No S**T Science
“Our goal is to keep people alive. That’s it. When you’re alive, you have another chance to have some type of impactful change.” Loris Mattox summarized in these words the importance of taking a harm reduction approach to addiction and recovery at Battery Powered’s Expert Night for our fall theme.
Seven time Emmy award-winning journalist Thuy Vu moderated our expert panel with:
- Vitka Eisen, CEO of Healthright 360;
- Andrew Herring, emergency physician, Associate Director of Research at Highland Hospital-Alameda Health System and Medical Director of Highland’s Bridge Clinic and Substance Use Disorder Program;
- Loris Mattox, Executive Director of the HIV Education and Prevention Project of Alameda County; and,
- Matt Wilson, Deputy Director of Open Society Global Drug Policy Program.
This is what we learned.
Why do some people become addicted?
Dr. Herring opened up the night discussing the biology behind addiction, clarifying why drugs are so appealing to us and how we become addicted. We all have a fundamental reward system in our brain: “It’s the same thing that told us when we were Neanderthals that it’s worth it to go get that elk … And through some fate of the universe, the sap of a small flower turned out to biochemically hit that reward center beautifully.” As do other substances. Once a substance has hijacked that reward system, it becomes in our mind akin to, and eventually even more important than, the other factors that we consider critical to our survival – food, shelter, sex.
Photo Credit: Marla Aufmuth
Why doesn’t everyone who tries drugs become addicted?
Matt Wilson explained how drug use occurs on a spectrum. It might be contrary to what you’ve heard, but “only about 15-20% of people who take a drug become addicted.” Amongst that subset, the occurrence of serious mental illness – depression, schizophrenia, bipolar disorder – is about 50%. Another roughly 50% of people with substance use disorders have experienced serious trauma. There’s a chemical hook to drugs to be sure, but we also have to consider the person who becomes addicted. For many with substance use disorder, drugs aren’t their issue; drugs are how they try to treat their issues.
Photo Credit: Marla Aufmuth
The criminal justice approach
U.S drug policy is such that many people who use drugs go through the criminal justice system at one time or another, which only complicates the problem for someone with a drug use disorder. Additionally, stigma, in large part due to criminalization, “pushes people to the margins away from the help and support they need,” explained Matt. Criminalization and the war on drugs, which have the intended purpose of reducing drug use and availability, has only resulted in large increases in the scale, scope, and sophistication of the drug market. “Even by its own measure, the criminal justice system “has failed.” Criminalization has also in part led to mass incarceration, particularly for people of color.
Other countries, such as Portugal, have decriminalized drug use and possession and seen reductions in overdose deaths, drug use, and HIV transmission while seeing increases in treatment rates. In short, all panelists argued for moving away from a reliance on the criminal justice system towards a public health approach.
Treatment models need help
Criminalization hasn’t been our only response. Treatment exists, but we still largely treat a chronic condition, addiction, as episodic. Vitka Eisen explained how this simply doesn’t work. Addiction doesn’t just go away after a 28-day inpatient treatment. If we don’t treat other chronic illnesses, like diabetes, this way, why should we with addiction?
Photo Credit: Marla Aufmuth
Furthermore, reliance on abstinence-only models sets up a pass/fail metric for success that is not realistic given the chronic nature of this disease. It’s important that those who relapse are brought in closer, welcomed back to treatment, and not treated as a failure, noted Vitka. As someone who went through several programs for heroin addiction and is now 30+ years in recovery, she knows. But she also cautioned us not to define someone’s recovery for them. Recovery can look different for different people, and should not be tied to abstinence alone.
Treatment models that are available 24/7, with no questions asked and that offer a variety of evidence-based treatment options and support services are needed more broadly across the country.
No shit science: harm reduction
So what does work for treatment? As Loris Mattox eloquently put it, harm reduction models for treating addiction is “no shit science.” Harm reduction is any behavior or practice that one does to increase their chance of survival. Think of putting on your seatbelt. You probably don’t get in your car and put on your seatbelt with the plan to get into an accident, you do it merely as a precaution to make driving safer. Harm reduction around substance use is no different: it’s a measure taken to reduce the risk associated with the behavior. “Our goal is to keep people alive. That’s it. When you’re alive, you have another chance to have some type of impactful change.” This idea is vital in eliminating the stigma around harm reduction strategies.
Photo Credit: Marla Aufmuth
What can we do?
Our audience wanted to know how to support someone struggling with addiction. Vitka offered that the antidote to pain and addiction is connection and caring. The idea of letting someone hit rock bottom is dangerous. And shaming family and friends as “enablers” is a stigma she also wants to see end. “Let’s remove the shame from people who are just trying to figure out how to love somebody and have them not die.” Lastly, if your child is suffering from problematic drug use, keep paying their cell phone bill, she implored. It’s their lifeline to support and services.
Next up for this fall theme is Organization Night on October 22nd. Come hear from the 12 finalists for this theme and understand how they are working to make communities and individuals affected by drug addiction safer and healthier. You can RSVP here.