Yesterdays’s headline in the Sun Sentinel was sobering: eleven pill mills were raided and several doctors were arrested. No one denies that drug abuse is a serious problem: every day in Florida alone, eleven people die of prescription pill overdoses. News stories are filled with interviews of grieving mothers who begged pain doctors not to prescribe pills to their sons or daughters to no avail. Their young adult children died and the doctors are still practicing medicine.
Although there is an obvious need to do something, it is not clear that police raids on pill mills and data bases to track doctor shoppers are the best solution. Too often, government intervention into personal issues leads to results that are even worse than the original problem. Such is likely to be the case in this instance.
Here are some possible negative outcomes:
If addicts can no longer obtain prescription opioids, many will no doubt turn to illegal drugs such as heroin.
Since illegal drugs are nearly always several times as expensive as prescription drugs, a likely result is an increase in crime. No doubt women would prefer addicts to get their fix in a legal clinic than mug or burglarize them to get their fix from a drug dealer. Family members of addicts will see prized possessions disappear as addicts pawn them for drug money. Trust within the family will break down, making it harder for the addict to get the help and support he needs.
Organized crime will reap greater profits as addicts turn to them instead of doctors.
Fatal drug overdoses from prescription drugs will decline while fatal overdoses from street drugs will increase.
There is also a possiblity that the government, and society, are approaching this problem in exactly the wrong way by viewing drugs as the problem instead of as the most visible symptom of another, deeper problem. Mental health professionals have oten noted that many addicts seem to be medicating severe depression. The human body makes its own natural opioids and the brain has opioid receptors for them. There appears to be a subtype of depression that involves an imbalance in the body’s natural opioid system. Clinical studies show that people with this subtype of depression respond favorably to buprenorphine, an opioid, and often show dramatic improvement when treated with this drug. Because this type of depression does not involve the neurotransmitters like serotonin, conventional anti-depressants do not help people suffering from this depression subtype. In fact, traditional antidepressants themselves carry serious risks such as suicide, hostility, violence, and liver disorders.
If addicts are indeed medicating depression with the most effective anti-depressant available, making prescription pain pills more difficult to obtain may lead to an increase in suicides. If Florida succeeds in cracking down on pill mills, a useful study would be to track the rate of drug overdoses AND the suicide rate.
In dealing with the problem of drug addiction, the Swiss model may be a good one. Prohibition did not work. Neither did decriminalization: public parks were filled with addicts who engaged in petty crime to support their habits. What did work was treating addiction as a medical–not a criminal or moral–problem. Addicts registered as addicts and reported to clinics once or twice a day for an injection of drugs. Crime rates dropped. Because addicts were freed from the day-in and day-out search for drugs, they were able to hold jobs and lead normal lives–and several years of normal life often gave addicts the courage to try to make their lives even better by seeking treatment for addiction.
What is clear is that the “War on Drugs” has failed. Given the previous history of the war on drugs, it is unlikely that recent raids on pill mills are likely to make much of a dent in the problem. Lives will be ruined and any chance an addict had of resuming a normal life will be greatly hindered by having a criminal record. It’s tempting to cheer these raids as a step in the right direction but in fact, they may have increased the suffering endured by addicts, many of whom are desperately medicating profound depression in the best way they know how, and their families.