A fresh way of responding to opioid epidemic

Let’s shift our approach, writes Dr. Trina Larsen Soles

The opioid epidemic is the biggest public health crisis to hit in decades.

One potential response, in addition to opening more supervised consumption sites, providing better access to Naloxone kits, urging people not to use alone, and trying to stop tainted drugs from being accessible — could be to deepen our public understanding and shift our approach to a more compassionate and effective outcome: recognizing and addressing the underlying role of adverse childhood experiences and how they make individuals more vulnerable to substance use.

The connection of adverse childhood experiences to future chronic health conditions, social and behavioural problems, mental illness, addictions and early death has been known since the late 1990s.

Called one of the greatest public health findings of all time, research studies now number in the hundreds worldwide.

In general, such experiences are identified with questions about exposure to physical, sexual or emotional abuse, parental addiction, divorce, domestic violence, and other forms of trauma or neglect.

One tool generates a score on a 10-point scale. The higher the number of adverse childhood experiences, the greater the potential relationship to future social, behavioural and health problems, such as alcoholism and substance misuse, suicide and chronic disease.

Researchers are investigating the neurobiological mechanisms that are involved, such as the impact of toxic stress on the developing brain.

Still others have been studying what can be done to mitigate the effects.

Despite two decades of powerful research, however, the concepts have been slow to translate into public understanding, as well as into policy and practice.

Too often, those with drug addiction, like those currently overdosing and dying, are subjected to public condemnation, humiliation, further neglect and ostracism, and further traumatization — often by the very people who are meant to help them.

There is a better way.

In November, more than 600 people from B.C., Alberta, Saskatchewan, Ontario and the U.S. gathered in Vancouver to explore and share approaches to acknowledging, mitigating and preventing adverse childhood experiences.

We heard from Judy Darcy, British Columbia’s minister for mental health and addictions, who stressed that addiction is not a moral failure, but a health issue.

She emphasized the importance of treating those with mental health and substance use issues with the same dignity and compassion that we treat those with physical health issues.

The two-day summit featured multiple presentations and panels to discuss and strategize how to embed awareness of adverse childhood experiences and response into all aspects of society, such as schools, communities, family doctors’ offices, maternity care, mental health and addictions treatment and the criminal justice system.

A five-member panel on adverse childhood experiences and the opioid crisis brought into stark light how our current approach actually contributes to higher death rates by isolating individuals who hide their addiction out of shame and use alone.

Panellist Calgary police Chief Roger Chaffin stated that we can’t arrest our way out of the problem, and that the focus has to be on people before they become addicted.

Linda Lupini of B.C. Emergency Services reiterated what many of us may not realize: that individuals who are dealing with emotional and physical pain through opioid addiction, were doing all this under the radar, and the reason we are talking about it now is because their supply is poisoned.

She stated that this has told us there are many, many more people than we ever realized who are struggling with this challenge.

Although the opioid crisis is a difficult one, November’s summit centred on a message of hope.

By focusing on understanding adverse childhood experiences, and how they contribute to addiction and other serious health conditions, we can enable more compassionate treatment and more effective prevention.

Together, we can help heal those with adverse childhood experiences already in their life story, and limit the creation of new such experiences in future generations.