American College of Emergency Physicians | News Room - Published Letters

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My Turn (re: Opioid epidemic narrative omits personal responsibility)

My organization and several others are concerned with Krista Kafer’s column last week, which argued that personal responsibility is the reason individuals become addicted to opioids and that addiction is rooted in poor choices and a decision to abuse drugs. These arguments are misleading, inaccurate and dangerous. Opioid addiction is a medical condition, rooted in changes to brain chemistry and is not a moral failing based on lack of personal responsibility.

Individuals are predisposed to opioid addiction through many factors including genetics, childhood experience and mental health. Overuse of opioids — be they prescribed or illicit — in susceptible individuals ignites a cascade of changes leading to addiction. Contrary to the author’s arguments, many responsible and productive individuals develop an opioid addiction, and choice has little to do with it. As a society, we must evolve our thinking about addiction.

Addiction, similar to most medical diseases, including diabetes, heart disease and cancer, has many determinants, including lifestyle and health choices — but blaming individuals for their disease is detrimental to the aims of healing and health.

Stigma is the enemy, and patients with opioid use disorders face bias and stigma every day — like the opinions expressed in this column. Stigma prevents communities from supporting patients with addiction, it hinders honest conversations with health care providers, it damages mental health and is a barrier to patients seeking help. Simply put, stigma kills, and the stigmatization of opioid addiction must stop.
As community members, friends, neighbors and family — we must all become educated on the risks of opioids, have conversations with your physicians about nonnarcotic pain control, carry naloxone if you know someone who is at risk for overdose and be compassionate toward those struggling with addiction. Science, understanding and relentless dedication — this is how we end the opioid epidemic — and in this fight, stigma is unacceptable and unwelcome.

This opinion carries the weight of Steven J. Summer, President & CEO of the Colorado Hospital Association; Robert Valuck with the Colorado Consortium for Prescription Drug Abuse Prevention; Debra J. Parsons, president of the Colorado Medical Society; and the Colorado chapter of the American College of Emergency Physicians.

Donald Stader is an emergency physician at Swedish Medical Center.

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