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Addiction – A State of Emergency

As most of you know, the federal government has declared the Opioid Epidemic a National State of Emergency. That was some time ago and to our knowledge, a plan to accompany this state of emergency has not come to fruition. Approximately 150 people are dying every day of drug overdoses, a number that is only growing.

You may remember that just prior to declaring a state of emergency, the President’s remarks were somewhat concerning. It sounded like a return to the “Just Say No” campaign of the 80’s and 90’s, which did not work. If people could “just say no,” they probably would. That said, we have seen no tangible government plan at this point.

By Shayne Sundholm, CEO, Clean Recovery Centers
Drugs have infiltrated society 
What many fail to understand is that children are now exposed to opioids and other powerful drugs daily in schools and at parties with their friends. These drugs and their distribution networks have almost completely infiltrated our society. These kids usually start with pot and some alcohol. Since other more powerful drugs are now so prevalent, many succumb to peer pressure and try them. They do this in much the same way they tried “a little pot and/or some alcohol.”

Many illegal drug distributors attempt to start young people out with pot and go from there. It is part of their strategy. Many defenders of the total legalization of marijuana claim that it is not a gateway drug. These statements tend to be made by people who are not addicted to drugs, social marijuana users who are not drug addicts or alcoholics. Being in the treatment space, I can tell you that most addicts start with marijuana and alcohol and it escalates from that point.

An accelerating crisis

To be clear, I am not against marijuana or alcohol use or prescription pain medications. Most people can use these substances responsibly. I cannot because I am a recovering alcoholic. I tried. It did not work and does not work for millions of suffering and recovering addicts. Most are not able to use opioids, benzo’s, cocaine, and meth, for example, in a social manner. Most users of these substances eventually do become addicted.

We are now in an enormous and accelerating crisis. Whatever we have been doing as a society to figure this out isn’t working very well. I don’t claim to have the answers though I do have some ideas. The problem is very complex and will require an extremely large effort to handle effectively.

Shutting down pill mills – a band aid solution
The federal government’s commission described the nation’s health care system as the root of the opioid crisis. I do agree that there is significant culpability in the healthcare system. However, shutting down pill mills has driven users away from ever more expensive pills to far less expensive heroin.

The commission recommends improved prescription tracking; increased treatment and education on substance use; and a call to ensure that law enforcement always carries the counter-overdose drug naloxone. I am sure these people mean well but to me this sounds very much like a band aid solution to a very real problem that goes much deeper than this and is much more complex.

Remove the stigma of addiction
Most of society currently does not believe that addiction is a disease despite mountains of evidence to the contrary. There is a tremendous stigma around the disease of addiction very similar to the AIDS stigma of the 80’s and 90’s where, unfortunately, the thinking of much of society was “You did this to yourself by choosing to be gay.”

Looking back, most people now view that thinking as shameful. How is it different than the stigma with addiction? It is not. The stigma needs to be removed. It took 20 or more years to change the stigma associated with AIDS. What will addiction look like 20 years from now if it takes that long to remove the existing stigma – 500 deaths every day? 1000 deaths every day?

Some “big ideas”
Overcoming this epidemic will be an enormous task. Much will need to be accomplished across a multitude of groups and communities at the federal, state, and local levels. Here is a list of some “big” ideas that Governor Christie and his commission may find useful as they attempt to address this “National State of Emergency.”
Increase Awareness
  • Pursue grass roots efforts where treatment centers, local hospitals, NA, AA, Celebrate Recovery, people in SMART recovery and recovery church groups develop a collective Recovery Oriented Systems of Care model. It would be something that could be replicated from county to county and state to state.
  • Encourage government officials, including the President, Senators, Governors, State Senators and celebrities inside and outside of recovery unite to raise awareness and resources through benefit concerts and other PR events.
  • The AMA defines addiction a chronic brain disease. Focusing PR efforts around this from the AMA and other medical associations may help increase awareness and education significantly.
Improve Access to Treatment
  • Petition insurance companies to reduce sky high-out-of-pockets, deductibles, and copays for substance abuse.
  • Have Federal, State, and Local Correctional and Law Enforcement Facilities re-examine their approach to drug addiction – placing suffering addicts into correctional facilities is not effective treatment nor is it doing anything to reduce the epidemic.
  • Continually emphasize recovery programs for the families and friends of suffering addicts.
  • Urge the Federal Government to expand Medicaid and Medicare substance abuse coverage to all certified private substance abuse treatment facilities.
And more . . .
  • Make sure that treatment center owners, local hospital leaders and leaders of various recovery foundations and groups sit on pertinent community non-profit boards.  From these positions they can work with municipal governments to increase awareness and access needed resources.
  • Pharmaceutical companies must understand that addiction should not and cannot be considered a profit center of their business models.
Many roads to recovery
I realize these are very broad strokes. Much detail needs to be fleshed out. Additionally, such an approach would require everyone inside and outside the recovery community to open their minds and set aside their own agendas.

There are multiple pathways to recovery, and I have witnessed them. Personally, I got well through the 12 steps of AA. Others got well through the church and other pathways. I respect that. I do not put my own personal bias into my work with those in recovery. Everyone needs to look for the similarities among the multiple pathways to recovery and not the differences.

Time is running out
These ideas are perhaps ambitious. However, if we aim for the moon we might just land among the stars and start making some real progress with this ever- worsening age old disease. We are running out of time.

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