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Our Bittersweet Path to Dealing with Opioid Addiction

When I meet strangers and they ask what I do for a living, the conversation tends to go something like this: I tell them I’m a physician. They ask what type. I say that I am a general internist, but I focus mainly on addiction…addiction to prescription opioids (painkillers) and heroin. Invariably, people will say something like, “This has become such a big problem.” I agree, but then they will emphatically state that it has become a really big problem, as if opioid addiction is a new phenomenon.

pills and needle, opioid addiction

These new acquaintances will then disclose that close friends, family members or they themselves are struggling with addiction. Often they dive into details about the challenges and difficulties their loved ones or they have faced.

This combination of me being an outsider and a doctor with addiction expertise creates a special situation—a safe space in which strangers pour out personal and intimate stories. I listen, empathize and provide nonjudgmental support and encouragement. Then we go our separate ways.

These stories, along with my experiences in the field, mirror what we see and hear in the media about America’s growing opioid addiction. On a local level, in the suburbs of New York City, my town’s newspaper now runs scores of front-page articles about young white men and women who have fatally overdosed on heroin or prescription opioids. On a national level, our attention to opioid addiction has become particularly heightened when celebrities such as Heath Ledger and Philip Seymour Hoffman die of opioid overdoses.

The truth is, opioid addiction is not new. Having worked in the South Bronx for 18 years, caring for patients in a community health center that is located in the poorest congressional district in the U.S., I can say firsthand that opioid addiction is not new. What is new, however, is our nation’s collective response.

For decades, we have been responding to drugs and addiction through the criminal justice system. Previously, when drugs and addiction were prevalent in cities among poor and minority communities, we responded by building more prisons. Now, with addiction spreading from cities to rural and suburban areas, from the poor to the affluent and from minorities to whites, the outcry is loud. Suddenly, we must do more. We must arm communities with naloxone (a drug available since the 1970s) to reverse overdoses. We must expand treatment facilities. We must train more doctors to prescribe buprenorphine to treat opioid addiction.

It’s about time that we finally recognize that drug addiction is a medical problem that requires medical treatment, not punishment. It is unfortunate that our path to this realization has been so bittersweet—and so long in coming.

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Chinazo O. Cunningham, M.D., M.S.

Chinazo O. Cunningham, M.D., M.S.

Dr. Cunningham is professor, department of medicine at Albert Einstein College of Medicine and associate chief of the division of general internal medicine at Montefiore Medical Center.

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