An amazing article just recently hit The Huffington Post. Erin Schumaker, the Senior Healthy Living Editor, prefaced it with a reference to “a landmark report” issued by U.S. Surgeon General Dr. Luther Terry in 1964 that “changed the course of American history.” It’s credited with sparking our country’s decline in smoking. 50 years later, Surgeon General Dr. Vivek Murthy is trying to spark yet another history-changing movement, except instead of focusing on smoking, he’s zeroing in on substance use disorders and addiction.
In what we’re calling a groundbreaking 400-page report that was released on Thursday, Murthy backs what so many substance abuse counselors and treatment facilities have been advocating for so long: evidence-based treatment methods and early intervention alongside rigorous education and the expansion of treatment programs are the way to inoculating, if you will, America’s substance addiction epidemic. Perhaps the most impactful statement in the report is this:
For far too long people have thought about addiction as a character flaw or a moral failing. Addiction is a chronic disease of the brain and it’s one that we have to treat the way we would any other chronic illness: with skill, with compassion and with urgency. – Surgeon General Vivek Murthy
It’s officially really official! The stigma of failure that surrounds addiction can be torn down because it’s not the result of a moral misstep. It’s most commonly the result of a brain disease, and it’s something we can actively work to treat. That’s HUGE. But when you take the microscope to addiction, it doesn’t take long to realize there are different strains. Take, for example, prescription versus illicit drugs. Both substances can be abused. Both can be at the center of an addiction. It raises the question, is prescription drug addiction different from illicit drug addiction? And with the call for change trumpeted by the Surgeon General, a new question arises: should they be treated differently?
A Look at Prescription Drug Addiction
First, let’s establish a baseline. When you research just what a prescription addiction is, it’s easy to be confused. The Internet seems to intermingle the terms “addiction” and “abuse” as if they mean exactly the same thing, but they don’t.
An addict doesn’t necessarily have to abuse a drug, and a person who abuses or misuses a drug isn’t always an addict. It’s entirely possible to abuse an RX without developing an addiction, just as it is entire possibly to develop an addiction to a prescription painkiller without ever having deviated from its standardized use.
Addiction is a disease. Specifically, it’s a brain disease. Addiction can manifest in two ways, as a physical or as an emotional need. A physical addiction occurs when the body becomes physically dependent on a substance and will experience withdrawals without it. An emotional addiction occurs when the brain thinks it needs a substance but the body itself is not dependent.
Abuse or misuse of a substance is the incorrect or unconventional use of it. Prescription drug abuse includes exceeding the recommended dose or taking the drug for something other than what it is intended for.
Prescription drug addiction is tough because some people don’t even realize they have a problem. In 2014, we covered the question, how do people who are addicted to a substance get medical treatment if they don’t know they have a “problem”? The most common prescription addiction stems from painkillers.
In 2016, we took a closer look at the 10 most addictive RXs in the nation, one of which (Xanax) happens to be a common medication used to treat anxiety and depression. “Legally dead” is a new term coined to reference the epidemic of RX drug abuse and addiction eking its way into our nation, and it cascades right into the next thing we want to look at…
A Look at Illicit Drug Addiction
Answer us this: what’s the difference between an illicit and non-illicit drug?
Most people would say an illicit drug is an illegal street drug, like heroin or cocaine. A non-illicit drug, well that’s just the opposite, it’s a non-illegal drug. And that’s where most people stop. Consider this:
“Illicit drug use – which includes the abuse of illegal drugs and/or misuse of prescription medications or household substances – is something many adolescents engage in occasionally, and a few do regularly.” – U.S. Department of Health & Human Services
Illicit drug addiction isn’t just addiction to illegal substances. It includes prescriptions because although being legal, they can still be used or obtained illegally or illicitly. In other words, double the dosage of a prescription painkiller without medical authorization, and you’ve just illicitly used a non-illicit drug. It’s a pretty thin line, isn’t it? Interestingly, illegal and legal drugs have a meeting point. The debate to protect Kratom is often thrown into the same boat, these complex matters are very difficult to unpack and effectively classify. Anyone who has seen someone try to use kratom capsules in a recreational manner, knows that it takes and extraordinary amount to achieve and so abuse seems unlikel, which is why it is legal I think.
Where Prescription and Street Drugs Intersect
We’ve described it as The Leap. It’s this intersection where prescription and street drugs mingle. Thousands of Americans are exposed to addiction through prescriptions. Some realize they have a problem while others don’t.
There is no single recipe for substance addiction. Some people start using a prescription drug and later turn to illegal street drugs for their needed fix. Others start with and never get off illegal drugs. Is prescription drug addiction different from illicit drug addiction? Yes and no. The difference between a prescription and illicit drug comes down to legality, and as we’ve discussed, even a legal drug can be illegally used. So yes, there is a difference if we want to talk legal versus illegal drugs. But the difference between the two is that small. Addiction is addiction; it’s a disease whether fed legally or illegally.
The future of addiction treatment is placed squarely in your court, America. The problem has been well documented. The Surgeon General has issued his report. We have the opportunity to mainstream addiction treatment, stripping away the emotionally charged stigma of moral failure that stops so many from getting help. It’s time to focus on how to make addiction treatment available to those who need it and to those who are struggling to afford it.