First, Do No Harm: Marshaling Clinician Leadership to Counter the Opioid Epidemic (2017)
Chapter: How Does the Opioid Epidemic Impact Our Families and Our Communities?
appears that clinicians may provide less aggressive treatment for pain (including opioids) to African Americans and Hispanic Americans, perhaps due to conscious or subconscious biases, or misperceptions that pain is experienced differently according to race (Weisse et al., 2005).
A challenge in understanding the nature and sources of, and trends and shifts in, the use and impact of various categories of opioids has been the inconsistent and inadequate support for monitoring systems. Ironically, as the epidemic was beginning to take form, support for two of the surveillance programs—the DAWN (Drug Abuse Warning Network) and the ADAM (Arrestee Drug Abuse Monitoring) programs—was eliminated, ADAM in 2004 and DAWN in 2011.
Overall, accelerated in part by lack of awareness, misinformation, misperceptions, and misinterpretations, the epidemic has spread so vastly that few families—regardless of ethnicity, age, geographic location, or socioeconomic status—remain untouched in some fashion by the occurrence of opioid use disorder or death among their circle of family members, friends, colleagues, and acquaintances. Along with the rapidly growing numbers, the broad demographics of those suffering from the consequences of opioid use disorder has focused attention on, and shifted prevailing attitudes toward, use of opioids as a public health crisis.
HOW DOES THE OPIOID EPIDEMIC IMPACT OUR FAMILIES AND OUR COMMUNITIES?
The impact of the opioid crisis extends well beyond the mortality tables, deeply impacting lives in communities, schools, and homes. Already shallow addiction treatment capacity in many communities is seriously strained, with waiting lists sometimes comprising hundreds of people. Nationwide, 9 of every 10 persons with opioid use disorder do not receive the treatment they need, and around 80 percent of people ready to accept help for opioid use disorder report an inability to access treatment (Jones et al., 2015; Saloner and Karthikeyan, 2015).
Emergency departments, often representing the front lines of care for overdose victims, are also stretched to the limits of their capacities, their resources diverted by the need to treat rapidly increasing numbers who have overdosed. Between 2009 and 2014, opioid-related emergency department visits nearly doubled. The state of Ohio saw the greatest jump in visits, with a 106 percent increase (Weiss et al., 2016). In Dayton, Ohio, at least 20 percent of emergency department visits have been related to drug or alcohol abuse (Wedell, 2017; Weiss et al., 2016). Overdose occurrences have become so prevalent in
