Understanding the Opioid Crisis

Several months ago I was browsing through the local news magazine, Hometown News, and I came across an article with haneously false information about the opioid crisis and addiction.  I became so frustrated by the misleading information being spread to people in my community that I wrote a response.  I submitted it to the paper, and they rejected the submission and basically told me to go f* myself.  So at this point, I think my article still needs a home and without further adieu…

opioids

One of today’s most prominent issues permeating politics, local and national news, and the homes of caring families across the nation is the current opioid epidemic. Unfortunately, this issue is widely misunderstood and the internet is rife with false information.  Although we are a county in crisis, losing tens of thousands of lives annually, the most important fact to disseminate is that there is hope in recovery.

To increase understanding of this societal problem, we must first look into the phrase itself—“Opioid Epidemic”.  Opioids are substances that include nefarious drugs like heroin and fentanyl, and also less conspicuous substances that can be found right in your medicine cabinet, such as oxycodone or  Roxicet.  An epidemic is defined as “a temporary prevalence of a disease” and in order to grasp the nature of this definition, it is important to first understand the ways in which addiction, or substance use disorder as it’s clinically defined, is a disease.  

Substance use disorder is a disease that impacts the way a person’s brain functions on a core, primal level.  It creates chemical and structural changes to areas of the brain, visible in an MRI, including the ventral tegmental area and nucleus accumbens.  Over time, an addicted person ceases to feel pleasure from drug use, and is instead driven by primitive, automatic urges beginning deep inside these brain centers.  Decades of research by leading scientists across the world have confirmed these changes that define substance use disorder as a disease.

There are numerous reasons why a person may begin using drugs; young people may feel curiosity or peer pressure, and others seek to numb discomfort from troubling or traumatic experiences, such as abuse or loss of loved ones, or to cope with underlying mental illness.  It is important to distinguish between casual/recreational drug use and addiction, because addiction is the point at which an individual’s ability to choose and control their actions becomes overridden by underlying urges that occur after these structural brain-changes take place.

Many people still question the labeling of today’s opioid use as an “epidemic” since people have used drugs all throughout modern history.  Opioid use is at an all-time high, and in recent years has skyrocketed at an alarming rate.  According to the Center for Disease Control and Prevention, annual overdose death rates have increased fivefold from 2000 to 2015, and these statistics continue to increase rapidly, leading to epidemic proportions.  To put the numbers into perspective, in the United States there were less than 500 accidental firearm-related deaths in 2015, and over 52,000 accidental drug overdose deaths that same year.

Although substance use disorder is a chronic condition that cannot be cured, there is hope for people to manage their illness and recover.  For nearly 100 years, millions of alcoholics and addicts have experienced healing and sustained recovery through self-help or mutual-aid groups like Alcoholics Anonymous or Narcotics Anonymous.  These groups can be found in community centers and church basements throughout the entire country and across the world.  Newcomers can receive guidance and support from others who have had decades free from drug use.  Membership is free, and people afflicted with the disease of addiction can congregate every single night to share experiences, strength, and hope to navigate the difficulties they face with substance use disorders.

Individuals may experience fluctuating motivation to follow the program and sustain their recovery.  With that in mind, relapse or returning to drug use, is common along their journey.  Once again it is key to maintain faith that any individual can recover, even after multiple relapses.  Many individuals enter rehabs or treatment centers in order to gain the knowledge and skills necessary to live a healthy, productive life in spite of their disease.  Evidence-based programs provide very effective strategies to help motivate individuals and perpetuate the changes needed for recovery.  Many individuals can access these services with no personal cost through county and state grants.

Furthermore, new pieces of legislation have recently been put in place to provide funding for treatment, and many government programs are shown to be highly successful.  Drug Court is one example of the criminal justice system’s involvement in addiction.  It is a program that facilitates non-violent offenders to obtain the treatment needed for ongoing recovery and holds individuals accountable for their actions while providing years of support.  Drug Court has shown to keep crime recidivism rates as low as 16% and can save taxpayers over $12,000 per participant.  And that is just one example of positive steps society can take toward ending this epidemic and ultimately saving lives.

Education and prevention are also valuable resources in the fight against addiction.  From educating children regarding the dangers of experimenting with drugs and alcohol, to furthering one’s knowledge of medications prescribed by their doctors, people who have an appropriate understanding of how these drugs can impact their lives and how their use can develop into a disorder is proven to decrease the chances of developing addiction.

Here are some fundamental facts about addiction:

  • Addiction is a chronic disease characterized by compulsive behavior which requires ongoing monitoring rather than a one-time “cure”
  • Addiction itself is NOT a “moral weakness” or a personal choice once changes have taken place inside the brain
  • Individuals with addiction need to take responsibility and  personal accountability to participate in an ongoing program of recovery and sustain lifestyle changes
  • Individuals and families can empower one another and create meaningful changes in the lives of an addicted person to overcome the compulsions associated with addiction
  • Addiction commonly occurs with other physical and mental health issues, such as chronic pain or depression
  • Addiction impacts an individual physically, mentally, financially, socially, and often legally

If you or someone you know may have an addiction problem, it is recommended to:

  • Seek support through mutual aid groups, such as Narcotics Anonymous for addicts and Nar-Anon for family members;
  • Seek professional treatment through withdrawal management, rehabilitation programs, medical doctors, and/or mental health professionals; and
  • Get education on drug and alcohol use, prescriptions from your doctor, substance use disorders, and mental illness

The use of drugs and alcohol has existed throughout most of American history, and sadly it will continue to do so.  Prevention is key to discourage individuals from experimenting in the first place, and treatment is helpful to those who already suffer from addiction.  It is important to remember the message of hope, that recovery is possible for anyone and everyone who is willing to ask for help.

Nicole J. Rossetti, MSW, LSW Columbia University and Primary Counselor at Turning Point, Inc.

Firearm death statistic: https://gun-control.procon.org/view.resource.php?resourceID=006094

Overdose death statistic: https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf

Drug Court statistics: https://www.nadcp.org/sites/default/files/nadcp/Facts%20on%20Drug%20Courts%20.pdf

photo credit: https://www.huffingtonpost.com/entry/the-opioid-epidemic-how-big-pharma-and-congress-created_us_59e4e02ee4b003f928d5e8bf

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Ladies: Speak Up At Work

I recently read an article in Cosmopolitan Magazine called “Can Looking Too Young Hurt You At Work?” (Feb. 2013 issue, pg. 113).  The article’s author Marissa Hermanson wrote about her struggles with feeling that her age and appearance misrepresented her as a professional — well I not only look young, but I know I could be doing more to speak up and show more initiative with my opinions to combat the stereotypes my looks might be giving off.

My current position is a Social Work Intern at an inpatient drug and alcohol rehab unit in a hospital.  I already have 2 semesters experience interning in rehabs and I think my skill level is quite high for an undergrad student; yet I still feel shy about myself as a professional.

At the hospital we have these weekly meetings called Treatment Planning, and this is where the social workers and counselors meet with the psychiatrist, program director, nurses, and occasionally some other higher-ups to assess patients’ progress one-on-one.  Needless to say, being the new kid on the block in a room full of such prestigious titles is a bit intimidating.  I find myself thinking of the right questions to ask patients but not saying them, which is particularly frustrating when another person then asks the same thing right after.  I also have a lot more insight than I give myself credit for, but during the time it takes me to debate saying things in my mind, the conversation moves along and my point becomes moot.  I keep encouraging myself to open up and just go for it, but it’s a difficult hurdle for me to get over (*for those of you who know me personally, I know this must sound odd because I’m so not shy or reserved, but it’s true).

I also feel shy talking to other professionals in my field outside of Treatment Planning.  I either avoid the subject and clam up, or find myself rambling on and feeling like an idiot.  For example, I have several friends with family members in social work or mental health.  When my friends offer to put me in contact with them (which I really appreciate), I never know what to say & additionally I always prefer to speak via email – talking on the phone would just be too on-the-spot.  Again, the reason that this is so troubling is that I really am well-read in my field and I do know what I’m talking about (or would be talking about).  I get positive feedback when I speak in class, among my peers in school, and with my hospital co-workers individually.

The Cosmo article resonated with my life beyond just as an intern, but prior to my time in counseling I worked doing b2b sales for a printing company.  The company was very small, but they did excellent high-quality work & designed great graphics.  In that field, I enjoyed the challenge of being a young, attractive female in such a male dominated industry because I felt like I proved myself to everyone I encountered.  I’m by no means a printing or graphics expert, in fact I know much less about that than substance abuse treatment.  I think the difference is this: it was much easier to sell a product to a business in need of it than trying to sell the idea of myself as a professional to people I care more about.  I’m going to try to apply some of the principles I used working in printing to talking shop about social work.

The article ended with a section called “5 Ways to Be Taken Seriously At Work” — maybe someone who feels similarly to me can find this helpful.  “‘Your age and title don’t actually matter –executive presence comes from within,’ says career coach Rachael A. Keener, author of the upcoming book The Feminine Advantage.  Follow her tips and prepare to be respected.

  1. Consolidate your thoughts…
  2. Sit front and center: During a meeting,  sitting off to the side, which young women tend to do, signals that you’re not confident.  Don’t be afraid to be seen and heard.
  3. Unplug at key moments: In a meeting, take notes on paper… ‘Don’t use an electronic device like an iPhone,’ Keener warns.  ‘It can look like you’re texting or sending personal e-mails.’
  4. Speak high to low: Never end your sentences in a higher-pitched tone, as if you are asking a question.  ‘It comes across as insecure…’
  5. Volunteer to lead.”

I will follow up on this issue as my situation develops and also share insights from the class I’m taking, The Role of Women.

photo credit: http://www.allprodad.com/blog/2010/12/02/do-you-talk-to-your-kids-like-a-client/