The Opioid Epidemic: a multi-faceted crisis
Drug overdose is a pressing issue in the United States, being one of the leading causes of death. In 2019, more than 70,000 Americans died from drug overdose, including illicit drugs and prescription opioids(1). Overdose of opioids has adversely affected the entire country, but certain demographic groups have been affected more than others. Data has revealed that overdose is rising rapidly for minority groups in particular. In 2017, non-Hispanic Blacks had the highest percentages of opioid-related overdose deaths and total drugs deaths attributed to synthetic opioids compared to other race and ethnicities (2). These disparities are intimately linked to psychosocial determinants of health including racism, poverty, limited access to treatments and services, and socioeconomic status. Furthermore, there exist ethical problems related to prescription practices, naloxone availability, and clinician regulations. Prescription of opioids by clinicians, while used to ease the suffering of patients, is a source of potentially dangerous and addictive drugs.
In order to tackle the opioid crisis on a public health level, greater attention to the ethics of opioid prescription and regulation is necessary. Furthermore, the social determinants underlying this issue must be thoroughly analyzed and assessed. Factors such as economic conditions and social conditions create problems of accessing drugs in a proper manner for many minority populations (2). This then results in drugs being administered in an unsafe environment, which increases the likelihood of a negative outcome. Drug behavior can be heavily influenced by the drug use context, such as the setting or location under which it is administered. The stigma surrounding opioid use and addiction can also increase negative health outcomes. Stigma often prevents people from seeking help, due to fear of the social and legal repercussions. In order to address this issue, the discourse surrounding this topic needs to change. Those with opioid addiction need to have access to a safe, judgement-free space to share their experiences and spread awareness. Furthermore, the language used to describe opioid users needs to incorporate more person-centered language and acknowledgement of addiction as a disease requiring medical intervention. In order for the opioid crisis to be improved on a population level, there needs to be a social shift towards spreading awareness and destigmatizing addiction—factors not necessarily directly related to disease condition itself.
1. National Institute on Drug Abuse. Overdose Death Rates. [internet].; 2021 Jan 29 [cited 2021 Feb 20]. Available from: https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates
2. Centers for Disease Control and Prevention (CDC). 2019 Annual surveillance report of drug-related risks and outcomes —United States. [internet]. Atlanta, GA: CDC National Center for Injury Prevention and Control; 2019 Nov 1 [cited 2021 Feb 20]. Available from: https://www.cdc.gov/drugoverdose/pdf/ pubs/2019-cdc-drug-surveillance-report.pdf