A Tough Pill To Swallow

There’s an opioid addiction crisis nationwide, and it affects even the best of families. To swallow a tough pill here’s how it started and what we can do about it.

Sean Murdick of West Sand Lake, N.Y., was a co-captain of his high school football team who took a few classes at local colleges before finding work in construction. After he fell and broke his arm on the job, his doctor prescribed a 30-day supply of oxycodone to manage his pain.

His mother, Kim Murdick, didn’t think the opioid prescription was a good idea. Sean reassured her:

“Mom, I got this,” he said.

Before his prescription had run out, however, Sean was addicted. He began buying oxycodone on the street. Soon after, he switched to heroin, a cheaper and widely available alternative, to feed his addiction.

When his parents learned he was addicted, Sean asked for help. Tim and Kim Murdick checked out treatment centers for their son but found either that Sean didn’t meet admissions criteria or that insurance would not cover the cost. The Murdicks exhausted their savings as Sean went through several three- and five-day detox stays and intensive outpatient programs. Nevertheless, Sean repeatedly relapsed. At one point he described his opioid addiction as “this demon inside me.”

Sean finally was accepted to a Florida residential treatment center that helped him get clean. Six months later, struggling against relapse, he checked himself back in for a week of stabilization before returning to his sober home. Later that month, his roommates found him on the bathroom floor, dead from a heroin overdose. He was 22.

“We thought we did all of the right things,” Kim Murdick said. “We don’t expect that when you get a prescription for a broken arm that it’s going to end up with a drug addiction, but that’s what can happen.”

SCOPE OF THE PROBLEM

Sean’s tragedy illustrates the crisis of opioid addiction in America, which has seen overdose deaths rise from 8,048 in 1999 to 47,600 in 2017, according to the Centers for Disease Control and Prevention. Often addiction has developed from the use of opioids prescribed by doctors as painkillers.

Opiates like morphine and codeine derive from opium, while opioids like hydrocodone and oxycodone are synthetic or semi-synthetic drugs that mimic the pain-reducing properties of opiates. Morphine was used as a battlefield anesthetic during the Civil War to treat wounded soldiers, but many became addicted. In 1898, Bayer began commercial production of heroin, which is synthesized from morphine as a supposedly less-addictive alternative. By 1924 all narcotics required a doctor’s prescription, and the sale or production of heroin was outlawed.

In 1980, the New England Journal of Medicine published a 101-word letter to the editor describing a very narrow hospital study that found addiction to be “rare” among medical patients treated with narcotics for acute pain who had no prior history of addiction. Other researchers and journals began citing that study out of context, and by the mid1990s pharmaceutical companies like Purdue Pharma, makers of Oxycontin, began aggressively promoting opioids to doctors with the assurance they were not addictive to patients.

Prescribing opioids for home use or to manage chronic pain, however, opened avenues for misuse and abuse. So as prescriptions for opioids skyrocketed, so did addiction rates and deaths.

Heroin sparked a second wave of overdose deaths beginning in 2010, and illicitly produced fentanyl – often laced into other drugs and 80 to 100 times more potent than morphine – initiated another deadly spike in 2013.

Drug manufacturers and suppliers now face major lawsuits for their role in the opioid epidemic as state and local governments seek compensation for the cost of responding to the crisis. Doctors have been accused of overprescribing, and many patients have admitted to using opioids irresponsibly; in 2016, more than 11.5 million Americans reported misusing prescription opioids in the past year. There’s enough blame to go around.

“In the beginning, there was certainly the emphasis on treating not only acute but chronic pain with opioids, leading to increased marketing, production, and prescriptions of opiates,” said Dr. Cynthia Hunt, chair of the National Opiate Task Force for the Catholic Medical Association (CMA). Pain came to be seen as a “fifth vital sign,” and physicians were required to receive continuing medical education in pain management. “Unfortunately there was a definite misunderstanding about the addictive nature of opioids.”

Another contributing cause is a trend in “self-medicating” not only physical pain but emotional and spiritual pain as well, Hunt added. “There is widespread abuse, trauma, and neglect that individuals suffer which contribute to the desire to ‘numb’ oneself.”

Other gateways to opioid addiction in addition to prescription drugs exist, and most individuals who are treated for acute or post-surgical pain with opioids do not become addicted, she noted.

But as the Murdicks found, securing help for someone with opioid addiction can be difficult.

“When someone has a substance use disorder, very often they are resistant to recognizing, seeking, and accepting help,” Kim said. “Yet far too often when the person has recognized that they want help and are willing to go into a treatment facility, there are so many barriers that treatment isn’t always available. That was the case with our Sean.”

CATHOLIC RESPONSE

Lawmakers and government agencies at the federal, state, and local levels have taken steps to address the opioid crisis and make treatment more available. Churches and other nonprofits have taken the lead as well. Catholic Charities agencies are tackling the epidemic as are many Catholic hospitals and ministries.

Last summer, Bishop Edward C. Malesic of Greensburg, PA issued a pastoral letter outlining a 14-point action plan for responding to the opioid crisis in a holistic way. He called for the diocese, its parishes, and the faithful to work with existing health care facilities and social service agencies to address the problem. He also stressed the importance of prevention and education — as well as prayer.

The CMA’s Opiate Task Force that Dr. Hunt leads was formed eight months ago to educate Catholic leaders about the struggles of addiction, to bring together existing treatment centers regionally, and to strengthen the faith-based approach to healing of the whole person. It has identified several pilot dioceses to help identify models for “best practices” for facilitating biological, psychological, social, and spiritual healing.

“Spiritually, we are a wounded society, and addiction is part of this spiritual malady,” Hunt said. “Most deep healing will arise with spiritual means, surrendering to God our entire being including our brokenness.” She cited “primarily spiritual” 12-step programs like Alcoholics Anonymous as successful examples of this holistic approach.

“To the extent that suffering can be relieved without harm to an individual, that should be our goal,” she explained. However, “with Jesus, suffering can be redemptive and can actually bring us closer to God, in union with Our Lord on the Cross.”

SHAME AND STIGMA

Out of their grief, the Murdicks founded NO piates, a nonprofit organization that seeks to raise awareness about opioid addiction and advocate for solutions. They share their story of Sean with other families, young people, and decision makers.

“We are seeking access to housing, employment support, addiction treatment, and community-based recovery supports,” Kim said. “Progress has been made regarding the treatments for those who suffer with the disease of addiction, but there is so much more that needs to be done.”

Some of the progress includes hospitals that offer detox and medical stabilization services to assist with physical withdrawals, as well as increased recognition of the value of peer-supported recovery. “It’s no longer a one-size-fits-all recovery,” she said.

Many people still need to understand that addiction is a disease and not a moral failing. “Shame and stigma are still deeply rooted in the disease of addiction for those who suffer from substance use disorders and those who love them,” cautioned Kim.

Dr. Hunt agreed that society must overcome the stigma of addiction so that those affected can be open to the professional help they need.

“If addiction is suspected in oneself or a loved one, it is so important to name it, ‘destigmatize it,’ recognize it as an illness — biologically, psychologically, and spiritually — and obtain help in a holistic manner as soon as possible,” she said.

GERALD KORSON is a Legatus magazine staff write