The Opioid Epidemic: A Deadly Disease

July 1, 2021

Office of Government Relations

EPPN Health Care Series Part 4

O blessed Lord, you ministered to all who came to you: Look with compassion upon all who through addiction have lost their health and freedom. Restore to them the assurance of your unfailing mercy; remove from them the fears that beset them; strengthen them in the work of their recovery; and to those who care for them, give patient understanding and persevering love. Amen.

-Book of Common Prayer, pg. 831

Background

In 2018, the 79^th General Convention of The Episcopal Church approved resolution 2018-C037 committing the Church to a comprehensive response to the opioid epidemic. That resolution also empowered a task force to study how the Church can more effectively respond to the opioid addiction crisis.

The devastation of this ongoing crisis could not be clearer. Over 81,000 drug overdose deaths occurred in the United States in the 12 months ending in May 2020, the highest number of overdose deaths ever recorded in a 12-month period. One of the largest contributors: opioids.

Starting in 1990, the medical community was incorrectly informed that opioid pain relievers would not be addictive to patients, causing an increase in prescriptions. However, widespread misuse led to a drastic number of addictions and overdoses which continue to occur today. Currently, 21 to 29% of patients prescribed opioids for chronic pain misuse them, and between 8 and 12% of people using an opioid for chronic pain develop an opioid use disorder.

The first widespread opioid-based product to be prescribed was OxyContin. It was heavily promoted in 1995 with the claim that it had a low potential for addiction. In 2007, the manufacturer, Purdue Pharma, admitted in a lawsuit to knowing that OxyContin was addictive; by then the structure of American health care depended on opioids.

This epidemic is also heightened by the fact that many doctors operate in private practice and can benefit financially from the overprescription of opioids. Overdoses from opioids claimed more than 90,000 lives in 2020, the highest annual number on record. Direct action must be taken to overcome this epidemic.

Racial Disparities

It is important to recognize that social determinants of health and systemic racism have contributed to ethnic minorities being more likely to die of drug overdoses. The Minnesota Department of Health reported in 2019 that African Americans were almost two times more likely and Indigenous Americans were seven times more likely to die of a drug overdose than whites.

Historically, the opioid crisis has mainly affected white communities due to under-prescribing to ethnic minorities. Although it was once thought that the under-prescribing was to protect minority communities from the effects of opioids, it is now clear it occurs because of less access to health care, the incorrect notion that Black people and other minorities have a higher pain tolerance threshold, and more.

Why is it a bad thing that minorities are under-prescribed opioids if they are dangerous? Because these communities are then accessing illegal substitutes for these drugs that are often laced with more dangerous synthetic opioids such as fentanyl. There has also been a recent uptick in opioid overdoses in communities of color. By whitewashing this crisis, the struggle of minorities goes unnoticed.

Government Response

The Department of Health and Human Services is strengthening health data surrounding the use of opioids and educating health professionals and the public on their dangerousness. HHS’s effort also includes improving access to prevention, treatment, and recovery programs.

In Congress, several bills have been introduced to confront the epidemic, including the Comprehensive Addiction and Recovery Act (CARA) 3.0 and the Opioid Patients’ Right to Know Act of 2021. The Episcopal Church’s policy on the opioid crisis directs the Office of Government Relations to advocate for a public health approach to confronting this disease. We fully support the provisions of CARA 3.0. This bipartisan legislation increases the funding authorization levels for the Comprehensive Addiction & Recovery Act (CARA) programs enacted in 2016. It also puts in place additional policy reforms to help combat the opioid epidemic that has worsened during the coronavirus pandemic. Another important aspect of drug misuse is criminal justice reform and CARA 3.0 supports limiting and decreasing incarceration through an investment in deflection and pre-arrest diversion programs in the criminal justice system.

Take action by asking your members of Congress to support CARA 3.0. It is imperative that we take strong steps towards ending the opioid epidemic.