We have a major problem in our state and federal prison systems as well. The Federal Bureau of Prisons (2016) reported 46% of prisoners across the US are incarcerated for drug related offenses. In fact, pharmacists in New York are now permitted to carry guns to protect themselves from deadly robberies related to painkiller abuse. The Bureau of Justice Statistics (2006) reported nearly half of prisoners had a mental health problem. With these individuals re-entering society with high rates of mental illnesses and substance abuse problems, only one in three state prisoners and one in six jail inmates with mental health disorders report having received treatment since admission.
On a global level, the US makes up nearly 5% of the world’s population, yet, 80% of the world’s painkillers are taken in the US. Deaths from prescription opioids are also on the rise in both Australia and New Zealand (NZ) and the US and NZ are amongst the countries with the highest numbers of residents in drug treatment programs. Interestingly, only the US and NZ allow pharmaceuticals companies to advertise pharmaceuticals, including opioids, on television.
“Death by Heroin Overdose” is an all too common headline in Hollywood with a long list of famous actors and musicians who have succumbed to deadly mixtures of heroin and alcohol and other drugs including the late: John Belushi, River Phoenix, Chris Farley, Janis Joplin and more recently Philip Seymour Hoffman and the young Cory Monteith (Glee star). But the epidemic affecting young people in the suburbs has been dominating the headlines across the US. In fact, the NJ Star Ledger posted an article on its front page on 10.27.16 crediting Narcan (naloxone), the anti-overdose drug, because it is on track to save 8,000 lives in NJ by the end of 2016. Sadly, that also means that at least 8,000 lives needed to be saved.
The treatment gap barrier is responsible for many losses
Family and friends can be extremely influential in encouraging individuals with addiction issues to seek treatment. Likewise, the passage of healthcare reform in March, 2010, made health insurance coverage for substance abuse addiction, available to millions of Americans. Unfortunately, federal and state regulators are struggling to implement that vision.
According to NIDA (National Institute of Drug Addiction), the treatment gap is massive. In 2011, 21.6 million persons aged 12 or older needed treatment for an illicit drug or alcohol use problem, but only 2.3 million received treatment at a specialty substance abuse facility.
The treatment gap encompasses both unmet needs and unmet demand for treatment. Essentially, not all who need treatment are seeking it, and not all who seek it are able to get it. Long waiting lists and high costs of treatment, even for the insured, often results in losses, both in dollars and lives.
How is our government addressing this epidemic?
Programs are being implemented on a local, state, federal and international level to address this epidemic. Anti-drug programs like D.A.R.E (Drug Abuse Resistance Education) were introduced back in the early eighties to convince young students to sign a contract to never do drugs or join gangs. D.A.R.E is the most widely implemented youth anti-drug program nationally and internationally and receives government support despite the fact that multiple studies show that children who participate are as likely to use drugs as those who do not participate, and sometimes, may even be counterproductive. In fact, some findings were disturbing. In one study, 20-year-olds who had D.A.R.E. classes were no less likely to have smoked marijuana or cigarettes, experimented with alcohol, used “illicit” drugs like cocaine or heroin, or succumbed to peer pressure, than kids who had never been exposed to D.A.R.E.
A town in Pennsylvania is trying a new approach at educating today’s youth about the dangers of opioids, something more personal. A presentation by Narcotics Overdose Prevention and Education (NOPE) uses a gut-punch style approach offering high school and middle school students education about prescription opiate painkillers. At an early morning assembly of a N.O.P.E. program in a PA high school, roughly 500 students looked at an urn filled with the ashes of a 17 year-old boy as a 911 recording played the cries of a desperate mother finding her son, dead, from a painkiller overdose. This is only one of a handful of prevention programs popping up around the country in an effort to prevent more senseless deaths.
At the state level, lawmakers are introducing bills which propose state sponsored funding of addiction prevention programs, prescription monitoring programs and opioid task forces. Governor Chris Christie has launched a state-wide treatment hotline and has pushed for first responders to have easier access to Naloxone.
- In NJ, a 6-bill legislative package was introduced to:
- Force rehab which would allow someone to petition the court to involuntarily commit someone to rehab.
- Track Narcan doses and have the data submitted to doctors to help them establish best treatment options.
- Electronic prescriptions for all controlled substances to prevent theft of prescription pads and fraudulent production of prescription pads.
- Education for health care professionals regarding opioids in order for them to maintain their medical license.
- A resolution proposes the State Board of Medical Examiners to adopt the CDC Guideline for Prescribing Opioids for Chronic Pain in order to improve patient safety and educate patients about the risks and benefits of opioid use as a pain management treatment.
- A second resolution proposes school nurses be informed if a student is prescribed opioids and allows monitoring of the student to watch for opioid abuse/misuse.