Rural America has a severe drug problem.
According to figures gleaned from the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2021 survey on nationwide drug use and health, 18.4% of rural Americans, aged 12 and older, reported illicit drug use, and to add to that, the overall opioid overdose rate in rural communities is 45% higher, per capital, than in urban areas.
The most recent figures I could find from the Texas Department of Health and Human Services state that, statewide, we are “experiencing a drug poisoning epidemic,” with an excess of 75% increase in drug poisoning, or overdose, deaths in a five-year reporting period.
In Tyler County, alone, the jail booking reports are filled with a bumper crop of drug-related charges, on a weekly basis, and district court dockets are clogged with the results of drug abuse and/or addiction, be it trafficking and manufacture, or robberies and thefts that occur due to drugs.
Law enforcement resources, aside, the problem also creates a drain on what mental health resources we do have available, regionally, as well as our ministerial community.
With that in mind, it only seems right to accept any steps that would work toward ameliorating the problem, right?
Recently, a health consortium, ICON, which operates under the umbrella of UTHealth Houston, installed a Narcan (Naloxone) vending machine in Woodville, in front of the Vape Nation store.
The machine is open to the public, so that anyone who needs a unit of Narcan can take one. Narcan is an opioid reversal medication, administered as a nasal spray, which can save someone from an opioid-related OD.
With such a prevalent problem, one would think that empathy and support would embrace such a measure, however, that assumption is incorrect.
Many online commenters weighing in about this service seemed to look at it with a sort of righteous indignation, with a programmatic “Well, if this is free for junkies, why ain’t insulin free for diabetics?” sort of groupthink, in reply to the outlets that reported on the topic.
It’s a completely wrong lens to look at this issue through. First off, saving a life is saving a life. Whether you agree with the person’s life choices or not, they are still part of this shared human experience and deserve to be treated as such.
Again, our area is eaten up with opioid abuse, as well as abuse and addiction of other drugs, and the collateral damage from those habits. In Tyler County, one in 16 people are prescribed opioids. The reason for those prescriptions could be anything from chronic back pain to the awakening of an old knee injury from someone’s high school football glory days.
Opioid users aren’t just the haggard man on the street begging for spare change, but even though some of you might look down on him, he has a story too and is just as deserving of compassion as the avuncular gent who accidentally took too many hydrocodone he was prescribed for back pain, and that gentleman, who serves as a deacon in his church, could just as easily end up on illicit street drugs once those prescriptions run out, and subject to an unintended overdose.
Many admired people in entertainment also fell prey to opioid abuse and died young. John Belushi, Layne Staley and Heath Ledger are only a small sampling of those who once filled headlines for their creative magic and later became headline fodder as statistics.
Now call me idealistic, but whenever I see Belushi onscreen in the old SNL sketches, the first thought in my mind is not “there’s a junkie,” and I daresay that he likely did not want to die young.
Long-term solutions, such as prevention and treatment, are essential in tackling the opioid epidemic, however, immediate harm reduction strategies like free Narcan, are critical, as well, and making it widely available can significantly reduce deaths from overdose.
Every life saved from an overdose represents a possible opportunity for recovery, and Narcan is that possible bridge; a second chance conduit, if you will. In this way, harm reduction doesn't enable addiction; it creates the conditions under which recovery becomes possible.
Naysayers will claim that once someone overdoses and is saved by Narcan, they’ll just return to the same bad habits. Some might, but, still, a life will have been saved.
The economic benefits of having a service like free Narcan are also nothing to once-over. Hospitalizations and long-term health complications from untreated overdoses can put a severe, costly strain on an already strained healthcare system. By reducing the number of overdose incidents, communities can then loosen that strain a bit, and redirect resources toward prevention, education and rehabilitation programs.
The practice of harm reduction also helps reduce the stigma associated with drug users and also helps foster trust between them and healthcare workers. Drug users/addicts are a vulnerable population, many who no doubt feel as though they’ve fallen through every imaginable crack, and when they can see that their lives are valued, regardless of their usage status, they are more likely to seek help. Studies have shown this to be true.
Some of the folks who cast doubts on the efficacy of Narcan distribution argue that it encourages riskier drug use, but evidence just does not support this notion. Studies that I’ve looked into have bore witness to it being conducive to long-term safer practices. Speaking of the long-term, harm reduction is never a compromise, but instead, compassionate, and opens the door to healing.
Solving the opioid crisis will require a protracted and multi-faceted approach, and harm reduction is definitely a necessary part of that overall equation. Free Narcan is a practical, inexpensive and humane component of that fight.
Building foundations for a more comprehensive intervention is humane and compassionate. Most of us have never walked a mile in the shoes of someone addicted to drugs, but in rural America, it’s a safe bet to say that every one of us knows someone who has.
Did Heath Ledger want to die young? My guess would be a resounding no. He was at the peak of his career, and possibly, had Narcan been around then, he might still be with us.
