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Linda Rosenberg

Former President and CEO, National Council for Behavioral Health

Philip Seymour Hoffman’s Death Reinforces Our Greatest Public Health Crisis

February 6, 2014 | Addiction | Comments
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Days after he was found dead in his apartment from a heroin overdose, Philip Seymour Hoffman is not even trending on Twitter any more. Old news already! Hollywood paid its tributes. And we’re ready to move on.

Hoffman’s death is the latest in a string of celebrity overdose deaths. But as before, we experience no sustained outrage. We see no attempt to address what is clearly America’s biggest public health crisis — substance use disorders.

As Vermont’s Governor Peter Shumlin reinforced during his State of the State, heroin is a public health problem that needs a public health solution: treatment.

Hoffman’s history reminds us that heroin is not a new problem. He was in recovery for more than two decades, but as with so many others, he relapsed. In 2008, when there was a crackdown on prescription opioids — in reaction to the growing number of fatalities — it led to a drastic drop in the availability of prescription opioids. But opioid addiction has not gone down: instead, people appear to be turning to heroin, it’s cheaper and it’s available.

For every Hoffman, there are hundreds like Emylee Lonczak, a 16-year-old who died from an overdose after her very first heroin injection. Her story was in the news just a day before Hoffman was found dead. James J. Hunt, acting special agent in charge with the Drug Enforcement Administration, says heroin is “pummeling the northeast, leaving addiction, overdoses, and fear in its wake.”

The fact that Hoffman had relapsed emphasizes that addiction is a chronic disease, and very difficult to control without ongoing treatment and community supports. Yet, we know that only 1 in 10 people with addiction disorders receive any treatment at all. For those who do, it is usually short term without ongoing care.

Effective treatments are available for addictions. For some people, it’s medication-assisted treatment: methadone, buprenorphine, and extended-release naltrexone offer good options particularly when paired with counseling and support.

Some think that when someone overdoses, it’s because they didn’t use drugs in a smart way. But with heroin, there is no “smart” way. Nobody knows what’s in a batch. Recently heroin’s potency appears to be boosted by forms of fentanyl. There’s no way to tell until it’s too late. Harm reduction messages are important: don’t inject alone, take advantage of “Good Samaritan” laws to call 911, and have naloxone available for resuscitation. These are short-term solutions to save lives. But the longer-term solution can be only in comprehensive treatment and community supports.

We must redesign care for substance use disorders using a chronic disease model and create capacity to deliver such care in every community. It will take the growing movement of people in recovery and their families as well as families that have lost their loved ones, supported by all of us  — advocates, researchers, organizational leaders, educators and practitioners — together driving policy and practice change. The time has come.