Since 2006, more than 300,000 people have died of opioid related overdoses. That’s more lives lost than there are people currently living in Newark, NJ. 2006 was the same year that I first heard of people dying of fentanyl laced bags of heroin. Fortunately, it was also the year I was arrested, because when I first heard people were dying, my instinct was to go out and chase those bags of dope. Between now and then, I have lost track of the number of people I’ve known who have died from opioid related overdoses. I can scarcely imagine that there are any people left that haven’t known someone who’s died from an overdose. The questions then are what is being done? And what can be done to stop the rising death toll of the opioid epidemic?
What are Opioids Anyway?
When asked what opioids are, the first answer is always heroin. The answer isn’t so simple, but heroin is probably the most famous opioid. So, it?s the fastest way to begin to answer the question. Opioids are drugs that interact with the nerve cells and opioid receptors in our brains. Other than heroin, the list includes drugs such as oxycodone, oxycontin, codeine, morphine, hydrocodone, fentanyl, and carfentanil. Even legal opioids prescribed to treat pain are easy for people to develop a dependence on.
A Hinderance to Regulation
Many people feel that the over-prescription and distribution of prescription narcotics is one of the main causes of the opioid epidemic. The DEA and the DOJ are doing their best to increase their efforts to put a stop to the over-prescription of pain medications. However, these departments have in some ways been hindered by a law put into place in 2016.
That law removed the DEA’s power to freeze shipments of prescription drugs that appeared to be suspicious. The law allows for the drug companies and doctors to continue pushing opioids into the hands of individuals for the sake of profit.
The DEA’s ability to fight against drug companies may have been crippled by congress’s decision to put a law into place that favors drug companies. However, it is also noteworthy that the DEA approves the number of opioids produced each year. In the end, they have not entirely lost their ability to regulate prescription opioids.
Lawsuits Against Opioid Manufacturers
Hundreds of lawsuits have been consolidated against drug companies and distributors with the Department of Justice throwing its weight behind those lawsuits. The government is siding with the plaintiffs in the lawsuits that are aimed to financially penalize the prescription drug industry. The DOJ has also set up a task force to aid in the prosecution and litigation of drug companies, doctors, and distributors.
The efforts being made are in many ways commendable. Although, anyone that has lost a family member or has a family member struggling with addiction knows that any money gained will do little if anything to reverse the tragedies those families have faced and currently live with. Still, considering that there seems to be no other repercussions for the actions of the drug industry, a financial penalization is better than no action being taken at all.
Chemically Modified Fentanyl
Fentanyl is a synthetic opioid 50 to 100 times more potent than heroin. The difference between fentanyl and heroin is that fentanyl’s production does not begin in a poppy field, but in a laboratory. While regulation in the US has been in place for decades, it is only recently that regulation of fentanyl began in China. However, because fentanyl is a synthetic opiate and produced in a lab, chemists have simply begun to tinker with the chemical composition.
The results of that tinkering have produced drugs such as carfentanil which is 1000 times more potent than morphine. The difficulty appears to be that the instant a new drug such as carfentanil becomes regulated, new strains begin to appear. The DEA can persuade the Chinese government to regulate a new analog of fentanyl, but the instant they do so, new varieties begin to appear in bags of heroin on US streets or simply sold on its own.
I have met more than a few people new to recovery that preferred fentanyl and its analogs to heroin that it was easier to get. Fentanyl and its analogs can be ordered off the internet in the same way a person can order virtually anything so long as they go to the right website. While those websites are being cracked down on, like the regulation of new derivatives of fentanyl, new web-sites form the moment one is shut down.
War on Drugs
The fight to regulate the traffic and production narcotics has been going on for decades. In 1971, President Nixon declared a war on drugs. Forty years after Nixon made that grand declaration, the Global Commission on Drugs determined that the war on drugs was a failure. In fact, it is quite clear that the number of people living with substance use disorder has not decreased but increased exponentially.
In 2016 more people died from drug overdoses in the united states than from car accidents and gun related homicides combined. Two thirds of those overdoses were from opioids. The numbers of people dying from substance use disorder are staggering, and addiction rates are climbing. These statistics aren?t surprising to me, but the numbers are still terrifying.
Why Can’t Addicts Just Stop?
As I stated when I heard about lethal overdoses in Camden, I wanted to buy those bags of dope. I know that likely sounds unimaginable to people that aren?t living with substance use disorder, but it is the reality of addiction. Before becoming active in my own recovery, I was unable to care about anything or anyone. The only thing that kept me alive a lot of the time was the compulsion to get high.
I was in one of the most heavily regulated prisons in New Jersey. I still found the ways and means to get high in that prison. So yes, regulation may help to decrease the number of people dying from opioids each year. However, regulation does not work on its own. In fact, it is entirely insufficient. Where there is demand, there are always going to be suppliers no matter what the legal risk might be.
Unfortunately, those of us living with substance use disorder that have not begun our road to recovery are not going to stop using no matter what the risk to their lives may be. The terrifying thing about addiction is that it is not only about the availability of a substance, but also about whether a person can find the will to stay clean.
The Fight to Get People into Recovery
It has been acknowledged that drug treatment facilities and peer recovery support services have a significant effect on those of us that live with substance use disorder. These programs increase people’s willingness and ability to become active in their own recovery.
While programs like Opioid Overdose Recovery Program in Woodbridge, NJ are making valiant strides towards ushering addicts into recovery programs. Programs like OORP are not nearly as widespread as they might be. It must be noted that it is not a stated funded program. OORP is a program that only exists because local government chose to intervene. Which is the case for most peer recovery programs except for the Connecticut Community for Addiction Recovery.
There is evidence readily available that support the implementation of peer recovery support services. As the body count continues to rise it must be noted that the costs of addiction extend well beyond those of us who have lost our lives to this disease. That billions of dollars are being spent each year and there has been overdose percentages are still increasing.
Deterrents to Treatment
There are several issues preventing people from getting into a drug treatment facility or to undergo the detox process. One of the key issues that addicts deal with is stigma. Many of us live in constant fear that people will discover we are struggling with addiction. Even when the signs of drug-use are painfully obvious, asking for help is often too much to bear. We don’t want to be seen as monsters or anything less than human. Many of us already perceive ourselves as such and don’t want to be further diminished by others.
There is also a general distrust of treatment facilities that every one of us that is active in addiction fears. A large part of the problem revolves around shady facilities. Some of those places claim to have a cure to the incurable. There is some justification for that suspicion. But there are good treatment facilities available, and research should be conducted no matter how pretty the place might be.
Insurance is often a barrier between those of us that need treatment and getting the treatment we need. They treat substance use disorder as something other than a mental illness. Medicaid policies even indicate that substance use disorder should be dealt with as something other than mental health. Which is a touch surprising given the fact that government other agencies define substance use disorder as a mental health issue.
Insurance companies also make decisions related to the length of time a person can be treated. They also decide whether a person can be treated at all. Insurance companies can deny a person entrance into a drug treatment facility or detox, because they stopped using on their own. They also deny treatment if someone begins their road to recovery in a jail-cell. No matter what the circumstance.
A person should not be denied help just because they have a few days clean. If a person reports having suicidal ideations they are admitted into to treatment immediately. It doesn’t matter if you’re insured or not. Suicidal thoughts will allow you to get treatment.
Treatment facilities that can accept patients with Medicaid or without any insurance are few and far between.
Those of us with Medicaid generally receive less to fund our stay in a detox. And we can receive no funding at all for long term treatment. Those of us without any insurance at all are placed on waiting lists for detox. Many of us die, before we are admitted into a detox for that minimal level of treatment.
…There is Hope
Those of us that have lost loved ones to this disease may feel a level of frustration. It is easy for us to imagine the difficulties our loved ones faced getting help. All of us in recovery, or in active addiction, or with family members dealing with addiction, or even those of us untouched by this disease may even feel like there is not nearly enough being done regarding the opioid epidemic. We can do something though. Talking about addiction and fighting to de-stigmatize the disease goes a long way toward decreasing the death rate of addicts.
There are numerous things that can be done on many fronts and I could list them all. However, it is everyone’s decision how much or how little they do to put an end to this epidemic. Every day, many of us fighting private battles against our addiction. We need to remind each other we are not alone in this struggle.