A Health Crisis in Need of Rehabilitation:
Part 1: The Great American Relapse
A health crisis could strike at any time. A disease state that monopolizes media outlets and exposes an unrecognized area of human frailty. Usually an infectious disease is the culprit; maybe it’s bacteria or maybe a virus that gained resurgence after a well-placed chromosomal mutation. Over the past century, science has improved upon this complex area of medicine by leaps and bounds. Not long ago, Polio seemed incurable; twenty years ago an AIDS diagnosis was a death sentence. Today one is nearly eradicated and the other is managed as a chronic illness.
What we usually identify as the cause of disease usually just represents an unrecognized vulnerability, a weakness one might call it, that would eventually be exposed. We rarely get away with anything. There are evolutionary repercussions for vulnerabilities, sort of like “universal consequences” one must pay. Preventing the onset of disease is difficult, but its potential to spread and have an impact on a society of people is determined by its environment. The culture is the rate-limiting variable that will either permit or prohibit the spread.
This is the challenge historians have interpreting former events. The context has changed. The mind is using its current paradigm to interpret behavior made using an entirely different one. For example, in 1919 Germany had to sign the Treaty of Versailles to begin reparations for the cost of war. At the time economists insisted that the treaty was too harsh, a “Carthaginian peace”, and that the results could be disastrous. Nevertheless it went into effect. Radical ideologies that existed in Germany at that time can be found in any country at any point in time to varying degrees. For this analogy lets consider these thought patterns as “disease”. The German people were cast into a severe depression that leveled public spirits. The country’s value system, or collective consciousness, which should have the power to resist these movements was now more vulnerable. Keeping with the metaphor of illness, their immune system was suppressed. A much larger percentage accepted what was being masqueraded as national pride. Then it just needed time to breed a generation of soldiers to defend it. The culture became a perfect environment to cultivate and spread the ideas like a virus. When the problem reached global awareness, it was too late.
Rarely is there real warning before we’re aware of a true threat. By the time we identify it, it has already spread its seed throughout the countryside – an intricate and far-stretched webbing that blended into the very framework of life.
Social response follows the sequence: awareness, acceptance, action, respectively. The first phase is most variable. Here awareness refers to true awareness, not simply manufacturing an acceptable story to quiet the unsettled mind. It depends upon the human ego and thus its tendency for denial. A microorganism pictured under microscope is easy to bring to public awareness. But before the microscope, social response to infectious disease was unpredictable, and many civilizations were destroyed by it.
The exact same challenges are seen today – illness undetected by sensory input, traveling beneath the wavelength of human detection. This is particularly true in the realm of behavioral health. If there is an undeniable problem – like the opioid epidemic of the past twenty years – the public is going to demand answers. Unfortunately, what sometimes gets lost when answers are being proposed is a little thing called reality. Consider the following headline:
“Over the past five years, drug cartels have quadrupled the amount of heroin smuggled into the United States and fueled a resurgence in use of the illicit drug use.”
This sounds reasonable. And it offers a nice hanger to relieve oneself of personal responsibility. It is both factual and gives us a common enemy to blame – very easy for the public to accept. The problem is it’s misleading and leads to misdirected efforts. The resurgence of drug use caused the increased production, not the other way around. In the world of drug addiction, the supply always perfectly meets the demand. If we want it, it will be there. From this headline one would think that gathering up all the offenders would improve the problem.
We have wasted a lot of time and resources to prove the drug war ineffective. Endless examples throughout history have shown that accessibility or legal consequence has never impacted addictive disease. During prohibition the prevalence of alcohol addiction did not change – only the risks one had to assume to sustain it.
Though often used interchangeably, understanding the difference between chemical addiction and chemical dependence is important- especially as it relates to the opioid epidemic. It will be discussed in detail in Part II.
Today we have implemented drug programs, assigned special committees, offered treatment options, warred on drugs and filled the prisons. Winston Churchill said,
“However beautiful the strategy, you should occasionally look at the results.”
The country has unintentionally created a marketplace that is so incredibly lucrative that a whole criminal industry flourishes as the result, corrupting life on many levels. It is why the arrest of a drug kingpin has no effect on the problem overall, because even before he is arraigned, he’s been replaced. For instance, when Pablo Escobar was finally taken down, he was immediately replaced by three people. So now we have a 3-headed monster instead of one. The drug problem requires a social approach. Currently, all the running around and big story headlines are doing nothing short of wasting a lot of money.
How will the problem be fixed?
Next: [Part II] – Twenty Year Anniversary of OxyContin
In 1952 Arthur Sackler bought a small New York drug manufacturer, which became Purdue Pharma LP. He operated the modest and respectable company for nearly forty years. Following his death, brothers Mortimer and Raymond assumed control of the company, and a few years later launched OxyContin. With it came a misleading sales strategy and a deceptive marketing campaign that cast a dark cloud over an industry. The product earned the company $3 billon in annual sales, the largest profit ever generated from a drug product. One blockbuster pain medication has put the family ahead of the Mellons and the Rockefellers in total wealth. According to Forbes, the Sacklers’ fortune ranks sixteenth largest in the country.