Not a Moral Failing—Understanding the Factors Behind Opioid Use Disorder

On June 18th, Dr. Anne Zink—Emergency Medicine Director at Mat-Su Regional Medical Center—presented a nationwide webinar through Becker’s Hospital Review titled, “Bending the Opioid Curve Through Care Collaboration.”

Dr. Zink has been an instrumental resource in reducing prescription opioid abuse not only at Mat-Su, but throughout the state of Alaska—lobbying for statewide opioid prescribing guidelines and promoting prescription drug monitoring program (PDMP) integration, patient and physician education, and other innovative efforts. That being said, her webinar was not a routine checklist of the do’s and don’ts of prescription opioids. Rather, Dr. Zink reminded us that addiction is a disease, not a moral failing.

The Person Behind the Disease

In her presentation, Dr. Zink went beyond the addiction itself to evaluate factors that impact a person’s addiction to opioids. For instance, she emphasized the role in Adverse Childhood Experiences (ACEs) in developing later addictions. This is especially important when realizing that 64 percent of the US population has one or more ACEs—and that 82 percent of those struggling with a substance use disorder have at least one ACE.

She also covered the biochemical changes that affect opioid addiction, the role of pharmaceutical messaging in marketing prescription opioids, and the physical and emotional symptoms of withdrawal that can make overcoming an addiction seem impossible, including:

• Dysphoria and anxiety
• Insomnia and restlessness
• Nausea and vomiting
• Diarrhea
• Muscle pain
• Elevated blood pressure

Misconceptions about medication assisted treatment (MAT) were also addressed—including the idea that options like Methadone, Buprenorphine, or Vivitrol are wonder drugs capable of “curing” opioid addiction. Rather, she brought to light that—even with MAT—relapse is an expected part of the addiction cycle, but not an indicator that recovery is impossible. Rather, she argued that medications like Naloxone should be seen as resources for opening the door to recovery, not the recoveries themselves. This is helpful in addressing existing stigmas for those struggling with opioid addiction who may have tried MAT once or twice before but been unable to break the addiction cycle the first time around.

An Empathetic, Synergetic Approach to Healing

While Dr. Zink acknowledged the importance of prescription regulation, PDMP integration, and statewide legislation, she chose to bring to light the element of patient care that is often missing when addressing prescription opioid use disorder: empathy.

By truly seeking to understand the people and the reasons behind the addiction, stigmas are softened and the door opens for dialogue about what really can be done to help these patients break the cycle. To help drive home this point, she shared a powerful quote from Andrew Sullivan—NY Times writer:

“To see this epidemic as simply a pharmaceutical or chemically addictive problem is to miss something: the despair that currently makes so many want to fly away. Opioids are just one of the ways Americans are trying to cope with an inhumane new world where everything is flat, where communication is virtual, and where those core elements of human happiness—faith, family, community—seem to elude so many. Until we resolve these deeper social, cultural, and psychological problems, until we discover a new meaning or reimagine our old religion or reinvent our way of life, the poppy will flourish.”

To learn more about Mat-Su and other providers seeking to address opioid use disorder, check out our whitepaper or view the webinar in its entirety here.