Co-authored by Gretchen Burns Bergman and Dr. Ken Khoury
For too many years people with addictive illness have been banished to the criminal justice system due to ignorance, fear, and stigma. We've known that drug addiction is a chronic relapsing disorder for decades, so why haven't we heard more of an outcry from the real stakeholders in this problem, (parents and health care providers) about the punitive and destructive way in which it is handled? Why hasn't the health care community been more vocal in challenging systems that are so damaging to sick individuals and why are family members so silent? Part of the answer is that stigma runs deep, and all of our systems for dealing with drug use and addiction actually promote further stigmatization and discrimination, none more so than the prison industrial complex.
But, it is time to speak out with a unified voice. One of us is a psychiatrist, specializing in
addiction psychiatry, who is ready to call his colleagues to action, and the other is a mother who has advocated for compassionate, therapeutic drug policies for years because of her personal experience with her sons' addictive illness and incarceration.
We are witnessing too many lives lost and liberties removed because of our current failed and devastating policies. Doctors recognize that drug and alcohol addiction is a disease, yet they have remained relatively silent as social activists, as a misguided war on drugs raged on. Social and public policy follow understanding, innovation and scientific discovery, but often tries to catch up, as with the internet, as society progresses.
In Dr. Khoury's 40 years as an addiction treatment physician, there has never been a more exciting time. An example of the effectiveness of education and policy change has been the extraordinary decline in nicotine addiction. Enormous advances are being made in understanding the genetics, brain changes and therapeutic interventions of addiction. Increasingly, treatment is uniquely designed for the individual, based on specific vulnerabilities, history, demographics and family. New medications for the treatment of opiate, alcohol and other addictions have greatly improved successful outcomes. Addicted people go from a course destructive to themselves, their families and their communities to dynamic, healthy and effective lives. There are few areas of medicine that can transform such serious, often fatal illnesses, into full recovery.
Sadly, the power of these treatments is poorly understood, sometimes even in the medical community. Helpless and hopeless stigmatizing messages prevail in the media. Horrible incidents such as the deaths of young opiate addicts get the headlines, while little is heard of our neighbors functioning beautifully in recovery.
Dr. Khoury hears every day in my office from patients and families grateful for having their lives back again. That is why he loves this work. What is disturbing is that we treat only a minor part of the population that needs help. Too many people and their families are alone, suffering a destructive course without treatment, and leading to homelessness, jail, illness or death. Why? Because of poor treatment availability, well intended but wrong-headed punitive approaches, and isolation through stigma and stereotype.
About 1 in 100 American adults -- 2.3 million people -- are incarcerated. Nearly half of all prisoners in state prisons are locked up for a non-violent offense. Every year 10,000 Californians are convicted of felony drug possession for personal use. This is not just about lives interrupted, but lives destroyed. Incarceration can leave children without a parent in the home, and often leads to life-long exclusion from housing, employment and educational opportunities. It creates severe roadblocks to recovery and reunification. Overdose is a leading cause of accidental death. This fact alone should make us realize that we need a change of direction in how we handle the problems of drug use.
We are on the cusp of real change. People are realizing that we can't incarcerate our way out of what is essentially a public health problem. President Obama's new budget calls for a $1.4 billion increase in treatment funding, and The Affordable Care Act will prohibit insurers from denying coverage to people with pre-existing conditions, including substance dependence. In this political climate we have an opportunity to expand much-needed community-based treatment programs.
That is why we have come together to write this article and to announce a "Moms & Docs" partnership, in order to place addiction under the proper arena for care. For a doctor, the first principal of the Hippocratic Oath is to "do no harm", yet we've seen so much harm done to individuals and families due to these misguided drug policies. And, the major role of mothers is to protect and nurture their offspring, yet we've stood by as our basic rights as mothers have been eroded because of overzealous policing policies that abandon core health issues. Moms & Docs stand together in demanding science-based, compassionate, health-oriented strategies that reduce the harm of drug use and addiction, rather than fanning the flames of stigma and discrimination with a failed war on drugs.
Gretchen Burns Bergman is Executive Director & Co-Founder of A New PATH (Parents for Addiction Treatment & Healing) & Lead Organizer of the national Moms United to End the War on Drugs campaign; Ken Khoury, M.D., is a psychiatrist board certified in addiction and forensic psychiatry in private practice. He has also taught at UCSD School of Medicine and directed in-patient and out-patient treatment programs and frequently lectured internationally.