A front-line actor who changed the drug epidemic

Dupont in DC

Source: Property of Dr. Dupont

In the United States, opioid addicts were once demonized as hopelessly ill and treatment options were virtually nonexistent. No one probably did more to change both than psychiatrist Dr. Robert Dupont, who was working with inmates in the District of Columbia Department of Corrections in 1969, when crime in the nation's capital was inexplicably rising. DuPont decided to drug test newly arriving inmates and was shocked to learn that nearly half (45%) were heroin addicts. Desperate for heroin, they turned to crime to make money.

At the behest of the district's mayor, DuPont established a clinic in Washington, DC, the Narcotics Treatment Administration. It treated over 15,000 heroin addicts over the next three years, and the crime rate in Washington fell by 50% as a direct result.

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Robert L. “Bob” DuPont, born in 1936, graduated from Emory University and Harvard Medical School and completed his psychiatric training at the National Institutes of Health. He became the first director of the newly established National Institute on Drug Abuse (NIDA), where he developed the first comprehensive training program of its kind for doctors, nurses, and counselors in addiction treatment programs. Drug overdose deaths began to decline, from 6,413 to 2,492 in 1980.

In 1978, DuPont left government service to found the Institute for Behavior and Health (IBH), a think tank dedicated to drug policy. Dupont has published more than 400 journal articles and 15 books, most recently Chemical Slavery: Understanding Addictions and Stopping the Drug Epidemic (2018).

The IBH conducted the first nationwide study of drug and alcohol-dependent physicians, their treatment and five-year outcomes. “Physicians are fully evaluated by a team of professionals and treated for comorbidities, but the focus is on their addiction. They are typically treated in an inpatient setting for a month or more and monitored as outpatients with random drug and alcohol testing for five years. If they miss a scheduled test or are found to be positive for any drug, including alcohol, they are removed from their practice, re-evaluated and sent back for treatment.”

DuPont points out that many doctors who participated in the program were initially upset because they thought there was nothing wrong with it – which is typical of people with substance use disorders from all walks of life. Still, most doctors valued their licenses very much and the overwhelming majority cooperated because participation and success enabled them to continue practicing medicine.

His study of nearly 1,000 drug-addicted doctors who were closely monitored for five years showed what is possible for the rest of the population. 78 percent never tested positive for drugs or alcohol, an excellent record. In addition, of those who did Almost two-thirds of them never tested positive a second time or did not test positive a second time.

A follow-up study of physicians who had successfully completed treatment and monitoring contracts five or more years previously found that more than 95% of them were still in recovery. Physicians rated the treatment they had received as important to their recovery, but said the most valuable part of their care was participating in the 12 steps.

Dr. Tom McLellan, Surgeon General Murthy and Bob Dupon

Source: Robert L. Dupont, MD

Lessons from drug abuse

According to Dupont, many people don't realize that most drug users rarely use just one drug. And that's especially true for people who die of an overdose, where two or more drugs can often be identified post-mortem.

He also points out that many of the drugs used today not in their natural form, but are highly potent synthetic substances such as fentanyl. In 2022, about 111,000 people died and in 2023, about 108,300 people died from a drug overdose.

Early diagnosis and treatment are crucial

The sooner patients are diagnosed and treated, the better their chances of recovery and lasting effects, says DuPont. Many people can abstain from substance use for a period of time. real Problem is not It is not drug withdrawal, as many people believe, but repeated relapses. Nevertheless, he has known many people with seemingly hopeless drug or alcohol problems who have emerged sober and productive. He owes this mainly to organizations such as Alcoholics Anonymous and Narcotics Anonymous.

Prevention is the best

If possible, it is best to prevent drug use, especially among young people. Not only is puberty the start of most addictions, but the brain is also particularly vulnerable during this time.

DuPont is now focusing on preventing youth substance abuse: no alcohol, nicotine, marijuana/THC or other drugs for anyone under 21. He notes that the percentage of 12th graders who say they have never used drugs in their lives has increased from around 26% in 2018 to 32% in 2023. The trend is also evident among younger students. DuPont emphasizes: “This trend is the key to reversing decades of pain, suffering and addiction.”

Dr. Robert DuPont, 88, advocates for treatment research, long-term treatment with outcome reporting, equal treatment for mental illness (which is just as important as physical health), and prevention. Recovery, he stresses, is possible.

Dr. Dupont presents his research at ASAM

Source: Property of Dr. Dupont