“During Alcohol and Drug Addiction Recovery Month and throughout the year, let us remember those who have bravely conquered their addiction. We also pray for those currently suffering so they may, through effective treatment and the strength of family and friends, transform their lives.” ~ President Donald Trump If you or someone you care about has ever struggled with a Substance Use Disorder or any kind of mental illness, National Recovery Day 2019 is dedicated to YOU. Now in its 30th year, National Recovery Month is a 30-day observance held every September in the United States. Sponsored by the Substance Abuse and Mental Health Services Administration, Recovery Month reminds us that intervention helps, treatment works, and that successful and enduring recovery is possible. No matter how bad the situation seems, people get better. 
Acknowledging, Educating, and Promoting Understanding
“Being in recovery has given me everything of value that I have in my life. Integrity, honesty, fearlessness, faith, a relationship with God, and most of all, gratitude. It’s given me a beautiful family and an amazing career. I’m under no illusions where I would be without the gift of alcoholism and the chance to recover from it.” ~Rob Lowe, in recovery since 1990 Let’s take a look at some of the primary goals of National Recovery Month
- To celebrate those individuals who are in recovery, whether it’s been years or just a few days
- To increase understanding and raise awareness of addictive and mental disorders
- To recognize the advances in treatment strategies, evidence-based therapies and FDA-approved medications.
But perhaps the most important goal of National Recovery Month is to educate the general public about mental health, addiction, and the complicated relationship between them. By removing the confusion and misconceptions about these separate-but-related disorders, Recovery Month helps reduce the unfair stigmas associated with them. This stigma —shame, guilt, embarrassment — is frequently what prevents many people who are struggling from seeking the professional help they and their families desperately need.
“Get the help you need today. We offer outpatient assistance, so you can maintain your work, family, and life commitments while getting the help you deserve!”
The Theme for National Recovery Month 2019
“It’s time for addiction to stand up and demand some respect. Because every time someone is ostracized for being an addict…yet another addict is shamed into silence.” ~ Kristen Johnston, in recovery since 2007 This year’s theme is “Join the Voices for Recovery: Together We are Stronger”. This slogan highlights the need for communities across America to join together to address these universal problems and cooperatively share both resources and information. Moving forward, this cooperation will be critically important in successfully addressing the Amercan drug crisis. Look at it this way — EVERYBODY knows SOMEBODY who drinks too much, abuses illegal drugs, misuses their prescription medications, or who struggles daily with a mental disorder. The Surgeon General’s Office has stated that 1 in 7 Americans will face addiction at some point. Let’s take a closer look at what “Together We are Stronger” means at every level.
What Can the Government Do?
“People on both sides of the aisle state clearly and in unequivocal terms that substance use disorders are a problem that we have to address now, because they are tearing apart our communities. So I am hopeful that we are all on the same page when it comes to addressing the crisis — and addressing it urgently.” ~ Dr. Vivek Murthy, 19th Surgeon General of the United States The National Center on Addiction and Substance Abuse created a set of recommendations presenting specific concrete actions that the federal government can and should perform to address the drug crisis in America:
- Develop, Fund, and Implement Effective Public Education and Awareness Campaigns
- Develop, Fund, and Implement Effective School- and Community-Based Prevention
- Reduce the Availability of and Accessibility to Opioids
- Invest in Research
- Increase Access to Naloxone
- Fund Enhanced Monitoring and Tracking of New and Emerging Synthetic Opioids
- Improve Providers’ Knowledge and Clinical Practice
- Improve Access to Quality Treatment and Disease Management
- Implement Comprehensive, Evidence-Based Addiction Care Services within the Criminal Justice System
- Remove Restrictions on Needed Services for Individuals in the Criminal Justice System
What Can States Do?
“The opioid crisis is taking lives and destroying families in Idaho. My executive order uses a broad, holistic approach to examining the crisis, so we can develop solutions that save lives and create a brighter future for our state. Idaho’s collaborative approach has led to significant progress in combating opioid misuse to date, but there’s more we can do. My executive order establishes an advisory group that will ensure we are investing in the right strategies and programs to make a meaningful difference for our state.” ~ Idaho Governor Brad Little Although the federal government can pass legislation, create national programs, and allocate funds, there is still much that individual states can and must do. Working within the framework established at the federal level, states must focus those broader measures into more specific action that address how the drug crisis has developed locally. Although every part of the country has been impacted by the drug crisis, it manifests differently in each individual state, creating distinct challenges. But some states have implemented certain strategies that have proven effective and which serve as a model for others. According to the National Academy for State Health Policy, here are some successful strategies that could be put into place on a larger scale:
- Tracking opioid prescribing — Since establishing a prescription drug monitoring program a decade ago, Florida has reduced the number of people who doctor-shopped to obtain multiple prescriptions by almost 70%.
- Limiting opioid prescribing — Again in Florida, state legislation was passed in 2018 restricts almost all opioid prescriptions to no more than a three-day supply.
- Invest in harm reduction — The Massachusetts Department of Health established an Overdose Education and Naloxone Distribution program that has to date trained over 64,000 people how to administer life-saving naloxone in an opioid overdose emergency. The OEND program has also dispensed naloxone kits to community health centers. As a result, nearly 12,000 overdoses have been reversed.
- Increase the capacity for Medication-Assisted Treatment — Although MAT — the combination of medication, counseling, and other support — is considered the “gold standard” of addiction care, some states are struggling to meet the overwhelming need. But when the State of Virginia established their Addiction, Recovery, and Treatment Services program that made MAT a priority, treatment rates have risen by more than 70%.
- Coordinate and integrate addiction treatment with behavior health services — Up to two-thirds of all substance abusers also struggle with one or more mental illnesses.
- Work with correctional facilities — The most lethal period for an ex-inmate with an Opioid Use Disorder is the first two weeks after their release. Rhode Island is combating post-release relapse and recidivism by providing MAT to inmates statewide, and by connecting them to outside post-release treatment services and support. According to the Journal of the American Medical Association, these programs have resulted in a 60% decrease in the number of post-release opioid-related deaths.
- Create alternatives to jail — Direct law enforcement officers and prosecutors’ offices to refer non-violent first-time drug offenders to local treatment centers instead of arresting and indicting them.
- Improve access to treatment in rural areas — Rural areas are the hardest hit by the drug crisis, because they face a number of unique challenges — transportation difficulties, attracting and providing support to professional addiction specialists, and dispelling the stigma associated with seeking treatment in smaller rural communities.
- Make reporting of overdose deaths andatory — By pinpointing where the problems are the worst, targeted interventions can be made.
But by following the Project Echo model, which uses modern technology to bridge the gap between clinical specialists and rural healthcare practitioners, those issues can be successfully addressed. For example, New Mexico is one of America’s most rural states. But because it uses the Project Echo model to help patients with Substance Use Disorder, New Mexico now ranks fourth in the nation for the number of healthcare providers who can offer and deliver MAT services.
- Expand Medicaid — Because income is a barrier to treatment for so many, this is a policy change that would greatly increase access to services. Recent research has shown that when states expand Medicaid services, they realize a significant increase in the number of MAT prescriptions.
What Can Local Communities Do?
“The swath of destruction to lives and families caused by opioids cuts across all ages, races and economic levels. In all likelihood, you know someone struggling with opioid addiction -– a co-worker, a friend, a family member…This issue impacts every community in Idaho.” ~ Dave Bieter, Mayor of Boise, Idaho In 2016, the International City/County Management Association released a list of measures implemented by communities across the country that have had a positive impact on their local substance abuse problems:
- Create community coalitions capable of working across sectors — These action groups tasked with coming up with viable solutions should have members recruited from a wide range of local sectors, including:
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- Doctors
- Pharmacists
- Law enforcement personnel
- Court officials
- Lawyers
- Professionals in the addiction treatment field
- Public health and human services personnel
- Social workers
- Counselors
- Teachers
- School administrators
- Faith leaders
- Youth workers
- Employers
- People currently in recovery
- Draft ordinances and designate sites for safe drug turn-in and disposal — In addition to scheduled drug take-back days, supervised lockboxes that are accessible by the public 24 hours a day, 7 days a week a safe and extremely effective way to remove excess prescription drugs from the community.
- Create a drug diversion task force — This is a team of local law enforcement officers specifically tasked with investigating drug-related crimes in the area, from trafficking to fraud to manufacture to any other issue that can affect the community.
- Supply all first responders with naloxone and training them how to use it — When paramedics, police officers, and other emergency personnel have the means and ability to reverse an opioid overdose, thousands of lives will be saved.
- Establish drug courts — This rehabilitative, rather than punitive, approach to sentencing reduces recidivism, alleviates the burden and expense of jail overcrowding, promotes continuing sobriety, and supports family members of offenders.
- Offer referrals to treatment programs through law enforcement agencies — Some communities allow substance abusers in need to voluntarily go to a police department or sheriff’s office and ask for assistance. County resources and donations are used to cover the cost of treatment.
- Expand awareness of laws that encourage citizen intervention — Too many citizens are unaware of existing laws that protect them when they intervene during a drug emergency — “Good Samaritan” laws allowing them to act without risk of penalty when they are attempting to save a life, overdose amnesty laws that permit them to call 911 without worrying that they will be arrested for possession or use, etc.
- Hosting community events — By directly interacting at the local — or even neighborhood — level to educate citizens, connect them with resources, and give them the tools they need to enact change in their own lives. It some communities, this includes free naloxone distribution and training.
What Can Individuals Do?
“I’m breaking the cycle that has basically destroyed the lives of generations of my family. Getting sober remains my single greatest accomplishment…bigger than my husband, bigger ~ Jamie Lee Curtis, in recovery since 1999than both of my children, and bigger than any work, success, failure. Anything.” Even with all of the programs and campaigns and measures taken by the government and by organizations within the community, recovery is still a very personal decision that starts with the individual. And as individuals, there are things we can all do to directly address the drug crisis and promote recovery, both for ourselves and for others in our community.
- ALWAYS be open and honest with your doctor — If you are abusing ANY substance, including you legitimately-prescribed pain medication, your doctor needs to know. Don’t worry, they won’t judge, but they will help you make the decisions that are best for your health.
- Get help for yourself — At some point, you will get sick and tired of being tired and sick because of your substance use. The good news is, help is standing by, just waiting to help you start your sober journey.
- Get rid of excess medications — Contrary to popular misconception, most people who abuse prescription drugs don’t buy them from a dealer. Rather, they either have a legitimate prescription, or they get them from a family member or friend…usually for free. This is why it is so important to properly and safely dispose or any unused medications.
“We treat both addiction and co-occurring disorders and accept many health insurance plans. Take a look at our outpatient program today!”
The Bottom Line about “Together We are Stronger”
“I come in, I ask for help. I’m willing. The person doesn’t tell me what to do, they tell me what they did. You do what they ask you to do and (stuff) happens. Your life gets better. Your life changes.” ~ Tobey Maguire, in recovery since 1994 As you can see, America’s substance abuse problem is a complicated issue, and it will require considerable effort at every level to turn the tide. Everyone has a part to play, and together, we can make a difference. And here’s the good news — WE ARE. In 2018, for the first time in decades, there were fewer overdose deaths than the year before. That is extremely significant, because it means that thousands of people are alive right now that wouldn’t have been if the trend had continued. 
The Challenges that Still Lay Ahead
“This crisis is different because the spread of synthetic opioids is largely driven by suppliers’ decisions, not by user demand. Most people who use opioids are not asking for fentanyl and would prefer to avoid exposure.” ~ Dr. Bryce Pardo, Ph.D., Associate Policy Researcher, the Rand Corporation But even the encouraging news of a reduction in overdose deaths highlights the ever-changing challenges America faces when trying to address the drug crisis. Even though prescription opioid painkiller overdose deaths are finally on the decline, other drug threats, both old and new, have arisen. And in some ways, the drug crisis is even more terrifying than it was.
- Heroin abuse and overdose deaths are slowly increasing. In some wayss, this is not a surprise, because as legitimate prescription painkillers become harder to obtain and thus, more expensive when purchased illicitly, many opioid-dependent people switch to much-cheaper and easier-to-find heroin. In fact, 4 out of 5 heroin addicts admit to starting out by abusing opioid pain medications.
- According to the United Nations Office on Drugs and Crime, global manufacture of cocaine reached an all-time high of 1976 tons in 2017. This is a 25% increase over the year before, and twice the amount produced in 2013.
- Mexican cartels, which produce an estimated 85% of the world’s methamphetamine have ramped up production so much that the supply is at a historic all-time high, while the price is at an all-time low.
- Marijuana is more potent — and thus more potentially dangerous — than ever before. A generation ago, a typical marijuana strain contained an average of about 4% THC. But today’s engineered, genetically-superior strains contain an average potency of over 20% THC, while marijuana “wax” may be up to 99.7%.
But by far, the biggest drug threat in the United States is fentanyl, a dangerously-powerful synthetic opioid that is up to 100 times stronger than morphine. Because fentanyl is manufactured in a lab rather than processed from a plant, it costs drug cartels much less, in terms of money, time, and manpower. Without a chemical analysis, fentanyl is virtually indistinguishable from other drugs, so cartels have taken to lacing their products with it to boost potency, or even worse, replacing the other substance entirely. This is a deadly misrepresentation, because a fatal dose of fentanyl can be measured in micrograms. The equivalent of six grains of salt can kill a full-grown man. How big is the threat?
“We accept many health insurance plans. You can get your life back in order with our outpatient program today!”
Roughly 1 out of every 3 overdose deaths are fentanyl-related. In 2001, fentanyl was involved in just 4% of fatal drug poisonings. In December 2018, the Centers for Disease Control and Prevention published a report confirming that fentanyl is the single deadliest drug in America. About fentanyl, Michael Morrell, the former Acting Director of the Central Intelligence Agency, said, “It is a weapon of mass destruction.”
What National Recovery Month Teaches Us
The theme of “Together We are Stronger” reminds us that the disease of addiction is bigger than we are as individuals — stronger than our willpower, our judgement, and even our desire for a better life. Our best chance for a successful recovery is when we seek the help of others — our family and friends, doctors, counselors, and especially, addiction specialists. When you look at all of the steps that can still be taken at every level, you can see why recovery is a very personal journey that is made easier with the aid, care, and support of others. If National Recovery Month has inspired you to start your own sober journey, click HERE.