Finding a way through the opioid crisis
Community building and healing are the keys to success.
America is in the midst of a second opioid crisis. While the first one centered around a rise in prescription opioids like oxycodone and hydrocodone, the current crisis has become much more illicit and illegal in nature.
“The source is no longer doctors and pharmaceutical companies … the source is now the Mexican drug cartel underworld,” said Sam Quinones, former reporter for the L.A. Times and author of two nonfiction books on the opioid crisis. “They figured out that there was a new market because we had created a new market of opioid-addicted customers who transitioned to heroin when pills were no longer available.”
Speaking at the 2024 session, “The Opioid Crisis in America: What This Means for Anesthesiologists and Pain Physicians,” Quinones said the drug taking center stage in the current crisis is fentanyl, because the cartels determined that unlike other drugs that require land, farmers, irrigation, and other necessities, drugs like fentanyl can be made in a lab from chemicals.
Despite the enormity of the problem, Quinones said there are lessons to be learned from the ongoing epidemic, not the least of which is that there is no single, magic solution for pain management.
“Beware of very potent, legal drugs that are provided in a widespread way with unfounded claims of their risk-free nature,” he said. “That’s a fairy tale. It’s this idea that we can have it all. Humans search for the magic answer. It’s such a difficult thing to deal with pain. We kind of bought into this magic-answer kind of idea, which gets away from all common sense and all reality that we have known.”
One of the biggest impacts of opioid addiction comes in the form of a loss of community in areas where the drugs have taken the place of human interaction. The way out of the opioid epidemic, Quinones said, is through healing those communities and taking even small steps toward rebuilding a sense of community among the public.
“I think the way forward is through the smallest steps, daily steps,” he said. “And not being discouraged when you’re not saving the world in the biggest way. We spend so much time trying to find big answers. I think what we got away from was a daily process of building better, local communities.”
And that, he added, is where anesthesiologists can come in – by getting involved with the people who are most affected by the drug problem and participating in economic and municipal community recovery at the smallest levels.
“I believe the solutions come when people are in community with each other,” Quinones said. “I have found too often that there are doctors over here, and then there’s all these other folks…. That side of the world needs to hear the voice of authority [from the medical side]. The more that happens, you find ways toward solutions you thought were impossible to find.”
