Confronting a Crisis

Take a moment, and picture a person with an opioid addiction. If the image you conjure involves an urban back alley or a superstar compound, you’re missing an important piece of the picture.

Opioid addiction has taken up residence in suburbia and shows no signs of pulling up stakes. Drugs including heroin, fentanyl, OxyContin, Vicodin and Percocet have dug their claws into everyday life, creating a national crisis where socioeconomic status is no guarantee of immunity.

In Virginia, the commissioner of the Department of Health, Dr. Marissa J. Levine, declared the opioid addiction crisis a public health emergency in late 2016. With the number of overdose deaths passing the number of automobile accident fatalities as a cause of death in 2014, and with more than 1,100 opioid overdose deaths projected for 2016 (data collection is ongoing), the commonwealth is clearly on the front lines of this public health challenge.

As a licensed professional counselor in Virginia for the past 30 years and a professor in Longwood’s counselor education program, I have seen the massive human tragedy of this crisis through the eyes of numerous individual patients. I also have had the opportunity to play a role in helping those who are dealing with this problem in a very real way. Treatment continues to evolve and is more than simply sending someone to “rehab” for the traditional, and somewhat obsolete, 28-day stay.

This spring, I was asked to share some of my experiences with members of Congress (see related story). In my comments, I emphasized that there are many misconceptions about opioid addiction and its treatment. One group I have worked with in my practice is healthcare professionals who are returning to the community after spending time in a residential treatment program. Most of my clients are serious, committed professionals who happen to have the disease of addiction—and who made mistakes along the way that influenced the progression of their disease.

If I were to imagine a typical patient, it would be someone like this—I’ll call her Jill. A successful 52-year-old physician specializing in internal medicine, Jill dealt with lower back pain for several years. One day, she used an opioid medication intended for a patient who no longer needed it. She felt a twinge of guilt, but was energized by the relief of her pain. Over the coming months—increasingly reliant on the medication—she wrote several prescriptions for herself to a local pharmacy. Eventually she was discovered and confronted by her medical partner, reported to the licensing board and sent to treatment. She could not believe that this had happened to her.

Virginia, like most states, has a structured monitoring program for healthcare providers like “Jill” who are returning to practice after treatment. The program consists of five years of supervised practice, random drug screening, counseling and attendance at support group meetings in the community. With appropriate help and treatment, they can return to full functioning—and many of them say that the experience, while not one they would have wished for, has made them better doctors, nurses and dentists.

And yet, the stigma of addiction persists. We see those with a substance-use disorder, which is an accepted and established medical diagnosis, characterized as weak, immoral, criminal and worse. Clearly, there is much work to be done before our society treats this condition like the chronic disease that it is.

For me, working with these patients is one of the greatest privileges of my life. You see, I get to be part of the journey with people who are working to recover from a daunting, challenging disease. People in the rooms of recovery often use the phrase “cunning, baffling and powerful” to describe opioid addiction, and I have learned that listening to the wisdom of recovering people is important.

As Virginia implements its multifaceted response to the crisis, students at Longwood in counseling, social work, nursing and other fields will be part of the effort to provide much needed treatment and prevention services to those in the grip of opioid addiction. I remain optimistic that these people, who come from all walks of life, can return to their lives as healthy, productive and recovering citizens.

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