THE OPIOID CRISIS – THE REAL PROBLEM IS UNDERSTANDING THE PROBLEM – The Emily Dahl Foundation

THE OPIOID CRISIS – THE REAL PROBLEM IS UNDERSTANDING THE PROBLEM

A VIEW FROM THE EMILY DAHL FOUNDATION 

"Some of the recent media articles published are alarming. Some are advocating the Ministry of Education to mandate secondary schools to have speakers or education on drug use and experimentation? At The Emily Dahl Foundation we want the Ministry of Education to mandate Mindfulness Training - that would make a tremendous difference and get us on a path of kindness and awareness." 

The Emily Dahl Foundation 

The opioid crisis and fentanyl, the opioid most responsible for drug overdoses, has once again brought addiction into focus. In British Columbia, where the crisis is at its worst in Canada, the overdose death rate from illicit drugs has been rising since 2008. By 2015, overdose deaths had reached 526, a number never seen before in the province, of which 152 were fentanyl-related (29%). In response, on April 14, 2016, BC’s Chief Medical Officer declared a provincial health emergency. Since then, our interventions have focused on reversing overdoses, treating users with opioid substitution medications, educating drug users on the dangers of fentanyl, and funding new treatment beds.

Six years into the health emergency, we appear to have accomplished little and additional deaths are now over 10,000 since 2016. 

Faced with such dismal numbers, not only in B.C. but throughout Canada and the United States, a handful of psychologists have admitted we’ve overlooked fundamental dynamics that underlie the crisis. In a study of 600,000 drug overdose deaths, for example, Hawre et al. (2018) have shown that the current opioid-overdose crisis is not a standalone, discrete event. It is the most recent manifestation of an exponential rise in drug overdoses since 1979, which have included, at various times and places, cocaine, methamphetamine, and other drugs. Rather than focus on opioids, the authors called for elucidating the “‘deep’ drivers of the overdose epidemic” , such as “despair, loss of purpose, and dissolution of communities." 

Despite being labeled by the media and professionals as the opioid crisis, these “‘deep’ drivers” have little to do with a type of drug, its prevalence, or its potency. The crisis is not about a class of drugs known as opioids; it’s about addiction, itself, and specifically the psychosocial drivers that make intoxication appealing, even when users know that the drug leads to severe and chronic suffering (American Psychiatric Association, 2013).

What Hawre and colleagues hint at is that addiction is a response to a meaningless life and loss of hope. 

Seeing addiction through the lens of meaning offers insights into the epidemic. For example, if chronic drug use is a response to a lack of personal meaning, then addiction must be in the person, not in the drug. Contrary to popular thought, there is nothing in a drug, itself, that dooms anyone who uses it. The vulnerability for addiction lies in an individual person’s experience of daily life as without meaning and purpose. In fact, the frequent media reports of people overdosing multiple times on opioids or using safe injection sites is not evidence that opioids have hijacked their brains but rather that they can find no reason to quit the drug.

Compare any meaning-centered approaches to our current interventions. The medical professions and U.S. National Institutes of Health blamed the crisis on physicians (and pharmaceutical companies), who were prescribing too many opioid medications for patients in pain, essentially turning them into addicts. According to this thinking, addiction is in the drug and not in the person. Patients who take enough opioid medication enough times become addicted. When the physician refuses to refill the prescription, the patient is abandoned, left to search out the street dealer. Medical regulatory bodies intervened by making it more difficult for physicians to prescribe opioid medications.

But reducing the crisis to opioid medications does not stand up to scrutiny. Research has consistently shown that only 1-2% of those prescribed opioids actually develop an addiction, although some current research puts the rate at 3-7%. Beyond this addiction rate, research in British Columbia has indicated that overdoses are not limited to opioids, such as fentanyl (76%) and heroin (23%), but also include cocaine (48%) and amphetamines (31%) (BC Coroners Service, 2018).

Another reality that ignored is that opioid users usually search out fentanyl. A more common thought is this: “If I don’t get fentanyl mixed in with my drugs, I consider I’ve been ripped off.” And it hasn’t escaped notice that as the media published more and more stories of fentanyl overdoses, fentanyl dealers did more and more business. It was the best advertising they could have hoped for. Interpreted from within a meaning framework, the reason why some drug users are attracted to fentanyl is precisely because it is so risky. Those suffering from addictions live with a drug-fueled intensity as a substitute for living meaningfully, and it is at the line between life and death that they find life is most intense. For those who can find no meaning in their lives, “Death is,” as the poet Henry Scott Holland said, “nothing at all.” In Vancouver, a new ritual has emerged known as yo-yoing, in which one person injects an opioid drug while another person is ready to inject naloxone in case of overdose.

The truth of the matter is that to stop the drug traffic or promote policies of harm reduction are not the best way to prevent people from using drugs. The best way is to not use drugs and to help others practice. Consuming mindfully is the intelligent way to stop ingesting toxins into our consciousness and prevent the malaise from becoming overwhelming. Learning the art of mindfulness is the way to restore our balance and transform the pain and loneliness that are already in us. To do this, we have to practice together. The practice of mindful consuming should become a national policy. It should be considered true peace education. Those who are destroying themselves, their families, and their society by intoxicating themselves are not doing it intentionally. Their pain and loneliness are overwhelming, and they want to escape. They need to be helped.  Only understanding and compassion on a collective level can liberate us.  

The Emily Dahl Foundation 
Vernon, BC 
September 6 ,2022