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Abstract

America is facing a reckoning born of its own duality. Our society is gradually embracing an increasingly permissive stance on recreational drug use, while at the same time we lament the human costs of addiction. What the media has dubbed the “opioid epidemic” has seen increases in drug addiction diagnoses and opioid-involved overdose deaths nearly every year since 1999. In a rush to designate guilty parties and to crown a “gold standard” for treatment options, we have focused on theoretically flawed approaches that fail to follow the science precisely. At the same time, we dismiss validated treatment modalities in their entirety based upon historical misapplications of those methods.

This multidisciplinary note advocates for the strategic use of what we will call New Paradigm Civil Commitment, or “NPCC,” wherein severely addicted persons would be compelled into longitudinal outpatient addiction treatment services until they can regain sufficient capacity to care for themselves. Such programs would be federally funded through grants awarded to local public health departments for implementation of the strategy. This review will seek to redefine the epidemic, illustrate how the proper designation necessitates a change in strategy, explore what those new preferred strategies should be, and then advocate for the implementation of said strategies both nationally and locally.

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