NEPA Vital Signs - Winter Spring 2018 - 24

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THE SILENT KILLER AMONG US

he world stopped for a moment at
10:05pm on Sunday, October 1, 2017.
Gunman Stephen Paddock opened
fire on thousands of innocent concertgoers
at Route 91 Harvest Festival as they danced
and sang along to the night's closing act.
By daybreak, over four hundred were
wounded. Fifty-nine were dead.
In the days following the Las Vegas
massacre, the nation mourned. Flags were
brought to half-mast. Press across the nation
memorialized the victims. As details of the
tragedy unfolded, anguish turned to anger
turned to action as communities across the
country mobilized and rallied in memory
of the fallen. Citizens from communities
across the nation waited hours to donate
blood to those injured. Legislators on both
sides of the political spectrum advocated
for stricter gun laws. The NRA denounced
modifications that made semi-automatic
weapons into fully-automatic weapons.

of females and 58% of males within our state
have a history of substance abuse. One in
ten Lackawanna County residents need,
but cannot secure, treatment.
The victims of addiction are too often
pigeonholed as poor, uneducated and minority. This mentality - eerily unchanged from
the early days of addiction study over two
centuries ago - has perpetuated decades
old stigma, jading the minds of patients and
providers alike and stifling the efforts to
respond effectively to the epidemic.
The epidemic is firing into our communities at random. First time users
are younger and older, poorer and richer,
more black and more white. Victims of the
epidemic are not all any one thing, except
more prevalent than ever.

Much like the weaponry Paddock used
in Las Vegas, addiction and its ammunition
have transformed in recent years. Commonly found opiates are now cut with even
The events of October 1 triggered more harmful additives like fentanyl and
a nation-wide outcry - proving our carfentanyl - an elephant tranquilizer - to
country has a unified, visceral response increase their potency.
to mass murder.
For those struggling with chemical depenWe were rightfully swift in vilifying dency, addiction isn't about morality. What
Paddock for his reprehensible actions, yet begins as a one-time decision to use often
remain eerily silent in the face of another quickly becomes physical dependency that
menace: chemical dependency's latest supersedes rational thought. Today's opiates
bear little resemblance to their predecesweapon of choice, opiates.
sors and contain chemical compounds that
We have heard enough about the epidem- change the way the body processes them. The
ic. I would know if my patient had a drug brain of someone struggling with chemical
problem. If only addicts had more willpower. dependency has been rewired by modern
formulas, challenging us as providers to treat
We have done all we can to help them.
addiction as a chronic illness. While those
Excuses are easy. Our complacency does struggling with addiction may consciously
nothing to change the fact that opiates take that first dose, the physical, brain-altering components of today's drugs can require
have claimed 35,000 lives this year.
far more than willpower alone to quit.
Pennsylvania is no stranger to addiction.
Abstinence-based treatments, including
In fact, we are the number one state in the
nation for opioid deaths. Alarmingly, 60% rehab facilities and 12-step programs, are
N E PA

VITAL SIGNS

available to those who qualify
for them, but for some, may
not be enough. The increased
potency and modified chemical
composition of today's opiates
has changed the way that the brain
becomes addicted. Prescription drugs
such as Buprenorphine and Vivitrol - otherwise known as Medically Assisted Treatment
(MAT) - help to block the receptors in the
brain that have been affected by the chemical dependency that today's opiates cause.
An addict's first step to recovery
shouldn't have to be over a hurdle. Making MAT readily available to those who
are ready to invest in their recovery will
help them break from the grips of opioids
while allowing them to focus on rebuilding
important aspects of their lives. Opioid Use
Disorder Centers of Excellence (COEs)
across the Commonwealth, including seven
locations within Northeast Pennsylvania,
are dedicated to eliminating patients'
barriers to right-venue care by providing
them timely social and medical supports,
including MAT when appropriate. In tandem
with interdisciplinary care teams, COEs
can help patients through the process of
reshaping their lives and are prepared to
face the epidemic head-on to challenge the
sobering trend of opioid related deaths.
As we continue to mourn the senseless
loss of those killed in Las Vegas, let's not
forget the silent killer still among us. Opiates will kill 95 people today.
Addiction and the drugs that fuel it
are changing at an alarming rate. It's
time we do too.
SCOTT CONSTANTINI is the
Director of Behavioral Health at The
Wright Center. Scott works to ensure
that patients receive treatment for
mental health and addiction issues, as
well as physical needs.

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NEPA Vital Signs - Winter Spring 2018

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