Because of the war on drugs, pain patients are treated with skepticism and pain doctors live in fear of being prosecuted for overprescribing. The end result is that addicts still get their opioids without much trouble, while genuine patients often can't find treatment. Those who do must typically be tracked in a database and must schedule frequent, expensive doctor visits for surveillance like urine testing.
Maia SzalavitzThere's traditionally been two different ways of seeing addiction. Either it's a sin and you're a horrible bad person and you are just choosing to be hedonist or it's a chronic progressive disease. And while I certainly believe addiction is a medical problem that should be dealt with by the health system, the way we've conceptualized addiction as a disease is not actually accurate, and it has unfortunately become stigmatizing and it's also created a lot of hopelessness in a lot of people.
Maia SzalavitzI also had my own addiction to cocaine and heroin in my 20s. I knew that it was driven not by the things that the drug workers were telling me; in fact, I couldn't believe any drug information that was given to me by authorities because I knew from my own experience that it was wrong.
Maia SzalavitzAddiction is when you fall in love with a drug instead of a child or a lover and the learning that takes part in that part of the brain is designed by evolution to get us to persist despite negative consequences to do what we need to do - because I don't know anybody who could survive a relationship or parenting if not for the ability to persist despite negative consequences. The problem is when that gets misdirected to a drug and then you can find yourself in some very negative and potentially deadly situations.
Maia SzalavitzA lot of addiction actually ends by age 30 - something like 50 percent of all addictions with the exception of tobacco - and I think a lot of what's going on there is that the self-control areas of the brain are finally developed enough to be able to stop yourself from relapsing or just continuing. There is a maturational aspect to it as well.
Maia SzalavitzBecause of the war on drugs, pain patients are treated with skepticism and pain doctors live in fear of being prosecuted for overprescribing. The end result is that addicts still get their opioids without much trouble, while genuine patients often can't find treatment. Those who do must typically be tracked in a database and must schedule frequent, expensive doctor visits for surveillance like urine testing.
Maia Szalavitz