Harvard Law & Policy Review

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Longreads: Fighting Addiction

Author: Emily Hogin

Like a lot of people from families affected by addiction, I cried when I read that Philip Seymour Hoffman died. The details of his relapse and death are chilling: after 23 years sober, he told TMZ a year ago that he had fallen off the wagon after taking prescription painkillers and checked himself into a rehab facility. Tragically, in the struggle between his sobriety and his disease, the disease won—he was found dead earlier this month after an apparent heroin overdose.

Seymour Hoffman’s death got headlines because he is famous, but his death is also, sadly, part of a growing epidemic of drug abuse fueled by prescription drugs. Below is a roundup of some of the best longreads on the subject of prescription drug abuse and how public policy can fight it.

How Prescription Drug Addiction Kills. The Washington Post gives a good overview of the deadly epidemic of prescription drug abuse, including the connection between prescription drug abuse and heroin. Some highlights from the article:

  • According to the Centers for Disease Control, pharmaceutical painkillers and tranquilizers account for 60 percent of drug poisoning deaths. Prescription opioids kill five times more Americans than heroin does.
  • Efforts to fight prescription drug abuse by cracking down on the market for these drugs without treating addicts can have the unintended effect of driving up the market for heroin: in Maryland, for example, a 15 percent drop in pharmaceutical opioid overdoses was accompanied by a 41 percent increase in heroin overdoses.
  • In Quincy, MA, police officers on patrol carry an anti-overdose medication called naloxone, which the city credits with reversing 216 overdoses in the last three years.

“Pill Mills.” In November 2012, the Los Angeles Times published an investigative series on a small number of doctors whose prescriptions were linked to a disproportionate number of drug poisoning deaths.

New Mexico and Vermont! According to a report by Trust for America’s Health, the two states with the best policies in place to fight prescription drug abuse are New Mexico and Vermont. The report identifies 10 indicators that reflect the most promising strategies to curb prescription drug abuse. Those 10 indicators are:

  1. A Prescription Drug Monitoring Program (PDMP)
  2. Mandatory use of the PDMP by providers
  3. A doctor-shopping law
  4. Expanding Medicaid under the Affordable Care Act, which expands coverage of substance abuse treatment
  5. A prescriber education requirement
  6. A “Good Samaritan law” providing a degree of immunity from criminal charges or mitigation of sentencing for an individual seeking help for themselves or others experiencing an overdose
  7. Laws supporting expanded access to and use of naloxone for overdosing individuals (like in Quincy, MA)
  8. Physical exam requirement prior to prescribing medications
  9. ID requirement for pharmacies dispensing controlled substances
  10. A pharmacy lock-in program in the state’s Medicaid plan that requires individuals suspected of misusing controlled substances to use a single prescriber and pharmacy

What Addiction Feels Like. For some excellent first-person accounts of what it feels like to be an addict, check out Russell Brand’s in The Guardian or Seth Mnookin’s in Slate.

If you or someone you love needs treatment for substance abuse or mental health issues, please visit http://findtreatment.samhsa.gov/ or call SAMHSA’s National Helpline at 1-800-662-HELP (4357).