As a bill moves through Colorado’s legislature to tighten penalties on the possession and distribution of fentanyl, experts note the complexities and hardships of addiction.
Coreen Brade, the Colorado program assistant for the nonprofit Young People in Recovery, said that often, drug users self-medicate to deal with traumas within their lives. She said it can be a root cause of addiction.
“We don't self-medicate for enjoyment, so to speak. We self-medicate to escape,” she said.
With drug use comes shame, she said, and that creates a cycle. It starts with using drugs, experiencing an overdose, feeling too shameful to receive help, attempting to withdraw alone, and then ultimately, staying on the same path of using drugs.
How does she know? She was a drug user herself.
“I just made a choice and stopped, and it was evident,” she said. “I got pneumonia, and I was put in the hospital.”
Lisa Raville, executive director of the Harm Reduction Action Center in Denver, said withdrawal from opiates is 1,000 times more painful than the flu, which makes detoxing alone extremely difficult and keeps people from quitting drugs once their bodies becomes dependent on the drug.
Criminalizing the drug reinforces the cycle and contributes to the shame. Once someone is convicted of a felony, attaining housing or finding a job suddenly becomes very difficult, Raville said.
“There's a lot of people that can go to a bar, have a beverage and move on with their day. That's totally possible to have managed use with fentanyl, heroin, meth or cocaine," she said. "It’s completely possible, but because we’ve never had a good conversation about drug use in the United States, a lot of people fall for that ‘one hit, you’re addicted’ kind of stuff. Every time we have a beer, we know it’s a safe supply.”
She said some people can use drugs while maintaining a job, paying for a home, raising a family and achieving other life goals. Falling into the prison system can suddenly uproot everything.
State Rep. Kyle Mullica, D-Adams County and a trauma nurse, agreed that uncontrolled substances lead to many unintentional deaths. He disagreed with the comparison to alcohol.
“I don't think that, from a medical standpoint, that you should be taking these hard drugs ever, and I think it's tough to compare that to alcohol,” he said. “There’s a much higher risk.”
Effects of the stigma
Brade explained that drug use comes with stigma as well.
She described what a perfect world would have looked like when she was trying to stop using.
“People who understand what I was going through, nonjudgment, just to be able to walk into the police station or the hospital and say, ‘you know, I'm struggling with this, it does not feel good anymore, I don't know why I'm going down this path, but I'm stuck in this rut and I need some help’ and to be welcomed with open arms,” she said.
Michael Miller, opioid initiatives coordinator for Jefferson County Public Health, said stigma plays a very significant role in people’s ability to and comfort in accessing care.
“I think that there's a significant number of people who are afraid to go seek treatment or seek care for anything related to their substance use because in the past — they've been treated differently as a result of their substance use,” he said.
Within the medical profession, stigmas can come from doctors, nurses and other health care providers.
“People who use drugs and health care providers actually have a very tumultuous relationship, so what we need to be doing is really starting to have that conversation,” Raville said.
Braden said some of that conversation starts with changing the language around addiction, like saying a person has "a substance use disorder" instead of "addict, junkie or druggie," saying a person is "living in recovery" instead of an "ex-addict" and saying "had a setback" instead of "‘relapsed."
And Braden offered more insight into the word relapse.
“If I'm on my road to recovery and my car veers off the road and goes into the ditch, the tow truck doesn't pull me back out and I'm all of a sudden at my house again, that's not how that works,” she said. “They pulled me right out of the ditch, and I'm on the road moving forward.”
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