AUG. 12, 2017

It’s Long Overdue That We Get The Opioid Epidemic Under Control

In Hawaii, almost twice as many people died from opioid overdoses than in car accidents in 2015. Opioid addiction and overdoses have been ravaging communities for years as a silent crisis with limited public attention. Part of the reason is that the opioid drug problem is perceived as a simple misuse of prescription pain killers -- fentanyl, oxycodone, hydrocodone, codeine, etc. -- and does not carry the traditional stigma that illicit drugs do, acquired from the streets and linked to criminal behavior. But the fact is opioids are claiming more lives due to their potency than popular street drugs like crystal methamphetamine or cocaine. And there is a growing black market for the opioid fentanyl and heroin that is causing even more fatalities.

The first step to dealing with a drug crisis is for the public to recognize it as a problem. In the early 2000s at the peak of Hawaii’s crystal meth crisis, the community demanded action. Hawaii lawmakers responded by pouring millions into drug busts and treatment. Town hall meetings and “ice” or meth summits were held and a powerful anti-ice youth campaign was launched. Lawmakers even passed a law that required popular cold medicines -- which ingredients were being used to create meth at home -- to be monitored. This had a dramatic impact in thwarting home meth labs and eventually slowed down meth’s availability.

The campaign against opioid drug addiction will also require coordinated efforts by the community, lawmakers, the police, and the medical community.

Physicians must do a better job in working with patients on pain management by designing more conservative opioid regimens to avoid dependence, and possibly recommending that patients utilize physical therapy or holistic modalities to alleviate pain.

 Pharmaceutical companies must better track their drugs as they move through the supply chain to prevent their drugs from ending up in the black market as the U.S. Justice Department ordered Mallinckrodt Pharmaceuticals to do. The pharmaceutical industry as a standard should voluntarily do the same and tighten the channels of their drugs. Drug makers must also provide better training to physicians on both extended-release and fast-acting release of opioids, as now required by the FDA. 

On the rehabilitation end, there needs to be improved access to treatment and recovery. More states ought to require health insurance companies to include substance abuse treatment in their health plans as some states are already pushing for.  Hawaii lawmakers ought to also consider funding for opioid treatment like they provided for meth addiction. Pharmaceutical companies that manufacture opioids should also be paying for the epidemic it helped cause and set aside private funds for rehabilitation. If they are unwilling to help, states facing opioid crisis should consider joining the states that have already filed legal suit against the pharmaceutical industry.

On the enforcement end, stiffer penalties for traffickers of fentanyl, heroin and other opioids should be adopted. Health insurance companies should also monitor more closely patterns of opioids prescribed by physicians to ensure opioids are not being prescribed inappropriately.

Leading public health experts believe that if the spread of opioids is not contained and opioid addiction properly addressed, the death toll in the next decade from opioids could kill nearly as many Americans in a decade as HIV/AIDS has killed since that epidemic started in the early 1980s. Experts believe fatal overdoses from opioids will not begin to level off until after 2020. One good news is that physicians are already writing fewer prescriptions of opioids.

Dr. Patrice Harris, former chair of the American Medical Association, made a smart commentary about how to approach the opioid crisis: “One key to bringing down the death toll is to spread the word that addiction is a chronic medical condition, not a personal failing.” If addicts can adopt this viewpoint, they would be more open to getting the help they need.


Loneliness Is a Real Health Problem

One of the greatest health risks that receives little attention is loneliness. It is a mental health issue that also affects the physical body. Researchers found that loneliness disrupts sleep, raises blood pressure, lowers immunity, increases the stress hormone cortisol that can wear down the body when sustained at high levels for long periods of time, decreases memory and learning, hastens the progression of Alzheimer’s disease, increases risk to cardiovascular disease and stroke.

A person suffering from prolonged loneliness is also more susceptible to suicide, alcoholism, drug abuse, and obesity. The Mental Health Foundation research shows that loneliness can lead to other mental health problems such as depression and anger management problems. Loneliness also disrupts regulation of cellular processes that can lead to premature aging. In a University of California, San Francisco study, researchers found 43 percent of seniors suffer from loneliness. In the same study, it found lonely seniors are more likely to die faster than seniors who are not.

Loneliness is not given the serious attention it deserves because of one big myth: People believe it is just a feeling that can be cured away by just becoming more social, getting more friends or a partner. This could be a partial remedy but the fact is there are many sufferers of loneliness who have full social networks and are in relationships. Loneliness is not physical isolation. Loneliness is a mental state of mind and often is a genetic disease. There are many lonely people in marriages, both healthy and unhealthy ones. There are lonely people who surround themselves with people all the time that often is an attempt to fill the emptiness that loneliness brings. The fact is loneliness is not easily curable, and arguably more difficult to recover from than other health damaging conditions such as smoking, drug addiction or overeating.

It is difficult to cure because loneliness is not just rooted in situational variables but in some cases a deeply set mental illness. Like depression, people who are lonely report of having been lonely for a great part of their lives. Studies show lonely people have a history of loss or trauma. They’ve had negative, abusive childhoods with very critical and harsh parents.

Loneliness caused by situational variables are more temporary. Examples of these include: a young adult going away to college, a person moving to a new city with little to no social networks in place, or the more difficult situation of going through a divorce or losing a spouse or lover from death. In these or situations like it, loneliness are more easily curable. Professor John Cacioppo, co-founder of the field of social neuroscience and one of the top loneliness experts, recommends developing quality relationships with people who have similar interests. Quality is emphasized; not quantity. He recommends approaching loneliness as something that needs to be changed. Being content with loneliness is like being content with being obese or a cigarette smoker. Know that loneliness is detrimental to one’s health. For people who are physically isolated in a new city, Cacioppo recommends doing community service or an activity that you enjoy and can meet new people. Experts also warn that sometimes social media can have an opposite effect of making people feel connected; it sometimes can make loneliness worse.

Loneliness is a serious matter deserving of far greater attention. Although loneliness is more frequent among seniors, it is a condition found in all ages. It’s often easily identifiable. Someone suffering from loneliness will find it difficult to reach out for help. Loved ones should first see loneliness for what it is, a mental health problem, and second be the person to initiate comfort to a family member or friend who suffer from it.

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