The opioid crisis, the hard way
In 2017, the opioid crisis came to the forefront of the national and local news. Television, internet and print reporting covered the massive death-rate from opioid use across the country. I read obituaries of young adults that described the ending of their lives as “died at home,” “died in their sleep,” or with no indication of the cause at all.
I cannot assume that all of these were narcotic-related deaths, but many of them were. Even more painful, some families chose to not publicly acknowledge the death with an obituary at all. The person just disappeared. An open wound was left. Who could blame them? Not I.
Losing a child to this crisis is hard. I know firsthand. On July 3 last year, my 30-year-old son, Stuart Moseley, lost his battle with opioid addiction.
Nationally, an average of 116 people were killed by opioids every day in 2016, according to the Centers for Disease Control and Prevention. In North Carolina, nearly 40 percent of the children in foster care were removed from parents with substance use disorders, according to a state report cited by The Raleigh News & Observer. In Asheville, about 400 babies were delivered with positive toxicology from mothers at Mission Hospital in 2015, according to a 2016 study done by Vaya Health.
It is almost numbing to read the numbers. But, behind every statistic there is a face and a tragedy. The ripple effects are vast, with stresses on our emergency services, hospitals and local government budgets.
Why is this epidemic so difficult to combat? Why do so many people relapse? Don’t they know that they’re killing themselves? These are simple questions, with not so simple answers.
The physiological and chemical damage to the brain by opioids is a documented fact. Researchers at the University of Alabama at Birmingham, Monash University in Victoria, Australia and Stanford University in California found decreased gray matter volume within human brains after patients with chronic low back pain were exposed to morphine (an opioid) daily for one month. Their research used Magnetic Resonance Imaging (MRI) technology to capture images of the brain before and after the trial. Their findings, published August 2016 in the American Academy of Pain Medicine’s journal Pain Medicine, offer a sobering look at the physical alterations made to human brains after only 30 days of opioid use.
According to the study, the reward center in the brain (the amygdala) lost approximately 3 percent of its volume. This research builds on previous studies showing the same pattern. By any measure, this is brain damage.
Treatment and recovery options for opioid dependence in America are limited. The primary treatment available to most persons seeking help with this disease is active participation in peer support groups. This has been the standard for treatment, based on 12-step recovery programs founded for alcoholism, since the 1930s. These programs have been a lifeline for thousands of people seeking recovery.
Stuart was in and out of a number of local recovery groups, intensive out-patient support groups and individual counseling for eight years. In 2015 and 2016 alone, Stuart was admitted to detox/rehab facilities on 14 separate occasions. In every instance he voluntarily asked for help. He attended support groups. And every time, he relapsed.
Does this sound like a treatment regimen that works? Simply being motivated was not the answer for Stuart or others affected by opioids. Stuart desperately wanted to be “clean” and live a normal life. But the damage to his impulse control and his inability to calculate risk-vs-reward constantly led him off track. What was missing? Could it be that the usual methods of counseling, support and talk therapy were not enough?
There are medications that treat opioid dependency, but they are not as widely used as they could be. One form of treatment uses buprenorphine, available in daily pill form, monthly injections (at a doctor’s office) and semi-annual implants.
There is a perception among some people that using a medication to treat a drug dependency is a crutch, that people are simply trading one drug dependency for another. However, I can’t help but wonder if using this medication is better than continually falling face-down. And I know for certain that utilizing this medication is better than dying.
I am convinced that if my son, and countless others, had combined medication-assisted treatment with a strong support group, they just might have made it. This combination needs to be made widely available, without stigma.
“We are losing a generation.” These are not my words, they are the words of doctors, politicians, tribal leaders and social service professionals in states as diverse as Alaska, Vermont, Ohio, and even North Carolina. If we want to make serious reductions in the opioid death rate, we must consider and fund all the treatment options, including medication-assisted treatment.
Counseling, meditation and support group meetings, while indispensable, are not enough for many struggling to overcome this chronic brain disease. We don’t treat other chronic illnesses with a one-size-fits-all approach. Why do we accept a lower standard of care for opioid dependence?
Medical professionals, family members and the larger recovery community should encourage those who suffer to seek whatever treatment works for them, including medication assistance. I may have already lost my son to this disease, but I refuse to sit by while we lose any more of his generation.
Anne Moseley Seaman will be a participant in the Buncombe County Commission's next Opioid Forum at 6 p.m. Jan. 30 in the A-B Tech/Mission Health Conference Center. To see Seaman’s video, visit abtech.edu/opioids.