The Tip of the Iceberg: PSH & the Opioid Epidemic
Like pretty much everyone else who's seen a few films over the last couple of decades, I was delighted with Philip Seymour Hoffman's acting skills. He racked up some amazing credits over two decades. I looked forward to seeing him mature and develop further. I thought he'd end up with one of those enduring, amazing careers like Paul Newman or Kirk Douglas, icons of my youth.
I didn't know he was 23 years in recovery from alcohol/drug addiction that overtook him at a very early age.
Twenty-three years, clean and sober.
Relapse can happen to anyone, and all too frequently does. We're starting to learn more about why, but that doesn't make it any easier to avoid.
Still... twenty-three years...
What, then?
Sometime in 2012 he began taking prescription opioids. I can't find any information on the "why" of that. A lot of people get prescribed these substances for conditions like back pain, oral pain connected to dental work, post-surgical pain, a whole raft of conditions. Ironically, we're learning now that with the exception of cancer pain, opioids may not be the best treatment strategy for chronic pain: They tend to lose effectiveness and sometimes even increase sensitivity to pain.
Maybe Hoffman was prescribed his first course of opioids. There was a great deal of hype (from pharmaceutical companies, natch!) about how "safe" they are, how non-addictive (yes, seriously, they MADE THAT CLAIM!) when 'used as directed', etc.
Maybe he wasn't prescribed them. Maybe he got them from a friend after complaining about pain. Maybe he believed the hype, assumed he could just take them for a short time to deal with a temporary condition.
Maybe he "relapsed by intent," and took them hoping/assuming the hype was true, and they wouldn't grab him as hard as "street" opiates, and he'd be able to kick them easier.
Except the hype wasn't true. Those "safe" prescription opioids are highly addictive, all too often lethally so.
Mr. Hoffman knew he was in trouble. He tried treatment in 2012.
In 2006, reflecting on the addiction that drove him into recovery in the first place, he said “I think back at that time, if I had the money, that kind of money and stuff, I would have died.”
This time he had the money.
He's not the only prescription opioid addict to make the switch to heroin. The painful truth about opioid addiction is that the brain adapts very quickly to the "high" sensation of any specific opiate, and it loses the ability to satisfy the craving. So they increase amounts. They look to other forms of opioids, to return to that potent "high" state.
And that quality of opioid addiction makes the struggle to quit all the more hazardous. A period of abstinence can decrease tolerance, sometimes drastically so, a phenomenon called the "kindling effect." Dosing themselves at the level they last used without even feeling the effects much becomes a lethal overdose.
The pharmaceutical industry, in its manic greed for profits, has preyed on chronic pain sufferers for a long time. In the past couple of decades they've ramped up the process, developing ever more potent tropes on the basic opioid analgesic mechanism, and carefully avoiding any research and testing that might contradict their claims of "safety." They've touted it for every kind of pain from acute cancer pain (the original justification for the medications) to chronic back pain, to temporary post-root canal pain.
We are now dealing with the consequences of the resulting opioid epidemic.
I wish I could say that the end is in sight, that we're on this one, that we're even making a dent in slowing the spread of the damage. But alas, I'm afraid that we're only seeing the tip of the iceberg.
sadly,
Bright
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