abuse and Mental Health Services estimates that almost 10 percent of 18- to 25-year-olds in Maine needed treatment for illicit drug use in 2012 and 2013 but never received it.
Like Brown, many don’t seek treatment on their own. That’s just one of the obstacles standing between a disease that’s arguably the most pressing public health issue of our time and the treatment that can help.
Here are some lessons that Garrett Brown’s story drives home.
1. Maine needs a good Samaritan law. When Brown overdosed on heroin last February, one friend who was with him fled. Fortunately, another stuck around and called 911. When he overdosed again on Halloween, his girlfriend was with him, but she hesitated before calling 911.
Thirty-four states and Washington, D.C., have laws that offer some level of legal immunity in precisely the sort of situation in which Brown and his friends found themselves, according to the National Conference of State Legislatures. The idea is that immunity for an overdose witness removes the fear of prosecution that can cause someone to hesitate before doing what’s needed to save someone’s life.
2. Naloxone should be available over the counter. The overdose-reversing drug naloxone saved Brown’s life — because paramedics carrying the antidote got to him soon enough. The more widely available naloxone can be, the greater the likelihood lives can be saved. There’s legislation pending that would allow pharmacies to sell naloxone without a prescription.
3. Police should have discretion. The law explicitly makes drug possession illegal. But someone suffering from an addiction needs treatment, not criminal charges and jail time. Many police departments across the country — including a number in Maine — are moving toward a public health approach and connecting people who need it with treatment. This should be the universal approach.
4. Jails should offer treatment. On June 30, 2015, Brown began serving a six-month jail sentence following his latest heroin possession charge. Jail can offer someone with an addiction a chance to begin treatment — if only it were more widely available.
Vivitrol, an injectable form of the drug naltrexone, makes it impossible for someone to get high from opioids and reduces cravings. Before Vivitrol can work, a patient needs to be drug-free for seven days, which makes jail the ideal setting.
5. Probation conditions should respect science. After Brown’s six-month sentence, he was to serve two years’ probation. One condition of his probation was that he not use drugs or alcohol. Another was that he attend substance abuse counseling.
Both conditions, however, ignored the science of addiction. Since addiction is a chronic disease, relapse is common, meaning a blanket prohibition on drug use sets someone up for failure. And substance abuse counseling on its own is rarely effective; research has repeatedly shown that the most effective course of treatment for an opiate addiction combines medication-assisted treatment such as methadone or Suboxone with counseling.
When judges and lawyers agree on probation conditions, they should, at a minimum, consult with an addiction specialist who can advise them on conditions that are consistent with the science of addiction.
These small changes are part of what’s needed to change the way we address addiction as a society — so it’s treated as a medical, not a criminal, problem.