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Core Topics => Psychology and Psychiatry => Topic started by: Chip on June 20, 2018, 05:57:41 PM

Title: We’re All Addicts Here !
Post by: Chip on June 20, 2018, 05:57:41 PM
source: https://www.nytimes.com/2018/05/28/opinion/opioid-addiction-tennessee.html

May 28, 2018

(https://static01.nyt.com/images/2018/05/28/opinion/28RENKL/28RENKL-jumbo.jpg?quality=90&auto=webp)

A memorial that consists of 22,000 engraved white pills that represent the face of someone lost to a prescription opioid overdose.

NASHVILLE — In 2009, my husband had an emergency spinal-fusion operation to prevent permanent nerve damage caused by a ruptured disk. I was rolling the I.V. pole while he pushed a walker around the hospital corridor when I got an urgent call from a friend: “Don’t let them give him pain pills,” she said.

I told her the nurses were giving him oxycodone on a schedule because the drug works better to prevent pain than to knock it back once it’s out of control. She was insistent: “Well, get him off it as fast as you can when you get home. Mom was addicted within a week of her back surgery, and she’s been addicted ever since. We can’t get her off it.”

I knew my friend’s mother, and I had no idea she was addicted to painkillers. I’d never even heard of an addiction to prescription drugs. To me, a “drug addict” was a desperate person who bought illegal drugs on the street. An addict was not an elderly woman who’d gone to a reputable surgeon and taken the medication he’d prescribed exactly as he’d prescribed it.

My friend’s mother is dead now, and rampant opioid addiction is something no one can ignore anymore. In 1999, 342 Tennesseans died of an opioid overdose, according to an investigative report from The Tennessean earlier this year. By 2009, the year my husband had his back operation, that number was up to 430, an increase of not quite 26 percent in 10 years.

Since then, the numbers have surged. In 2016, the most recent year for which figures are available, 1,631 Tennesseans died of an opioid overdose, an increase of 279 percent in seven years.

In spite of such appalling numbers, Tennessee still ranks second-highest in the nation in opioid prescriptions — “more than one prescription for every man, woman and child” in the state, according to The Tennessean. “For every overdose death, the state estimates there are 14 nonfatal overdoses.”

Despite being on the leading edge of this epidemic, Tennessee did not create it. This is, of course, a national trend. “Drug overdose deaths in the United States more than tripled from 1999 to 2015,” according to a 2017 report by the United States Centers for Disease Control and Statistics. “The current epidemic of drug overdoses began in the 1990s, driven by increasing deaths from prescription opioids that paralleled a dramatic increase in the prescribing of such drugs for chronic pain.”

Two weeks ago, Tennessee joined five other states in suing Purdue Pharma, maker of OxyContin, for aggressive marketing practices that included downplaying the drug’s risk of addiction and exaggerating its benefits in treating chronic pain. “We believe Purdue’s conduct has been unconscionable, and we intend to hold the company accountable,” Attorney General Herbert Slatery said in a statement. “Three Tennesseans are dying each day from opioid-related overdoses, and we are committed to the hard work that needs to be done to address this tragedy.”

It may seem unusual for the attorney general of a red state to take on Big Pharma, but this lawsuit is only one part of Tennessee’s response to the calamity. In January, Gov. Bill Haslam, a Republican, proposed a $30 million plan, called TN Together, to address the opioid crisis across the state. The plan, which the Tennessee General Assembly approved last month, limits prescriptions, equips state troopers with Narcan (an emergency treatment for opioid overdose) and funds addiction treatment for Tennesseans who can’t afford treatment, primarily those who have no health insurance.

In 2015, Gov. Haslam tried to persuade the Republican supermajority in the Tennessee General Assembly to expand Medicaid in the state through a federally approved, budget-neutral compromise to the Affordable Care Act. In keeping with a long tradition of defying common sense, statehouse legislators said no. If they had said yes, Tennessee would likely be enjoying addiction news similar to Kentucky’s: “After expanding Medicaid,” notes the Center on Budget and Policy Priorities, “Kentucky experienced a 700 percent increase in Medicaid beneficiaries using substance-use treatment services.” That number coincides with a 90 percent drop in overdose hospitalizations of uninsured Kentuckians.

My senior English course in high school was a survey of British literature. Somewhere toward the middle of the unit on Romantic poets, a boy in my class raised his hand and asked our teacher why so many of the writers we studied were drug addicts and alcoholics. More to the point, he wondered, why should we be reading the work of people who were clearly moral failures?

I don’t remember that student’s exact words, but I remember our teacher’s response. “When someone is struggling with addiction,” she said, “remember that you don’t know how many times he resisted that temptation before he finally gave in. A person who resists 99 times, even if he gives in the 100th, is a stronger person than someone who’s never been tempted at all.”

I have thought of the beloved teacher’s words countless times over the past 38 years. It’s such decent, human advice: Before judging another person, consider all the kinder ways there are to interpret what might seem at first like a terrible moral failing. And the way to do that is to imagine what it feels like to be fighting their battles.

Here in Tennessee, our struggling neighbors won’t benefit from federal dollars through Medicaid expansion for the same reason Tennesseans won’t benefit from so many other things that citizens of other states can take for granted. Why? Because Republicans in the Tennessee General Assembly are consistently more committed to defying what they see as federal overreach than to helping their own vulnerable citizens.

I don’t know what these legislators are thinking. No doubt they believe they’re doing the right thing. Still, it looks a lot like a colossal failure of empathy. Maybe they just can’t imagine what it feels like to have no medical insurance. Maybe they can’t imagine what it feels like to be in chronic pain. Maybe they can’t imagine what it feels like to be addicted and have no hope at all.

An optimist might call TN Together and the lawsuit against Purdue Pharma the start of meaningful efforts to resolve the opioid crisis. But if that’s as far as it goes, if a lot more isn’t done to help, it can’t be considered any kind of start at all.
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