Opinion: Turning corner in the opioid epidemic

When it comes to opioids, we are at a breaking point in the U.S. after 20 years of escalating fatalities. Every three weeks, the death toll from opioids surpasses the tragedy of Sept. 11, 2001. With just four percent of the world’s population, the USA consumes around 80 percent of its opioids and accounts for about 93 percent of its overdose deaths.

In 2015, 52,404 people in the U.S. died of drug overdoses, and more than 33,000 of those deaths were from opioids. Astoundingly, a provisional U.S. governmental account of drug deaths for 2016 shows a staggering rise of 22 percent over 2015, at roughly 64,000 people.

Primarily fentanyl and its analogues continue to push the death count higher with the first count of fentanyl deaths in 2016 up 540 percent in 3 years. With so many friends and loved ones lost to the epidemic, the time to act is now. Luckily, those in power are beginning to take notice.

Last month, President Trump declared the opioid crisis a national emergency. While the decision may be overdue, the resources dedicated to the crisis could make this point in our history the peak in the epidemic. Chris Christie has been appointed to lead the effort, and the commission has issued an interim report with a number of recommendations.

Excessive use of painkillers began in the 1990s and has accelerated in recent years. While deaths from prescription opioids continue to rise, many of those deaths involve heroin, fentanyl or a fentanyl analogue. There has been a resurgence in cocaine and methamphetamine deaths since these substances are now being cut with fentanyl and its analogues.

As a clinical psychologist for more than 28 years, I’ve seen addiction claim the lives of many Americans. Opioid addiction, as well as, other alcohol and drug addictions, pays no mind to age, race, gender, religious preference or economic status. Addictive substances have a unique trait, in that it is self-reinforcing, meaning it creates its own demand.

What brought our nation to this point has clearly been less than effective and involves multifactorial causation that is requisite for an epidemic. With 2.5 million Americans seriously over-dependent on opioids, it will take strategy and not “fixes” to resolve the opioid epidemic. At this point, the best we can expect is progress of an incremental sort, and we will need to track outcomes carefully from the onset.

Our strategy will need to focus on the long-term, rather than a series of high-profile attempts to “fix” opioid use in America and involve all aspects and segments of our society. From education for prevention to treatment using a 21st century neuroscientific approach; from legislation to regulate quantities, to increased cross-reference among physicians who care for the same patient; from medication-assisted therapies to improved access to medication for overdoses; from cultural changes on how Americans view pain to using alternative methods for pain relief; from regulatory oversight of Big Pharma to de-stigmatization of addiction with greater access to treatment – these and other approaches will be needed in a cohesive plan to bring about change to the opioid epidemic.

Even if death is not the result of opioid addiction, side effects can speed dementia, intensify mental health issues, and reduce individual productivity and quality of life. Too often those with addiction problems do not seek help until the addiction is out of control. Yes, we are in a crisis in the United States, and it is time for all of us to become aware, better educated, and more cautious about addictive behavior and the disease of addiction particularly with the frightening statistics of this out-of-control epidemic.

Janet Cox, Ph.D, is a licensed clinical psychologist with Synapse LLC in Atlanta.

X