For about 25 years the United States has been facing an epidemic of both opioid addiction and opioid overdose with an unprecedented level of mortality including more than 700,000 deaths since 1999. In fact, the time it takes you to read this page alone at least one person in the United States will have died from an opioid overdose. This opioid epidemic however is a replay of American history as this crisis is not new at all, in fact this present-day opioid epidemic is “old news” as we have experienced this same crisis before about 200 years ago.
If one were to excavate the medical journals such as The New England Journal of Medicine and start with Vol. 1 No. 1 which was published in January 1812, you would quickly find out that America was involved with its first opioid epidemic. During the time of the American Revolution (1775-1783), an alcohol-based tincture of 10% powdered opium called “laudanum” was widely used as a pain medication to treat injured soldiers. Laudanum contains almost all the opium alkaloids, including morphine and codeine. In the early 1800's, laudanum was also used to treat a variety of other medical conditions including dysentery, chronic cough, anxiety and several other ailments. As a result of the widespread and excessive use of laudanum, many people became addicted or dependent on opioids and America suffered its first opioid epidemic.
In the 1830's the United States was amid the Industrial Revolution and morphine was manufactured in mass quantities. Morphine soon became the mainstay of U.S. doctors not only for treating pain conditions but many other medical ailments including chronic diarrhea and respiratory problems such as persistent cough and a variety of female ailments. Morphine use quickly became widespread and this was the main source of the opioid epidemic at that time. In another development, in 1853 Alexander Wood of Scotland invented the first hypodermic needle after which morphine was begun to be used in surgical procedures. As it turns out, the inventor’s wife is the first one in history to die of an injected drug overdose.
The history of America’s first opioid epidemic continued onward then worsened during the Civil War when morphine was regularly given to injured soldiers. Because so many soldiers become dependent on opioids the post-war morphine addiction was known as "soldier’s disease." Addictive usage of the drug quickly spread from war hospitals to the general public across America, and over 500,000 Americans suffered from morphine addiction after the Civil War and this increase also coincided with the use of the hypodermic needle (IVDA).
Unfortunately, most of America and its physicians seemed to forget the previous opioid epidemic that ravaged America in the 1800's and early 1900's.
Methamphetamine is not a new drug, although it has become much more powerful and much more addicting in recent years as techniques for its manufacture for a purer product has evolved. Methamphetamine went into wide use during World War II, when both sides used it to keep troops awake. High doses were given to Japanese Kamikaze pilots before their suicide missions.
The abuse of methamphetamine is increasingly and becoming more of a serious problem all across America. According to data from the 2012 National Survey on Drug Use and Health (NSDUH), over 12 million people (4.7 percent of the population) have tried methamphetamine at least once. The number of fatal overdoses involving methamphetamine has more than quadrupled between 2011 and 2017.
In 2017, about 15 percent of all drug overdose deaths involved the methamphetamine category. Fifty percent of those deaths also involved an opioid. Dangerous synthetic opioids are sometimes added to street methamphetamine without the user knowing.
Methamphetamine’s intoxicating effects can alter judgment and inhibition and frequently lead people to participate in risky and unsafe behaviors, such as engaging in unprotected sex. For this reason, methamphetamine use is associated with higher risk for infectious diseases such as HIV/AIDS and hepatitis B and C. Methamphetamine use is also associated with serious health and psychiatric conditions, including heart damage and brain damage, impaired thinking and memory problems, aggressive, violent behavior and psychotic behaviors including paranoia, delusional thinking and hallucinations.
The most effective treatments for methamphetamine addiction at this point are behavioral therapies, such as cognitive-behavioral and contingency-management interventions. Several studies have demonstrated that participants treated using the Matrix Model show statistically significant reductions in stimulant use, prolonged periods of abstinence, improvements in psychological indicators, and reduced risky sexual behaviors associated with HIV transmission. The Matrix Model is a 16-week comprehensive behavioral treatment program that provides a framework for engaging stimulant (e.g., methamphetamine and cocaine) dependent clients in treatment and helps them achieve long term abstinence.
People can and do recover over time if they have access to effective treatments that address the multitude of problems resulting from their abuse of methamphetamine. The good news is that methamphetamine misuse can be prevented and addiction to the drug can be treated. The most effective treatments for methamphetamine addiction so far are behavioral therapies, such as cognitive-behavioral therapy, which helps patients recognize, avoid, and cope with the situations likely to trigger drug use.
In homes, physician’s offices, hospitals, schools, prisons, and communities across America, misperceptions about addiction continue to undermine medical care for patients with addiction. Although significant advances in neuroscience, brain imaging and behavioral research clearly show that addiction is a complex brain disease, addiction is still often misunderstood as a moral failing or a lack of willpower.
Like other public health and medical problems, the medical community understands the risk factors for addiction. There are effective ways of screening for risky substance use and intervening. While there is no cure for addiction, there are effective psychosocial and pharmaceutical treatments and methods of managing the disease. But in sharp detail however, this is where the comparison with other health conditions ends. Unlike other chronic diseases, little is done to effectively prevent and reduce risky use in primary care offices and emergency rooms across America.
The medical system, which is dedicated to alleviating suffering and treating disease, largely has been disengaged from these serious addictive health care problems. The consequences of this inattention are profound for people with addiction and their families. America’s failure to prevent risky use and effectively treat addiction results in an enormous array of health and social problems such as serious accidents, homicides and suicides, child neglect and abuse, incarceration, family dysfunction, unplanned pregnancies and all too frequently death.
Addiction can be a taboo subject, and shame and disgust can prevent families from speaking openly about substance abuse and addiction. Due to this stigma, many people with drug or alcohol addiction unfortunately simply do not seek medical attention, and in some cases, they even refuse it. So their medical condition remains untreated, their brain disease continues to progress, and their families continue to be exposed to high risk activities.
In addition to being an immense emotional and psychological burden on families, addiction takes an enormous economic toll. Addiction is this nation’s largest preventable and most costly health problem, accounting for one third of hospital inpatient costs, driving crime and lost productivity and resulting in total costs to government alone of at least $500 billion each year. These figures cannot measure the incalculable impact on the families of loved ones suffering from addiction.
When we are face to face with a client, Blue Willow sees a family portrait of addiction. We know that those close to the client are intensely affected by addiction and our program includes family consultation, education, and resources for loved ones to be actively involved in the recovery process.
Blue Willow dedicates resources towards family therapy, support and education including the concepts of codependency, harm reduction and contingency management.