Suicide and opioid abuse present a double crisis in a world where risk factors for both are at an all-time high.
Michigan State University’s Institute for Public Policy and Social Research hosted a Jan. 16 Public Policy Forum on this double threat, sparking questions in my mind. For most students, a day without stress is rare. Family, friends, and professional life all place individual demands on you. Each forgets you have other responsibilities, not to mention self-expectations that often carry even greater pressure. Sometimes these stressors become too much and wear on the body. Headaches, along with back and neck pain, are some of the most common ways stress and anxiety physically manifest. So, if someone told you a little pill could keep you pain free; why would you not take it? Without knowledge of the dangers of opioid addiction, this offer sounds tempting.
From my experience, the availability of opioids is a major concern for college students. College culture often makes excuses for questionable health behavior. According to a study at Rutgers University, college students exhibit higher rates of risky behavior and pressure to perform. It may seem that binge drinking before a noon football game is socially acceptable. If this is the case, what else is okay? As a population with already risky behavior and increased pressure to perform, college students need to focus on healthy behaviors contrary to suicide (depression) and opioid abuse (self-medication). https://journals.sagepub.com/doi/pdf/10.1177/0013916591235003
Opioids are commonly prescribed after routine surgeries. When I had my wisdom teeth removed at age 17, I was sent home with a large bottle of pills commonly known as Vicodin. I managed most of my pain with over the counter Tylenol and probably took only four or five doses of the opioid, so there are still quite a few remaining at my house. This is how easy it is to access opioids. With depression and suicide rates at a record high, the immediate availability of lethal drugs is concerning. According to a panelist at the IPPSR Forum, there are enough opioid prescriptions in Michigan for every resident to have more than one. Although many prescriptions are for chronic pain and prescribed by a licensed physician, the rates of abuse are high enough to call the quantity of written prescriptions into question, according to a study by Colombia University Physicians. https://journals.sagepub.com/doi/pdf/10.1177/003335491412900207
Why are at-risk users like college students not seeking help? Dr. Jennifer Johnson, C.S. Mott Endowed Professor of Public Health at MSU and forum panelist, spoke to mothers serving an average of eight years in prison on nonviolent drug charges. She was struck by the tragic stories she heard, specifically those involving the mothers’ relationships with their children. Based on these facts, if a child was 5-years-old when his mother went to prison, he would be a teenager and the mother has missed essential years in his life, reducing the potential for parent-child reconciliation. Because addicts are frightened by the implications and stigma of incarceration for drug charges, they simply don’t seek help and their condition worsens, Johnson said. Avoiding treatment for addiction can happen for many reasons ranging from an inability to cover medical costs to a genuine desire to die, but the most prominent seem to be fears of criminal record, family devastation, and further deterioration of health status, particularly mental health.
According to the panelists, the criminal justice system has an opportunity to reform in a way that encourages addicts to seek treatment. The following figure, shared by Johnson, highlights five specifically identified intercepts, of which many have two or three subunits. The experience of shuffling through this system is a risk factor for suicide and opioid abuse in and of itself.
Juli Liebler, former East Lansing Police chief, indicated the potential use of these intercepts to identify drug addiction and mental health issues immediately so that individuals may be transitioned out of the criminal system and into treatment centers. The current funding for psychiatric and addiction recovery services in the criminal justice system is severely lacking. A call to action for legislative change in the structure of sentencing for opioid users and funding allocation for treatment was evident in these presentations.
Beyond advocating for policy change, what can we do every day to keep our loved ones safe from suicide and opioid abuse? Panelist Courtney Cuthbertson, Community Behavioral Health Specialist for MSU Extension, provided tips for supporting a loved one after a suicide attempt. I would emphasize that these can be followed even when someone appears depressed and before an attempt occurs.
- Tell the person you care.
- Ask what you can do to be more supportive.
- Help to make a safety plan.
- Encourage the person to engage with mental health professionals.
- Keep in regular communication.
MSU Extension also suggests knowing your limits as a loved one. Consider this: You’re not a therapist, nor are you immune to experiencing the same overwhelming thoughts and feelings of the person at immediate risk. Seek professional counsel for yourself when someone close to you is struggling.
Addicts often look to friends’ and families’ past prescriptions for a drug supply, so eliminating access to opioids is key. When prescriptions are not finished, what do we do with leftover pills? The U.S. Food and Drug Administration indicates three main methods of safe drug disposal.
- Some medications may be flushed down the toilet. The FDA provides a clear list of drugs safe for such disposal. See them here.
- Medications can be taken to registered facilities equipped to properly dispose of controlled substances. The Drug Enforcement Administration has created a database to identify permanent collection sites by zip code.
Disposal of drugs in household trash is the last option. Scratch out or remove the label, and pour the medication out of the bottle when disposing.
The epidemics of opioid abuse and suicide hit close to home for Michiganders of all ages. The January IPPSR policy forum shed light on the most prominent characteristics, but the conversation is far from over. There is much to do in terms of research, education, and systematic reform to reduce the number of lives affected and lost by opioids and suicide. Check out other resources from the forum posted at http://ippsr.msu.edu/public-policy/public-policy-forums/past-forums-archive.
Leah Owens is a communications assistant at the Institute for Public Policy and Social Research in the College of Social Science at MSU. She is a junior majoring in kinesiology.