Mental health and opioid addiction have infiltrated every fabric of society. No matter your profession, position or perspective, most Americans have been or know someone who is directly or indirectly affected by this epidemic. The collection of literature clearly underscores this fact. Families are torn apart, friendships destroyed, relationships shattered, and communities in distress, all as a result of its devastating impact and severe consequences. Its subject matter is divisive and capable of causing long-term, seemingly irreversible destruction, distress, and dismantle to anything or anyone it touches.

The most pertinent literature specifically examines the pervasiveness of opioid addiction and the efforts employed by law enforcement officials, legislators, medical professionals, and community leaders to develop sustainable solutions. From a historical context, the literature chronicles the transition of opioids. Originally prescribed by physicians to relieve or manage pain, patients developed an uncontrollable dependence on opioids and would resort to unconventional methods to acquire the medications and misuse them. The potency and availability of these drugs increased its popularity and created the public health crisis we have today.

Despite the nobility in a cause, opposition to it will always exists. There is opposition to peace, opposition to love, opposition to activism, etc. The collective decision and responsibility to end opioid addiction and mental health illness represent noble causes and are no doubt worthy of the actions necessary to combat the debilitating effects both have on its victims and communities. Yet, an all-inclusive commitment, consensus, and resolve to ending the epidemic has not been achieved. Some argue the blame should be placed on physicians who fail to properly identify other factors and characteristics of the patients (e.g., potential for dependence, personal history, etc.). However, placing the blame squarely on the shoulders of physicians ignores the complicity and responsibility of the other groups to identify solutions.

 

Written by: Annette Kee, DNP(c) MSN APRN PMHNP-BC

The lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) community experiences and confronts mental illness to an arguably greater degree than the remainder of the population. Because of implicit and oftentimes explicit biases and prejudices, the LGBTQ community must endure both overt and covert discriminatory practices, behaviors, and beliefs that compound the fragile nature of mental illness in otherwise normal environment. Confronting stigmas emanating from sexual orientation and gender identity, which are exponentially multiplied when combined with mental illness and potential treatment options, are noteworthy and may become impediments to individuals seeking treatment.

Written by: Annette Kee, DNP(c) MSN APRN PMHNP-BC

 

The misuse of and addiction to opioids—including prescription pain relievers, heroin, and synthetic opioids such as fentanyl – is a serious national crisis that affects public health as well as social and economic welfare. The rate of opioid addiction continues to skyrocket despite the introduction of programs designed to combat its pervasiveness, funding to encourage treatment for patients and training for providers, and policies aimed at reducing the availability of opioids. It is the most challenging problem facing the health department, yet the majority of opioid deaths are preventable. Fighting this epidemic requires a real-time, multifaceted approach that focuses on life-saving measures, proactively identifying programs and resources to prevent future abuse, and allocating funds to treat addicts whenever and wherever they are found. Incarceration does not solve the problem!

Excessive finger pointing between the pharmaceutical industry, physicians, politicians, and the drug users themselves, is mindless. Year after year, drug makers, distributors, prescribers and politicians have contributed to the problem, by looking the other way and, in many cases, benefiting from the deaths that ensued. In an interview on 60 Minutes, (here’s the link: https://www.cbsnews.com/amp/news/jailed-doctor-barry-schultz-interview-opioid-epidemic-60-minutes/?__twitter_impression=true),Bill Whitaker asks incarcerated Florida physician Barry Shultz to define his culpability in the ongoing epidemic. It is no surprise that he proclaims himself to be a scapegoat. The pharmaceutical companies and politicians’ responses are consistent and offer little in the form of viable solutions or strategies to nullify the continued proliferation of opioid addiction and death. Even as opioids flood American communities and fuel widespread addiction, hospitals are facing a dangerous shortage of the powerful painkillers needed by patients in acute pain, according to doctors, pharmacists and a coalition of health groups.

Policy solutions developed around the concept of making treatment for addiction easier to access than the opioids themselves, is a great start! For reference, a 2016 study by Florence, Zhu, Lou, & Xu, estimated the total economic burden of prescription opioid overdose, misuse, and addiction at $78.5 billion in 2013, about a third of which was due to higher health care and drug treatment costs. By deductive reasoning, the conclusion that billions could be saved in the long-term, is pragmatic.

Leadership is a top-down concept. Consequently, the president remarking that drug dealers deserve the death penalty for their role in opioid-related deaths and addiction, is not only absurd and disappointing, it does nothing to resolve the crisis, except erroneously place ownership on drug dealers as the sole source of the problem of opioid addiction and death in our communities. In spring 2018, Congress added an additional $500 million to the NIH budget to invest in science to find solutions to the opioid crisis. Additionally, the Helping End Addiction Long-Term (HEAL) Initiative aims to improve opioid addiction treatments and enhance pain management to prevent addiction and overdose.

These types of collaborative approaches to combating opioid addiction on multiple fronts is what is necessary to end the epidemic. We can no longer afford to sit idly by while pointing the finger at other entities in hopes of one group claiming full responsibility. In the interim, people are dying and the cost of healthcare is rising. We must identify and implement compatible strategies and solutions to end this epidemic now!  Otherwise, we are doomed to face the consequences of our inactions and inability to change the outcomes of those facing addiction.

Written by: Annette Kee, DNP(c) MSN APRN PMHNP-BC