A View of the Opioid Crisis From the Front Line

In light of headlines both national and local regarding the Opioid Crisis, I wanted to take some time to discuss my thoughts on the matter as an addiction professional. I believe that it is important that those of us who work in the field share our experience, as well as possible solutions. From my perspective, these discussions should be free of partisan politics, and undertaken with the utmost humility, realizing that viewing a problem from multiple perspectives is surest way to find solution. Also, I believe that it needs to said that anyone who says they have a 100%, surefire-solution in regard to treating any addiction is probably selling snake-oil. Addiction is multi-layered, complicated, complex, and unpredictable. But we do know that there are treatments that work well, though not necessarily for everyone. My belief is that we need to figure out a way for people to have access to the most successful methods of treating addiction, and that means we as a society are going to have to find ways to make treatment affordable to all who suffer from addiction, not just the ones who can afford expensive treatment.

According to a U.S. News and World Report article, dated April 19, 2017, the government approved spending of $485 million dollars to combat the opioid epidemic.

“The grants are targeted at training for health professionals, technology and support for prescription drug monitoring programs that aim to prevent abuse and identify patients who may need help. Price said the grants also can be used to promote the use of overdose-reducing drugs such as naloxone.”

All of these measures, while positive, will barely put a dent in the problem. What concerns me is that there is no mention of how to help pay for expensive drug and alcohol treatment and therapy, both of which are proven effective in the fight against addiction. The article states that a large portion of the money will be used to help train professionals. Again, this is a positive step, but there are thousands of trained professionals ready to help those with addictions, and the problem is we are not connecting people with these addiction professionals. Right now, in middle Tennessee, there are probably hundreds of empty beds and chairs at many quality treatment centers. And there are thousands of suffering addicts who would love to be receiving treatment, but cannot afford the high cost of these treatment centers. The sad part of this scenario is that there are people today who will die from addiction, who would take the help if it was offered. In Tennessee, we have Hope Scholarships funded from the lottery to help people go to college. Why can’t we provide grants for those who are seeking treatment? Why can’t the alcohol industry pay into a system that it consistently drains of resources by contributing to DUI’s, accidental deaths, spousal abuse, health problems, and the prison system? Instead of the tobacco companies paying for ineffective public service announcements that shock people with graphic depictions of former smokers, how about they contribute to a scholarship fund to help people have access to good addiction treatment? Jack Daniels spends millions to run commercials depicting their quaint, folksy approach to making whisky. Unfortunately, whisky doesn’t make most people more friendly and down to earth, so they can pay into the fund as well. It is estimated that 1.6 billion dollars in drug money is seized each year. Forget the War on Drugs, put this money into drug and alcohol treatment and you could greatly reduce demand for the drug cartel’s products, decreasing criminality and creating a movement that would produce a more stable, safe and productive society.

With the $500 million dollars earmarked by the government to address opioid addiction, you could pay for drug and alcohol treatment for roughly 50,000 individuals in an outpatient setting.  This is nearly the same number of people who died from opioid overdoses last year. And I know this truth from working in addiction treatment for fifteen years: The effect of quality addiction treatment and therapy is cumulative. The old aphorism is true, a rising tide does lift all boats.

Lastly, a key in reducing the opioid crisis is early intervention. This comes from educating people about what addiction looks like in its early stages. Rarely does someone begin with heroin or opiates, there is a trail of evidence that the disease of addiction leaves long before the person is using so called ‘hard drugs.’  Early consequences from any drug and alcohol use, including marijuana, must be recognized. Parents, educators, judges, and politicians cannot dismiss heavy drug and alcohol use as part of adolescence, and we as a society cannot sweep addiction under the rug, afraid of the stigma that comes with it.

Last year I spent six months trying to provide quality alcohol and drug treatment to prisoners in a medium security prison outside of Nashville. I knew that inmates had access to drugs in prison, but I had no idea how rampant drugs were in the prison, in particular Suboxone, which according to inmates, is the most prevalent drug inside. The most disturbing aspect of working in the prison was the apathy and complicity I saw from prison officials and government employees. It was known by everyone that drugs were rampant in the prison, but the solution was to  post flyers that warned about the dangers of drugs. Repeatedly, I tried to get treatment for those that needed it, and repeatedly I was denied. It seemed that what was most important to the officials at the prison system was that they could say that they were providing addiction treatment, even though they did almost nothing to support me in my efforts. I say this, because from what I have witnessed, the best thing the government can do is provide the needed money for accessing treatment, and leave the facilitation of drug treatment to counselors, social workers, therapists, and medical doctors trained in addiction.

In no way do I think I have all the answers to the opioid crisis, nor am I under the false belief that we can ever totally eradicate addiction. But I have lost dozens of friends and clients to the disease of addiction, so much of my passion is fueled by the lives that might have been lived were it not for the disease. I believe that it will take a movement to address the opioid and drug crisis in this country, and the movement has to begin with those of us who have lost loved ones to the disease.

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