What Is the opioid crisis?
The Opioid Crisis (also referred to as the Opioid Epidemic) is a way of describing the very sharp increase in the use of prescription narcotic painkillers, and the very large increase in addiction that has resulted
Because of these increases, addiction to opioids has spread to people and places not traditionally affected by addiction to “hard drugs” and illegal substances. This includes many who never intended to “get high” at all and became addicted only by following their doctor’s orders to manage the pain associated with a medical condition.
As efforts have been made to better and more appropriately control the use and abuse of prescription narcotics, those already addicted but no longer able to get prescriptions have increasingly turned to drugs like Heroin – which is cheaper, but far stronger and far more addictive. As a result overdoses and overdose-related deaths have also increased dramatically.
Why don’t those who use them just stop when it gets them in trouble?
Some people incorrectly believe that continuing to use drugs even in the face of problems is due to lack of willpower or other personal choices.
But use of addictive substances, even prescription medications used correctly, can physically change the way that the brain works.
Multiple parts of the brain are affected, including the parts that regulate reward, memory and learning, response to stress, hormones, and decision-making. In addition, because of changes the body makes to compensate for the physical effects of the drug, users soon begin to feel extremely ill when the drug begins to wear off, increasing the need to use again.
This same physical effect also requires using larger and larger amounts of the drug just to prevent that illness; what was enough last month may no longer be enough this month. This progressively and continuously deepens the addiction – and is also a factor that increases the risk of overdose.
Can that be changed?
There is currently no cure for addiction -- but there are effective treatments and methods of managing the problem.
When evidence-based best practices are followed, outcomes of substance use disorder treatment are comparable to those of the treatment and management of other chronic health conditions like Diabetes.
There are medications that have been scientifically demonstrated to help restore brain chemistry in ways that reduce the cravings and compulsions, and without the high.
There are also behavioral treatments that have been scientifically demonstrated to improve the ability to identify, recognize and avoid some of the thought processes, behaviors and situations associated with substance use.
The use of medication, evidence-based behavioral care, or both allows many people to control their addiction effectively.
But there are many inaccurate ideas about addictions – even among some doctors and addictions specialists. For instance many believe that taking medication for addiction does not result in “sobriety,” and is simply “replacing” an addiction to one substance with an “addiction” to another. While such sobriety is ideal, it may not always be achievable for those whose brain chemistry has been changed by the use of addictive substances.
Many also believe that there is only one right way for all to achieve recovery, such as:
- Twelve-step programs,
- 30 days (or 60, or 90, etc.) of residential treatment,
- Working with peer counselors who have recovered from addiction themselves, or
- Treatments that focus on willpower and making healthy choices.
While any of these approaches might help a given person, the best chance of success comes when treatment is tailored to the particular needs of the individual involved, and includes the use of evidence-based approaches.
Where can I find out more?
The Tufts Health Plan Navigator can answer questions about addictions, treatments, benefits, coverage, and programs. Call 800-208-9565 and ask to speak with the Navigator.