Hardly a week goes by without the Coroner’s office getting another request for statistics on the opioid crisis. My office is tasked to the maximum right now and we don’t currently have additional personnel on staff dedicated to answering the growing number of inquiries.
As I write this, sitting on my desk are two stacks of case files. The higher one is of cases that need to be closed out after my review of newly returned toxicology reports. The much shorter stack is of homicide cases I must review. Looking at the difference between the two piles, I marvel at how much knowing the numbers, statistics and data matters. Yet simply knowing this information doesn’t save any lives.
Ten years ago, I could see this coming. OxyContin became the solution to everyone’s pain, chronic or short-term. Suddenly, clinical treatment and all procedures were expected to be completely pain-free. When I had my wisdom teeth pulled as a kid, my dentist said to me as I left the office, “Now when the Novocain wears off, it’s going to hurt like hell for a day or two, but just keep washing out your mouth with salt water.” He was right. It hurt like hell, but in a few days, it was better. You just dealt with the pain.
Of course, I realize that in certain cases medications are indispensable to patients with specific conditions. I’m not disputing that. But today’s insurance companies and the government now tie reimbursements to a hospital or doctor through a survey of the patient’s reported pain. This led to the expansion of opioids in clinical medicine which became the gateway to the abuse of pharmaceutical opioids. Even today, prescribed opioids are more abused than street drugs.
In my view, the worst approach to this problem is for the federal government to throw money at it and build bureaucracies around it, as was recently suggested, to the tune of fifty-nine billion dollars. (Without, of course, any explanation of how the money would be spent, or for that matter, a clear definition about what the crisis really is. In reality the crisis is just another opportunity for the government to make more money.)
Every time a politician or the press asks me about this issue it is clear they don’t understand what is really happening across America. We don’t have an “opioid epidemic” we have an “addiction epidemic.”
Opioids exist to kill pain but we must define the pain. Why are the richest, most free people in all of history in such physical, emotional and (dare I say) spiritual pain?
My friend Tommy Rosen has a marvelous definition of addiction, which is found in his comprehensive book entitled “Recovery 2.0: Move Beyond Addiction and Upgrade Your Life”.
The definition is important because it takes us beyond the symptom (in this case, opioids) to the real dis-ease. Simply put by Tommy: “Addiction is any behavior you continue to do despite the fact that it brings negative consequences into your life.” Suddenly, it becomes clear we have an addiction epidemic and opioids are only one of the tools.
This is subtle but very significant.
I have seen this over the years because my job is to listen to the dead. I have seen that the patterns of addiction ultimately impact how, when and why we die.
This list could go on but I think you get the point. As a society we are more anxious, less healthy and more prone to all of the above. Yes, we are addicted to drugs... but as Tommy points out, we are also addicted to alcohol, food, people (relationships, sex and intimacy), money and the insidious newcomer... technology.
Tommy goes a step further to identify what he calls the four aggravations, or potential addiction triggers:
These root causes need to be deeply examined.
The money we put into this epidemic should be block granted to the states, meaning that each state would determine the best use of the funds. This would provide us with fifty different laboratories to develop the best approaches for true rehabilitation. There should be some use of methadone and buprenorphine to help with the chemical transition to detoxification, but the real issue is the addictive personality and how we got here.
I recently heard a public official say that the government was considering the development of a vaccine for addiction. Folks, there is no vaccine for the soul. One has to delve into the subconscious and realize their uncontrollable need to do negative things is the result of past pains. We must identify and face these pains. Pain can be a great teacher. The nationwide state of addiction we are in is an opportunity for each and every one of us to grow and evolve.
Tommy Rosen has the right idea. He is holistic in his approach and he shares it with thousands by creating a virtual community. His website r20.com offers sanctuary to anyone seeking to dig deeper into patterns, thoughts, beliefs and behaviors that no longer serve them. I encourage everyone to check it out.
Bottom line, there is no easy solution. There is no solution “from the government.” There is no pill and there is no vaccine. The only route is within. Recovery starts with each one of us, individually, and then as a community.
Drug overdoses are now the leading cause of death among Americans under 50. To say this is a crisis is an understatement.