America’s opioid crisis does not seem to be abating despite the intense public exposure it has received in mass media and among medical and mental health professionals. Many factors keep it going strong:
- Addicts unwilling or unable to deal with emotional pain drown their feelings with drugs,
- Legitimate and illegitimate drug distributors willing to take advantage of a disheartened population do so,
- The USA’s law enforcement, medical and mental health worlds are overwhelmed by the impact of the problem, divided as to how best to handle it, and
- The enduring debates as to whether or not excessive prescriptions of opioid painkillers are partly to blame for the society-wide addiction problem and if opioid-induced death rates are falling or climbing, have not been settled.
This America’s Opioid-Use Epidemic: 5 Startling Facts look at the problem is a quick look at why opioid-induced death rates remain high with no end in sight. The epidemic of opioid-induced deaths is so damaging and huge that other people are losing strength as they flail against the living hell that ends lives or cripples them. The fact sheet didn’t mention that elephant tranquilizer carfentanil is also in use among opioid addicts. Boston’s opioid crisis has been covered extensively by CBS news and other media. San Francisco health officials have declared an emergency regarding the Hepatitis A outbreak among drug users. It endangers California’s wider public, too.
New Hampshire’s chief medical examiner Dr. Thomas Andrew, retired in September 2017. He and some of his colleagues from coast to coast have been overwhelmed by the growing numbers of bodies of people who died from drug use and abuse. Incapable of performing expert autopsies on the ever-growing numbers of bodies, these medical examiners cannot perform their duties in a timely manner. Some cadavers remain in morgues awaiting exam for remarkably long periods of time while overworked medical examiners fail to meet demand. Even if they could keep up with the frenetic pace of autopsy requests, their credentials could be threatened for working beyond industry standards. Andrew chose early retirement rather than the stress of not having enough hours in a day to perform his professional duties. Meanwhile, due to other professionals leaving their jobs rather than succumbing to dangerous pressures, the National Association of Medical Examiners indicates staff shortages around the country. They’re due to job departures plus insufficient time to train newcomers.
The Baltimore Sun newspaper carried an October 13, 2017 article about fentanyl use outpacing heroin use. The article noted that “Within China’s vast drug industry, which produces much of the global supply of pharmaceutical ingredients, laboratories are taking advantage of cheap labor and lax oversight from Beijing to churn out new versions of the cheap, powerful and often deadly synthetic opioid faster than U.S. authorities can identify, classify and ban them.” Addicts are dying from the counterfeit versions of fentanyl, as the article indicates. Some only survive if they’re treated with mega-doses of overdose remedy naloxone aka Narcan, but remain addicted. Three days after sharing the news, the newspaper’s The opioid crisis spills into the workplace article described opioid addicts endangering themselves and colleagues on the job, slowing down workforce production, limiting profits and forcing employers to insist on urine checks plus other methods to detect dangerous drug use on the job.
Proposed Solutions Clash with Political Problems
Congressman Rep. Roger W. Marshall M.D (R) wants to end the opioid epidemic by advocating for an end to the stigmatization of addiction problems, and for the public to view it as a chronic health issue instead. Marshall also wants adequate follow-up so that medical professionals can prevent a patient’s regression from withdrawal efforts. His optimism that such efforts can reverse America’s opioid epidemic course, however, clashes with the October 15, 2017 reality check offered by Dr. Matthew Hahn, who opines that “…Everyone in America could have decent, affordable health care. Millions of Americans suffer, and many die because they do not. It is a moral stain on the nation. And yet Republicans propose plans that would result in fewer people having access to care, and Democrats offer no decent solutions to improve upon the failures of Obamacare. Time and again, our leadership fails us. The opioid crisis may be the most far-reaching effect of our failed leadership. Millions of Americans are so hopeless about their prospects for the future, and so disinterested in the dregs of the American dream that remain for them, that they choose instead to tune out through the painless oblivion of heroin and prescription narcotics. An entire generation may be lost and beyond repair. The fix only begins with better and more comprehensive treatment, but even that appears to be beyond us. What is really needed is the hope and meaning created by a supportive society that values and attempts to ensure general safety, affordable education, affordable health care, and secure, good-paying jobs…”
Though Marshall and Hahn want improved healthcare for addicts, the prospect of it hangs in the balance because, in 2016, Congressman Tom Marino (R) limited the Drug Enforcement Administration’s abilities to forcibly close down drug dealers involved with suspiciously lucrative sales for pills numbering in the hundreds of millions. A distinct contrast to the focused healthcare mindsets of Marshall, Hahn and their associates, and not a likely subscriber to Hahn’s “… hope and meaning created by a supportive society” mindset, Marino declined President Trump’s request to lead the Office of National Drug Control Policy after being exposed on the 60 Minute’s show.
Limiting the supplies of opioids is presently an option, but not across the medical spectrum. CBS news reported this past September about Trump’s imposed patient limits on opioid supplies. CVS pharmacies are limiting some opioid prescriptions to seven-day supplies. The New York Times, though, has reported on insurers refusing to pay for expensive though less addictive drugs, and failing to approve treatments for addictions. Medical professionals across the country are seeking solutions to the highly destructive problem.
Addiction is a multifaceted issue, not limited to substance abuse with drugs and liquor. Social media, shopping, gambling, sex and other addictions fill the files of mental health professionals, disrupting the lives of the people suffering those problems. What each addiction has in common with any other is that all of them are compulsive responses to conflict/emotional or physical pain, even if the addiction began accidentally (e.g., involuntary addiction to pain medication) rather than intentionally. And, the rewards for various addictions might range from a matter of pleasure to simply ending the stress of internal “Will I or won’t I?” debates and other counterproductive impulses. The addictive craving for a given substance usually requires professionally administered treatment aka medical and psychological rehabilitation to end it.
Tech executive Justin Rosenstein observations, in an ‘Our minds can be hijacked’: the tech insiders who fear a smartphone dystopia Guardian newspaper article on October 6, 2017, indicate the endless loop of addiction problems. “All of us are jacked into this system,” he says. “All of our minds can be hijacked. Our choices are not as free as we think they are.” Referring to cellphone use in which many heads are bowed to screens even as users endanger themselves while walking in or outdoors, or alienate relatives, colleagues and friends with whom they share airspace, Rosenstein noted that “Everyone is distracted… all of the time.” As his and other comments in the article note, the best means for preventing and ending online addiction is to stop using digital devices designed to distract users from the rest of life. What’s not mentioned in the Guardian article is that addiction therapy is sometimes necessary for digital addicts who want to end their dependence on something or other. The same is true for drug addiction. Willpower is not the universal solution to digital addictions just as it is not the One-Size-Fits-All panacea for substance abusers.
Without incontrovertible evidence to prove that the opioid epidemic did or did not grow from excessive prescriptions for narcotic medications, the debate over the problem and how best to overcome it leaves one thing increasingly obvious, however: US addicts are not utilizing productive ways to deal with physical or emotional pain. Drowning unhappiness in drugs or other addictive behaviors is not a workable solution. The situation calls for alternative solutions to drugging chronic unhappiness and the lack of skills to ameliorate it.
Several proven-to-work solutions are readily available, such as spending time in nature, meditating and exercising on a regular basis, playing or listening to soothing music, private journaling (public blogging about personal misery is not a proven way to end it, Ed.), breathing in a calming manner, confiding in trustworthy friends, aromatherapy, uptalk to oneself and other people, and focusing on happiness.
There are emotionally sophisticated techniques such as learning from failure and enjoying the fun of failure as a learning experience. Social support is another sophisticated technique, though it need not be. As the Heleo site explains, Social support requires friends, which requires being likable: “Listening is not hearing the words that were said. Listening is making someone feel heard.” That lighthearted approach prevents a sense of shame and other forms of negativity. But as evidenced by the opioid crisis, many Americans seem to need mental health strategies aka positive psychology instruction for lowering and for preventing emotional and physical pain. Such strategies empower people to withstand suffering, and to use their energies in productive ways lifelong.
Public and private schools can add mental health/positive psychology classes to their curricula. Businesses can make relevant workshops part of the workplace environment. Informing people of the soothing powers of hobbies, music, deepening friendships, cultural pursuits, positive behaviors, putting life into perspective and other self-help techniques can facilitate long-term addiction recoveries and prevent addictions in the first place. Cognitive Behavioral Therapists have demonstrated the reality with their clients for some time. The time is ripe for someone to pull that effort together across America.
Yocheved Golani is a popular writer whose byline has appeared worldwide in print and online. A certified Health Information Management professional, she is a member of Get Help Israel. Certified in Spiritual Chaplaincy (End of Life issues) and in counseling skills, her life coaching for ill people puts healthy perspective into a clients’ success plan for achieving desired goals.