Drugs Are Bad

RECEIVED Mon., Dec. 30, 2019

Dear Editor,
    Re: “Making the Trades,” News, Dec. 27 [2019]: What young people need in order to do well are vocational goals and, even more importantly, meaning in life; they need to develop resilience and an ethical personal culture. A problem with vocational goals is the flux in changing job markets – truck drivers losing their jobs because of self-driving trucks, etc. Learning to be ethical includes practicing compassionate empathy without us-versus-them thinking and avoiding abuse behaviors (abuse means unethical use).
    Today’s youth are involved in numerous harmful subcultures. One of the most damaging is extreme nicotine abuse; nicotine has been/continues to be the main gateway drug to worse addictions. Many young people have a history of physical, emotional, and sexual abuse. There are many aimlessly drifting and traumatized young people who are drawn into drug-using subcultures. These individuals cannot adequately benefit from job coaches and college without specific treatments. Yet, there is widespread ignorance and our health care system fails most of these patients.
    How to address the drug abuse contagion? As in any epidemic, patients that spread the disorder need effective treatments. Some patients would benefit from long-term, low-intensity residential treatment, which is hardly available. AA sometimes helps. Virtually all opioid-addiction patients need prolonged methadone or, in lesser addictions, buprenorphine maintenance, as Juul addicts benefit from nicotine patches. These slow-onset, long-acting medications help people function normally with little craving. Most patients need also psychotherapy, educational-therapeutic groups, and/or treatment of other disorders, particularly depression, ADHD, and PTSD. No short-term hospital program will do. Both detoxification of opioid addicts and the popular, expensive Vivitrol have unacceptable rates of relapses and sometimes-lethal overdoses after discharge from treatment; and many “successful” patients move to other/worse abuse patterns: methamphetamine, alcohol, food, etc.
Heinz Aeschbach, M.D.
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