Opioid Crisis Surges in DC

The opioid epidemic that has driven fatal drug overdose numbers to new record highs year after year shows no signs of abating any time soon. According to the latest statistics from the Centers for Disease Control and Prevention, “two out of three drug overdose deaths involve an opioid… Overdose deaths from opioids, including prescription opioids, heroin, and synthetic opioids (like fentanyl) have increased almost six times since 1999.” Every single day, more than 130 people in the United States die after overdosing on opioids. 

U.S. News & World Report called it “America’s Deadly New Normal” earlier this year. "Things are now worse—much worse—than they've been in the past 20 years," Rocco Perla, co-founder of the nonprofit The Health Initiative told U.S. News.  

Despite numerous attempts to combat the crisis at the federal, state, and local level—including a White House declaration of a public health emergency, the overdose death numbers keep going up. Things are particularly bad in the very backyard of the federal politicians debating and adopting measures that are supposed to turn the tide. 

According to data provided by the National Institute on Drug Abuse (NIDA), there were 244 overdose deaths­­­ involving opioids in Washington, D.C. in 2017―a rate of 34.7 deaths per 100,000 persons compared to the average national rate of 14.6 deaths per 100,000 persons. This makes it the third highest rate in the country. District figures indicate an even higher number of fatalities at 279. 

According to NIDA, “the greatest rise occurred among deaths involving synthetic opioids other than methadone (mainly fentanyl), with 13 to 182 cases between 2014-2017. In the same period, heroin-involved deaths tripled from 37 to 127 and prescription opioid-involved deaths doubled from 23 to 358 cases.”

Opioid Overdose Deaths by Year

Under the leadership of Mayor Muriel Bowser, the Strategic Planning Working Group developed an ambitious plan aimed at reducing opioid use, misuse and opioid-related deaths in DC by 50 percent by 2020. There is hope that the 2018 overdose statistics were already slightly better than 2017 but the data is not yet complete. 

According to WAMU, the “LIVE.LONG.DC” plan involves “exponentially” increasing the availability of the overdose-reversal drug Naloxone. “Other goals outlined in the plan include educating residents on the risks associated with opioid use, working with health organizations on the prevention, and early intervention of substance abuse and ensuring ‘equitable and timely’ access to treatment and recovery support.”

Like many other plans devised by law enforcement and lawmakers, Washington’s “LIVE.LONG.DC” plan will only go so far. Naloxone (Narcan) may reverse a deadly overdose but it does not promote recovery. Educating residents on the “risks associated with opioid use” assumes they are somehow unaware of those risks and doesn’t do much to explore why so many of our fellow citizens want to take addictive drugs in the first place. 

Addiction is a complex biopsychosocial disease, often driven by underlying mental health issues such as anxiety, depression, and unprocessed trauma. If these co-occurring conditions are not addressed as part of a comprehensive addiction treatment plan, the chances of a successful recovery are remote. Focusing almost all the efforts on the reduction of opioid use in particular is problematic since it is not primarily the substance that is causing the addiction. If the underlying reason for self-medicating emotional pain with addictive substances is not addressed in therapy, users will simply switch to a different substance. Many are misusing more than one substance anyway. 

Putting a lot of emphasis on providing buprenorphine-based medication-assisted treatment (MAT) may help stabilize some people with drug addiction, but buprenorphine and methadone can only suppress cravings in people with opioid use disorder. There are no such medications for cocaine, benzodiazepine, or methamphetamine addiction.   

True recovery is a life-changing experience, creating sustainable healthy habits to achieve and maintain long-term sobriety. The Farley Center at Williamsburg Place is an abstinence-based treatment program because ultimately patients need to learn how to handle emotional pain without recourse to an addictive substance—any substance—to enjoy the benefits of genuine recovery.