To raise awareness that abstinence kills.
The concept of abstinence developed over the 19th and 20th century through the Temperance Movement, Prohibition, and the development of Alcoholics Anonymous (AA). The point is that abstinence strategies evolved to deal with alcohol during an era when medical treatments did not exist. Today, abstinence is also being applied to opioids in an era when very effective medical treatments are available.
Alcohol kills over 178,000 Americans every year, more than double the 84,000 American lives lost to opioids in 2022. Yet fatal alcohol overdoses are rare. Why?
Alcohol is consumed very differently from opioids, cocaine, or methamphetamine. Alcohol is consumed slowly in small servings (a bottle of beer, a glass of wine, or a shot of liquor) and in microservings (sips and slurps). It generally takes over an hour for alcoholics to consume their daily dose. Alcoholics almost always pass out before they can consume a lethal dose of alcohol, protecting them from overdoses.
By contrast, people addicted to opioids, cocaine, or methamphetamine consume the drugs all at once as one line of powder, one syringeful of drugs, or some pills. The lethal dose can be exceeded immediately without any warning. There is no opportunity to slow down.
Both alcoholics and opioid addicts lose tolerance if they stop all use and become totally abstinent. Loss of tolerance to alcohol does not lead to fatal overdoses because alcoholics with lower tolerance will still pass out and stop drinking before they can consume a fatal dose.
Opioid addicts who become abstinent become vulnerable to fatal overdoses because they have lost tolerance and much lower doses of opioids could kill them. Abstinent opioid addicts are at much higher risk of dying when they relapse from states of abstinence. The higher risk of fatal overdoses for abstinent opioid addicts have been documented for the following situations:
- After release from jails & prisons
- After finishing a drug-free rehab program.
- Discontinue medications for opioid use disorder (suboxone, methadone, or naltrexone).