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Response to “If Addiction Is a Disease, Why Is Relapsing a Crime” New York Times Editorial

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By Elizabeth Weinberg, MD

Addiction“When Julie Eldred tested positive for fentanyl in 2016, 11 days into her probation for a larceny charge, she was sent to jail.” 

The recent New York Times editorial, “If Addiction Is a Disease, Why Is Relapsing a Crime?” explains clearly and succinctly why criminalization of addiction can never be an effective way to reduce drug use, addiction, or death.

The epidemic of opioid dependence has resulted in escalating death rates and disrupted families. The Centers for Disease Control and Prevention (CDC) reports that in 2016 there were 63,600 deaths from drug overdoses, of which two thirds were due to opioids; 115 people are estimated to die every day due to opioid overdose. Often, addiction and substance use problems are handled in the criminal justice system both because selling and using these drugs is illegal, and because of gaps in the treatment system. Fentanyl, the drug Ms. Eldred misused, is both a highly addictive and highly lethal opioid and opioid users know they are at high risk of death. Threatening users with incarceration does not provide users with the tools for recovery or a positive reason for recovery grounded in a realistic hope of a better future.  

Effective treatment, as described in this editorial, must involve a fully informed, integrated approach that addresses the powerful activation of reward and emotional attachment centers in the brain, the need for the opioid addict to learn how to manage life without the temporary relief provided by these drugs, and assistance in rebuilding family and community supports to sustain the addict in recovery. Punishment can be tempting, but achieves little; more can be gained through effective interventions, paired with genuine understanding.

 

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