Opioid Addiction Treatment Should Not Last a Lifetime

By Percy Menzies

“Once an Opioid Addict, Always an Opioid Addict” should not be a guiding principle of the treatment system.

The epidemic of overprescribing opioid pain medications and the new restrictions placed on prescribing opioids has led to a new problem – an alarming increase in the use of heroin and overdose deaths. I am convinced that the problem is only going to grow, as we see several factors coming together to cause a veritable tsunami of heroin.

In the shadow of all the attention that the prescription opioid epidemic has been receiving, heroin has been steadily and stealthily creeping into the U.S., as small time dealers have begun selling heroin under the radar to a white, suburban crowd that was previously not their target market. By the time the DEA got wind of the problem, it was almost too late. We saw the problem in the St. Louis region around 2006. The Mexican Mafia and cartels started selling Mexican “black tar” heroin to white suburban users, mostly young white males, then shrewdly recruited them as small time dealers and distributors. They used heroin while staying at home, raising no suspicion from their parents. The signs and symptoms of heroin use are difficult to detect and it was inconceivable for most parents to even remotely suspect their kids were using heroin—a highly stigmatized drug, historically confined to poor black inner-city communities. The change in behavior and other signs were there—missing spoons, money and valuables stolen from the home, falling grades, abrupt changes of friends—but none of these behavioral changes raised the suspicion of heroin use.

Because there are so many opioid addicted people in the U.S., the country is extremely vulnerable to a veritable tsunami of heroin addiction due to the voluminous influx of cheaper heroin. Afghanistan, Burma and Mexico produce 90% of the world’s heroin. Afghanistan and Burma are becoming increasingly unstable. In anticipation of the withdrawal of the U.S. and NATO troops from Afghanistan this year, the acreage of opium cultivation has exploded. The weak Burmese government has little to no control on the opium growing regions of Burma. Additionally, the unintended consequence of legalizing marijuana in states like Colorado and Washington has virtually dried up the demand for Mexican marijuana. These farmers controlled by the Mexican drug cartels have switched to growing the opium poppies that are used to produce heroin.

Cheap and ubiquitous heroin coming from Mexico is going to be purer and more potent. Our citizens will no longer have to be introduced to opioids from prescription painkillers. A truly frightening scenario exists—how did we get here?