In her book Crank about a girl named Kristina, who ends up living with an addiction to “the monster”, Hopkins writes “Life was good before I met the monster. After, life was great. At least for a little while”. Individuals who are addicted to opioids abuse these drugs for a variety of reasons. Each individual addicted to substances has a different story about how they were exposed to, abused, became addicted to, and in some cases recovered from addiction to substances. The truth is that once you’ve met one person with an addiction, you have met one person with an addiction. So, in the face of this epidemic of addiction to opioids, the question becomes how do we confront the issue? How do we aid individuals living with addiction and their families as they embark on their journey to recovery? What connection do the mind, the body, and the spirit play in the journey to recovery?
In this blog, I will begin by introducing the opioid epidemic that is currently happening not just locally in various parts of Pennsylvania but nationally. Then I will move into some interventions that are being used to combat the opioid epidemic. From here I will talk about how this impacts the individuals, their families and the community in which they live. I will end by talking about the importance of being in touch with the mind, body, and spirit to live a healthy and holistic life.
As seen in the video above, nationally, and even locally, there is an epidemic, individuals are abusing and becoming addicted to opioids. Opioids such as oxycodone, hydrocodone, and buprenorphine, are powerful painkillers that when used can cause Euphoria, Decrease respiration, heart rate, and blood pressure, and slower digestion (Vaccaro, 2017). Opioids are an important tool for treating symptoms of diseases, and procedures that cause individuals an extreme amount of pain. So, how did something intended to help individuals become this much trouble? The answer to this is complex because the issue has multiple factors associated with it. However, we can attribute the rise in abuse, addiction, and overdose to three things: “(1) a change in the pain treatment standards in the 1980s, (2) Development of powerful pain relief medication in the 1990’s, and (3) The increased availability of illicit opiates in the 2000’s” (Vaccaro, 2017). The reality according to data presented NESARC (Nation Epidemiological Survey on Alcohol and Related Conditions) is that nonmedical prescription opioid use has increased 161%, and Lifetime use of heroin increased almost 5 times (Douaihy, 2017). With this increase, there are complications such as various types of health problems, and deaths of despair (a term used to describe the intersectionality between opioid overdoses, suicides, and addiction-related diseases, and globalization, societal disruption and economic decline). According to CDC data, Pennsylvania’s deaths from opioid-involved overdose increased by 20%, making the deaths equate to 25 per 100,000. Every day, we wake up turn on the news, and we listen to stories about individuals who are addicts, we hear how they are overdosing or dying, and how those numbers are rising. So, how do we keep the number of deaths of despair down, and help individuals with addictions to opioids recover?
Interventions to the Abuse and Addiction of opiates
As seen in the video above, there are a variety of interventions that are available to individuals with opioid addictions. In addition to your personal network made up family, friends, and teachers, some interventions include health care and behavioral health providers, peer to peer recovery support groups, faith-based organizations, educational institutions, neighborhood groups, government agencies, and family and community support groups (SAMHSA, 2016). The problem is that we have these various types of interventions but not all of them work, and sometimes they can present issues, challenges, and barriers to the recovery process. The golden rule in any role where you are providing services is to think about whether or not the services that you are providing are meeting the needs of the community. When we think intervention strategies, and what is needed to help individuals facing addiction we often forget to ask the people what it is that they need. It is imperative to conduct a community needs assessment and invite all of the stakeholders into the conversation (Spencer & Smith, 2017). You can’t take someone who has never experienced addiction or have been impacted by addiction and expect them to make an effective intervention program unless they work with individuals who are in stages of long-term recovery. Programs, where peer mentor strategies are used, are so successful because an individual in long-term recovery know the needs of the individuals they are working with and can act as a liaison to sober communities (Hillios, 2013). Even when programs are successful and they meet the needs of the individuals there are still a few challenges, such as stigmas and the physiological effects of the opioids that make recovery hard.
Impact of Opioids, and their Stigmas
“The Greeks, originated the term Stigma to refer to bodily signs designed to expose something unusual and bad about the moral status of the signifier. The signs were cut and burnt into the body and advertised that the bearer was a slave, a criminal or a traitor” (Goffman, 1). Humans, because of the way that the biology of the brain works, categorize and label things in their environment. Stigmas a side effect of the labeling process, carry with them four components: “First, people distinguish and label human differences. Second, members of the dominant cultural group link labeled persons with certain undesirable attributes. Third, negatively labeled groups or individuals are placed in distinct and separate categories from the non-stigmatized. Fourth, as a result of the first three components, labeled individuals experience status loss” (Kusow, 4786). This becomes important to the topic of opioid addiction, treatment, and recovery because of weight that it creates on the shoulders of the individual and their families. For more information on stigma and its impact on individuals addicted to opioids see the video below.
Individuals, Families, and Communities
Opioid addiction is not something that is solely about the individual. Addiction impacts the social networks around the individual as well. So in addition to having effects on the individual opioid addiction also affects the family, and the community to which the individual living with addiction lives in. For a brief introduction to this see the video below.
Opioids, like other medications, when taken change how the brain functions by raising the level dopamine release to 975 per dl, causing what is known as dopamine flooding (Daley, 2017). The more that an individual living with addiction engages in the use of the opioid their body naturally adapts and creates a tolerance for the drug making it harder and harder to reach the state of euphoria. As their tolerance increases they need greater quantities of the drug which do two things, cause economic strain and increase the risk of overdosing, leading to a death of acute respiratory paralysis (Vaccaro, 2017). The struggles associated with the economic strain and losing things that these individuals had in their lives can turn them towards other deviant behaviors that impact the community, such as dealing drugs and theft, which later lead to incarceration (Spencer & Smith, 2017).
Families have it especially hard. They have to watch someone the love transform into someone that they don’t know and engage in destructive behaviors. They are experiencing a great deal of pain, anger, and confusion, just as their loved ones who are living with addiction. Having a family member with a substance abuse disorder can lead to a variety of health issues (Daley, 2017). It also has a great impact on the children in the family unit leading to higher instances of anxiety, depression, and attention disorders (Daley, 2017). So often times even though they don’t believe it families need social services as well to learn how to adjust to life knowing that their loved one is living with an addiction so that they can more effectively help not only that loved one but also themselves.
Finally, in terms of the community members, emergency services have to add a new responsibility to their jobs that puts more pressure on them as they cannot meet the demands of responding to calls for overdoses with their current responsibilities (Bradbury, 2017). In addition to this, the responders have to see the same people, multiple times which can have a psychological toll. In addition to this as mentioned above people are fearful that crime will come to their communities because of an addict’s need to fuel their addiction. Addiction is not just about the individual, addiction impacts every component of their lives including their networks and the places in which they live. Addiction and the journey to recovery is a difficult and long process but the road to recovery can begin by being one with your mind body and spirit.
Being One with Your Mind Body and Spirit
Living a healthy and holistic life is important because it is about bringing a sense of balance into all aspects of your life. Often, individuals living with addiction have an imbalance in their lives acting as a trigger for use. Taking three small steps and changing how you eat, think and what you do can improve your physical and mental health (Parkinson, 2017). Dr. Parkinson said he believes “diseases that we have today are diseases of social isolation, no man is an island, yet they act as island”, part of mindfulness is knowing what you need to be your best self and how to communicate that, so that you can help yourself and others. As humans, we are social creatures who need social interaction. We need strong support systems. We need something to believe in. We need ways to decompress and relieve stress. This is why a healthy and holistic lifestyle is so important not just to the individual on their journey to recovery, but also to the service providers who are treating individuals facing addiction.
Daley, D. (2017). Strategies to Address the Opioid Epidemic [PowerPoint slides]. Retrieved 7/10/2017
Douaihy, A. (2017). Medication-Assisted Treatment for Opioid Addiction: The New Gold Standard? [PowerPoint slides]. Retrieved 7/10/2017
Goffman, E. (1963). Stigma: notes on the management of spoiled identity. Harmondsworth: Penguin Books
Hillios, J. (2013). Transcending Addiction and Redefining Recovery. TEDxBoulder. Retrieved July 11, 2017, from https://youtu.be/gzpTWaXshfM
Kusow, A. M. (2007). Stigma. In The Blackwell Encyclopedia of Sociology.
Parkinson, M. (2017). Walking the Talk: Being Our Best Self to Help Our Patients Do The Same [PowerPoint slides]. Retrieved 7/10/2017
Smith, A & Spencer, R. (2017). Recovery is a Journey, not a Destination : Hope for Individuals, Families, nd Communities Affected by Addiction [PowerPoint slides]. Retrieved 7/10/2017
Substance Abuse and Mental Health Services Administration. SAMHSA Opioid Overdose Prevention Toolkit. HHS Publication No. (SMA) 16-4742. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2016.
Vaccaro, C. (2017). Opioids and Opiates [PowerPoint slides]. Retrieved 7/10/2017