Half steps little help in fighting addiction
By Steve Wildsmith |stevew@thedailytimes.com
Over the weekend, National Public Radio reported on a vote by a U.S. Food and Drug Administration advisory committee to change the classification of a common narcotic pain reliever.
By a vote of 19-10, the panel agreed to recommend that drugs containing hydrocodone — synthetic opiates commonly known as Lortab and Vicodin — move up from Schedule III to Schedule II classification. This essentially means that if the FDA goes along with the recommendation, significant restrictions would be placed on such medication: Doctors could only write prescriptions for 30-day supplies, refills could not be issued without patients returning to the physician’s office and nurse practitioners and physician assistants would no longer be able to prescribe them.
Drugs, incidentally, are classified according to potential for abuse and addiction. An opiate like heroin, for example, is classified as a Schedule I drug, meaning it has the highest potential; by moving up to Schedule II, Vicodin would be recognized as being in the second-to-the-top tier of addictive drugs.
As a recovering addict who got started on Vicodin, I have mixed feelings about this. On one hand, I agree with Dr. Andrew Kolodny of the Maimonides Medical Center in Brooklyn, N.Y., who was quoted in the article as saying, “It will lead to less people becoming addicted, which is the most important thing that needs to happen to bring this crisis under control.”
On the other, as someone who recognizes the legitimate needs of chronic pain sufferers — those with cancer, arthritis and similarly afflicted individuals who need pain management therapy to have a decent quality of life — I see the other side of the argument. Dr. Lynn Webster, president-elect of the American Academy of Pain Medicine, expressed such concerns: “I hope people in pain won’t suffer as a result.”
Of course, there’s also a chance nothing will happen. In 2008, the FDA rejected a similar recommendation, but the epidemic of addiction has gotten more and more publicity in recent years. According to NPR, more than 136 million prescriptions are written for hydrocodone-based painkillers every year. Other prescription narcotics, such as Oxycontin and Percocet, are classified as Schedule II drugs. And by tightening regulations, I can certainly see how physicians can more closely monitor whether a drug is being abused.
As a personal example: When I lived in South Carolina, I had a physician who wrote me a prescription for 120 hydrocodone tablets at a time ... with six refills. He was a legitimate rheumatologist, not some pill pusher who wrote a prescription without any sort of examination; but he was uneducated when it came to addiction, and he didn’t stop to think of the dangers of such an open-ended prescription.
Ultimately, though, I believe that while this isn’t a bad thing, it’s also another measure aimed at fighting the symptoms instead of the disease itself. Unfortunately, whether it’s the FDA or the FBI, the government mindset seems to be one of containment rather than one of treatment.
I maintain that we will never truly make an impact on addiction in this country without a comprehensive approach to both prevention and treatment. We spend millions of dollars every year fighting a war on drugs, and yet we continue to cut funding to education, the arts, health care and social services. We don’t invest in the young people of this country, but when they come of age and make decisions that lead to addiction and all of the negative choices that accompany such a disease, we seek to punish them.
It’s a flawed philosophy, and it’s one that’s doomed to failure. The War on Drugs is now in its fifth decade, and while certain statistics can be doctored (no pun intended) to show that it’s been a successful war, the troops on the ground — recovering addicts and ones still caught in addiction’s grip — tell a different story. Every week, I go to meetings where more and more people come in to recovery beaten, broken and destitute. And even after more than a decade, I could leave this computer terminal right now, drive to certain parts of Blount and Knox counties and within an hour procure just about any drug you wanted.
That isn’t victory. And until the government decides to do something beyond simple prohibition and punishment, the war will drag on. Which reminds me of a saying we have in the rooms about recovery and sobriety, and the lengths we must go to in order to keep ourselves clean and sober: “Half measures avail us nothing.”
The same is true for our approach to addiction. Unfortunately, half-measures will continue to be par for the course until our leaders recognize that new tactics are needed in order to claim any sort of victory.
Steve Wildsmith is a recovering addict and the Weekend editor for The Daily Times. Contact him at (stevew@thedailytimes.com) or at 981-1144.




