Wednesday, September 13, 2017

Opioid Crisis Discussion

Today, I attended an event that is part of the Addiction Professional Panel Series.  This particular event was entitled “Driving Community Solutions for the Opioid Crisis”.  This event was at the lovely Capital Grill in Troy, MI, and was well attended.  The panel was made up of a few clinical directors as well as a drug court judge.

While there was some disagreement about whether or not we have seen the peak of the crisis, all agreed that there is a need for a multi-disciplinary approach to the problem.  There is a need for medical professionals, legal professionals, employers, first responders, and families to have a better understanding of the disease of addiction.  Understanding the level of shame that is part of the disease and keeps users isolated.  Understand and acknowledge the barriers to treatment, which come in many forms.

Lack of quality treatment, a lack of understanding of the disease by judges who, by sentencing individuals to jail or home confinement increase the isolation for the user, and financial barriers to treatment all contribute to these barriers.

There were examples given of successful initiatives, such as the Operation Rx and Hope Not Handcuffs programs here in Michigan, and a recognition that the stigma of drug use and addition still exists and often prevents an individual from seeking help.

And I was very pleased to hear the recognition on untreated PTSD as both a contributing factor to opioid abuse and a barrier to recovery.  PTSD, along with other co-occurring disorders, must be addressed as part of an overall treatment plan.

In some ways I was struck with a sense of deja-vu, as if we have had these conversations before.  While I was working in an inpatient program in the mid to late 1980’s, we had similar conversations about what we then labeled the “crack cocaine epidemic”.  We developed specific tracks within our treatment program for folks who abused cocaine.  There were public service announcements on TV and radio about the dangers of this drug.  Many book and articles published, etc.

In the early 2000’s, we had a similar response to the “methamphetamine epidemic”.  Much attention (and many dollars) was given to intervening and treating users of this very dangerous drug. 

And here we are now with the “opioid epidemic”.  So, if much is the same, what is different now?  Well, I think for starters, the sheer number of deaths is staggering.  The fact that this is evident in not only the younger population, but in the over-50 age group is alarming.  And, thankfully, I think old stigmas may be changing, albeit slowly.  Part of the conversation today focused on the use of the word “addict” and the negative connotations that may stem from that.  Language matters, and while we can get bogged down into issues like this that may not be a priority given the circumstances, there does appear to be more societal acceptance of folks in recovery, and that could go a long way to lessening the stigma and removing at least one of the barriers to treatment.

But conversation is not action, and I hope the folks in the room left with a renewed purpose to form community partnerships, to work together to remove barriers, and by doing so begin to lessen the staggering numbers we see reported.

Oh, and by the way, in what I thought was an inevitable turn in the conversation, a participant asked about medical marijuana as an alternative to opioids for pain management.  If there had been time, I am sure there would have been no shortage of opinions on this very important and current topic.  That will be for another day.

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