Doctor: Stigma must end to beat addiction

Most people have no idea what addiction feels like. 

Dr. Andrew Highberger, attending physician of addiction services at Shepherd Hill, said people might think they crave a muffin for breakfast or a nap when tired, but that is nothing like what an addict faces. It's more like a non-addict's desire for air.

He asked guests of his speech at Licking Memorial Hospital to imagine someone putting a plastic bag over their heads. That all-consuming effort to remove that bag and get a breath of air is what a heroin addict feels six hours after their last dose of the drug.

"They are dealing with a craving more powerful than their own will," he said.

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The good news is addiction can be successfully treated, but Highberger said the stigma society places on the disease puts up unnecessary roadblocks. Many people believe addicts become addicted because they are morally bankrupt people, or that the addicts are not worthy of care. He said it is common for people to question the point of saving an addict, that it would be better for them to die because they brought the consequence on themselves. 

Highberger said nobody would think a diabetic should die because they failed to follow the proper diet, but a stigma exists around addiction. This stigma causes addicts not to seek treatment because they are told their problem is caused by a moral failing. It also limits resources available to treat addiction because many in society don't even consider addiction a medical disease.

For example, he doesn't understand the controversy over prescribing milder opiates, such as buprenorphine, to help treat opiate addiction. Medically it has proven to reduce mortality for opiate addiction by half, he said, but some don't feel it is appropriate to give an addict an opiate. He questioned whether we'd ever consider withholding a medicine that would reduce lung cancer mortality by half or whether we'd withhold giving a diabetic insulin because they relapsed.

Highberger said it takes roughly two years for the brain to heal from the damage caused by drug addiction. This means patients can be prescribed buprenorphine for 18 months or longer. He said they should be on medication as long as it is needed.

The problem is it is difficult to get insurance companies to pay for 90 days of treatment. He noted a 28-day stay at Shepherd Hill costs roughly $19,000, a sum impossible for many addicts to pay. 

Fortunately, he said Medicaid has recently expanded the options for treatment.

Additionally, some doctors only prescribe addiction medication without providing a full treatment program, which Highberger said is critical.

"If you just write Suboxone prescriptions, you are nothing more than a drug dealer with a prescription pad."

Many diseases once faced their own stigma, and Highberger hopes society can overcome the stigma of addiction as well. For example, in the 1930s people though cancer was caused by living in poor and dirty conditions. Women in the 1950s with epilepsy were sterilized.

With better understanding of addiction as a society, Highberger has hopes that progress can be made.

"The truth is, it's a very treatable disease," he said.