Over the last several weeks you have heard a number of different perspectives (individuals, family members, law enforcement, treating providers, coroners, etc.) about the impact of the opioid crisis. These stories are difficult to listen to and in many instances gut wrenching. You might ask how we got to this point. Why have we allowed drugs to control our society and the individuals in it? Is it enough to just listen and not take action?
As a behavioral health provider for over 35 years, you can imagine the issues I have seen and heard. Mental illness and addictions affect all of us in some manner. There is virtually no one, if you are being honest, who hasn’t been impacted by this widespread crisis. But have we missed the bull’s eye in treating the opioid crisis? Are we treating the symptoms, not the cause or disease itself? Would you stop reading if I said it is my professional opinion that we have failed our fellow societal members by failing to recognize and treat, not just what may be the underlying cause, but for certain a mutual influencer in the opioid crisis?
Mental illness plays a major role in our current national opioid crisis. Of more than 115 million prescriptions for opioid medications in the United States, more than 51 percent were for persons with a mental illness. Further, depression is known to double the likelihood that a person will use opioids. And conversely, use of opioids doubles the likelihood that a person will develop depression in as short as 30 days, which also can escalate further to a suicide attempt. Anecdotal evidence from the field suggests that as many as half of those with serious mental illness in our urban areas use or are dependent upon opioids.
We have focused so much on the symptom, the use and abuse of opioids, that we have forgotten to look deeper at the causes. You might say, “The doctor prescribed it to help my pain go away”. While your pain may have begun as a physical manifestation, how quickly did it affect your mental health? Did it take much time at all to have other symptoms of depression or anxiety such as poor sleep, poor eating, inability to concentrate, trouble going to work, isolating self, panic attacks, etc.? Most people will tell you likely not long.
We have become a society of “band aid” appliers or “quick fixers.” Covering the real issues with a superficial coat of “take this and you will feel better” rather than a deep dive into the layers of anger, hurt, pain, trauma, fear, and depression which has led us to forgetting that some things cannot be corrected with a pill or a quick feel good approach. I wonder if we have not contributed to the opioid crisis by failing to make it okay for people to accept their depression and seek help for it; help that requires people to delve deep and address some really difficult issues in their lives. Not only, have we as a society enabled individuals to become addicted to opioids and other drugs, but we have supported their addictions by not taking a stand; A stand to work together to empower our fellow citizens. We have become a nation and community of by-standers who watch the world happen around us and shy from anything that makes us feel uncomfortable. We are too busy focusing on our needs and making ourselves look good, often times to the detriment of others. We fail to see those in our community in need of a helping hand or a word of encouragement. It has become far too easy to look away and go about our individual lives.
Is treating depression the answer to the opioid crisis? I think you can find support for this idea in the professional healthcare provider community. But we are back to the same question that has been a theme of all the recent press coverage on the opioid crisis in our communities…how do we fix it? I am convinced there is no one right answer to fixing the opioid crisis in our communities, but I do know one very wrong answer—lack of action. We cannot continue to ignore those individuals in our community who struggle with depression and other mental illness that too often lead the way for addiction. We cannot turn the other cheek and hope they will go away. We cannot continue to focus on ourselves to the exclusion of others. We CAN step up to offer a listening ear, encourage someone to get help or improve them self, drive someone to a treatment appointment, pay for someone to get the help they need, offer hope and support, make someone smile, accept someone as different but no less valued. There are so many things we can do as a community and it all begins with looking beyond you and taking that first step to action.