The Opioid Crisis by Natalie McFarlane
The opioid crisis has been a major issue facing the United States for over twenty-five years. Over 500,000 people have died from opioid overdose and the amount of deaths continues to rise every year. Not only is this a national issue, but it is also a major issue facing our state. To help reduce the deaths from opioid overdose, we should implement harm reduction tactics in our communities, make rehabilitation centers and treatment more accessible, and establish education to reduce the stigma surrounding opioid addiction.
The first strategy that should be implemented in the community is harm reduction tactics. Harm reduction tactics include strategies that reduce the damage caused for people who do not want to achieve sustained, long term remission. Two tactics that can be extremely helpful in reducing harm are making naloxone (Narcan) available to more people, and creating supervised injection sites in Colorado. Naloxone temporarily reverses the effects of an opioid overdose and allows for more time for emergency medical services to help save the individual’s life. To make naloxone more accessible to people in need, our state should ensure that educational institutions, community centers, and the police force have an adequate supply to help save lives from overdose. Having naloxone in educational institutions and community centers allows for any individual to help a person who has overdosed before emergency medical services arrive. Having a larger supply of naloxone for the police force also allows for the police to help any individual they think could be experiencing an opioid overdose. Overall, having naloxone more accessible in Colorado would reduce the amounts of opioid overdoses (Addressing the Context). The second tactic, supervised injection sites, could also reduce the amount of opioid overdoses. Supervised injection sites are locations where individuals can bring their illicit substances and use them with the supervision of trained healthcare professionals. Not only are the healthcare professionals equipped with naloxone in case of an overdose, but they also supply sterile instruments to inject the illicit substances with. Implementing these sites into our state would not only reduce the amount of overdoses, but it would also lessen the transmission of diseases from contaminated instruments. According to an article from PLoS Medicine, “…use of supervised consumption facilities can reduce the risk of overdose mortality… Mary Clare Kennedy and colleagues contribute to this literature by showing that, among clients of the first supervised consumption facility in North America (in Vancouver), frequent utilization was associated with a reduction in all-cause mortality over 2006–2017,” (Addressing the Context 7). Examining the results of these sites in other countries, it shows how beneficial they can be overall. Supervised injection sites allow for safe consumption of illicit substances and focuses on the safety of the user.
The second way Colorado can help the opioid crisis is by increasing individuals’ accessibility to rehabilitation facilities. Having more access to treatment makes it easier for individuals struggling with opioid use disorder to get the help they need. Currently Colorado only has about one third of the treatment capacity needed to help these individuals (Attorney General). To help in this front, the Attorney General of Colorado, Phil Weiser, has filed lawsuits against multiple pharmaceutical companies that are responsible for the opioid crisis. Over the next eighteen years Colorado will be receiving nearly 400 million dollars in settlements from these companies to help fight this crisis. The money will be distributed to all regions of Colorado and will have to be spent on allowed uses to help improve the effect of the opioid crisis (Williams). This funding will greatly improve Colorados’ ability to help individuals struggling with substance use disorders.
As well as making rehabilitation facilities more accessible, opioid agonist treatments (methadone, Suboxone, Kadian, etc.) also need to be available to more individuals. It has been shown in many articles and journals how beneficial these treatments can be to individuals struggling with an opioid use disorder. Opioid agonist treatments are used to help individuals achieve sustained remission by reducing withdrawal symptoms and craving for opioids. Opioid agonist treatments can be very effective for individuals who are having a hard time getting sober. Not only do these treatments help with achieving sustained remission, but they can also reduce the likelihood of an individual assisting another with using illicit substances. As stated in an article from PLoS medicine, “Charles Marks and colleagues found that people who inject drugs and who receive opioid agonist treatment are approximately half as likely to assist others in initiating injection drug use” (Addressing the Context 5). This effect of opioid agonist treatments can be very beneficial to lowering the amount of people becoming addicted to opioids. Even if the accessibility to these treatments was slightly improved, it would benefit a lot of people’s lives.
The final approach that Colorado should take is reducing the stigmas associated with opioids and opioid use disorder by educating our communities. Education about opioids is a very important aspect in combatting the effects of the opioid crisis. Many people have preconceived opinions and thoughts about the opioid crisis and the people struggling from it. Educating the citizens of Colorado, it can lessen the major stigma surrounding opioid users and help improve the harms associated with these stigmas. Not only should people be educated on the harms of opioids and how they can negatively impact people’s lives, but also about addiction. Education pertaining to addiction will help society to know that addiction is a disease and that individuals struggling with addiction are worthy of help. This aspect of the strategy to help the opioid crisis is the most important because of how harmful stigmas and stereotypes can be to people struggling with addiction.
The stigmas surrounding opioids and the opioid crisis are present in many aspects of our communities. There are stigmas around the treatments for addictions and the individuals struggling, and are encouraged by how the media addressed the opioid crisis. These all negatively impact an addict’s ability to get help as well as how willing medical professionals are to help. Internalized stigma can make an individual struggling with opioid use disorder feel as if they are not worthy of getting help. A lot of the time, these people see what the media portrays them as and how people view them and think those ideas are true. In an article published by PLoS Medicine, the authors state that, “Among people with OUDs, internalized stigma has been associated with psychological distress and poorer quality of life, continued substance use, and reduced engagement with substance use treatment” (Stigma as a fundamental hindrance 12). These stigmas are very harmful and reduce the amount of people seeking professional help for their addiction. As well as internalized stigma, the stigmatized language used in the media can have a very harmful effect as well. Not only do they affect the individuals struggling, but also how others view the opioid crisis. In the media, the use of “epidemic” has negative connotations like “isolation” and makes people think of this crisis the same as an infectious disease. This can isolate addicts even more than they already are. As well as language, the way the media treats the opioid crisis is also detrimental to improvements. According to an article in PLoS Medicine, “News coverage of the US opioid overdose crisis has inadequately emphasized treatment and has instead largely framed the crisis as a criminal justice issue, particularly in ways that are racially disparate” (Stigma as a fundamental hindrance, P11). Treating the opioid crisis as a criminal justice issue dehumanizes this issue and causes people to treat addicts as such. In addition to these stigmas, the preconceived ideas around treatments and the doctors that treat addicts negatively impacts the treatment offered. To be able to use opioid agonist treatments to help individuals struggling with addiction, these doctors have to obtain a waiver from the Drug Enforcement Agency. Also, many of these physicians are not operating at full capacity. Most of the time this is from the public’s stigma around treatments for addiction. As stated in an article from PLoS Medicine, “…many express little interest in taking on patients to reach capacity. This gap in treatment access may reflect provider distancing from patients stereotyped as “difficult,” dangerous, or being involved in criminalized behaviors. Other providers may wish to avoid the legal scrutiny associated with being… considered a ‘pill mill’” (Stigma as a fundamental hindrance, P8). This not only affects the doctors trying to help these individuals, but also the individuals themselves. This public stigma directly impacts the level of care being received by addicts. Overall, the stigmas around opioids and opioid use disorder are harmful and education will benefit these stigmas effects.
In Colorado these strategies can be achieved and we can reduce the amount of lives lost to the opioid crisis. By implementing harm reduction tactics, access to treatment, and education, change can be made. With the addition of the settlement money, Colorado has already taken the first step in helping the opioid crisis. Hopefully Colorado will continue to take the necessary steps to help put an end to the overdose and opioid crisis.
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“Attorney General Phil Weiser Is Fighting the Opioid Epidemic on Many Fronts.” Colorado Attorney General, 17 Mar. 2022, https://coag.gov/opioids/.
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Williams, Heidi. Interview. By Mcfarlane, Natalie. 1 April 2022.