Transcript Dracunculiasis? - Georgia School of Addiction Studies

What We Believe
About Addiction
Matters:
A Public Health Perspective
Dr. John Dyben
DHSc, MA, MS, MCAP, CMHP
Clinical Director, Hanley Center at Origins
What Do We
Believe About...
Crime?
War?
Poverty?
Diabetes?
Cancer?
Dracunculiasis?
14th century
problem:
The Plague
Belief: Punishment from God.
Result: Expel or kill those deemed sinful
in order to earn God’s favor.
16th century
problem:
Mental
Illness
Belief: Demon possession or moral defect.
Result: Attempt exorcism and lock up in
terrible conditions when that failed.
Society, to a large degree, came to
understand Plague and Mental
Illness as diseases that:
• Can be better understood through research
• Not of supernatural design
• Not a matter of moral failing
• Treatable
Diabetes
Cancer
Dracunculiasis
• Resources for treatment and research
• Facilities to care for the afflicted
• Demand high standards of care
• Walks and fundraisers
• Ribbons and special days
• Public awareness campaigns
• Apply epidemiological triad
Epidemiological Triad
Dracunculiasis
(Guiney Worm Disease)
• Affected multiple millions every year in
dozens of countries
• No cure, only palliation
• Today, almost completely eradicated
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What is Addiction?
“…a primary, chronic, neurobiological disease
with genetic, psychosocial, and environmental
factors influencing its development
and manifestations.”
AAPM, APS, ASAM
Liaison Committee on Pain and Addiction (2001)
Epidemiological Triad
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How do we deal with Addiction?
• More than 95,000 federal prisoners are serving time for
drug-related offenses—up from fewer than 5,000 in
1980. (2015)
• Health insurance rarely pays for treatment beyond
acute medical care or lower than necessary levels of
care.
• “People are significantly more likely to have negative
attitudes toward those suffering from drug addiction
than those with mental illness, and don’t support
insurance, housing, and employment policies that
benefit those dependent on drugs” (2014)
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How do we deal with Addiction?
Incarceration instead of Treatment
Punishment instead of Care
Arrests instead of Research
Result:
More people are addicted, more drugs are in the
country, and drug overdose is now the leading
cause of accidental death in the US.
Epidemiological Triad
Agent
• Naloxone availability
• Non-addictive anti-craving medications
• Realistic controls
• Medical education
• Continued medical research into vaccines
• ???
Host
• Longer-term treatment that is driven by
research and outcomes
• Funding for academic research and neutral
investigation of outcome data
• Social support systems such as AA/NA
• Prevention efforts supported by long-term
outcomes-based research
• ???
Environment
• Educate the public (cannot be overstated)
• Support treatment rather than
incarceration for non-violent, nontrafficking drug offenders
• Turn war on drugs into war on addiction
• ???
References
• Barry, C. L., McGinty, E. E., Pescosolido, B. A., & Goldman, H. H. (2014).
Stigma, discrimination, treatment effectiveness, and policy: public views
about drug addiction and mental illness. Psychiatric Services, 65(10), 12691272.
• Center for Disease Control and Prevention, National Center for Health
Statistics, National Vital Statistics System, Mortality File. (2015). Number
and Age-Adjusted Rates of Drug-poisoning Deaths Involving Opioid
Analgesics and Heroin: United States, 2000–2014. Atlanta, GA: Center for
Disease Control and Prevention.
• Heit, H. A. (2003). Addiction, physical dependence, and tolerance: precise
definitions to help clinicians evaluate and treat chronic pain patients.
Journal Of Pain & Palliative Care Pharmacotherapy, 17(1), 15-29.
References
• Join Together Staff. (2014, March 11). Substance Abuse Treatment Centers
Report Problems with Insurance Coverage. [email protected]
• Pew Charitable Trusts (2015). Federal Drug Sentencing Laws Bring High
Cost, Low Return. http://www.pewtrusts.org/en/research-andanalysis/issue-briefs/2015/08/federal-drug-sentencing-laws-bring-highcost-low-return
• Sifferlin, A. (January 9, 2015). Why you’ve never heard of the vaccine for
heroin addiction. Time. http://time.com/3654784/why-youve-neverheard-of-the-vaccine-for-heroin-addiction/
Questions?
Dr. John Dyben
Hanley Center at Origins
[email protected]
originsrecovery.com
561-841-1254