Category: blog

The Opioid Epidemic: Why is it More Prevalent Now and Targeting Young White Americans?

The Opioid Epidemic: Why is it More Prevalent Now and Targeting Young White Americans?

With drug overdose being considered the leading cause of accidental deaths in the US with an estimated 91 people dying every day from opioid use disorder, it is no wonder why we are in an opioid crisis. In 2015, 2 million Americans 12 or older had a substance use disorder involving prescription pain relievers and over 20,000 overdose deaths were related to prescription pain relievers (American Society of Addiction Medicine, 2016). This paper takes a look at why more people have access to legal opioids, the implications on having this access, and why the opioid epidemic is targeting primarily young white Americans.

This epidemic is partially due to the fact that the number of written opioid prescriptions has skyrocketed. In 2012 alone, 259 million prescriptions were written for opioids (American Society of Addiction Medicine, 2016). This incredible number includes an estimated 60% of patients with nonmalignant pain being prescribed opioids; 20% of which are considered long term users (Tripp, Rak & Burker, 2017). Looking at the history of opioids being prescribed shows even scarier facts. The prescribing rates of opioids to adolescents and young adults has nearly doubled from 1994-2007 (American Society of Addiction Medicine, 2016); the amount of prescription opioids sold and the amount of deaths due to prescription opioids have more than quadrupled since 1999 (American Counseling Association, n.d.). With so many prescriptions being written, it is important to look into why they are being written.

Chronic pain and the use of opioids have gone hand in hand for many years. The experience of chronic pain is subjective and is shaped by numerous factors, including biomedical, psychological, and behavioral. Due to this, it is difficult to diagnose an opioid use disorder for those who have used opioids long term for chronic pain since addiction criteria cannot be applied to them. Previous to the late 1990’s, opioids were rarely used as treatment for chronic pain. When physicians started prescribing opioids for acute pain in cancer patients, pharmacological manufactures started advocating for the use of opioids in non-cancer patients for treatment of chronic pain. From then, the use of opioids for chronic nonmalignant pain greatly increased in which 21-29% of those prescribed opioids for chronic pain long term were considered as misusing opioids and 8-12% of those are experiencing addiction (Tripp, Rak & Burker, 2017). According to Kirk Bowden, an American Counseling Association member who chairs the addiction and substance use disorder program at Rio Salado College in Arizona,  opioids should not be used for chronic pain, instead they are more suitable for acute pain. Long term use of opioids can exacerbate pain as shown by neurobiological studies (Bray, 2017).

With opioid dependence having the possibility of beginning as early as 5 days, it is a serious question on why doctors typically prescribe 30 day supplies (Bray, 2017) following a surgery, trauma, or an exacerbating health condition and usually increased in dosage until the opioid reaches effectiveness (Tripp, Rak & Burker, 2017). “By the end of 30 days, the opioid is not addressing their pain anymore” (Bray, 2017). There are many contributing factors for the rise of opioid use disorder. One of the biggest contributing factors has to do with the prescribing doctors. Nearly 99% of opioid prescribing physicians going beyond the recommended 3 day dosage limit with a quarter of them writing 30 day supplies instead. Dr. Vivek Murthy, a US Surgeon General, stated that most of the opioid abuse are “coming from legally written prescriptions” (American Counseling Association, n.d.). With the focus of opioid addictions coming from those legally written prescriptions, race becomes another contributing factor.

An article written by the American Public Health Association in 2016 called “Is the Prescription Opioid Epidemic a White Problem?” touched on this subject. According to the article, there are a few reasons why opioid addiction has targeted majority of white individuals; marketing, the FDA’s classification of OxyContin, access to insurance coverage and treatment, and the changes in drug policies.

The marketing of buprenorphine, the “office-based opioid maintenance” treatment, is one of the main focuses in the article. Marketing is becoming primarily internet based with this rise of technology, which obviously caters to the computer literate. This in turn caters more towards middle to upper class SES; hence primarily white. These internet service announcements are sponsored by the buprenorphine manufacturers primarily included images of “white professionals” (Hansen & Netherland, 2016). When all demographics are not included, individuals might not feel as if they fit into that category and do not pursue these lines of treatment.

Additionally, the US FDA changed the classification of OxyContin (an opioid) in 1996 to a “minimally addictive pain reliever”. This, in turn, gave the manufacturers of OxyContin, Purdue Pharma, the ability to approach physicians with their medication to treat pain; promotion which was in primarily white states like Maine, Kentucky, and Virginia (Hansen & Netherland, 2016).  With this lessened classification, physicians have fewer restrictions and qualifications that need to be met in order to prescribe the medication.

An individual’s access to insurance coverage and treatment are also huge components of why whites seem to be the target of the opioid epidemic. The United States Census Bureau reported in their 2016 “Health Insurance Coverage in the United States” report that 93.7% of non-Hispanic Whites had health coverage as compared to 89.5% Black, 92.4% Asian, and 84% Hispanic (Barnett & Berchick, 2017). Hansen and Netherland (2016) stated that “opioid prescriptions disproportionately went to White patients… which increased racial differences in opioid use”. This, coupled with changes in drug policies when it comes to opioid drug offenses and their sentencing, can lead to a racially motivated epidemic.

Instead of arresting consumers of nonmedical opioids, policymakers are requesting “reduced sentencing for nonviolent illicit drug offenses” (Hansen & Netherland, 2016). Physicians are being mandated more frequently to use Prescription Drug Monitoring Programs, voluntary take-back programs for unused medication, and Good Samaritan laws that protect individuals who are calling for emergency medication attention from attaining drug charges as well. This does not carry over to Blacks and Latino communities; “many drug addicted [Black and Latino] individuals continue to be incarcerated rather than treated for their addiction” (Hansen & Netherland, 2016). While the use of these programs could be helpful, they need to be applied to all communities and therefore to all races/populations. Another important topic to touch on is why the opioid epidemic seems to be targeting young adults.

According to Substance Abuse and Mental Health Services Administration’s (SAMHSA) report on the 2016 National Survey on Drug Use and Health (2017),  4.4% of the population (approximately 11.8 million) aged 12 or older have misused opioids within the past year. The main reason reported as to why they misused opioids was to relieve pain (62.3%) but other reasons were also included: to feel good or get high (12.9%), to relax or relieve tension (10.8%), to help with feelings or emotions (3.9%), to help with sleep (3.3%), to experiment or see what it’s like (3%), because they are hooked or have to have the drug (2.1%), to increase or decrease the effects of other drugs (0.9%), or some other reason (0.9%). While the majority of participants reported it was for some sort of pain relief, how they obtained the drug could also be considered misuse. Participants reported to SAMHSA that they attained the opioids in the following ways:  given to them from a friend or relative for free (40.4%), a prescription from one doctor (35.4%), bought from a friend or relative (8.9%), bought from a drug dealer or other stranger (6%), took from a friend or relative without asking (3.7%), prescriptions from more than one doctor (1.4%), stolen from a doctor’s office, clinic, hospital, or pharmacy (0.7%), or some other way (3.4%) (Substance Abuse and Mental Health Services Administration, 2017). Within these statistics, it is shown how many different ways young adults are getting their hands on opioids and why they are using them. The trend for continued use is also prevalent; “It is known that youth who use opioids, whether prescribed by a medical practitioner or used non-medically, are likely to continue opioid use in the future” (Osborne, Serdarevic, Crooke, Striley, & Cottler, 2017). The younger an addict starts, the more likely they are to continue use and the more time they have to become addicted. With generations starting earlier and earlier, other societal issues can start to worsen for the future like life expectancies, the quality of the economy, overall public health, etc.

The opioid epidemic is being more popularized with the news and media in order to promote treatment but we need to look at more than just possible treatments. Why are more people getting legal access to opioids, what are the implications on having this access, and why the opioid epidemic is targeting primarily young white Americans are major topics to be studied. This paper took a brief look at these topics in order to better understand what we are dealing with when it comes to the opioid epidemic we have on our hands.

 

Christina D. Eubanks M.S.

Primary Therapist/Spark of Hope

 

 

 

Citations

American Counseling Association (n.d.). What are opioids? Retrieved from: https://www.counseling.org/images/default-source/cam2017/opiods_cam.jpg?sfvrsn=2

American Society of Addiction Medicine (2016). Opioid Addiction: 2016 Facts and Figures. Retrieved from: https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf

Barnett, J. and Berchick, E. (2017). Health insurance coverage in the United States: 2016. Retrieved from: https://www.census.gov/content/dam/Census/library/publications/2017/demo/p60-260.pdf

Bray, B. (2017). We’re in danger of losing a generation. Retrieved from: https://ct.counseling.org/2017/04/danger-losing-generation/

Hansen, H. and Netherland, J. (2016). Is the prescription opioid epidemic a white problem?  Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5105018/

Osborne, V., Serdarevic, M., Crooke, H., Striley, C., and Cottler, L. (2017). Non-medical opioid use in youth: Gender differences in risk factors and prevalence. Retrieved from: https://www.sciencedirect.com/science/article/pii/S0306460317301351

Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www. samhsa.gov/data/

Tripp, C., Rak, E., and Burker, E. (2017). A review of effective treatments for patients with co-occurring chronic pain and opioid addiction. Retrieved from: https://www.counseling.org/docs/default-source/vistas/article_437fce2bf16116603abcacff0000bee5e7.pdf?sfvrsn=e1d84b2c_4

 

It’s about women empowering women!

It’s about women empowering women!

On April 11th 2018,  our Hope Dealers attended an awesome event at Hanley Center at Origins entitled “Women Empowering Women.”

When like minded people put their heads together, there is nothing that can stand in their way. This is especially true for a group of like minded women within the behavioral health industry. We are all driven by the desire to help others.  Upon walking into the event, we immediately felt a surge of energy.  There was an inherent sense of purpose.  The women gathered here, from all walks of life, were each bringing our brand of motivation, empathy, understanding, collaboration and willingness to help to an industry that is sorely in need of these qualities.

We had the pleasure of hearing an inspirational talk by Dr. Maritsa Kelley – a successful author, retreat host, business and life coach. She spoke about the importance of values in not only our personal lives but our business lives as well. Her personal stories were relatable and inspiring to most of us as women in the workplace attempting to balance the importance of family and career. One such story stands out. She recommends buying a Tikker watch, which is no ordinary watch. This watch does not only tell you the time, but it also counts down the rest of one’s life in years, months, days, hours, minutes, and even seconds! Talk about taking time management to a whole new level! This would invariably help some of us whom might be victims of procrastination, but more importantly, it is a constant reminder that time is indeed the most precious commodity that we possess. Imagine if one can see his or her life counting down continually without pause by merely looking at the watch.  It creates a sense of urgency within each of us like never before.  No more putting off things that we can accomplish today. Time is of the essence.  This was the message of the day – Carpe Diem! #girlpower #womenempoweringwomen

Spark of Hope is attending the Ethical Marketing Practices (EMP) conference on 3/30/18 – hope to see our friends there!

Spark of Hope is attending the Ethical Marketing Practices (EMP) conference on 3/30/18 – hope to see our friends there!

Unlike virtually any other industry, marketing, or “ethical” marketing in the behavioral health and addiction industry is fraught with challenges, particularly for new entities entering into this space.  There are a myriad of obstacles, from regulatory to legal, from best practices to programming efficacy, new treatment center operators must learn and adapt to the ever-changing legislative landscape.

This is why Spark of Hope will be attending Behavioral Health Network Resources’ Ethical Marketing Practices (EMP) Conference on May 30, 2018.  “Our objective is to learn as much as we possibly can on how to effectively market our program to ensure its efficacy, compliance and sustainability”, said Raul Fridman, Spark of Hope’s Director of Business Development and Latin Outreach.  “We also want to network with other reputable centers, many of whom are feeling the pain as our industry is experiencing a correction, hopefully one in which new centers, as well as the established ones, can work together in a spirit of collaboration to help those we have been entrusted to serve and to treat.”

The Conference will feature up to seven “executive thought” panelists, all of whom are experienced in the field of addiction marketing and outreach.

Among the topics the event will be covering are:

  • Learn the “big picture” reasons why marketing has failed in our industry
  • Learn about a new detox technology (FDA approved for marketing) coming into our industry that will allow us to offer outpatient detox at an extremely low cost
  • Get educated on search engine optimization and how to get on page one of Google generating 1000’s of calls
  • Learn how to get an entire organization involved with marketing
  • Learn how the billing company can help generate revenue
  • Learn why an organization is not on the 1st page of Google
  • Learn “white hat” strategies to get ranked on Google and start getting the 1000’s of calls generated by the 1st page of Google
  • Learn the common mistakes made by many centers on their websites and with SEO
  • Learn about tools to help you with your marketing strategy
  • Learn proven strategies in gaining new referrals
  • Learn how to utilize Facebook and LinkedIn to build referrals

“In my experience as an entrepreneur, marketing is the lifeblood of any business, and knowledge is power”, said David Lam, Executive Director of Spark of Hope.  “This is particularly true in our space, since the barriers to success are much greater than in other industries.  Therefore, ethical operators must rely upon events such as these to keep us abreast on the latest marketing practices and organizational strategies.”

For more information on Behavioral Health Network Resources’ Ethical Marketing Practices (EMP) Conference, please visit: https://www.behavioralhealthnetworkresources.com/events/emp-ethical-marketing-practices-addiction-conference-2018/

Parkland Strong isn’t merely a slogan

Parkland Strong isn’t merely a slogan

(To be featured in the April 2018 issue of the Sober World)

2.14.18. Wednesday. Valentine’s Day. A day that will forever be etched in our memory. It was a day that Parkland, our home for the past 18 years, lost its innocence. In a matter of minutes, beginning at 2:21pm, 17 innocent souls perished.
If only we could turn back the clock. You see, Parkland isn’t like any other town. It’s a rare piece of Americana that is disappearing across our country. It’s our few remaining bastions of suburban utopia where families gather to provide a haven for their children. It’s a community where neighbors greet each other. In fact, many of us know each other well, and care genuinely for our fellow residents. We often stop and say hello, whether it’s at our local dry cleaner’s, or the Starbucks on Hillsboro Blvd or the one on Coral Ridge Drive…just blocks away from Marjory Stoneman Douglas High School. Tragically, it is now the infamous site where the shooting took place. When a deranged gunman opened fire on unsuspecting students and teachers that fateful day, he murdered not only 17 lives. He destroyed our Parkland.

Or did he? On that very evening after the shooting took place, our city immediately organized a vigil at the Parkland Amphitheater, led by community rabbis and lay leaders. More than 30,000 people showed up in a matter of hours! There were news agencies from all over the world covering the event. While tears and melancholy filled the air, we began to witness the resilient spirit of our town almost immediately. Scores of students, many of whom were hunkered down in classrooms just a few short hours before, came out to console their peers. Others arrived to pay respects and to mourn for the loss of their classmates. As if united by a divine calling, we witnessed the incredible solidarity of the students in attendance. Overnight, a movement in Parkland had begun. A movement that will cast far reaching effects upon the annals of our country’s history.

I’d witnessed the aftermaths of other mass shootings: Orlando, Las Vegas, Sandy Hook, even Columbine. But Parkland was different. Not because it took place in my home town. But there was an undeniable feeling in the air beginning on the eve of the vigil. Somehow, we all knew that the students of Stoneman Douglas and the city of Parkland would react differently to this act of atrocity. Undoubtedly, we were not going to let this tragedy go away lightly. Or ever.

The immediate days following the shooting saw our streets lined with protestors and activists, led mainly by vigilant students and angry parents. From Parkland to Coral Springs, from across America to the nation’s capital, the spirit of Parkland resonated loud and clear. While still grieving, many of us occupied ourselves with communal affairs. We called our neighbors and city officials asking how we can help. We simply wanted to do something. We all felt this was our way to heal.

Just a few weeks prior to the Stoneman Douglas tragedy, Spark of Hope launched our First Responders’ Recovery Program called the Cindi McCue Initiative which provide substance abuse treatment and mental health counseling services to our country’s Finest. It was named after a police officer that took her own life in 2015. We wanted to give back to those whom have dedicated their careers to serve and protect us. Many first responders often put their lives on the line witnessing unspeakable tragedies daily. We had no idea at the time that such a tragedy could hit so close to home. Since then, we’ve mobilized our First Responders’ campaign beyond the local communities and seek to nationalize it throughout the country, by the grace of G-d.

Spark of Hope is also an active player on the planning committee of the Broward County Mental Health Summit, alongside the Broward Sheriff’s Foundation and 2-1-1 Broward. Our mission is to promote mental health awareness and education throughout South Florida. Our inaugural event will take place on Wednesday September 12, 2018 featuring many supporters including FPL, Broward County VA, Broward Sheriff’s Office, Baptist Health and Wells Fargo. Additionally, Spark of Hope has set up complimentary mental health counseling services and trauma workshops, including Trauma Yoga therapy to those affected by the Parkland tragedy. We will continue to provide these services free of charge to anyone so long as there is a need. Moreover, Spark of Hope has dispatched our trained counselors and therapists to neighboring organizations such as 2-1-1 Broward, and to local schools, to provide the needed services to the many employees, volunteers and students that they so rightfully deserve. So long as Spark of Hope exists, we will endeavor to do more.

For in the words of Dr. Martin Luther King, Jr. “darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate; only love can do that.” And through unconditional acts of love, Parkland will overcome, for we are indeed Parkland Strong!

Semper Fidelis,

David Lam
Spark of Hope
www.ethicaladdictiontreatment.com