Ground has been taken, progress has been made. But there is still much fighting left to be done.
Jen Smith, a 38-year-old resident of Jonestown, is one of Pennsylvania’s leaders in the fight against addiction, and opioids specifically. Her title says “Secretary of Drug and Alcohol Programs,” but she’s really a general.
“I so wish I had this magic quantification of what progress means,” said Smith. “Some people would look at the overdose deaths in Pennsylvania and say we’ve certainly made progress in that area. But I think the answer lies more in the programs which have been implemented. What used to happen is that patients would overdose, they’d be transported to the hospital, they’d be treated, released and that was it. Hospitals were trying to get patients out the door as quickly as possible.”
“We’re still losing 4,000 Pennsylvanians every year,” continued Smith. “It’s still very critical. While we have been seeing a decline, I think in 2020 we might see an increase. Isolation, financial hardships and job loss are detrimental to relapses. I think we’ve proven we’re headed down the right path. The command center has been critical in maintaining the momentum. It’s really easy to get tired of talking about it. It’s really easy to get burned out. But losing 4,000 Pennsylvanians every year is not acceptable.”
Two years ago, Pennsylvania Governor Tom Wolf first signed a 90-day declaration empowering state agencies to fight the opioid crisis, considered to be a large health and safety threat to the citizens of the commonwealth. Since, that declaration has been re-signed ten times, and one of the fruits of the subsequent labor has been the creation of the Opioid Command Center.
The Opioid Command Center seeks to tackle the crisis through treatment, prevention, rescue, recovery, and sustainability.
“By putting together resources, it gives us the flexibility to relax regulations,” said Smith, a member of Gov. Wolf’s cabinet. “The command center meets every Monday to talk about the opioid crisis predominantly. The goal of the meetings is to bring all of the 16 agencies together, and to bring forth ideas on how to tackle the crisis. It’s a way to coordinate what everyone’s doing and how we’re directing resources.
“It’s so important for people to realize that addiction is a brain disease,” Smith continued. “It’s more difficult to treat than just taking the drug away. Folks need to seek treatment. What we’ve learned over the last decade is that the gold standard of care is medication that assists with treatment, which sounds counter-intuitive. You have to identify what your triggers are, and you have to want to get your life back on track. People who use drugs tend to not have a job and float in and out of the justice system. People have to be willing to accept help. You’ve got to agree to be part of the process.”
The current opioid crisis is just the latest in a long line of challenges that Pennsylvania’s addiction-challenged residents have faced over the years.
As early as 2012, researchers began to identify the abuse of the drugs initially intended to relieve pain. Three years later, the illegal use of opioids began to gain steam, and it wasn’t long after that the abuse evolved into a crisis.
“It took some time to see that it was spiking,” said Smith. “When we started seeing an increase, I don’t think it was taken as seriously as it should’ve been. There was an over-prescribing of opioids by the medical community. In some cases, physicians were hearing the message from pharmaceutical companies that they weren’t addictive. At the same time, we were also seeing a large amount of drugs coming into the country. All of that kind of came together. And in 2018, Gov. Wolf declared the opioid crisis a disaster.
“It could be anybody [abusing opioids],” added Smith. “One of the things the opioid crisis has taught the nation is that the perception of illegal drug users was wrong. We’ve got folks who have white-collar, six-figure jobs, who look like they’ve got it all together, using opioids. From the outside, everything looks great. It really comes in all forms, all income levels, all races, all religious beliefs.”
Throughout many years, opioids have been prescribed by physicians to lessen pain, for patients recovering from surgeries and those stricken with diseases like cancer. Their effectiveness is connected to intended use and moderation.
“In reality, opioids can be a medication used to treat pain,” said Smith. “They are used very frequently in medical communities, with folks who are experiencing real pain and for people who have long-term pain. For many, many years, opioids were essential for treating pain, and that use still exists. The medical need for the drug isn’t going to go away. It’s very effective. Many times, it’s the right medication. The problem is that some people can become dependent on that drug.
“In general, it blocks certain receptors in the brain,” Smith added. “If someone is not in pain, it would make you feel good, good to the point of feeling sleepy. It works very much in contrast to a stimulant. Opioids depress the stimulation and make you more calm and relaxed. And the more dependent you become, the less effect the opioids would have on your body. You need more to have the same feeling.”
Part of the battle Smith and the state’s drug and alcohol programs continue to fight is one of stereotypes and public perception. Drug addiction is not a character weakness, but a mental and physiological condition.
“I think this is the worst we’ve ever seen, in terms of deaths,” said Smith of the drug crises Pennsylvanians have faced throughout time. “If it had been a one-year event, it might’ve been a different story. The underlying message is that when you look beyond deaths, so many people have become addicted. Addiction is a life-long disease. At any moment, there’s a possibility of relapsing. This could theoretically wipe out generations. After five years of recovery under their belts, people can typically sustain it. But what we’ve seen with the COVID-19 pandemic, and isolation, job loss and financial difficulties, those people have relapsed too. There are so many ripple effects with the disease.
“It’s really important for people to know that there’s hope for recovery,” continued Smith. “By getting the right help, people can live healthy, happy and productive lives. That all is possible for people who have this disease. Lots of other people have been able to do it.”
People who need help can call 1-800-662-4357.
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