Opioid Epidemic: Tackling Community Decay and Loneliness with Sarmed Rashid

Most recently, just given the trends that we're seeing. We've been working on the opioid epidemic in this country, which kills approximately 70,000 people every year. And the office of national drug control policy works both on. Law enforcement and what we call supply side issues. So rip that, reducing the supply of drugs by working with international partners, doing border controls, border control stuff, working with domestic law enforcement.

But then also public health measures, what we call demand reduction. And so I worked on more of the public health side. Developing helping develop the kind of national strategy to address substance use in this country from a kind of a public health standpoint and then implementing that strategy across the entire government. Yeah I was there for about two years and had an amazing time. I feel like this is one of those issues that transcends politics for many people, including myself.

It's very personal. Addiction is something that I think a lot of us have seen in our families or in our friends, unfortunately. And I'm just, yeah. Happy to talk about happy to talk about my experience. Yeah, thank you

The first wave is I think what a lot of people are familiar with, which is the overprescribing of prescription painkillers like Oxycontin. And I'm just skipping my mind right now. But like octagon, I think the kind of the biggest one and it was. There's a lot of complicated factors that led to it. But I think that, ultimately what happened was that many of the guardrails that we put up in order to make sure that prescriptions are adequately, prescription drugs are adequately prescribed.

Many of those guard rails guard, rails failed. And as a result, we ended up having a lot of people being put on these highly addictive drugs when they shouldn't have or. Being prescribed in rates that they shouldn't have. The second wave was that people many individuals stopped going after prescription painkillers and started using heroin.

And so what we saw was because heroin is a cheaper substance and what we saw was that, a lot of people ended up switching from prescription painkillers to heroin and heroin became much more plentiful and much more breath. Easily available and popular in this country and the third wave. And what we're in right now is the emergence of a highly potent painkiller called fentanyl.

Fentanyl is something that's often used paramedics or used by hand ecologist for painkiller Purposes, but it's an extraordinarily important drug that can be mixed in with a whole bunch of other drugs. And as a result, a lot of people are overdose on it with the COVID-19 and public health emergency. The pandemic has, it's interacted with the epidemic in some very interesting ways. And we'd seen early signs that you were beginning to make some progress.

And a lot of the work that we do before COVID and COVID can have significantly complicated the experience in a number of different ways. As we've seen, a lot of people have lost their jobs due to the epidemic. And, in this country, a lot of people get their job, their health insurance through their jobs.

So all of a sudden they don't have access to treatment lifesaving treatment or mental health Mental health treatment or access to like different recovery support services that are necessary to help sustain long-term recovery. We've also seen a lot of research that talks about the effects of joblessness on deaths of despair which includes overdoses, suicides and kind of alcohol misuse.

In short places that experienced high level of joblessness are also placed that experience subsequently experienced high levels of debt, deaths of despair. And so with a lot of people out of work, that will probably, unfortunately translate into likely translate into more deaths of despair, ongoing social distancing measures makes it difficult for you able to get tree. For example, are, like shifting their focus, towards COVID. And so you have a lot of people who just.

For many of the different reasons aren't able to access either treatment or long-term recovery support services alcoholics anonymous or what have you. The other thing is that we're seeing a lot of folks just kinda been, COVID taken a lot of resources and as a result, there's not as much care available for many people who might've, for example, experienced an overdose.

I volunteer as an EMT in out in Virginia and, Anytime that we get a call to deal with someone who might be experiencing COVID symptoms, that puts us out of service for someone who could be experiencing an overdose. So it's a question of resource allocation. Social isolation is very highly addictive of loneliness, which is highly predictive of mental health issues, which are highly predictive of then pretend for many people deaths of despair.

And the last thing I'll say is that, we've seen that the COVID-19 epidemic or pandemic has especially affected them some of the most vulnerable populations. So homeless populations and criminal justice populations, especially. And these are also populations that are more. Predisposed to deal with substance use issues. To answer your question in short the COVID-19 pandemic has just exacerbated a lot of the underlying conditions of the opioid epidemic.

So like actions like that have helped increased access to treatment for a lot of folks. Same thing with virtual recovery support services. So what we've seen right now is a lot, is that a lot of these VR Re recovery groups have turned to zoom and Skype and what have you to help hold some of the sessions. And it may not be as effective as the in-person, it's still significantly better than not having anything at all.

So I think that a lot of those have been extraordinarily beneficial, but I think that, we are still. Frankly, I can, it's still very early for us to see exactly how this epidemic outside of this pandemic has exacerbated the epidemic. Like when I was at the task force, you cannot learn from people on the ground and finding you and you, and just like we kept on discovering new ways that, you know the situation on the ground had changed. So even with innovations, we're still, I think.

It's still too early to have a list of best practices or, slam dunk innovations.

And whether that includes, issuing emergency funding for hospitals or healthcare centers, many of which are counterintuitive counter intuitively not doing that well financially during the COVID epidemic, a pandemic that's something that's super important. I think that there's also a conversation about, making sure that. First responders are, and other kind of frontline workers are adequately staffed.

As I said I've worked as an EMT out in Virginia and, we've had some firefighters in some Penn, paramedics who've been who've become sick. So making sure that workforce is ready and that we're workforce is fully staffed is I think super important, obviously. But I th but. W one of the biggest ones I think is, understanding that addiction doesn't exist in a vacuum. It definitely exists in a broader context.

And I think a lot of the work that there's been a lot of research on how things like joblessness affect people's psyche or loneliness. Affect people's psyche in a way that makes them more predisposed to turn to drugs.

And, I think that a lot of kind of regional and city level governments, are very strongly, very well positioned to begin, looking at things like loneliness and to begin looking at things like, joblessness and how do we make sure that, we don't let, what kind of slide during this really difficult time,

So the first is I think just learning about it, I mentioned the book dreamland, which I think is just an incredible once again, an incredible book, but I think that does a really good job of kind of setting the context and setting the stage of how we ended up with an epidemic in this country. And I think what it also does is it make the point that, addiction is a mental illness, I think for the longest time we treated it like a personal feeling, but it's important to really.

Understand, and to fully appreciate that, that shift. Because then, and that gets me into my next point, which is understanding the role that stigma can play personal stigma, institutional stigma in preventing people from getting treatment and then maintaining their recovery. I think being.

Knowledgeable about, the kind of larger context that gave rise to addiction can help undermine, the, belief that some people might have that this is a personal failing, also being aware of your language, there's been a significant amount of research that using certain words over others may make made it predispose.

Or make it more difficult for, let's say policymakers to pass legislation that deals with this, or, makes it more difficult for doctors and other healthcare providers to treat those with addiction. Just as like a small example, we never say the word addict because it's a very stigmatizing term, but what we found to be less stigmatizing is the term person with substance use disorder. To at a high level, the reason being is because when you say attic, you're defining someone by this one behavior.

When you say, some person with a substance use disorder, you're recognizing that they're a person and this happens to be just one unfortunate part of their larger, experience. And the third thing I'd say is that. Get CPU and frankly get CPR training. We, a lot of people talk about Naloxone, which is this kind of miracle drug that can revive someone who's having an opioid addiction. You don't even, but you don't need to have this drug in order to pay, in order to save a life.

Someone who is someone who's overdosed can be revived with chest compressions and rescue breaths. And I just generally encourage everyone to get CPR training. It takes two days. The dividends that it pays can be. So