The Opioid Crisis

What is the opioid crisis and how does it impact women specifically? Anney and Samantha discuss how we got here, and what we can do about it.

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Episode Transcript

Speaker 1 (00:05):
Hey, this is Annie and Samantha and welcome to Steffon.
Never told your protection of I heartradious house to Parks.
Today we're taking on a serious topic, so we wanted
to put the trigger warnings right at the front um

(00:25):
because we're talking about the opioid crisis. So drug use, overdose, addiction,
and death. And this is something that's been on my
mind a lot lately. UM. I have had two relatives
almost die from overdose and a close family member of
mine is currently in the hospital in a coma from
an overdose. UM and today is this his birthday? So yeah,

(00:48):
it feels weird double damn. Yeah. Yeah. Right before my
dad died, my mom she lost a packet of oxy
codon I think, and the nurse said that they would
have to be a police investigation because of that. It's
a felony level. Yeah, and she was so so scared
and so stressed about it. So it is a big

(01:11):
It's impacting a lot of people I know, and that's
in fact for me, my experience has come from my
day job. I've had several deaths among teens due to
the use of heroin and opiate usage such as like
fentonyl um. And statistically the death rate is highest for
the fifteen age group. UM. I don't mean in general,
just like if teenagers are dying, they're dying at the
ages of fifteen through nineteen. UM And from n sixteen,

(01:34):
the increase of team death due to opiate overdose rose
over three h right, and it's bigger and bigger every year.
And of course we have the whole conversation of access
versus costs versus all of the things. And this is
a lot to do with self medicating, which is a
whole different conversation in itself. But I've definitely had to

(01:57):
deal more and more and more with that recently, and
it's really hard ranking and just traumatic in itself. Yeah,
and for this episode, we did want to look at
women in particular and and things that we can do
about it. UM. I will say for me, I am
actually allergic to most opoids. I found out when I

(02:19):
got my wisdom teeth out. Yeah, so I guess lucky me. Um, Yeah,
I think I think overall after doing this research, lucky. Yeah.
It's definitely a huge thing. And no, UM, I typically
don't take those um because with my drugs wing even
though obviously if you have, you know, a prescription, it
won't matter. But I do get drug swaen with my

(02:40):
other job. That stuff UM causes a lot of havoc
and a lot of questions and a lot of different
things because people can. Obviously for the reason it's been overused,
and we'll talk more about that, it's because of the
level of being prescribed UM. And I know my mom,
because she has had to deal with back paint, gets
so scared of it because of the mirror feelings and
understanding of it, that he will count every pill and

(03:02):
then make sure to do halves of it like that's
and it's smart. Actually I'm the same way. I get
really nervous just about any kind of medication. I just
have this fear, which is kind of unfounded and kind
of not that I'll just magically be addicted to it.
So I understand your mom completely absolutely. A couple of
years ago, I interviewed a US representative who I believe

(03:22):
is still in the house UM, and when we stopped rolling,
he looked at me and he had this super serious
face and he said, with such urgency, your generation is
going to have to find a way to deal with
the repercussions of this crisis, like we weren't even talking
about it. But he's from I think he's from the state,
is it West Virginia. It's one of the biggest impacted states.

(03:44):
So it's obviously huge where he's from. And before we
get into all of this, I didn't want to say
at the top, chronic pain is difficult. Um don't want
to undermine the toll that that takes on someone, or
the difficulty of seeing someone in pain and providing individualized
treatment plans. That's that's hard. Around of Americans report experiencing

(04:08):
pain on a daily basis, and that's about twenty five
million people and double that live with chronic pain. So
it's a huge scale problem, like it is, and I
know it's under misdiagnosed often and and that's a problem
in itself. I'm not a doctor. I'm not in the
medical field, so I could never say how a doctor
or anybody in that fields should do their job. But

(04:30):
of course that there's been a lot of miscommunication and
misunderstanding between the patients and the and the physicians, and
that causes a lot of problems and trying to understand
what chronic pain even means. Right, all right, So let's
start with our kind of basics here. Opioids are drugs
that target specific receptors or the nervous system to minimize

(04:52):
the experience of pain. If used overall long period of time,
a patient or a person can develop a tolerance, meaning
that the same amount won't have the same effect, and
this might lead to taking more and more to achieve
that result that you had in the beginning, or or
withdrawal symptoms, and that can lead to overdose and death,
especially when combined with other drugs and prescriptions. Right, and

(05:13):
just to put it in a more layman's terms, I
don't know why I say that would be you know,
it's what you would understand is oxycodone, hydrocodone, codeine. Um.
It's an opiates. So it derived from poppies. Yes, think
of the Wizard of Oz puppies. You gotta say it
that way. I always think of the poppy seed muffin
from Seinfeld. Yeah, and actually that I don't know how

(05:36):
much of a myth, but there has been some confusion
there has been about poppy seed muffins, but it does
derive from the poppies. Yes. In the United States, more
than thirty people die a day due to opioid related overdose.
In over forty two thousand Americans died from opioid overdose,

(05:56):
and of that and estimated of those opioids are prescribed.
From seventeen, over seven hundred and two hundred thousand people
have died because of opioid overdose. Two out of three
overdose deaths involved opioids. The number of deaths has increased
six times since the economic burden of the opioid crisis

(06:19):
is estimated to be seventy eight point five billion dollars,
and over of the people who use heroin first abused
opioids a gateway drug past opiod abuse is the strongest
risk factor to starting to use heroin. In twenty seventeen,
drug overdoses involving heroin accounting for fifteen thousand deaths, and
that's an increase of five times since two thousand ten.

(06:39):
That same year, enough prescriptions were handed out in sixteen
percent of US counties that every person residing in that
county could have a prescription. I remember the last time
I broke my foot. Um even though I specifically said
I'm allergic to opioids, is fine, I don't need them,
they gave me some like on the way out, they're like,
here's your prescription, and a friend of mine jokingly said

(07:00):
I should get it filled anyway and sell them, and
I just tore it up. But it's like I said
I didn't want any, they gave me some. I'm literally
I think we joked. I joked about it with a
friend and it's not funny and you shouldn't do it.
But about five years ago, we someone had a prescription
and you could sell a pill for fifty bucks one wow. Yeah,

(07:22):
that's don't do it though, do not do it, we
do not, please, because this is eight Once again, it's
a felony level crime. So this is not a petty
level crime. Just enough why I yes, important fhy And
it's estimated three point three billion over prescribed pills end
up going to nonintended users. And it's important to remember
not all overdoses result in depth. Someone who overdoses wants

(07:45):
is likely to do it again. Um, which is why
I prevented. An access to informed care is so crucial
after someone who has suffered an overdose ends up in
the hospital. Yeah, so how did we get here to
these all of these terrible statists dicks to answer that
we have to go back to the nine nines, which
you might have guessed because a lot of the statistics
seemed to start in the nineties. UM Pharmaceutical companies reassured

(08:09):
medical professionals that opioids posed no danger for addiction for patients,
and in response, these healthcare professionals started prescribing them at
higher rates. Before we knew how big a problem we
were creating or that we had a problem, even the
addiction was spreading to both prescription and non prescription opioids.
This has also led to the increase of babies born

(08:30):
experiencing withdrawal symptoms. In two seusand one the Food and
Drug Administration approved the use of oxycodon for quote daily,
around the clock long term use. In the f DA
passed up a chance to be more vocal about opioids,
but since has taken a more active role. While they
send the letters of warning to companies selling opioids online illegally,

(08:51):
they pretty much stopped there when they could use their
Office of Criminal Investigations. They have learned and progressed when
it comes to abuse to turn opioids like making a
drug less potent when grown up. It's like a technology
that they've been looking into UM, but that's had mixed results. Right.
The rate of opiated prescription has been declining since two
thousand twelve, but the amount of prescribed more female agram

(09:14):
equivalence is three times higher than when it was in nine.
Out of one hundred Americans, fifty eight are prescribed opioids.
That's around three point four prescriptions per patient with a
daily m m E or as we were saying, more
female gram equivalence amount of forty five point three. The
number of days per prescription has been rising as well.
The average into eighteen days per prescription in two thousand seventeen.

(09:37):
At its peak in two thousand twelve, it was eighty
one point three prescriptions per one people. Wow. Yeah, that's
shockingly high. Analysts break down this crisis into three waves,
the first in the nineteen nineties with overdose deaths of
prescribed opioids on their eyes, and then the second death
due to heroin overdose skyrocketing UM. Some of the biggest

(09:59):
increases of you susage and abuse took place in demographics
with previously low rates of heroin use, like among women.
In seventeen, almost half a million people reported using heroin.
The third wave in UH. This one was marked with
an increase in death from synthetic opioids, especially illegally manufactured finnel.

(10:19):
It's fifty times more potent than heroin um. And when
it comes to stuff like fentnol um, contamination is a
growing problemse well, like different drugs exactly. The U s
Department of Health and Human Services declared a public health
emergency in twenty seventeen and issued a five point strategy
to combat the opioid crisis. One improving access to treatment

(10:41):
and recovery services to promoting use of overdose reversing drugs.
Three strengthening our understanding of the epidemic through better public
health surveillance. For providing support for cutting edge research on
pain and addiction, and five advancing better practices for pain management.
So this is a lot, a lot, and it's all

(11:02):
happening now, and there are so many things at play
in it um it's really hard to isolate it into
one thing. But we did want to look at women specifically.
But first we're gonna pause for a quick break for
word from a sponsor, and we're back, Thank you, sponsor.

(11:33):
So we did want to take a moment to focus
specifically on women because the impact on women in many
ways is greater, and it's an indicator of so many
other societal problems. Like we were saying, right from Health
Resources and Services Administration Deputy Administrator Bride Declaire, women are
experiencing increases of use and overdose from opiates at a

(11:53):
faster rate than men. And if you slice the demographic
pie even more narrowly, the picture doesn't look at a
lot better. The opioid used to sort of crisis affects
women across all age groups, all racial groups, and all ethnicities,
all geographical quarters of America, and all the socioeconomic status levels.
Of the prescribed opioids in the US, women received two
thirds of them. There's an argument to be made that

(12:15):
this has related to the fact that women are more
frequently dismissed, misdiagnosed, and or not believed, and opioids are
a quick, easy way to treat the symptoms without ever
getting to the root of the problem. The whole time
I was researching this episode, I kept thinking of the
one we did about how UM women not being believed
when they go right to get treatment. UM These doses

(12:38):
are on average higher than what are given to men.
And this is translated to an increase in opioid overdose
mortality rates of five hundred and seven percent from sixteen,
while men's on increase of three over the same period.
Women were being hospitalized for opioid related reasons at a
higher rate than men in all but eleven states in Washington,

(13:01):
d c. And compared to men. Women are especially at
risk for developing opioid dependency more quickly, and this could
be because of a variety of factors. Women's generally smaller bodies,
the relationship between pain sensitivity and hormones, and women's increased
likelihood of experiencing chronic pain, and are increased likelihood um
risk of trauma. That last one has been found to

(13:23):
be a factor driving women to abuse opioids, but not
men trauma. We know a little about the science of addiction,
but it does seem that there is a difference in
addiction between men and women, and that women are more
susceptible to relapse and cravings. Women may also be less
likely to respond to treatment or respond to it differently

(13:43):
right and despite the severity of the problem, less than
half of treatment programs supply any materials covering the specific
risk post to women. Only twenty one provided programs focused
on pregnant women or women with postpartum depressions. According to
one study, men are three times more likely to receive
the lock zone, which is the overdoor reversal jug from
first responders. Three times more likely. We've already discussed how

(14:04):
this type of caregiving, of caring for someone with chronic
pain or struggling with addiction most often falls to women.
That's another impact, right, And I guess you can also
talk about the silence that women have to bear pain.
It seems like women are more likely to be quiet
and try to fix it themselves. And that's a whole
different conversation. UM. And then we want to talk a
little more about women of color and people of color. UM.

(14:26):
This is kind of the generalized information UM, specifically to
those in the black community, Latin X community, people of color,
just kind of some of the numbers. As of twenty seventeen,
the rate of death for those in the black community
and several of the research cities are higher than those
of the non Hispanic white communities. In seventeen, the race
higher for the black population while the white community was

(14:49):
at only eleven and then for the Latin XT community
was eleven point five percent higher, and according to a
research conducted in Washington State, the opioid related deaths for
Native Americans and Alaska Natives surpass those of all white individuals.
And there are many debates about who they are focusing
on for treatment and understanding the problem, and as many states,
why white people are victims and people of color, specifically

(15:10):
Latin X and the Black community are addicts and criminals.
Of course, this is a bigger and bigger conversation which
needs to be paid attention to. We have to talk
about the racial inequalities of addiction and criminalization of addiction.
Studies have shown how discrimination and bias effect treatment for
those of color anyway, So you put that with those
of color and those who are women, and then add

(15:31):
um that the racial bias for those who are suffering
from addiction and the likelihood of them getting the correct
treatment or being treated as a victim instead of as
a criminal. And I think that's a big over analyzation
obviously of what I'm saying, because you have to look
at the intersectionality of what it is to be an
addict as a black person who may be LGBTQ, who

(15:51):
maybe uh identify as female or transgender whatever, that the
likelihood of people even listening to them and their needs
and all they get as oh there and of courtune,
I don't agree with this crazy move on. There's no
hope um. And unfortunately I've ran into this just watching
children and teenagers who suffered through many addiction problems, just

(16:14):
like the white community, but they are more they are
less likely to be treated seriously um, and they're going
to be more likely treated as criminals. And that's a
problem in itself, and I think we have to address
repeatedly about why this is inaccurate and how it is
increased a lot in the last five years and people

(16:34):
are not not acknowledging it and just still using it
as a white problem. For it to be fixed as
as opposed to um, an actual problem for everyone, and
that it needs to be listened to and heard and
treated equally. UM. That reminds me of that the one
that Sykes joke about how prescription drug abuse is a

(16:55):
white person thing because medical professionals refused to prescribe opioids
to black people do to racist stereotypes that they are
drug addicts just trying to get drugs. So yeah, that
is also a huge part of this conversation that we
do need to continue having. UM. What are things that

(17:15):
we can do? UM? Well, first off, if you suspect
someone has suffered from an overdose, call nine one one. UH.
Signs include small pinpoint pupils, falling asleep or loss of consciousness, choking,
our gurgling sounds, pale, cold or blue skin, limp body. UM.
Did want to say that because I've heard this play

(17:37):
out in college and it's it's so scary that this
even comes up. But good Sumaritan laws in many states
prevent the person suffering from the overdose and those that
help from being charged with possession. Right, Well, it's supposed to,
it's supposed to, it's supposed to. But that is that
absolute big fear within communities, especially groups who maybe doing
these things together UM and allowing not allowing for UM

(18:00):
emergency treatment because they're afraid of being caught. UM. And
just a reminder, drug overdose and drug usage is not
always clear obviously, because if you look at any of
these signs, it could just mean they started choking or
past out, UM. And it's not your job to diagnose.
Let's just remind of that and act fast if you're concerned.
There are any ways of counting overdose. UM. That's what
we kind of mentioned before the locks on and UM

(18:22):
and we'll probably talk a little bit more later on.
As well as the fact that it's not your job
to judge. No, so I know there's this whole conversation
not conversation, but there's all these jokes with people in
the homeless community and the addiction in that era. It's
not your place if they need help. Help. Yeah, of
course you're not a savior either, so right, double edgedged.

(18:47):
When it comes to what we can do to tackle
this crisis, a big one is changing prescription practices, particularly
in this case when it comes to O vioids. One
way to accomplish this is by establishing practical clinical guidelines,
and the CDC has guidelines for describing opioids for patients
eighteen and older experiencing chronic pain if you want to
look up those. Another recommendation for reducing opioid exposure is

(19:10):
using a Prescription drug Monitoring Program on p d MP,
which the CDC provides funding for UM depending not for everybody,
but it is an option. UM. Changing state drug prescription laws,
reformulating insurance policies, education for providers about prescription guidelines, as
well as how to have conversations about the potential cost
of taking opioids and proper storage and disposal, and raising awareness.

(19:33):
UM also have discussions about other options, because there are
other options to opioids, providing treatment for opioid use disorder
in the form of evidence based treatments like medication assisted
therapy m AT, which are not equally available to low
income women and women of color. As we kind of
talked about the inequalities that's happening for those UM who

(19:54):
are lower income or those of a color, White people
are the ones primarily benefiting from m A T drugs,
up to thirty five times more likely to receive than
a black person. Also, it can be quite expensive without
private insurance and even then making it inaccessible for the poor,
which is infuriating, very infuriating. Another thing that's infuriating of
women going to treatment centers have children, and without access

(20:17):
or resources for childcare, it can be really difficult. UM
Having access to free or low cost childcare or centers
that provide childcare on site would be a huge thing.
It would also help if we improve access to overdose
reversaal drugs lab in the lock zone, which is non
addictive and that can save a life if given in time.
Having standing orders at pharmacy's distributions at local community centers,

(20:39):
training and access on how to administer for law enforcement
and medical staff would also be a giant, giant improvement.
Another big thing collecting better data so we can fully
understand the scope of the problem and make informed policy
recommendations on how to move forward. And there are a
couple other things that we have that we could do,
but first we're going to pause for one more quick

(20:59):
break for word from our sponsor, and we're back, Thank
you sponsor. So when looking at women specifically, the National

(21:19):
Women's Health Network recommends expanding Medicaid to cover those with
lower or moderate income and this increases access to care
and decreases occurring devastating medical bills. Medicaid it can also
provide access to treatments for opioid use disorder. However, not
all states have the same benefits through medicaid, so this
is not an end all, be all solution at all.

(21:42):
Centers for Medicare and Medicaid services will introduce their maternal
Opioid Misuse Model m o M to address the need
of new mothers postpartum are otherwise going through opioid use
disorder in twelve states. In twenty three states, substance abuse
during pregnancy is charged as child abuse, and of course
they are more often used against low income women and

(22:03):
women of color. Of these arrests take place and Shelby County,
Tennessee is African American one county. Yeah, that's telling this
of course discourages people from seeking treatment for addiction. Without
access to information about treatment options and rights to seek
them without police involvement, the problem is only going to

(22:25):
get worse. However, I completely understand black women being skeptical
of that information right, absolutely not. And this is a
huge problem that does not exist in the bubble. Addiction,
big pharma, lack of access to mental healthcare, in ability
to afford long term health care options like physical therapy
or multiple doctor visits, insurance, chronic pain that does not

(22:46):
have an easy answer, and a failure to put patients
and people first. A lot. There's a lot, yep, But
there are some resources out there. The CDC is a
great one for more information, best practices and links to
other resources. They also have an r X campaign to
spread awareness about the opioid crisis. It includes stories from
people who have been directly impacted by it. There's Health

(23:10):
Resources and Services Administration, the h r s A, the
U S Department of Health and Human Services UM, and
they have a number you can call is one eight
hundred six six to four five seven UM Substance Abuse Help.
Sams's national helpline is one hundred six six to help.
And all these national hotlines there are individual UM offices

(23:31):
in each state, so they will have a better access
for you to have locally. I did want to put
a few out there that do work with some of
our minorities and some of our under represented individuals. The
Trevor Project actually works with the l g P, d
q I plus UM community that works with substance abuse.
The Asian Health Coalitions actually work with the Asian community.

(23:53):
That's right there. And then there are county organizations like
the Urban Minority Alcoholism and Drug Abuse Outreach Program that
happens in Franklin County in Ohio. So there are different
organizations that work specifically with specialized groups, and I think
that's actually really important. UM. If you guys Obviously there's
tons more out there that I'm not talking about, but
these are something that just came out. UM. And of course,

(24:15):
as you know, any and I love more information, so
give me that. Yes, please please send us any information
resources you have. Yes, this is it's really massive and
effects everyone, UM. As we understand the idea behind addiction
in general, I think, and in the fact that it

(24:36):
is hurting so many communities, so many families, UM, and
that we need to learn to be louder and to
advocate for those who can't advocate for themselves. Yep, yep, UM.
So that's what we have to say about that today.
But we really really would appreciate, um, any any resources
that you have or any stories that you have that

(24:57):
you would like to share. You can email us at
Stuff Media, mom Stuff at iHeartMedia dot com. You can
find us on Twitter at mom Stuff podcast and on
Instagram at Stuff I've Never Told You. Thanks as always
to our superproducer Andrew Howard, and thanks to you for
listening Stuff I've Never Told You the protection of I
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(25:19):
you listen to your favorite shows,