The White House states that over 20 million Americans are recovering from substance use disorder (SUD) noting that, “For many struggling with untreated addiction, securing housing and long-term employment can be a real challenge, restoring relationships can take time, and treatment and recovery services can be expensive and hard to find.” I believe we are stronger when more people with SUD are in recovery as it is a family disease that affects everyone connected to the person with SUD.
As September marks National Recovery Month, it’s worthwhile to reflect on some of the key areas of concern that need our help, including:
- Disparities in the overdose crisis between Black and White Communities In America: Disparities in the overdose crisis exist between Black and White communities in America according to this research study, which shows that throughout the opioid crisis death rates have generally worsened, but not at the same rates. In fact, death rates are consistently double for African Americans when compared to White Americans with a growing disparity in recent years, including during the COVID-19 pandemic. The implications of this study’s findings found that“results highlight a critical need to attend to equity in opioid overdose prevention, intervention and treatment resources as well as targeting efforts in states with demonstrated disparities in opioid involved overdose deaths.”
- Sexual Orientation Disparities In Recovery: In the U.S., 11.7% of adults in recovery identify as lesbian, gay, or bisexual (LGB) according to this research study. Findings from the research found that, “LGB adults in recovery were less likely to be employed, had fewer rears in recovery, and were more likely to have an arrest history, report opioids as their primary substance, and have a co-occurring psychiatric diagnosis compared to their heterosexual counterparts.” More comprehensive LGB-affirming recovery services are needed to help compensate for sexual-orientation stigma and discrimination.
- Drug Traffickers Targeting Our Youth: The DEA recently warned of brightly colored fentanyl, called “Rainbow Fentanyl,” being used to target young Americans. This deliberate effort by drug traffickers to drive addiction amongst kids and young adults is proving deadly to our youth. According to the DEA, just two milligrams of fentanyl, which equals 10-15 grains of table salt, is considered lethal, and tragically it is often becoming the “drug of choice” for our youth. These factors have been contributing to the spike in overdose deaths to 107,622 in 2021 – 66% of which were related to synthetic opioids, like fentanyl. In September 2021, the DEA launched the “One Pill Can Kill Public Awareness Campaign” to educate Americans about the dangers of fake pills, but with adolescent brains not being fully developed, they continue to be more vulnerable to dysregulated mood swings, lack of impulse control and peer pressure, in turn, making them more vulnerable than others with SUD or predispositions to SUD.
- Big Pharma And Big Tobacco Profiting Off Addiction With Legalized Weed: We need more longitudinal studies to understand the long-term effects of weed now that it is legalized in many states. The drastic change in potency from the 1960’s to today have created the misperception that it is a casual drug, when it is actually a very potent and addictive drug that can cause significant psychosis symptoms in users. Dr. Roneet Lev, an addiction medicine doctor in San Diego notes: “From Big Tobacco to Big Pharma to Big Marijuana—it’s the same people, and the same pattern.” She goes on to state, “In the 1960s, the stuff the hippies were smoking was less than 2% THC. By the ’90s, it was closer to 5%. By 2015, it was over 20%…In the era of legalized weed, the drug you think of as “cannabis” can hardly be called marijuana at all. The kinds of cannabis products that are sold online and at dispensaries contain no actual plant matter. They’re made by putting pulverized marijuana into a tube and running butane, propane, ethanol, or carbon dioxide through it, which separates the THC from the rest of the plant. The end product is a wax that can be 70% to 80% THC. That wax can then be put in a vacuum oven and further concentrated into oils that are as much as 95% or even 99% THC. Known as “dabs,” this is what people put in their vape pens, and in states like California and Colorado it’s totally legal and easily available to children.” And lastly, this August, NPR noted, “Young adults are using more weed and hallucinogens than ever. The amount of people from ages 19 to 30 who reported using one of the other are at the highest rates since 1988, when the NIH first began the survey.” The article goes on to state, “The amount of young adults who said in 2021 that they used marijuana in the past year (43%), the past month (29%) or daily (11%) were at the highest levels ever recorded.”
- Psychiatric drugs Alone Are Not The Answer To Solve Mental Health Issues and Addiction In Teens: This New York Times article describes the medication cascade a female teen, now 19, went through to eventually be prescribed 10 psychiatric drugs to address her depression and anxiety. In the article, Lisa Cosgrove, a clinical psychologist at the University of Massachusetts, Boston stated, “This is a generation of guinea pigs.” According to the NIH, there is a strong connection between SUD and mental illness, with about half of those who experience mental illness during their lives also likely to experience a SUD and vice versa. The NIH says research suggests that adolescents with SUDs also have high rates of co-occurring mental illness. The practice of prescribing stimulants for adolescent ADHD is a challenging mindset to create that a pill can fix you, especially if that adolescent is also genetically and environmentally predisposed to developing a SUD (Epigenetics) vis a vis trauma and intergenerational trauma. Enough care is not being given to holistically approach adolescent mental illness to screen for this, but could be with the adoption of mandatory ACEs screenings in all pediatric doctor practices for both the adolescent and parent. This would help pediatricians holistically understand the source of the issue, while helping prevent misdiagnosis and overprescribing of psychiatric medication that can set up a cycle of “a substance can fix me” that can later lead to SUD.
These are complex issues with no easy answer. We must do better to dig deep and come up with solutions that aren’t based on stigma, profit or not being willing to think outside of the box. An attitude of creativity, compassion, seeking to understand instead of being understood, humility and perseverance is essential as we tackle healing America from its systemic mental illness and addiction to holistic recovery. In doing so, we will be a stronger nation.