Hoffman Is Not Alone
The loss of Philip Seymour Hoffman is indeed a dark moment for American cinema. This author still remembers the brilliant intensity that Hoffman brought to his portrayal of rock journalist Lester Bangs in “Almost Famous,” over a decade ago. Yet to focus only on Hoffman’s celebrity is to do a disservice to the pandemic of opiate abuse that has this country in a chokehold.
The governor of Vermont, in his State of the State speech in January of 2014, spoke at great length about the “full-blown crisis” that heroin has caused statewide.[3] Abuse of opioid prescription medications like OxyContin has skyrocketed year-over-year nationwide, with no end in sight. And every day, another hundred lives are snuffed out by these drugs.
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A New American Addiction Crisis
Hoffman has become one of the more recognizable names and faces associated with heroin addiction, but this problem is much bigger than the late actor. Here are a few sobering statistics to help paint a picture of how the problem has worsened over the last decade plus.
- The number of nationwide deaths involving heroin increased from 3,041 in 2008, to 8,260 in 2013.1
- The Office of National Drug Control Policy estimates there are 1.5 million Americans who are chronic heroin users (anyone who has used heroin at least four different days in the past month)[4]
- The RAND Corporation estimates there are as many as one million daily heroin users in the United States.[5]
- In 2012, 156,000 people used heroin for the first time, a significant increase over the 90,000 who tried it for the first time in 2006.[6]
- In 2011, 4.2 million Americans aged 12 or older admitted to using heroin at least once in their lives.[7]
- It is estimated that approximately 23 percent of all heroin users will develop a dependence.6
- The number of people who met the criteria for dependence or abuse of heroin, based on the most recent Diagnostic and Statistical manual of Mental Disorders, more than doubled from 2002 (214,000) to 2012 (467,000).5
The heroin addiction problem in the U.S. is a slowly growing epidemic that is only outpaced by the nation’s problem with opioid prescription pill abuse and addiction. Many theorize that opioids like OxyContin and Vicodin (which have similar effects to heroin) have become gateway drugs for heroin abuse. The National Institute on Drug Abuse reported that nearly half of all young people surveyed in multiple studies admitted to using prescription opioids before starting heroin. Some reported switching to heroin because of its affordability and availability.
Many Are Not Seeking or Receiving Treatment
At approximately 44,000 annually, more Americans die from drug overdose deaths every year than from any other cause. The CDC reports that the amount of drug-related overdose deaths have increased by more than two fold since 1999. But of the 22.7 million Americans who needed drug or alcohol treatment in 2013, only 11 percent actually received it.[8]
While this low figure is partly based on addicts not seeking rehabilitation or not seeing the need, it is also based on insurance companies not paying for inpatient treatment. Much of this is a byproduct of an erroneous point of view held by many private insurance carriers that addiction withdrawal is not a life threatening condition.
The National Alliance on Mental Health Illness found that patients are denied care for substance abuse more than any other medical condition.[9] USA Today reported that studies have shown people with private insurance are up to six times less likely to receive addiction treatment than people with public insurance.7
At approximately 44,000 annually, more Americans die from drug overdose deaths every year than from any other cause.
Instead, many insurance companies are offering outpatient treatment initially, in what is being criticized as a “fail first” strategy; meaning addicts are being forced to fail at less intensive outpatient rehab before being allowed to enter residential treatment. Additionally, for recovering addicts who happen to have an unfortunate relapse (which is highly common), insurance companies are even less willing to pay for rehab a second time.
According to Tom McLellan, former drug czar deputy under President Barrack Obama, even when insurance companies do pay for rehab, it is often not the 30 – 90 day complete treatment that is optimal for recovering addicts; instead, they are often offered treatment that is under 20 days. McLellan said that average duration is 11 – 14 days, a woefully inadequate amount of time for most addicts.[10]
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What Can We Learn?
Let us celebrate Hoffman’s life and mourn his passing with every bit of gravitas an actor of his caliber deserves. But afterwards, we cannot let ourselves go back to ignoring the elephant in the room. Heroin and its derivatives are killing thousands of people every year, and if we do not begin to educate the public and further develop our facilities for providing compassionate substance abuse care, that number is only going to increase.