Alarming statistics indicate a sharp increase in opioid-related deaths in 2020. About 90,000 people across the country have died of drug overdoses in 2020, up almost 30% starting in 2019, when overdose deaths were the leading cause of death among Americans under 50.
Tennessee is well above the national average, with a 45% jump in overdose deaths in 2020. Full CDC Numbers show a country struggling to chart a course in a crisis that has no easy solutions. Safety measures related to COVID-19 have reinforced addictive factors such as isolation and economic instability and made treatment rarer and more difficult to administer. In the years to come, an effective response will include a fundamental reconsideration of the health system and social context that made the opioid epidemic possible in the first place.
My dad was prescribed opioids in the late 1990s or early 2000s, information I will never get. He had a history of alcoholism, critical information for any primary care provider. After surgery for a herniated disc, my father’s official diagnosis was chronic pain. The solution was pain management. He called the regular prescriptions of OxyContin âmedicine for my back,â muddying his addiction with medical advice. I don’t know where or how he maintained a steady supply of pills.
The 64,000 deaths in the United States attributed to overdose in 2016 do not include it. He died of a traumatic brain injury after falling down the concrete stairs of the warehouse where he lived. I don’t know if he was drunk or high when he fell. I guess he was. He was homeless and without a regular income at the time, ran a bankrupt company, divorced and separated from his two college-aged children.
Statistics tell an incomplete story of the opioid crisis. Data is collected when individuals come into contact with reporting systems, such as emergency departments and hospitals, usually during an overdose. Overdoses are the tragic extreme of a crisis of isolation, stigma, and mental and physical health, a crisis that is unfolding in real time across state and country. It’s much harder, if not impossible, to paint the full picture: families who worry, calls to voicemail, money disappearing, hours and days missing, all the ways drugs are spread. in the capillaries of a community.
The other major development this year that defined the opioid crisis has been a series of lawsuits, agreements and regulations determining the accountability of the main architects of the crisis. In each case, a growing body of literature and information suggests that the manufacture, marketing of opioids and the distribution took place with full knowledge (or willful ignorance) of the potential human consequences.
Purdue Pharma, the multi-billion dollar pharmaceutical company built on OxyContin (a reformulation of morphine), appears close to a $ 3.4 billion settlement for its role in the nation’s flood of pills. Purdue was founded and is owned by the now infamous Sackler family, whose members served as the CEOs of the company until 2017. The family’s total wealth is estimated at $ 11 billion. A week ago, state attorneys general, including Herbert Slatery of Tennessee, has a roughly $ 26 billion deal with maker Johnson & Johnson and three major opioid distributors.
When and if they do take hold, these billions will no doubt be used to support the widely available and readily available Naloxone, a life-saving drug that can save someone who has overdosed. They could help fund community mental health resources or drug-assisted addiction treatment, two elements of many successful recoveries. Tennessee could see as much as $ 500 million from a single settlement, a boost to the state’s relatively new and grossly underfunded opioid response.
My father was prescribed opioids in the late 1990s or early 2000s. He had a history of alcoholism, critical information for any primary care provider.
This overwhelming focus on accountability – executives who orchestrated an addiction epidemic and walked away with profit, distributors who turned a blind eye, doctors who pretend they don’t know any better – will save many lives and help rebuild communities. It should not be confused with justice. True justice for the billions of prescriptions sold as “health care” and families like mine where pills have become a household staple would start with an acknowledgment of the wrongdoing of those who have done wrong. The Sackler family, who have sold the addiction to millions of people and, adhering to disciplined legal defense, have yet to admit mischief. Doctors who write prescription after prescription. Lawmakers who have blocked and continue to impede access to health care for all Tennessees, regardless of their ability to pay.
The opioid epidemic has laid bare a healthcare system that makes people sick. He exposed the perverse incentives that occur when we commission for-profit drug companies to deliver health care. As organizers and lawmakers push for a modern healthcare system that provides free and accessible care to all, a shifting stigma around opioid addiction and drug use must clearly center drug users as the victims.
Punitive measures taken against drug addicts continue to make little sense in the fight against drug addiction, often condemning users to forced withdrawal and increase the risk of overdose after incarceration as much as twelve times. It will require constant reminders that addiction requires a lifetime of treatment and strong support systems. A comprehensive understanding of addiction includes recognizing the symptoms of addiction as a lack of health care. An informed understanding of addiction is necessary for any state or local response to associated crises such as homelessness, mental health and unlivable economic conditions.
One of the last times I heard from my dad was in an email. He told me he had hit his head and was not feeling well, but did not want to have it checked. He didn’t trust doctors or hospitals. They were overpriced and they didn’t help. I don’t blame him for that.
Over the past two decades, America’s largest corporations have made millions of disproportionately poor and rural people addicted to opioids. As we dive deeper into the crisis and overdose deaths are twice as high as in 2015, the U.S. healthcare system has done little to regain that confidence.