Dr. Trip Gardner likens the struggle with addiction to driving a car and attempting to pump a set of broken brakes.
A person suffering from addiction is able to recognize the harm they’re causing themselves and those around them, but the choice to use isn’t their own, Gardner told a crowd of about 50 people Wednesday night at a Dirigo Speaks event sponsored by the Bangor Daily News.
“Even if the person is thinking, ‘I don’t want to do it,’ the choice can be made, but there’s no reaction. Hit the brake, it doesn’t work,” said Gardner, who serves as chief psychiatric officer and medical director of Homeless Health Services at Penobscot Community Health Care.
There’s a disconnect in the brain between reason and the need to fulfill an addiction, which can be akin to the sensation of starving to death, Gardner said.
“What would you do if we turned off the oxygen in here? We would do things against our values to get that thing we needed,” he said. “You’re just trying to survive. We’re not able to register the consequences in a way that allows us to stop.”
Gardner believes addiction is a brain disease in need of a medication-assisted treatment plan.
But the first step toward mitigating the opioid epidemic in Maine and preemptively treating future generations of people predisposed to addiction is dissolving the stigma, he said. It should be treated as a disease in the same way physicians treat diabetes.
“We don’t really think it’s a disease,” he said. And for those who do believe it is a disease, “we don’t act like it.”
Shaming an individual into recovery doesn’t work and neither does forcing them to face recovery alone, Gardner said. It takes a coordinated effort across communities, institutions and health care providers, and should rely less on legal punishment.
“We want to make life easier for people not to have a felony hang over their head for the rest of their life for an addiction-related crime,” he said. Likewise, he said there aren’t enough primary care doctors offering medication-based treatment.
Last year in Maine, heroin and opioids were responsible for a record 418 overdoses, an increase from 367 in 2016. The Centers for Disease Control released preliminary numbers earlier this month ranking Maine the highest in New England and sixth-highest in the country for its rate of overdose deaths.
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