“This is the epidemic of my generation. This is my HIV. This is my black plague. Oklahoman's are dying from this treatable and preventable disease on a daily basis.”
Within Oklahoma, opioid addiction has reached crisis levels. In the last 12 years, deaths from oxycodone and hydrocodone have quadrupled while the in the last 3 years combined more than 2,684 Oklahoman's have been killed by some sort of opioid overdose. In an effort to help stem the tide of addiction-related devastation, an organization named FATE (Fighting Addiction Through Education) has released “Killing Pain”, a seven-part documentary series on the opioid addiction epidemic within the state.
FATE aims to end the crisis through ongoing education about the scope of the problem and the kinds of solutions it will take to help. They worked with government leaders, business leaders, law enforcement, and addiction experts in order to craft this documentary, drawing on investigative journalism and interviews with experts to accurately tell the story. By creating something so compelling, engaging, and real, they hope to bring the reality of the crisis into people’s homes.
This seven-part documentary series is broken up by topics, dealing with the whom the addiction crisis affects, the biology of addiction, how the crisis was started, the cost of addiction, how to treat addiction, and what the framework for moving forward should look like. The prologue sets up the severity of the opioid epidemic, from the damage to communities and businesses to the number of lives lost (somewhere close to 1,000 Oklahomans dying per year from overdose). Opioids were intended to help kill pain, but they have wound up creating an entirely new misery for the family, friends, and communities of individuals addicted to these drugs.
In Faces of Addiction, the filmmakers offer a glimpse of what an addict can look like. John McGregor is a native Oklahoman, father, and husband who has suffered from chronic back pain for his entire life due to skeletal disfigurement at birth. John began seeking treatment for his back pain and was temporarily prescribed Oxycodone. However, in less than a year his doctor had upped his prescription and before long John was turning to street-level dealers in order to escape from the unbearable pain of withdrawals. John knew it was wrong, but the pain of being off the drug was a thousand times worse than the initial back pain he had been trying to cure.
“You have more loyalty to the drug and your drug dealer than you do to your own family”
Eventually, John turned to heroin as the cheapest, most potent substitute available. It felt like craziness at the time, and John couldn’t believe what he was doing, but it felt like autopilot. There was simply no alternative in his eyes. For thousands of Americans, drug addiction is not a sudden choice but a progressive sinking, like quicksand, into a situation that feels inescapable.
“Biology of Addiction” tackles the science and stigma of this disease. For years, science avoided the mechanisms of addiction while policy was built around the idea that addiction was a moral failing and lapse in self-control. Nowadays, science is beginning to uncover the genetic underpinnings and physiological changes that comprise addiction. Opioids literally rewire the brain and anyone who takes opioids for a prolonged period of time will develop withdrawal symptoms.
“I think that’s how we see it. If you have more will-power. If you were raised better. If you could just exercise more self-control. I promise you, none of my patients suffer from a lack of willpower.”
Opioids hijack the limbic system, which comprises our instinctual attractions to sex, food, aggression, and more. Scientists believe that opioids acclimate within the limbic system and become similar to the sensations of life-preserving instincts such as eating, drinking, and sexual urges. When you quit taking opioids, your system is essentially starved of what it believes to be a life-preserving activity. Imagine the sensation of starving and extend that to days and even weeks. It’s difficult to fathom this concept because like to believe that we are highly evolved creatures capable of choosing and deciding our lives, but drugs hijack our most basic, primal, and fundamental brain functions.
“How Did We Get Here” traces the origins of the epidemic and its specific relationship to Oklahoma. The state still remains at the top of the list for overdose deaths, prescription rates, and the highest percentage of individuals using medications for non-medical purposes. The crisis began when The American Pain Society (a non-profit funded by pharmaceutical companies) began a national marketing campaign to label pain as the “fifth vital sign”, along with blood pressure, temperature, etc… that doctors should look for. The plan worked. The Federation of State Medical Boards began recommending that doctors not face punishment for prescribing large quantities of opioids to patients and even outlined penalties for doctors who under prescribed for pain. In the 1990’s, one class action lawsuit also awarded $16 million to families and patients that did not receive adequate amounts of opioids, calling the doctors guilty of negligence.
“We didn’t realize how addicting these were because the pharmaceutical companies instructed their reps to tell physicians they weren’t addictive.”
“We were hearing this from more than just the pharmaceutical reps. We were hearing this from our professional societies. We were hearing it from our hospitals. From our states and medical boards. It turns out some of these professionals...had financial ties with opioid manufacturers.”
The Joint Commission began to require that hospitals assess their patients using one to ten pain scales to measure patient suffering. Purdue Pharma began selling a time released version of Oxycodone called OxyContin, which was going to be targeted at the over 25 million Americans suffering from chronic pain. By 2001, the company would be spending more than $200 million on promotion and marketing for their product while raking in over $1 billion annually. In Oklahoma, thousands received an abundance of painkillers touted as miracle pills. In reality, they were being dealt death.
“The Cost of Addiction” looks at the cost of the opioid crisis for individuals, Oklahoma, and the country at large. The criminal court system of Oklahoma has been particularly inundated with cases involving drug-related crimes, ranging from intoxication charges to drug-related motives behind robberies to the mind state of criminals when they commit acts of violence. Addiction fuels the economic devastation that causes people to do things that they would never dream of beforehand, such as robbing, lying, and even killing. Addicts find themselves with no other alternatives, being forced to turn to a life of crime as the means of simply maintaining the ability to function every day.
“Crime just keeps increasing, we’re not gonna have enough prisons and we’re not gonna have enough policemen.”
“The system has been ravaged by the volume of cases we’re seeing now where the root of the problem is an addiction to opiates. We’ve seen the onset of opioids become a new scourge in the community. Easily a majority of the criminal cases that get filed, when you get down to the root of what’s driving the criminal activity. We can easily say that a majority of those are being driven by addiction.”
Taxpayers in Oklahoma wind up fronting the bill when it comes to the economic damages caused by the opioid epidemic. Estimates place the total cost of the epidemic to exceed $55 billion annually for the country. Criminal justice and correctional facility costs are over $2 billion per year and over $1.5 billion for law enforcement. Within Oklahoma, the cost of prison per individual is $19,000 per year, while the cost of treatment is only $2,000. The question for lawmakers is whether or not they support saving money while saving lives in the long run.
“Treating Addiction” explores the successes and challenges surrounding the implementation of drug courts. Drug courts everywhere recognize that individuals who commit drug-related crimes may be suffering from the disease of addiction. As such, prison may not be the ideal environment for someone to address the underlying physiological mechanisms that cause addiction. With mandated treatment through a drug court, individuals have the chance to attend rehab, rebuild their lives, build skills, and learn to manage their addiction long term. Within Oklahoma, John McGregor and thousands of others have successfully worked with drug courts to receive outpatient treatment, ongoing monitoring, and caseworker support.
“You can’t lock your way out of this problem. When you don’t treat addiction, the criminal activity is going to continue to escalate.”
In “What Now”, the final episode of the series, addiction specialists and lawmakers discuss the kinds of policies that can help to end the opioid crisis. Psychologist Sara Evans draws a parallel between the implementation of seat belts and the implementation of evidence-based treatment modalities in combating the crisis. Other interviewees recall the government response that helped solve the AIDS crisis, which comprised a decisive government response and national campaign. It may seem like a hopeless battle, but every day thousands of people make the decision to get treatment and just as many stay sober one day at a time.
“There’s nobody beyond treatment.”
“Our drug courts are some of the best in the United States/ We have amazing teams lead by a judge who ensures that people are held accountable to make sure they are engaged in treatment, they’re going to work, and we have some of the best outcomes in the United States. But our drug courts are full every day. We haven't seen an increase in drug court funding in over a decade.”
Ultimately, FATE has done an excellent job of portraying the scope of the opioid epidemic in a way that makes it feel real and urgent. The documentary filmmakers plan on making more of this series, but as of yet have not announced any specific locations. To adequately address the nation’s rising crisis of deaths relating to suicide, alcohol, and drug use will require a comprehensive treatment approach that involves health care systems, communities, and businesses to rally and face the problem head-on. At Landmark Recovery, we incorporate leading techniques and methods for giving the highest quality treatment available to our patients. Our program is built on a foundation of love and support. Our Oklahoma rehab center is fully equipped and staffed to help you or a loved one overcome a substance dependency.