THE EVOLUTION OF ADDICTION AND RECOVERY

Twenty years ago, I relocated to Washington County, got sober and started a new life. The people I met in the local recovery community were warm and supportive. They taught me how to persevere as a recovering alcoholic. Over the past several decades, the meaning of addiction and approaches to recovery have been transformed in meaningful ways. This commentary will discuss some of these important developments nationally and in Washington County.

As late as the 1990s, an individual’s drug and/or alcohol addiction continued to carry the erroneous stigma of a flawed, weak-willed character. The prevailing opinion was that those afflicted could not be trusted to perform well in society. While the recovery fellowships and medical profession recognized addiction as a disease, the average person was not buying it. There appeared to be no rational explanation for an addict or alcoholic going through negative life-altering consequences and unimaginable withdrawal symptoms only to chronically repeat the addiction cycle.

Over time, this impression has changed. Several events moved the needle toward treating addiction as a serious medical condition, requiring society’s compassion not disdain. First, in the 1980s, drug dealers converted cocaine powder into smokable "crack" that could be sold in smaller quantities and to more people. Unlike alcoholism that is progressive and takes years to develop or opioid (narcotic) addiction that progresses over a period of months, crack addiction was occurring in first time users. By the mid-1990s, crack use was an epidemic in the inner cities, but found in suburbia as well.

Second was the prescription-opioid crisis (Vicodin, OxyContin) that became widespread after 2010.  Pharmaceutical companies claimed that the risk of addiction to prescription opioids was very low and gave reassurances to prescribers.  To compound the problem, these companies sought large profits by promoting the use of powerful opioids to patients who did not require them.

The Council of Economic Advisers estimated that in 2018 alone, the cost of opioid addiction (including the value of lives lost) was $696 billion. Synthetic drugs distributed by “pill-mill” pain clinics decimated rural communities. (With recent litigation awards, Pennsylvania will receive more than $2 billion from these drug manufacturers to help fight addiction.)

Third, by 2014, the opioid fentanyl illegally entered the country in larger quantities and started to kill not only chronic heroin users, but also thrill seeking young people. Fentanyl is twenty times cheaper to produce and fifty times stronger than heroin. More recently, dealers began lacing other street drugs with fentanyl to increase potency. Weekend partiers now overdose in large numbers.

Lastly, the pandemic had a profound impact on addiction. Statistics showed that alcohol consumption in 2020 was 15% higher than just before the pandemic. There are troubling signs that the stay-at-home drinking binge has not abated. In addition, drug induced deaths skyrocketed during the pandemic. Many believe that the absence of in-person drug and alcohol fellowship meetings during the COVID lockdown, a lifeline for many recovering people, contributed to the problem.

Today, everyone knows someone who is fighting addiction. Most people accept addiction as a brain disease. The habitual intake of harmful chemicals causes changes in the brain systems that involve pleasure, reward, motivation and memory. Physical and psychological cravings and uncomfortable withdrawal symptoms make it more difficult for a person to stop using drugs or alcohol. The general population now understands that without medical intervention and therapy, addicts will continue to use a substance despite harmful or dangerous consequences.

Washington County has always been in the vanguard of addressing addiction through sound recovery options. There is a vibrant recovery community with multiple fellowship meetings every day of the week. When I sought treatment over twenty years ago, Greenbriar Treatment Center was already well established. After leaving Greenbriar, I was fortunate to become a resident of a local recovery house for six months that broadened my ability to live as a sober individual. Today, there are three long-term recovery houses for men and four for women that operate within the county.

In recent years, local government and the courts have recognized that addiction and recovery require pro-active solutions other than incarceration. President Judge, John DiSalle, supervises Washington County’s Drug Court along with a full time probation officer and case manager. This team works together to support and monitor a participant’s recovery. The twenty-three month program maintains a critical balance between supervision and encouragement.

Former District Attorney Eugene Vittone was instrumental in organizing the Washington County Drug and Alcohol Commission in 2003. He was proud of how this independent non-profit worked collaboratively with county government to facilitate its prevention programs. The aim was to help alcoholics and addicts recover in a nonjudgmental way. The D&A Commission now offers support in job training, housing, transportation, childcare and connections to mental health resources. Washington County was one of the first in the Commonwealth to provide naloxone, a life-saving medication used in the event of a suspected overdose, to first responders and the public.

Not all is well in the local recovery community. New legislation designed to provide state oversight of drug and alcohol recovery houses has made it difficult for small, independent operators in Washington County to comply. Some misplaced regulations undermine the “house rules” voted on by the residents to keep order and insure sobriety. Local recovery houses have stayed in business and continued to get referrals because they know what works. Unfortunately, state bureaucrats, even with good intentions, do not.