The Opioid Pandemic - Part 1

By John Athanasatos, PharmD, MDiv.

Introduction

How an Opioid Epidemic has become a Pandemic, its meaning, its growth, who is responsible

The drug problem has been a major concern for decades, from the 1960s with marijuana and heroin, to the 1980s with crack and cocaine and the 1990s with Speed and LSD.  However, for the past decade or so we have seen prescription narcotic painkillers spiral out of control and surpass the stage of an epidemic to become a pandemic.  The opioid crisis has affected individuals nationwide and even worldwide.  So why is it a pandemic and not an epidemic?  An epidemic is an outbreak of a disease that attacks many people at about the same time and may spread through one or several communities.  A pandemic on the other hand is when an epidemic spreads throughout the world.

Recently on a 60 minutes episode, it was claimed that at least 200,000 lives have been lost in the US due to this crisis.  Unfortunately, this number is expected to grow.  In 2018, President Trump declared a state of emergency nationwide for this pandemic.  The problem is believed to have originated with the drug manufacturers who make prescription drug medications more and more addictive which then the drug distributors sell to local independent pharmacies, exceeding their regulatory thresholds.  Doctors are given incentives to write these narcotic prescriptions even if a patient’s medical condition does not warrant them.  These drugs have even reached the black market, working their way to the streets of America where they are sold along with illicit drugs like heroin and cocaine.

Unsuspecting Victims

Many of the victims of this crisis who developed an addiction to prescription narcotics did not have any prior history of any kind of illicit drug use.  Many had an injury or health condition causing tremendous pain that necessitated the need for such medications.  However after only a few weeks on them or even in some cases a few days, many people developed a dependency on these drugs.  Even once their injuries healed or health conditions improved, they maintained a dependency on these medications.  At that point it was the negligence of the physicians, whether intentionally or unintentionally, who continued to prescribe the same drugs without any legitimate medical need.  So, in theory, anyone is a potential victim in the event that some unfortunate injury or disease warrants the need for such medications.

Does this affect the Orthodox Church and its parishioners? How? What can we do?

No one particular demographic of people is immune to this pandemic.  It has affected people of all ethnic/religious and socio-economic backgrounds.  Many of our fellow Orthodox Christians are included in the casualties of this pandemic.  Yet, it is not only those who take these medications and become addicted that are affected, but also our health care workers who interact with those addicted.  Imagine for a moment the ethical challenges our faithful face day after day who have to prescribe, dispense and administer narcotic medications in light of this pandemic.  As a Church, both as a royal and ministerial priesthood in Christ, we have a responsibility to become more aware of this pandemic and do what we can to intervene so that this astronomical number of 200,000 lives does not grow.  It is not just ministering to the addicts of these narcotics, but also providing support for those who are in recovery, for the families and friends who have endured seeing their loved ones suffer and perhaps perish from this pandemic, and for those who are interacting with all of the above on a daily basis in the healthcare field.

Of course as a Church our priority should be concern for our own faithful and their needs, but our mission should not end there.  Christ said to his Apostles, ”You are the light of the world… Let your light so shine before men that they may see your good works and glorify your Father in heaven” (Mt 5:14, 16).  We as a Church united in the battle against this horrific adversary, the opioid pandemic, have both a duty and an opportunity to lead not only this nation, but the world in defeating this crisis.  Let not our efforts stop at our Orthodox faithful, but let it include the entire world.

How can we educate parishioners to have a better understanding and awareness of the problem?

To do this, we need to first have a better understanding and awareness of the problem. This requires reaching out to our faithful.  Things like offering discussion groups on this topic and providing literature in bulletins and information on websites and other forms of media can be a start.  The target audience can be separated into three categories: healthcare workers who face this crisis on a daily basis, addicts and recovering addicts, and families and friends of the latter.  This setup is very similar to what is offered for alcoholism.  AA (Alcoholics Anonymous) is for alcoholics and recovering alcoholics and Al-Anon is for families and friends of alcoholics.  What would be different is the addition of a third targeted audience, all healthcare workers who interact with addicts or potential addicts.

Although there are programs in place providing services to addicts, recovering addicts and their families and friends, they are more on a secular level. We need to expand on this issue in light of our Orthodox Faith.