(Seventeenth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
Perhaps it is impossible for a person who does no good to do no harm.
–Harriet Beecher Stowe
(a fitting quote and post for Martin Luther King Jr day 2021)
I think Harriet was on to something. Raised in a prominent family in Connecticut during the early years of the 19th century, her father was a preacher who spoke vehemently against slavery. The 13 children were taught to fight injustice and to influence their society towards doing what was right. The Fugitive Slave Act of 1850 was the result of Southerner’s new justification for slavery: a societal good ordained by God and Scriptures. Northern Christian abolitionists felt the Bible clearly taught the opposite: slavery was common throughout history but was not God’s plan.
Activists on both sides were in a deadlock and they needed to persuade the majority of citizens to commit to one side or the other. Harriet’s firsthand knowledge of the abusive treatment and plight of many escaped slaves prompted her to write Uncle Tom’s Cabin in 1851. It was an overnight success that exposed Northerners to the truths about slavery because her story vividly dramatized the horrible and violent experiences of slaves so people could relate to them personally.It was a turning point for the abolitionist movement that grew into a large social-political force while inciting anger in the South. Uncle Tom’s Cabin is considered one of the primary contributing factors leading to the Civil War.
Clearly, if you don’t do anything, you may not directly hurt someone. But inaction won’t help anyone and it is likely to cause harm. We actually do harm when we withhold good. This is what Harm Reduction and Medication Assisted Treatment (MAT) is about. After decades of unnecessary and premature deaths from drug overdoses, the medical and addiction recovery community realized that addiction is not a one-dimensional moral issue. Telling someone they can simply decide to not use drugs and to not help them in ways that we can is harm-full. The Hippocratic oath for physicians: First, Do No Harm, serves as a moral and ethical guide to practice medicine to the best of one’s ability, and to give sympathy, compassion, and understanding.
Sadly, I relate personally to the antiquated approach to addiction when it comes to our son and his decade-long battle with opioid addiction as reflected in this journal entry from Chapter 14:
October 27, 2014
Mom here. My heart breaks as I think again of you at our appointment with Dr. Cai last January saying, “I never want to use opiates again.” It is a sadness I will always remember and feel strongly about because we didn’t “get” that you needed more than 12-Steps or Alcoholics Anonymous to support that desire. You needed physical help (i.e. medicine), too. And I tell people this every time I tell your story, and someone says they know someone or a relative who is an opiate addict. Maybe it will give someone else a second chance for their loved one before it is too late.
To this day, over 6 years since JL’s death, it is hard for me to look back to the last year of his life. To be fair, before our son died in 2014 we hadn’t heard of Harm Reduction or MAT, although we knew medication was an option. Our regrets lie in not taking the advice of his doctor. By doing so, our inaction inadvertently caused harm, leading to our son’s death.
What I can do now is to work to influence as many parents and loved ones as I can to actively do good for those who struggle with addiction and not just watch them self-destruct without throwing them any and every lifeline available.
Some of the best options available for opioid addiction treatment:
- Suboxone Sublingual Film® – A combination of buprenorphine and naloxone (also known as Narcan®). This is the most widely used form.
- Subutex Sublingual Tablets® – Contains only buprenorphine.
- Buvidal® is a modified release formulation of buprenorphine for administration by subcutaneous injection once a week (Buvidal® Weekly) or once a month (Buvidal® Monthly).
- Sublocade® is an extended-release formulation of BPN, administered monthly by SC injection.