Is the opioid crisis a national emergency
United StatesSix billion against the opioid crisis
"Everyone here is united with others today in the vital goal of freeing our fellow Americans from the grip of drug addiction and ending the opioid crisis once and for all."
A scene that happens hundreds of times a day in the USA, whether on the street like here, or unnoticed in an apartment: an overdose of opioids marks the temporary end point of a drug career. The victim can barely breathe because the opioids paralyze breathing. So it is high time for the police officers to help. An antidote is given in the form of a nasal spray. Incidentally, the sheriff's office of Pasco County in the US state of Florida published this harrowing scene on the Internet.
There is a good reason why Donald Trump declared a national medical emergency in the fall of last year. Around 100 Americans die every day from an overdose of opioid pain relievers, more commonly known in Germany as morphine and prescribed only in exceptional cases - unlike in the United States. The trail to the starting point of the crisis leads to the eighties:
"We have heard this from our professional associations, from journalists across the country, from hospitals and state governments: We heard from every direction that people without need are in pain. And that the risk of opioids being addictive, was exaggerated. "
This is what drug researcher Andrew Kolodny from Brandeis University in Massachusetts says - he is considered a luminary in this field.
The grip on the familiar pills
Targeted advertising campaigns ensured that the strong medication was also prescribed for chronic back pain. What that does to people is shown by the drug career of Bill Kinkle, whom I meet in a suburb of Philadelphia, one of the strongholds of drug abuse and drug use in the USA:
"In 2004 I had a kidney stone. And for the pain I was given opioids. Whenever I took them, it was like a new life. No euphoria, but I felt so satisfied in the world and everything was right with the world. And then I stopped taking the medication for the pain, but kept it so I could have nice moments with other people. "
So far so good. Because at that time the registered nurse had not yet become dependent, gave lectures on emergency medicine at congresses. But with the divorce from his first wife in 2007 everything changed: Depression came over him. But instead of therapy, the now 45-year-old resorted to familiar pills that made everything a little easier.
"Well, that wasn't difficult back then. I worked in an intensive care unit where opioids were given all the time. So I put ten milligrams in my gown here and then something again."
After only six months, the pills were no longer enough to make you feel completely carefree, Bill no longer showed up for work, put all his belongings in for heroin, because it was much cheaper than the pills, and was fired. That was the road to an 11 year drug career, with numerous relapses.
Group discussions as therapy
For drug therapist Steven Drzewoszewski, relapses are part of everyday life. Just like the peacock screaming on the premises of the Carrier Clinic in Hillsborugh, New Jersey, USA. The smart 45-year-old heads the withdrawal department with around 40 patients, many of whom are opioid dependent. Peacocks, horses and other animals can be found on the premises. According to Steven, this reassures the patient and contributes to the success of the therapy:
"Yes, the peacocks, they live here on the premises. Sometimes people think that patients here are crying out for help, but of course that is never the case, it's always the peacocks."
Steven has retained ease in dealing with difficult fates. And while we walk across the extensive clinic area with its pastel-colored low-rise buildings, he tells me what the real part of the therapy is: especially group discussions, supported by medication that alleviate the withdrawal symptoms.
"I treated doctors, lawyers, janitors, garbage collectors, I treated people from the street, I treated fathers and I treated the children of these fathers, all of them ..."
- What if a doctor doesn't want to prescribe anything after all?
"There is actually the concept of doctor shopping when addicts first go to one doctor, then to another, then to another. At some point, this becomes apparent with the insurance company, then they no longer pay for it. Then people pay cash ! "
"Hello, I'm Frank. I take Movantik for opioid-related constipation. I had back pain, got opioid, but with that came constipation. My doctor asked me how long it had been ... that was my Movantik momen."
The struggle for America's youth
The continued widespread banalization of opioid use in the USA can hardly be better illustrated. But back to Philadelphia, to Bill Kinkle. He apparently made it, has been clean for a year. He wants to go back to his job as a carer. He has to be available every day for unannounced drug tests, an app on his smartphone ensures:
"I take part in a special monitoring program of the professional association of nurses. I check in every day via this app and can be tested at any time, so I cannot take methadone or anything else. I have to avoid any mind-altering drug."
America is fighting, especially for its youth. Because it is those around the age of 20 like this patient whom Steven Drzewoszewski unfortunately has to greet again at the Carrier Clinic:
"Hey, are you all right? Good, thanks for asking."
It remains to be seen whether the billions from Washington will help. Because for many, opioids are as natural as aspirin. After all, the number of deaths has stopped rising for the first time in decades - a glimmer of hope, even if any help comes too late for many Americans.
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