- The Washington Times - Sunday, January 6, 2008

ANALYSIS/OPINION:

We face a crisis of drug and alcohol addiction in America. Most experts agree about 10 percent of our population of 300 million are addicted or routine users. Many more family members, friends, co-workers and employers suffer harmful consequences — and our medical establishment is strained by people with addictions.

On Jan. 1, in almost every hospital emergency room across America, at least one or two individuals could be found suffering from Delirium Tremens (DTs), milder tremors, seizures and other alcohol and drug-related overdose symptoms.

My friend, physician and recovering alcoholic Len, took me for a post-party tour of a big city hospital emergency room on New Year’s. “Look at the carnage following the biggest annual drinking binge Americans wink at every year. It will look like this the Monday after the Super Bowl, too,” Len told me.

In fact, experts say “Super Bowl Sunday” is the biggest day for drinking in America because it is an all-day party. Most police issue more tickets for impaired driving on “Super Sunday” than on any other day. And the Center for Science in the Public Interest claims beer and alcohol ads for the Super Bowl target underage drinkers.

Len invited me into his work environment after reading an article I wrote in the Dec. 27 Commentary section of The Washington Times.

That article discussed the time of year when many recovering alcoholics and drug abusers relapse and end up in the hospital: the “holiday” season between Thanksgiving and Jan. 1.

“For all sorts of reasons, many of the addicted who are in recovery and making progress crash and burn during the holidays. I think the pressure and chaos of buying too many presents and acting like a Boy Scout drives some in recovery back into really bad and sometimes fatal habits,” Len said.

Len is a recovering alcoholic who attends daily Alcoholics Anonymous (A.A.) meetings. Len is not his real name. We agreed to protect his anonymity in keeping with A.A. traditions and guarantees.

As an emergency room physician, Len has gained invaluable insight into the disease of the mind called addiction. He is also an expert in how many of his colleagues treat alcoholics and the drug addicted.

“Most physicians I know are first-rate. They care deeply for their patients, spend the time necessary to provide excellent care, and operate fair and honest practices,” Len told me.

But once Len finished with what sounded like an American Medical Association (AMA) commercial, I told him I had personally seen some sloppy, even potentially criminally negligent “care” of the addicted doled out by his M.D. colleagues.

Two patients seeking emergency care for bouts with alcohol were not admitted to emergency rooms while I researched this topic. They were told to make an appointment for 10 days to two weeks later. For some this poses a life-threatening dilemma. We also experienced physicians misprescribing and overprescribing drugs and medications to patients they knew were addicted.

One doctor had his sleepless patient on Ambian for two years. The maximum recommended duration of Ambian therapy is one week. Ambian is addictive. We also saw doctors giving Xanex to drinking alcoholics to relieve anxiety. Xanex relieves anxiety in people who do not drink: It is never recommended for heavy drinkers, who react violently to it and vomit sometimes for hours after taking it and experience other distressing and even life-threatening side effects.

We also met a man who went to his doctor two years ago with severe anxiety symptoms. Today he rarely ventures out of his one-bedroom apartment. There are three deadbolts on the door. He has five prescriptions delivered to his apartment when he needs refills. He is no longer able to work. He is lost as a productive member of his family and our American society.

“There are doctors in America who are killing alcoholics and drug abusers because they haven’t properly availed themselves of the literature and education needed for treating the addicted and they pay too little attention to the warnings associated with all medications,” said Bill Alexander, who manages a private drug and alcohol rehabilitation facility.

We also observed a clear disregard for many addicted patients — an attitude and action akin to racial prejudice. Alcoholics can be viewed as “winos” or other disreputable types not worthy of full and complete diagnosis and care. If the addicted man or woman seeking treatment unsettles the doctor, the doctor might quickly end the evaluation phase of treatment and hastily write prescriptions for pain killers, sleep aids and other drugs.

“Some doctors, but clearly not all, cut corners. They reach for the prescription pad too readily. Even when the vast majority of care givers to the addicted advise doctors to first consider a cold-turkey detoxification — without the benefit of additional medications,” Mr. said Alexander.

Len agreed with this assessment. “We doctors write prescriptions sometimes even when they are not mandated. Insurance companies pay most of the cost and the doctor feels that he has taken action on behalf of his patient. Some have even told me, ‘I gave the patient exactly what he wanted.’ ”

Despite the herculean efforts of an army of diligent caregivers and treatment facilities nationwide, many alcoholics or drug addicted people are misdiagnosed, living on the streets, ignored, abused or shunned. Treatment facilities and inpatient care is at maximum capacity with no room for newcomers. And the care of medical professionals is stretched thin. One doctor told us, only after asking for anonymity, “You’ll be lucky if this man can see a physician’s assistant or a nurse. There are no doctors available.”

Between the end of the holiday season and “Super Bowl Sunday” might be a good time to reassess America’s response to a growing number of alcoholics and drug addicted people in need of treatment. We can ill afford to ignore or “write off” the 10 percent of our potential productivity, science and arts that this segment of our population represents.

John E. Carey is a frequent contributor to The Washington Times, a former senior U.S. military officer and president of International Defense Consultants, Inc.

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