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Shrugging at Addiction

What can be done about the opioid crisis?

Source: unsplash

“A mass killer we’re meeting with a shrug.” Nicholas Kristof

At this point in the American epidemic, 145 people are dying every day from opioid overdoses and there is no real solution in sight. Families, friends, and first responders search frantically for an addiction antidote so they can save lives today, while government officials squabble with behemoth pharmaceutical corporations over who is to blame for a crisis that has killed hundreds of thousands since it began in the late 90s.

Given the seismic reach of this crisis, you likely know someone who is either addicted to prescription opioids, illegal opioids, or has lost their battle with addiction. Clearly, the stereotypical drug addict no longer exists—the heroin addict nodding out in a dirty room with a dirty needle. Now it’s everyone and anyone: a teenager that takes some of dad’s oxycodone from a medicine cabinet, the construction worker that throws out his back and needs to get back to work quickly to provide for his family, the young lawyer that gets her wisdom teeth removed after landing a position at a law firm that provides medical and dental insurance, the new mother that underwent an emergency C-section to save her baby’s life, or the senior citizen that undergoes knee-replacement surgery.

We need to ask the tough questions so we can develop a long-term solution that addresses all of the gaps in our response to addiction.

For the hardest hit communities, like rural towns in West Virginia, we need to literally rebuild from the ground up. It will take time but we can help these families heal. The government needs to incentivize businesses to open up new locations so people can have meaningful and sustainable jobs. And we need to give people ways to relax and find joy in their lives, whether it is through local sports leagues, meditation classes, or walking clubs at the Y, so that they don’t have to turn to drugs for dopamine (a chemical released by nerve cells in the brain that increases pleasure) in the first place.

Recently, the White House announced that they plan to launch a “massive advertising campaign to get people, especially children, not to want to take drugs in the first place.” When I first read about this strategy, my feeling of déjà vu was quickly replaced by absolute irony. The anti-drug ads from the 1980s (“Just say no” and “This is your brain on drugs”) are largely considered a failure: members of Congress may have found the message compelling but that message didn’t dissuade children and teenagers from taking drugs.

However, after spending a few days thinking about how advertising could be used to combat the opioid crisis, I have two ideas to share. Assuming that the government will dedicate more federal funds and waive regulations so those in need have access to treatment, advertising may be the key to combating this crisis.

Idea #1: Ads that educate

Lawmakers won’t act until their constituents put pressure on them to do so and the public has been apathetic at best when speaking out about the opioid crisis. Many people just don’t care because of the stigma that addiction is a moral failure despite the fact that doctors and experts know it is a medical condition. I’ve seen it in my own family. My nephew has been in rehab seven times for oxycontin addiction—every year since he was 17 years old—and the family is too embarrassed to talk about it.

And there is a callousness about the problem. Missouri State Rep. Robert Schaff (R) once said that when people die from an overdose, it “just removes them from the gene pool.” In addition to being a director at the Missouri Doctors Mutual Insurance Co., Schaff is also a doctor, and he famously filibustered and defeated a bill that would have created a statewide prescription drug monitoring program because he believed it would violate personal privacy. Clearly, the only bad judgment and criminal activity going on is that Missouri is now called “America’s Drugstore” and neighboring states have no ability to stop people from driving over state lines to fill a prescription.

If there was a massive advertising campaign that informed voters in Missouri about the benefits of a prescription-monitoring database—and how a lone-wolf doctor was the one to put a nail in the bill’s coffin—well, they might think twice about voting him back into office. In addition to informing voters about crucial legislation designed to curb addiction, an advertising campaign that focuses on educating the public about the realities of addiction will help those who are unaffected truly understand. The HBO documentary Heroin: Cape Cod, USA, profiled multiple people, none of whom fit the “drug addict” stereotype, and opened the eyes of those watching.

If this advertising campaign can help create empathy for the addicts, we will move over a hurdle that we’ve been stuck at for decades.

Idea #2: Remove direct-to-consumer pharmaceutical ads

The United States accounts for approximately one-third of the opioid painkiller market, despite the fact that we have only five percent of the world’s population. What makes this an American phenomenon?

Direct-to-consumer pharmaceutical advertising is legal in only four countries in the world: Hong Kong (1953), New Zealand (1981), the United States (1985), and Brazil (2008).

Since the mid-90s, it’s been nearly impossible to turn on the TV, open a magazine, or browse through a website or app without seeing an ad telling you to “ask your doctor about a brand-new drug” or directing you a website that has a discount card to use when you try the prescription. As a consumer, I’m okay receiving a coupon that incentivizes me to try a new laundry detergent, but I’d rather have a medical doctor advise me about a prescription drug that is going into my body.

You may be laughing right now, thinking “I’m not susceptible to those ridiculous ads, Deborah!” And that’s fair, you may not be...but your doctor might. In addition to marketing directly to you, pharmaceutical companies employ small armies of sales reps that visit doctors’ offices and provide them with marketing materials, free samples, and patient coupons. Any doctor can be susceptible to a marketing campaign.

Americans have spent the last 20 years reaping the consequences for the tactics employed by Purdue Pharmaceuticals (the maker of Oxycontin). Purdue and other painkiller producers spent nearly $900 million on lobbying and political contributions—eight times what the gun lobby spent during the period between 2006-2015.

We should be alarmed by these marketing tactics. Is it any wonder that people, especially the young, are more frightened today than they used to be, more depressed, more anxious?

Make no mistake, it would be foolish to sit back and assume someone else will stop tragedies like the opioid epidemic. There will always be corporations out there ready, willing, and able to exploit people for profits. Remember when Big Tobacco lost market share in the United States? They went overseas to Asia, and now we see videos of children as young as two years old smoking cigarettes. After saturating the market in the United States, packaged food corporations have moved onto India, where diabetes and obesity are now a significant problem among the country’s growing middle class. Even now, while Americans are combatting an opioid epidemic, Purdue Pharmaceuticals, through Mundipharma, is brazenly taking those same painkillers to Asia, Latin America, and the Middle East.

Stand up and make some noise

How can you stop it?

You stand up and speak out against injustice. Call your congressmen. barrage your local representatives with calls and emails, protest, and demand accountability. You will not ignore the pain and suffering of others. Embrace love and compassion and be a force for healing. Set an example of speaking out and, together, our voices will have to be heard.

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