A female heroin addict was asked why she did not carry sterile syringes to use when she injected drugs:   “Because, she answered, I would rather get AIDS than go to jail.”

There is an attitude that addicts should “just stop.”  Such thinking fails to account for the intense psychological and physiological craving that IDUs experience.  It is precisely this craving that compels IDUs to do whatever is necessary to satisfy that craving, including sharing dirty needles.  But there is a reason for sharing as the National Institute for Drug Abuse (NIDA) Director, Dr. Alan I. Leshner notes, “For an addict, there is no motivation more powerful than drug craving.” 

NIDA defines addiction as , “a chronic, relapsing disease, characterized by compulsive drug seeking and use, and by neuro-chemical and molecular changes in the brain.”  Research suggests that addiction is rooted in brain chemistry and may have a genetic basis.  Prolonged use of heroin or cocaine changes the brain.  According to a Yale University School of Medicine study, the brain function – size, shape and specific neuron functioning – of an addict is different from that of a non-addict.

Smoking, obesity and car accidents are public health threats that we seek to reduce.  No one expects to entirely eliminate these threats.  We look to reduction strategies such as banning cigarette advertising, requiring the use of seatbelts, and increasing insurance rates for smokers as means to curtail these behaviors.  Yet when it comes to drug addiction, our expectation seems to be an impossible standard – complete abstinence – and now.

Defining how local communities respond to drug abuse prevention for their children and treatment needs for substance abusers is at the heart of this issue.  Recognizing that recovering from drug addiction is not only a matter of individual will helps insure discussion of realistic options to keep the community safe and thriving.