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What the Heroin Abuse Crisis Means for Public Health

How has heroin addiction evolved into the current crisis we're facing today? What are the implications for public health?
Framing the US Discussion
Dr Frieden further cited a lack of understanding about the long-term effects of opioids among some in the medical community, and the need to consider alternative treatments. “When I went to medical school, I had one lecture on pain,” he said. “I was told that someone who went on an opioid would not get addicted.” 

In Principles of Drug Addiction Treatment: A Research-Based Guide, the National Institute on Drug Abuse highlights the difference between addiction (compulsive drug use despite harmful consequences) and dependence (in which the body adapts to the drug and may require more of it as tolerance develops). The report notes that dependence can evolve from taking drugs as directed, and that dependence does not equate to addiction, but often accompanies it. 

Understanding such dynamics are important when considering the historical discussions around drug abuse in our country—which have often been framed within moral and legal frameworks. However, there is now an increasing shift in attitudes, as research supports the fact that “addiction (to opiates and other drugs) is recognized as a chronic, relapsing brain disease with a wide range of serious medical consequences.” The result has been more effective treatment options available to medical professionals, as well as a new attitude among public officials—including those within the criminal justice system. 

In a 2014 report from the Police Executive Research Forum, Executive Director Chuck Wexler noted that “While police are still focusing on the major drug dealers and traffickers of heroin for arrest and prosecution, what has changed is that they recognize that the users will continue using if they don’t get treatment. Simply arresting them over and over again is not working.” 

Implications for Public Health
The heroin abuse crisis poses a wide array of significant implications for public health—including the effects of illicit drug use on business and the economy.

In the US, the most recent data available related to the economic cost of drug abuse dates back to 2007—when it was estimated at $193 billion. Certainly, such estimates would be much higher today, but would be largely attributed to similar factors that include lost productivity, healthcare costs, and criminal justices costs. Meanwhile, the impact on the individual, family, and greater society is even more significant, and attributed to a variety of factors, including the spread of disease, overdose deaths, crime, and homelessness.

The new heroin crisis is not an isolated issue for any single sector of our society. It impacts each of us either directly or indirectly. For more information, a number of national agencies offer resources for providers and others involved in drug abuse prevention and treatment. In addition, the National Institute on Drug Abuse offers a variety of resources to support individuals and family members seeking information about treatment.


 
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