Shah: Opiate Fiasco

The opioid crisis is destroying lives just next door. We need real solutions.

by Rachna Shah | 9/15/17 12:30am

Health, according to the World Health Organization’s Constitution, is defined as “complete physical, mental and social well-being.” Drug abuse can take all that away. Opioid addiction is not a “moral issue” as the Association of Certified Biblical Counselors claims. It is an illness and deserves to be treated as such.

According to the National Institutes of Health, approximately 25 percent of patients prescribed opioids for chronic pain misuse them, and about 80 percent of people who use heroin misused prescription opioids first. Despite this fact and the state’s negative track record of drug abuse, New Hampshire doctors prescribed 72 to 82 opioid prescriptions per 100 people in 2012. In prescribing opioids, doctors are generally trying to do good — they want to reduce patients’ pain and reduce the need for those in rural areas to return for refills. Yet without programs that monitor prescriptions, addiction is prevalent through practices such as “doctor shopping.”

In 2015, the Centers for Disease Control and Prevention found that New Hampshire was the state with the second highest death rate due to drug overdose; with 34.3 deaths per 100,000 people, this reflected a 30.9 percent increase from the previous year. The next year, CNBC reported that drug abuse was the number one issue New Hampshire residents considered when they went to the polls in 2016. New Hampshire is taking action — the state recently sued Purdue Pharma, the manufacturer of prescription painkiller OxyContin, for “deceptive marketing practices.” Yet even going as far as to declare the opioid epidemic as a national emergency does little to treat the causes of the issue.

A key obstacle to decreasing the opioid epidemic in New Hampshire is the misguided cultural stigma it receives. Drug abuse is often viewed as a simple matter of lack of self-control that can be fixed without help or money rather than as a complex disease that necessitates interventions. Isolating and condemning people only exacerbates the vicious cycle. Group-based acceptance and decreasing stigma on a structural level requires that communities, ranging from health care providers to police officers to students, work together. For more people to receive the treatment that they need, communities must do more than just limit the amount of opioid prescriptions given out — they must also acknowledge this need and encourage them to seek treatments that are becoming increasingly available.

Unfortunately, these treatments are less likely to be covered for those who aren’t well-off. Some, such as physical therapy and behavioral therapies, are considered alternative treatments and are less likely to be covered by insurance companies, though they can promote long-term progress rather than short-term fixes. And medicine effective at combating opioid addiction can be pushed out of reach through price gouging. The drug naloxone, sold under the brand name Narcan, combats the effects of opioids. Yet due to a sudden increase in demand, the price for a naloxone injector (Evzio) recently rose from $575 to $4,500 for a twin-pack auto-injector. In the midst of this nation’s opioid crisis, price gouging should be prohibited.

By understanding and acknowledging that drug abuse is a disease rather than a result of a moral flaw, communities can help advocate for expanded access to necessary treatments. Developing rehabilitation programs is a responsibility that both the public and the private sector should uphold, and it is one that is positive for both addicts and society. Rather than imprisoning addicts or leaving them to die, rehabilitation allows them to return to work and a more stable family life. Addicts can thus give back to their communities and loved ones.

Many of the strategies above have been stated as priorities by the New Hampshire government. HB 271 “allows for a broad prescribing, dispensing, and distribution of Naloxone.” The Anyone, Anytime campaign promotes prevention and recovery, and the New Hampshire Statewide Addiction Crisis Line helps callers determine what level of treatment and what types of treatment would be best for them. There are no sweeping answers, simply small solutions that cumulatively make an impact. To reach these solutions, New Hampshire as a community must first acknowledge and accept that drug abuse is a disease and should be treated as such.

Shah is a member of the Class of 2021.

The Dartmouth welcomes guest columns. We request that guest columns be the original work of the submitter. Submissions may be sent to both opinion@thedartmouth.com and editor@thedartmouth.com. Submissions will receive a response within three business days.