By Kathy Miles
Coordinator, Boyle County Agency for Substance Abuse Policy, Inc.

For all of 2020, during the pandemic which continues today, University of Kentucky Healing Communities staff were working with Boyle County residents to plan and implement strategies to lower overdose deaths in our county. This task, funded by the largest National Institute of Health grant ever received by U.K., has been greatly complicated and sometimes slowed by COVID-19. Nevertheless, the planning is merging into actual implementation.

Many of the strategies are fairly concrete, and easy to understand. Most of us would not be surprised that getting the overdose-reversing medication for opioid overdoses, Naloxone (Narcan), out to as many people as possible is an effective action. It only makes sense that increasing the number of people in workplaces, restaurants, schools, and homes who know what to do when someone overdoses can help save lives. Making that Naloxone free and easily accessible in locations where people already go as part of their daily routines is providing a base of support for a “Don’t let them die” mentality.

Another strategy that has begun as part of the study, is to increase the local accessibility to medications for opioid use disorder (OUD). It’s not uncommon for people with OUD to return to using opioids, and because of the lethality of drugs available today, that return to use is often deadly.

Research studies increasingly show that being prescribed and taking as directed one of the FDA-approved medications for OUD as part of solid treatment and recovery plan decreases the likelihood of relapse, thus lowering the risk for death. Ways to increase accessibility to medications include increasing the number of medical providers who are trained to prescribe those particular medications, making it easier for people to begin taking the medications after an overdose, and assisting persons with OUD leaving incarceration having medication as part of their reentry plan.

These strategies are already in the works and are adding to our county’s ability to save lives and be more recovery friendly. They will, however, be most successful when a less concrete, but more pervasive and very important strategy is embraced in Boyle County – reducing the stigma associated with substance use disorders.

Stigma includes all of the negative and unfair beliefs not based on facts and current research. Some of the most common and longest lasting stigmatizing beliefs are:

1) Having a substance use disorder is the result of a moral failing or character flaw; 2) Having a substance use disorder is a choice; and 3) Having a substance use disorder is a hopeless problem with no recovery answers.

These beliefs can be found in some form in most of us, until we examine our learned beliefs, understand the facts, and commit to applying those facts in our personal lives and work.

Stigma can result in a person being denied access to housing, jobs, custody of their children, community leadership roles, fairness in the criminal justice system, and participation in a faith community. Very seriously, experiencing stigma can result in a person with a substance use disorder failing to seek treatment and additional recovery support when it is most needed. So, yes, stigma can contribute to death.

The antidote to stigma related to substance use disorders is accurate information that shows that substance use disorders are unequivocally, a brain disease – a chronic, but treatable disease.

People don’t choose to have an addiction – they may make bad choices that contribute to having it, as is also true for many other chronic diseases. But, they don’t seek the pain and suffering of a severe substance use disorder. And, believing it is hopeless and won’t improve is not consistent with the large number of people in recovery, and ever-improving research on addiction treatment.

In spite of real challenges, we have the opportunity locally to turn around some very serious problems. The increasing number of incarcerated parents of young children, children in out of home placements, an inadequate workforce, increasing homelessness, and law enforcement time spent on substance use issues, are just some of those problems we are seeing.

Solutions for some of these are already being implemented. We won’t, however, reach our goals without addressing the deeply ingrained stigma around substance use disorders. It’s up to all of us.