The death of one of our greatest actors today was avoidable. Hoffman's untimely death can be attributed as much to U.S. punitive practices as to his failed battle with addiction. Found on the bathroom floor with a needle in his arm and surrounded by dozens of heroin bags, the actor's death is the latest of a growing number of fatalities of drug users from overdoses of heroin.

According to the Drug Enforcement Administration (DEA), heroin seizures in New York state are up 67 percent over the last four years. And the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that 17,000 deaths a year are attributed to heroin use. Sometimes death comes from the tainting of heroin with a more dangerous substance, such as the painkiller, Fentanyl, an opiate that is 10 to 100 times stronger than morphine. Sometimes the death comes later from disease related to the use of dirty needles. But the biggest risk stems from the fact that there is no way for the user to regulate the dosage due to differences in levels of purity. Also following a lengthy period of abstinence, the user's tolerance level breaks down, and his or body is unable to handle a heavy dosage of the drug.

Reasons for the increase in the popularity of heroin, especially to middle class users, is the recent crackdown on use of the prescribed painkiller, OxyContin and related opiates. Patients who have become addicted are moving from this expensive and less available drug to cheaper drugs sold on the black market and relatively easy to find.

Philip Seymour Hoffman's struggle for sobriety was well known. He had received extensive treatment for substance addiction when he was in his 20s, and, only recently, he had turned himself in to a 10-day detox center for heroin abuse. We can assume that the ideology of these treatment centers like over 90 percent of those in America was of the total abstinence variety or referral to a methadone clinic for treatment by a synthetic opiate to reduce the craving. Although the use of methadone (or the improved prescription drug, buprenorphine) is regarded as a godsend to many, its attractiveness is far less than that of opiates.

The drug that Hoffman was addicted to, although highly addictive, can be prescribed on a regular basis and under close medical supervision safely and legally in a number of countries, the UK, Switzerland, Denmark, and Germany, among them. Patients receiving prescribed heroin can lead normal lives and their dosages carefully monitored. Treatment of heroin addiction as a public health rather than a criminal justice problem is the pragmatic approach to this form of addiction. This is a harm reduction approach of proven effectiveness in reducing overdose, contamination through dirty needles, reduction in crime and incarceration rates. According to research sources, such as the New England Journal of Medicine, prescription heroin is a safe and effective treatment for many.

To understand why the U.S. has failed to adopt the solution that is the most obviously practical, we have to consult our history books and study about the Puritans who introduced an ideology to this nation, some of which lingers today. Moralism is the predominant strain. This ethos is infused in our criminal justice system, our social welfare system, and even determines the form of substance abuse treatment that is provided. This is the one-size-fits-all mandate for total abstinence that many, such as Phillip Seymour Hoffman, cannot achieve. Hoffman was 46 years old and did not have to die.

About the Author

Katherine van Wormer, MSSW, Ph.D.

Katherine van Wormer, M.S.S.W., Ph.D., is the author or co-author of 14 books on various aspects of human behavior.

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