Opioid Addiction: What It Is, Isn't and Our Impact

It’s difficult to acknowledge that when we mention the word “opioid” it possesses an unnerving connotation. What once was considered the best and safest way to eliminate pain and discomfort has morphed into a nationwide addiction epidemic. Let’s look at the facts:

• Since 2008, opioid overdoses have been the leading cause of accidental death in the U.S.
• Drug overdose is the leading cause of accidental death in the U.S., soaring from 64,070 deaths in 2016 to more than 72,000 in 2017.
• 53,332 of these overdoses have been linked to opioids – a 61 percent increase from 2015.
• The rising rate of overdose deaths can be largely attributed to heroin and fentanyl.

The numbers keep rising. How do we address it? In 2016, an estimated 21 million people aged 12 or older needed treatment for substance use disorder (SUD), yet only 3.8 million of them received treatment. There’s clearly a need, know help exists and is out there. So, why has opioid use continued to skyrocket?

Stigma is a big part of it. Some people still perceive addition as a “choice” and that addicted individuals really can control it but don’t choose to. Many view addiction to be a weakness or a flaw within an individual. People with SUD don’t want to feel less than someone else, so shame or embarrassment often prevents them from reaching out for help. They also may fear criminalization within the community or discrimination in their workplace or other social settings if they admit they are an addict.

Here’s the thing. Substance use does not equate to:

• A moral or spiritual failing,
• A lack of will or responsibility,
• A character defect,
• An addictive personality type (which doesn’t exist), or
• Denial, rationalization, evasion, defensiveness, manipulation or resistance.

Addiction is a disease. And like any primary chronic disease, it needs to, and can, be treated. To get started, we need to change the way we look at treatment. The evidence-based practices, social support and recovery approach is edging out antiquated views of short-term interventions as the most effective way to address addiction. Integrated, holistic care gives individuals the best chance for long-term success.

Medication Assisted Treatment (MAT) is currently one of the most effective ways to treat SUD. A combination of medications, recovery support, intensive psychological, social and behavioral counseling paired with evidence-based support provides a whole-person approach. Some may argue that MAT simply replaces one addictive substance for another, yet the numbers tell a different story. It’s been shown to cut death by overdose in half, and additional research shows that the longer the person stays on MAT the more successful they are in their recovery.

So now that we know addiction is not someone’s fault and there is treatment available, how can we get individuals the help we know they need?

Eliminating stigma is a great first step. Addiction is a disease, not a choice. In fact, approximately half the risk for addiction is conferred by genetics. If someone was predisposed to another condition such as diabetes or cancer, they would be strongly encouraged to seek treatment. Individuals with SUD shouldn’t be treated any differently.

By reinforcing this, we can empower individuals to ask for help and pursue the treatment they need to potentially save their lives.

From a clinical approach, care needs to be truly integrated with strong case management as the person receives support from multiple providers. Delivering a wide range of services as needed such as motivational interviewing, peer and recovery coaches, trauma-informed care, patient-centered medical homes can be beneficial as well as engaging family members and educating them as much as possible to support an individual’s recovery.

From squashing stigma to providing access to proven treatment methods, we all have roles to play in quelling the current addiction crisis plaguing the nation. The opioid epidemic is real and just like any disease, we must give SUD the same respect and attention as other conditions, so we may no longer lose countless loved ones to addiction.