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Stopping the Overdoses: America’s Problem with Opioids

You quite literally must have been living under a rock for the past five or six years if you don’t know America is facing a drug overdose epidemic. Last year, as reported by the NIH, the National Institute on Drug Abuse, a total of 64,070 people died from a drug overdose in the US. That’s more than 175 fatalities every single day – over seven per hour. Overdose is now the leading cause of what’s known as injury death, surpassing both car crashes and gunshot wounds. Approximately two-thirds of these fatal drug overdoses are caused by opioids.

It’s important to recognize two things before we move on. One is that heroin, while quite deadly, is actually responsible for much fewer deaths than synthetic opioids, such as fentanyl. These synthetic opioids are usually cut into such drugs as heroin or OxyContin (or other opioid pharmaceuticals), and are up to 100 times more potent. Single grains of some commonly abused synthetic opioids can kill a full grown human being.

The other important thing to recognize is that there are indeed a remaining one-third of fatal overdoses that are not caused by opioids. For instance, cocaine was responsible for well over 10,000 deaths last year. Meth killed nearly 8,000 more, and methadone, one of the most popularly used medicines to treat opioid addiction, killed over 3,300 people. So yes, we are most definitely amidst an opioid epidemic, but it is just 66% of what we’re truly facing: a drug overdose epidemic.

Public Health Emergency

Maybe it’s just a synonym for ‘epidemic,’ but last October, President Trump and his Commission on Combating Drug Addiction and the Opioid Crisis declared the situation an official public health emergency. By doing so, a handful of benefits came about:

  • There is now more availability of telemedicine services, an example of which is remote prescribing of substance abuse medicines. This means a doctor in Kentucky could access the medical records of his or her addicted patient in Virginia and prescribe medicine without a physical visit.
  • There is now less resistance in the hiring process for the Department of Health and Human Services, meaning quicker acquisition of the necessary clinicians and specialists and other critical employees who are essential in the combat against drug overdoses.
  • The Department of Labor is now able to produce dislocated worker grants, which give funding to workers who have been “displaced from the workforce because of the opioid crisis…”
  • The resources of HIV/AIDS programs are now able to be shared with substance abuse treatment programs. This is monumental, considering the close ties between HIV/AIDS and opioid abuse.

Whether you’re a fan of Trump or not, his administration’s decision was a good move for our nation. In addition to declaring a public health emergency, several other government-based factors have come into play to help end the epidemic.

Continuing in Obama’s tradition, over $1 billion has been allocated to fight drug abuse since Trump has taken office. The Centers for Disease Control issued the Prescription Awareness Campaign, which aims to increase awareness surrounding prescription drug abuse. The multimedia-based campaign shares real stories of people whose lives have been torn apart by prescription opioid abuse. Since 1999, prescription drug overdoses have killed more American people than the entire Vietnam War did.

The Food and Drug Administration is doing what it can to crack down on the over-prescribing of opioid medications. The Opioid Fraud and Abuse Detection Unit, run by the Department of Justice, recently “netted the largest-ever health care fraud takedown, secured the first-ever indictments against Chinese fentanyl manufacturers, and seized AlphaBay, the largest criminal marketplace on the Internet and a major source of fentanyl and heroin,” as stated on the White House website (linked above).

The State Department has made it harder for people to access fentanyl ingredients. The National Institute of Health is working with big pharma to develop non-opioid pain relievers, and a potential addiction vaccination. Several government organizations are working on developing non-drug therapies for pain.

This is all wonderful, but is it specific enough?

The authors of a recent article published in Annals of Internal Medicine believe that race-and-gender-specific therapy would be much more fruitful – and they have plenty of evidence to back it up.

Trends in U.S. Drug Overdose Deaths by Ethnicity

The above subtitle is not the exact title of the aforementioned article. The actual title is Trends in U.S. Drug Overdose Deaths in Non-Hispanic Black, Hispanic, and Non-Hispanic White Persons, but you get the idea. The research team wanted to find out if ethnicity plays a factor in opioid overdose rates, and ended up discovering more than originally bargained for.

The team took death certificates of those who died from drug overdoses between 2000 and 2015 in order to determine the exact cause(s) of death. Then, the team split the information by four-year blocks of time, (2000-2003, 2004-2007, 2008-2011, & 2012-2015). This is customary. However, they also, according to Harvard Health Publishing, “broke up the data based on gender and race, separating non-Hispanic black, Hispanic, and non-Hispanic white people into different groups.” This is not customary. It is, in fact, a new methodology for such studies, making it groundbreaking in the world of medical publication.

The results create many lines of necessary conversation, some of which have not yet been discussed. For instance, the study’s results show that for all three ethnic groups, drug overdose death rates increased steadily over the sixteen year period. However, the overall death rate increased most among non-Hispanic black people aged 45 and older. Also, opioids were responsible for the most deaths among non-Hispanic white people, but cocaine was responsible for the most deaths among non-Hispanic black people.

In fact, alarmingly, “…from 2012 to 2015, deaths related to cocaine were almost as common in black men as deaths from natural and semisynthetic opioids were in white men.” This provides some evidence that the opioid epidemic may only have become an ‘epidemic’ once it became a ‘white’ problem as well. More on this later…

The study also showed that for Hispanic people, while death rates from drug overdose are lower than those of non-Hispanics, that between 2012 and 2015 “…there was a large spike in heroin-related deaths in both sexes.”

Opioids cause the most deaths of all drugs, regardless of age, gender or ethnicity. We are indeed facing an opioid epidemic. Still, as the study shows, cocaine and other non-opioid drugs are also killing people by the thousands, particularly in the non-Hispanic black community, wherein death rates from drug overdoses are quickest on the rise. Perhaps the results of this study prove that we need to take a more specific approach to how we treat/prevent addiction.

Time to Get Specific

First of all, dear reader, this particular section of this article will be based solely on the evidence found by the aforementioned study. As it is a first of its kind, no other published evidence exists that was found in the same manner.

Okay.

If cocaine is killing as many non-Hispanic black people as opioids are killing non-Hispanic white people, common sense tells us it’s time to focus on cocaine abuse treatment and prevention in non-Hispanic black communities. As said by Dr. Scott Weiner, author of the previously mentioned Harvard Health Publishing article, “With so much attention given to opioids, neglecting the important problem of cocaine can further exacerbate inequality in rates of overdose deaths [for non-Hispanic black people].”

Also, just because Hispanic people tend to show lower rates of drug overdose death than non-Hispanic people does NOT mean there isn’t a crisis going on in the Hispanic community. There sure is, and perhaps some culturally relevant approaches could help.

Finally, we have the issue of the opioid crisis being, as New York Times contributor Ekow N. Yankah calls it, a “white problem.” When one considers how in the 1980s and 1990s, crack-cocaine absolutely ravaged the non-Hispanic black community, and especially when one considers how the American government did nothing but criminalize first crack, and then seemingly the entire community, it becomes easy to see that Mr. Yankah is correct.

The attitude toward drug addicts and addiction itself is slowly turning from one of dissent to one of care and willingness to help. Surely the non-Hispanic black community could have used such an attitude shift when crack was killing people left and right. Now that the mortality rate among white males is on the rise, and higher than in many years, is it a coincidence that this attitude shift is occurring?

Obviously one hopes not, and the best way to look at this is optimistically; the war on drugs is shifting to a war on addition, and that is most definitely a good thing for everyone.

Addiction is a Disease

When a patient with a disease is seen by a doctor, all things are considered: lifestyle, family background, race, height, weight, etc. Why then shouldn’t the disease of addiction be treated the same way? The study talked about above definitely proves there is some worth in considering at least race when being treated for drug addiction. Perhaps the reason why anti-drug campaigns and educational programs are so “one-size-fits-all” is because addiction is still not fully viewed by the American public as a disease.

Consider the following quote from the New England Journal of Medicine:

“…despite the scientific evidence and the resulting advances in treatment and changes in policy, the concept of addiction as a disease of the brain is still being questioned. The concept of addiction as a disease of the brain challenges deeply ingrained values about self-determination and personal responsibility that frame drug use as a voluntary, hedonistic act. In this view, addiction results from the repetition of voluntary behaviors. How, then, can it be the result of a disease process? The concept of addiction as a brain disease has even more disconcerting implications for public attitudes and policies toward the addict.”

Basically, the author is saying that for the public to recognize drug addiction as a disease, an entire framework of opinions would have to be undone. That bum on the street begging for booze money? That’s not a lack of willpower. That’s an alcohol-addicted brain making poor decisions. That kid who is always doped up? That’s not some loser. That’s a kid who has become addicted and will continue to use despite adverse effects. You get the idea, hopefully… If addiction really is a disease, thinks the average American, then all of these addicts who we hold so low in society are suddenly on equal ground with, say, everyone who has Alzheimer’s. Well, yeah. That’s the idea. Why kick someone when they’re down and then expect him or her to change?

In Conclusion

If you enter into a treatment program at a The Recovery Team’s facility, you need not worry about whether or not your recovery will be catered to you. It will be. We aim to make your path to recovery as smooth and comfortable as possible, which obviously includes using personal aspects of all sorts.