Guest Commentary: The Opioid Epidemic — Why We Are Losing
By Matt Mossburg
Four years ago, I received a Christmas gift that saved my life: The Gift of Desperation.
In addiction recovery, this gift opens the door to meaningful change. It involves addicts hitting bottom, accepting defeat, admitting our powerlessness and surrendering our wills and lives to a new way of living and thinking. Ironically, the worst day of my life also became, in retrospect, the best day of my life.
With the current opioid epidemic, we fight an enemy that is cunning, baffling and powerful. Despite all the state is doing to combat the crisis, overdoses and deaths continue to rise. The the numbers of opioid-related fatalities here in Maryland and across the country are mind-numbing.
But here’s a quick take on Maryland’s numbers. On the surface it appears prescription deaths are leveling off, but keep in mind that many of these users moved on to illegal opioids years ago, and those numbers continue to spike.
Nearly 70 percent of opioid-related deaths in Maryland are due to fentanyl and related opioid analogs, according to the latest numbers from the state health department. Equally disconcerting is an old enemy appearing again in overdose reported deaths: Cocaine. Cocaine, not an opioid, is now registering as a component in state data, mixed with opioids resulting in death. It’s like a sick, nightmarish game of Whac-A-Mole.
Needless to say, fighting the opioid epidemic involves law enforcement, treatment and prevention. Law enforcement’s role is clear: stop the diversion of legal prescription opioids on the streets, interdict shipments of fentanyl made in Chinese labs and shipped to the U.S., to name two examples. The difficulty comes in addressing treatment: How do we define success?
One area of concern is so-called Medically-Assisted Treatment (MAT). We should not be fooled into thinking there is a “magic pill” that makes addiction go away. Former U.S. Health Secretary Tom Price caused an uproar this spring when he said, “If we’re just substituting one opioid for another, we’re not moving the dial very much.” There is a lot of truth to that.
In fact, there are widely divergent approaches on MAT. One drug blocks opioid receptors in the brain, so there is no euphoric feeling. Another popular drug is itself an opioid that essentially is a less potent version of what addicts previously abused. On one side is Vivitrol, which blocks opioid receptors to the brain, thus eliminating the “high” one would get from illegal heroin or prescription oxycodone.
On the other side is Suboxone, itself an opioid, which eases painful physical withdrawal symptoms but does not break the cycle of addiction. This is not a taste test, like choosing Pepsi over Coke; choosing the wrong drug leads to relapse, and for too many ends in death.
As a recovering opioid addict, I learned the hard way that I could not take a short-cut and medicate my way out of addiction. In the rush to embrace so-called “Medically-Assisted Treatment” to fight the opioid epidemic, let’s not forget that rehabilitation starts with an individual’s commitment to end a deadly habit – and remember that recovery never ends.
The chords that bind an addict are medical, physical (addiction) and psychological, or emotional attachment. The latter is more difficult to deal with and causes so many addicts to relapse and give up. Other factors, too, exist and are dealt with in addiction recovery programs. These other factors are much more elusive but just as deadly, and require the addict to undergo a psychic change through Step Work in a recovery program. While recovery programs might fly under the banner of different names, their DNA is essentially the same since the founding of Alcoholics Anonymous almost a century ago.
The State Health Department plans to launch a public awareness campaign to educate people on Medically-Assisted Treatment. This is a tremendous opportunity to help people understand that these drugs do not all work the same and the key word in Medically-Assisted Treatment is ASSISTED.
There are substantial limits to medical treatment, and those of us in the recovery community know this. In fact, we have known this truth for almost 100 years. In 1939, Dr. William Silkworth, an addiction recovery specialist, wrote: “[I]f a doctor is honest with himself, he must sometimes feel his own inadequacy. Although he gives all that is in him, it is often not enough…we physicians must admit we have made little impression upon the problem as a whole.”
Unless an addict takes ownership of his or her addiction and commits to a recovery program, relapse is all but certain, and there is no medication in the world that can overcome an addict’s unwillingness to get honest with themselves, take ownership of their addiction and commit to a new way of life.
My plan – what I call “real recovery solutions “– is what I will be lobbying for in Annapolis. We want the State of Maryland to emphasize:
- Immediate inpatient detoxification care for addiction
- Six -to-12-month sober living environments
- Peer-to-peer networks to assist people in recovery
- Comprehensive guidelines to steer MAT programs away from opioid-based treatment
Spend any time in the rooms of recovery, and you will hear the expression: “Insanity is doing the same thing over and over again and expecting different results.” Whether an addict or a government agency, employing the same tactics and strategy will continue to produce the same results. There is no easy way around addiction, but there is one incontrovertible fact: Recovery programs work, and have almost a century of proven success.
It might not be the easy answer, but it has the most reliable data as a proven answer. Making these treatment and recovery programs more accessible and empowering the recovery community to play a larger role in solving the epidemic will go a long way to turn the tide and start winning this fight.
Former state Del. Matt Mossburg is seeking the Republican nomination for Congress in the 6th District.