Prescription Drug Abuse And Treatment In The United States
“An estimated 1.9 million people in the United States suffered from substance use disorders related to prescription opioid pain medicines in 2014, and 586,000 suffered from a heroin use disorder” (Volkan, 2016). The statistics are continuously inclining. The goal of this literature review is for the reader to understand the history of opioid use, current knowledge and treatment associated with the opioid crisis, and the importance of the social work core values regarding working with individuals with opioid substance abuse disorder. Furthermore, the reader will understand what evidence still is needed to remedy the opioid crisis the nation is facing.
Opioid Crisis Background
“Over the past two decades, the United States population has experienced an extraordinary increase in the rates of death from opioid overdose. A steep rise in fatal overdoses caused by pharmaceutical opioids observed over the last 15 years has been overtaken by rapidly increasing rates of heroin and illicit fentanyl overdose death as the supply of prescription opioids has been reduced”. According to the Social Justice Brief, Opiates in Our Backyard: Implications for Drug Policy, “opiates date back to the 19th century. In 1803, morphine was created and in 1890’s, heroin was introduced for medical use. Between the 1930’s and 1950’s, there was a major wave in opiate addiction due to the Vietnam War. It was in 1973 that President Nixon created “The War on Drugs”. During the late 1990’s, the Food and Drug Administration approved opioids and doctors were under the impression that the opioids were non addictive”.
“Abuse of and addiction to opioids such as heroin, morphine, and prescription pain relievers is a serious global problem that affects health, social, and economic welfare of all societies” (Wilson, 2016). “Increases in overdose deaths from prescription and illicit opioids are driving a decrease in America's life expectancy for the first time in generations”. “The total economic burden is estimated to be $78.5 billion. Over one third of this amount is due to increased health care and substance abuse treatment costs ($28.9 billion). Approximately one quarter of the cost is borne by the public sector in health care, substance abuse treatment, and criminal justice costs”.
There are many different treatment options available to an individual who is addicted to prescription pain medication. On September 4, 2019, “the Trump administration announced that it will award 1.8 billion in grant funding to state and local governments to bolster treatment and prevention efforts in the battle of the opioid epidemic”. There are multiple medications to attempt to reduce opioid addiction. “One such possibility is the drug naloxone. Naloxone blocks or reverses the effects of opioid medication, including extreme drowsiness, slowed breathing, or loss of consciousness. It is used to treat a narcotic overdose in an emergency” (Wilson, M.H., 2016). Furthermore, there is a drug called Buprenorphine. “Buprenorphine is used in medication – assisted treatment (MAT) to help people reduce or quit their use of heroin or other opiates” (Lynne, 2019). “Other options for gaining more control over the gaps in opioid prescribing oversight include initiatives that would limit the number of pills given in prescriptions and encourage use of prescription monitoring programs (PDMP). PDMPs are systems that track when patients fill prescriptions”.
An addict who is seeking treatment must maintain case management or counseling. At times, counselors use a strength assessment when working with clients. “Strength assessment asks the question, “What kind of life does the client want?” It concentrates on the client’s capabilities and aspirations in all areas of life’s functioning”. “It is a way of conceptualizing and understanding people and their circumstances from the strength point of view and clinicians try to build-up from the core strengths, towards achieving client's goals” (Moorkath, Ragesh, & Hamza, 2019). An additional treatment option is transitional housing after rehabilitation stays. “Use of homeless and transitional housing (e.g., recovery homes) programs can be associated with success in substance abuse treatment, perhaps because many of these programs encourage or mandate sobriety” (Rash, Alessi, & Petri, 2017). While researching, it was found that,
“Housing options for people exiting homelessness and seeking recovery from substance use disorders are limited. Policies tend to favor low-demand models such as housing first and permanent supportive housing that do not require abstinence but offer immediate housing placement based on consumer choice and separate housing from clinical services”.
Social Work Core Values
With the opioid crisis, it is not just social workers who have noticed this epidemic, but also community members, community leaders, and national leaders as well. Everyone is coming together and voicing the issue at hand. According to the National Association of Social Workers, the six core values are Service, Social Justice, Dignity and worth of a person, Importance and centrality of human relationships, Integrity, and Competence.
Social Justice is an ethical principle meaning, “social workers' social change efforts are focused primarily on issues of poverty, unemployment, discrimination, and other forms of social injustice. Social workers strive to ensure access to needed information, services, and resources; equality of opportunity; and meaningful participation in decision making for all people” (Council on Social Work Education, 2019). While assisting an individual who struggles with addiction, Social Workers continuously advocate for the client to ensure they are obtaining the help needed in the recovery process. There have been many suggestions to end the crisis; to include safe injection sites, ending the “War on Drugs”, and providing more resources for the addict. “The broad assumption about public health and national drug policy is that the use and abuse of illicit and/or prescription drugs and alcohol is ultimately a public health issue” (Wilson M.H., 2016). The position social workers hold in this epidemic is imperative. Social Workers play a major role in substance disorders regarding the core value of Service. For example, “Social workers operate from a holistic perspective, vital to helping individuals, families, and communities fighting addiction. They provide services in community settings; schools; clinics; hospitals; child welfare agencies; and local, state, and federal agencies”. Per the National Association of Social Workers (NASW) Code of Ethics, “the primary mission of the social work profession is to enhance human wellbeing and help meet basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty” (Code of Ethics). As social workers, we hold a standard to treat clients compassionately and respectfully no matter their race, age, gender, or background which falls under the dignity and worth of a person core social work value. Social Workers must maintain data and information per the core value of competency regarding opioid addiction while working with clients. “The National Association of Social Workers (NASW) acknowledges the importance of social workers contributing to knowledge as well as monitoring and evaluating practice and policy implementation”.
The opioid crisis has been an eye-opener to America. The goal of this literature review was to explain the history, current knowledge and treatment available to opioid substance abusers, and how the core social work values play a role in opioid addiction. The reviewed literature suggests with the treatment available, there are options for those addicted to receiving the assistance needed to begin their journeys to stability. There is available funding to the individuals who struggle with opioid addiction with grants approved. Although after researching the literature, there was not much information found on whether the locality of transitional housing is harmful to the addict. Transitional housing many times are in drug invested neighborhoods. A proposed research question is; Does transitional housing increase the chance of relapse for opioid users? Current research does recognize the opioid crisis at hand; however, more research is needed to determine if the locality of transitional housing is helping or harming abstinence.
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- Moorkath, F., Ragesh, G., & Hamza, A. (2019). Strength-based approach in dealing with severe mental illness. Open Journal of Psychiatry & Allied Sciences, 10(2), 175. doi: 10.5958/2394-2061.2019.00038.7
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