“Opioid addiction is here to stay,” said a social work professor we recently interviewed. “But as long as we turn away from the horrors of this widespread addiction and choose to remain in denial, we will not make a concerted effort to widely administer treatment. The pharmaceutical industry has already created both long term treatments and emergency life-saving medications that are simply not being administered on a wide enough scale. I believe that a nationwide effort to make these medications available to anyone trapped in this particular substance abuse disorder should be a number-one priority for the social work profession at large.”
CDC Reports Current Status
More than 932,000 people have died since 1999 from a drug overdose. In 2020, 91,799 drug overdose deaths occurred in the United States. The rate of overdose deaths increased by 31% from 2019 (21.6 per 100,000) to 2020 (28.3 per 100,000).
- Opioids—mainly synthetic opioids (other than methadone)—are currently the main driver of drug overdose deaths. 82.3% of opioid-involved overdose deaths involved synthetic opioids.
- Opioids were involved in 68,630 overdose deaths in 2020 (74.8% of all drug overdose deaths).
“Despite this ongoing public health disaster, very few people can readily access evidence-based treatment for opioid use disorder (OUD). A recent estimate in California reveals that between 48 and 70 percent of people with OUD lack local access to buprenorphine or methadone treatment. Rural Americans are an especially hard-hit group for treatment shortages. In Michigan, 55 of 57 rural counties lack an opioid specialty clinic. While treatment is comparatively more available in urban areas, many residents experience barriers related to health insurance, poverty and financial challenges, and a lack of reliable transportation. As an illustration, we found in a study of publicly insured African American patients, living more than five miles from the methadone clinic was a determinant of treatment dropout even after accounting for other factors.”
(Addiction Technology Transfer Center Network- Jamey J. Lister, PhD, MSW - March 11, 2022)
Social Work’s Role
An untold number of unsung social workers are already laboring in the field of opioid use disorder (OUD). They are tortured daily by the sudden deaths of people they have come to know and grow fond of. These deaths could have been prevented if already available medication was well distributed, especially in rural communities. This is where social workers come in. They are working tirelessly to improve the distribution of emergency and long-term care medication indicated in OUD.
Medication-assisted treatment (MAT) is the preferred OUD treatment among leading substance use organizations. MAT includes medications like methadone, buprenorphine, or naltrexone combined with psychosocial services. Traditionally, OUD patients accessed MAT through methadone clinics (“opioid specialty clinics”), though it has become increasingly common to access buprenorphine and extended-release naltrexone treatment in non-specialty settings such as family medicine clinics.
Social workers are particularly interested in facilitating access to naloxone (Narcan®), a medication that can reverse the complications of an opioid overdose. They are promoting uptake by educating patients about naloxone, directly providing this medication to patients in the clinic, and gaining training in administering naloxone. They are also partnering with community stakeholders (first responders, libraries, correctional settings, and homeless shelters) looking to administer and supply this medication. Social workers are also helping to reduce the harms associated with injection drug use (i.e., infectious disease transmission) by building partnerships with local Syringe Exchange Programs.
Changing The Narrative
“We recognize that the greatest impediment to creating wider access to these lifesaving medications is the narrative surrounding opioid addiction. Social workers must begin to push back against unethical and pseudo-scientific perspectives on OUD and treatment. A few examples of these narratives include “medication-assisted treatment replaces one addiction for another”; “people with addiction cannot be trusted”; and “people with addiction will never change.” Not only are these narratives in violation of the National Association of Social Workers Code of Ethics (2008), but they diverge from the scientific literature. Given our regular interaction with patients and practitioners, our ability to reframe these into productive narratives has the potential to decrease stigma and promote help-seeking for addiction,” our social work professor said.
With the recounting of each weekly story this blog condenses for our readers, we here at GVT are amazed at the vast scope of work social workers engage in across the country. We try to honor them by telling their stories.