The U.S. government reported that 130 Americans die every day from an opioid overdose. The growing crisis costs the country approximately $75.8 billion a year in lost productivity, criminal justice intervention, and healthcare. Those costs are expected to keep rising in the coming years, according to a January 2019 U.S. News & World Report article.
That expectation reflects an element of insanity underscoring the gravity of this crisis. If policymakers, doctors, public health officials, and others keep trying to tackle the opioid crisis with the same methods that have been failing, then yes, the crisis will continue to escalate. According to the American Psychiatric Association, already one-third of Americans know someone who is or was dependent on opioids. Changes in how opioid use disorder is identified and treated — or better yet, prevented — will be key to turning the epidemic’s tide.
Labeling vs. Understanding: The Zero-Sum Game of Substance Abuse Stigma
People living with opioid dependence or addiction are often labeled “addicts.” They then carry the connotation that their opioid abuse is a personal failure or some untenable character flaw. Furthermore, the mental health conditions or other underlying causes that led them to develop substance abuse disorders are minimized, disregarded, or overlooked.
Oversimplifying opioid use disorder by labeling people with the condition “addicts” can make them feel isolated and hopeless. Don’t shame, shun or ignore a person living with an opioid dependence. Attempting a “tough love” approach by abandoning them will also do more harm then good. On the contrary, providers and their loved ones need to show them that they are seen, heard and understood.
Unaddressed Factors Keep Driving the Opioid Crisis in America
According to the National Institute on Drug Abuse, about 80 percent of people using heroin first misused prescription opioids. Opioid dependence and addiction — including the use of heroin, fentanyl, and prescription painkillers — has been increasing since the 1990s when oxycodone, brand-name OxyContin, surfaced.
At the time, physicians and researchers said this powerful new class of painkillers was safe and non-addictive, which caused rampant over-prescribing. Furthermore, medication abuse was at a rate of nearly 30 percent for those taking prescription painkillers. Lastly, people are turning to cheaper, more accessible, and more powerful illicit street varieties. Not much has changed to slow these trends. In 2012, doctors wrote 259 million prescriptions for opioid painkillers — enough for one prescription for every single American adult, according to the American Society of Addiction Medicine.
This opioid crisis isn’t just a consequence of a lack of oversight by the medical community. Emotional and psychosocial factors are at play, too. America is rife with heated political and social disputes, strained economic conditions, and a culture that rewards instant gratification. Individuals are facing loss, trauma, chronic stress, and emotional and physical pain, with 59 percent of Americans saying they consider this to the lowest point in U.S. history that they can remember, according to a 2017 American Psychological Associate report that surveyed multiple generations.
Self-medication has become a common response. Yet the despair fueling the need to self-medicate continues to go unaddressed. Instead, treating the symptom — addiction — has become the standard.
Treating Addiction with More Drugs
People with opioid dependence and addiction receive socially acceptable and legal ways to feed their addiction under the guise of help or treatment. These substitute opioids — such as methadone, naloxone, and other pharmacological interventions — can mitigate the disruptive effects of opioid withdrawal, but they don’t end the dependence.
These replacement opioids end up propagating the very cycle they claim to try to address. People who are off heroin but reliant on Suboxone to survive the day are not free of their addiction.
See Also: The Truth About Substance Abuse Treatment — 7 Common Myths Debunked
Replacement opioids extend the sense of numbness and escapism that originally led the person to develop opioid use disorder. This numbness keeps people from seeking clarity about their underlying feelings — and often removes the incentive to do so. These drugs aren’t coping mechanisms or crutches; they become chains with different names, keeping the person in bondage to substance dependence.
Without detoxing from the substance, the person cannot get the much-needed clarity to discuss an accurate diagnosis of the underlying cause of the dependence with their doctors. And without accurate diagnoses of and treatment for those issues – whether mental health conditions, unresolved trauma, underdeveloped coping skills, anxiety, or other struggles — successful treatment and lasting solutions will continue to elude the individual and the country.
Patient-First Approaches to Help End the Opioid Crisis
Opioid addiction affects every aspect of the socioeconomic scale. Drugs do not discriminate — but healthcare providers and members of society have. Instead of labeling all people struggling with opioid dependence as addicts and funneling them into a cycle of failed treatment methods, communities, doctors, and policymakers need to consider a more effective person-first approach.
The person-first approach to addressing the opioid crisis requires a significant reprioritization in treatment, starting with the following:
- Place a higher value on the individual’s and community’s healing.
- Utilize treatments such as medical detox to help a person eliminate physical dependence on opioids.
- Leverage the clarity gained from detox to treat the real causes of the person’s drug use.
- Evaluate other methods of treating long-term pain.
- Provide the support systems necessary to help a person maintain treatment for those underlying causes of dependence to stay opioid-free.
The in-depth, state-by-state analyses provides the devastating statistics which illustrate the gravity of the opioid epidemic are helpful to an extent. They capture mass attention to increasing awareness. But they shouldn’t be accepted as signs the problem is unfixable. The crisis doesn’t need to continue to escalate for years to come if they employ new approaches to finding real solutions and cast aside failing methods.
Reviewed by Clare Waismann, CATC, Founder of Waismann Method® Advanced Treatment for Opiate Dependence
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