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The Pivot features stories of impact, discovery and surprise in public health. A production of the Gillings School of Global Public Health at the University of North Carolina-Chapel Hill.
Sgt. Vause - 00:00:05:
This doesn't pick a race. It doesn't pick a social economic background. It just, it takes whatever it can and whoever it can.
Shauna - 00:00:15:
You know, if somebody's not alive, they can't get better, they can't get help.
Host - 00:00:26:
Welcome to The Pivot, produced by the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. The pivot features stories of impact, discovery, and surprise in public health, with an emphasis on the human element that helps make big macro ideas more relatable.
Juan - 00:00:45:
The opioid crisis began in the 1990s with the first wave of deaths caused by a rise in overdoses involving prescription opioids. The next wave of the opioid epidemic began in 2010 with a spike in heroin-involved deaths. And now, today, we are currently in the third wave of the epidemic, which is defined by a rapid increase in deaths due to synthetic opioids such as fentanyl. In 2020, 82% of opioid-involved deaths were attributed to synthetic opioids. This provides a really important opportunity for Narcan. Narcan, also referred to by its generic name naloxone, is a medicine that rapidly reverses an opioid overdose and can be easily administered by anyone. If administered properly, it could save as many as 110,000 lives per year. While there is more public awareness of Narcan in recent years, Narcan has been around for decades. It was approved by the Federal Drug Administration in 1971 and used by paramedics and hospitals to reverse overdoses for decades. In recent years, Narcan has become more available for anyone's use to try to prevent even more overdoses. In order to learn more about Narcan, we spoke with three people, each of whom are involved with the opioid use support community in North Carolina. The first person we spoke to was Shauna Guthrie. Shawna is a family physician who currently serves as the medical director for a rural two-county health department in Granville Vance counties in North Carolina. Simultaneously, she serves as the chief medical officer at the local hospital, Maria Parham Health, and maintains her own private primary care practice, Sunflower Direct Primary Care. Over the years, Dr. Guthrie's role has changed. While she still distributes a good amount of Narcan in the community, her work has shifted more now to providing treatment of opioid use disorder. Granville Vance Health Department was actually the first health department in the state to provide medication-assisted treatment. We talked to Dr. Guthrie about what this treatment looks like and how it gets delivered to those who need it. She emphasizes how community care can humanize this crisis. So now you know more about her roles, let's hear about the work that she does in Granville Vance counties.
Shauna - 00:02:47:
If you think you don't know anyone with an opioid use disorder, you are probably wrong. And, you know, just really. Normalizing that the medication is very safe, it's effective, you could come upon anyone. It's not about you and your personal beliefs or behaviors. It's about being part of the community and the opportunity to save a life. You know, at somebody's first visit, we talk about what kind of experiences they've had before with the mental health system. Is there a therapist locally they've worked with that they liked? Are they willing to see a therapist? You know, we try not to push anyone too hard into doing anything that they're not ready for. We really want to be collaborative. But sometimes we have to push a little harder. So the main groups really are the health department, our local OTP, rural health group, and then our handful of mental health practitioners around the community who can really help with that. And my goal. At those moments is really to normalize having Naloxone available and talking with people about the rates of opioid use disorder in our community. Anytime that we give out Narcan, I always make sure to provide information and training on it, so it's a brief. You know, information. Focusing on the fact that you really can't harm someone if you come around someone. Recognizing signs of overdose, You know calling 911 all those things. And then, and then I also point out that there are instructions on the box and that there are websites they can go to and YouTube videos and everything else. If they want to learn more. You know, I think I would rather give 10 people Narcan and give them a quick training than give two people Narcan and give them a really long in-depth training that they probably. Don't need that much information to do a good job. And information on, you know, they're not going to get in trouble for using it. You know, that the state law protects them from getting in trouble.
Juan - 00:04:37:
In addition to teaching others how to use Narcan, the Health Department also has Narcan available for community members to carry with them. We asked Dr. Guthrie to walk us through how to access Narcan through the health department.
Shauna - 00:04:48:
So at the health department, when somebody comes to the front desk and says, hey, I heard you're giving out free Narcan. They will call up one of the members of our team. Who has been sort of trained to train people. On how to use Narcan. It used to be a little more difficult just because for a while all we had was the injectable and that required a little more teaching than the nasal spray, which is primarily what we're able to give out now. So typically a nurse, but also we had some of our health educators trained. And they'll come up and provide the medication and the teaching on how to do that. You know, we ask people to give us a name just for our record keeping. So when we say we gave it out to this many people. We ask them to let us know. If they've used it, because we also kind of report that up. But we also make it very clear that they can give us The name Mickey Mouse. And you don't have to give us your real name and your ID and your social security number to get access to life-saving medication. Yeah, I mean, I think just the general population needs to understand that. That it's horrible to have opioid use disorder. And it is one of many chronic diseases that people have. And when people have chronic diseases, you have... Relapses. When you have asthma, you have flares. When you have diabetes, you have high blood sugars sometimes. None of us is perfect and we're doing the best we can here, right? And one story that I heard from a person in recovery, that I share a lot is, you know, they talk about how when they were using, they could get $100, $200 a day, no problem, because of the things they were willing to do, because their body was telling them when they would start to go on withdrawals, their body was telling them they would die. Without more opioids. And that's why your body responds so strongly and why people are willing to do things. And that now that she's in recovery, she's like, I can't get $2 for gas. Just because, you know, really showing the way how your brain is different when when you're on opioids, you know, when you're using them.
Juan - 00:06:58:
With that in mind, we asked Dr. Guthrie how someone could best support people they know with opioid use disorder.
Shauna - 00:07:04:
So we don't really recommend people do a TV style intervention. That can be very off-putting, and we know that people do better in recovery. And treatment. When they feel ready and they're ready to seek treatment. Always being there, available to people, available to help them, walking that fine line and providing that support. Having opioid use disorder can be incredibly isolating for individuals. And, uh, you know, the number of people that I've treated that. Basically don't have contact with anyone in their family or the majority of their family, or even if they're. Living in a home with their family, they don't feel that connection because that opioid use disorder is kind of always there in the background and providing a little bit of a fog. So providing information about resources. Gently, trying not to push anything on anyone, but just making sure people know that you're there. You care about them. And when they're ready, you're ready with information. And then of course, having Narcan. So that if something does happen, because back to the beginning, you know, if somebody's not alive, they can't get better, they can't get help.
Juan - 00:08:22:
After that insightful conversation with Dr. Guthrie, we were interested to learn more from another person working on the front lines of opioid use disorder. Sergeant Justin Vause serves in the Detectives Division in the new Criminal Indiction Unit at the Selma Police Department. He is actively involved in providing Narcan education and training with the Johnston County Health Department, as well as administering Narcan in the community. He spoke to us about the work he is doing in his community, what signs and symptoms of opioid use and overdose look like, and some common misconceptions that people have about Narcan.
Sgt. Vause - 00:08:53:
I've been in law enforcement for about 18 years. With that, I'm a general instructor. I teach Narcan administration throughout the county. Also, I teach for the county health department, teaching Narcan administration for community people, also law enforcement, firefighters, and so on and so forth. So we try to make sure that they get the help that they need. There's not a place in this world that. Is not affected by this drug. So what we try to do, or how I try to do it, is educating the public. Educating them on you know, the signs and symptoms if they notice something, because there's times We are all young at one time. There's times whenever you go to a party or something like that and people will try anything. And just because you tried something doesn't mean that you're a user or anything like that. And so I want to educate the people on how to use Naloxone or Narcan. Because who knows, you might be that one person that's at the party and your friend just might happen to pick up the wrong drink. And now you're starting to notice the signs and symptoms, and oh man, they're having a fentanyl overdose. And bam, you can give them Narcan and you know what's going on. Or You can be at Christmas dinner and your uncle is in the living room and he's passed out. And now you're starting to recognize the signs and symptoms. Damn, you can give him Narcan. You know what's going on. So education is how I support those with opioid use. We educate, like I said, we educate the public on Narcan administration signs and symptoms, things to look for, things that parents can look for on their kids' phones and whatnot, and just make sure that their kids are not going down the wrong path. We also, every single officer at our agency carries Naloxone or Narcan on them at all times. Just like me, I have one in my door pocket of my patrol vehicle. I have one that I carry on my vest, and I also have one on my passenger door, just in case. It just depends on what side of the car I'm on that day or what I need. I know at least I'll have one somewhere, somehow. Each one of our officers are certified in Narcan administration, recognizing signs and symptoms of an overdose. And then they also educate the public. When we go out to these scenes where we have to administer Narcan or whatnot, we explain to them, hey, look, there's there's Johnston County Health Department that has Narcan kits. There's also information on fentanyl overdosing. And they just educate the people as we go to these calls.
Juan - 00:11:28:
Ensuring the safety of the community is a huge task, so we asked Sergeant Vause to talk more about what other departments he and his team collaborate with to fight the opioid crisis and what led him to doing this work.
Sgt. Vause - 00:11:40:
So I'm part of the Johnston County Opioid Task Force. Also, I was selected to do the Opioid Task Force throughout the state. And I also teach for the Johnston County Health Department Narcan Administration to the public. Before I got into law enforcement, I was in EMS. I worked in EMS all the way until I was... I worked in EMS almost 18, 19 years. I started out when I was 14. And Kept on going up, kept on going up, and then I decided one day that I wanted to be a police officer, and so now here I am. Oh. But I still keep my certifications for all my EMS stuff. So I work along with firefighters, EMS. Law enforcement, Johnson County Health Department. But we as an agency, we work with everybody. We work with the fire departments, the... The EMS, all that. We are all one collaborative group to try to combat this.
Juan - 00:12:36:
Narcan has a lot of stigma attached to it, so we want to talk about some of the myths we've heard about Narcan. Starting with the most common question, can someone overdose on Narcan?
Sgt. Vause - 00:12:46:
No. No. I can literally, if I had some with me right now, I would show you, you can drink it. I mean, it's not going to do anything to you. A person could be having a medical emergency other than being an overdose. Let's hypothetically say that there's a person going into diabetic shock or something, and you recognize it, and you're like, wait a minute, that kind of looks like they're having an overdose, and you happen to give them Narcan. You're not going to hurt them. Narcan is very safe. It's... You cannot overdose on it.
Juan - 00:13:14:
But can Narcan be administered for any type of overdose?
Sgt. Vause - 00:13:17:
If they're overdosing on benzodiazepines or blood pressure medicines or something like that or Tylenol or whatever, it's not going to work. So the best way that I can describe it for you. So inside of your brain. You got these little receptors that are right here, right? So when your brain is like that right there, it's telling you everything's good. You're breathing fine. Everything's great. Well, then the Narcan comes. I mean, not Narcan. The opioid comes in here and it blocks that receptor. And as it's blocking that receptor, then it's telling, all right, I don't need to breathe. I don't need to do anything. I just need to sit here and relax. I don't need to do anything. Well, what Narcan does is once you take the Narcan, it comes in and it pushes all that out. Pushes everything out, and then it puts a little barrier over the receptor right there. Just for a few, maybe about 30 minutes, maybe an hour, because there is a chance that you could possibly overdose again. Once you're given Narcan, there is a possibility for a re-overdose. Unless the body has metabolized everything that's going on in it. So basically Narcan is designed to push all that stuff out and say, no, you got to start breathing again. You got to start breathing again. Let's go. Let's go. And then you just got to keep watching them, keep watching them. Because like I said, there's a potential for a re-overdose. And then after that. Just keep watching them, and as long as they're going good, they should be okay.
Juan - 00:14:38:
But in every scenario, you're going to want to take that person to the hospital, right? After giving them Narcan.
Sgt. Vause - 00:14:44:
I say it's always best because they have programs that they can get you in touch with and stuff like that. There's also other things, too, that you don't know that maybe that's not the only thing that they were overdosing on. Maybe there was something else in that. So, yeah, most definitely always get checked out. Can you make them go? You force them to go. I would highly recommend it, though.
Juan - 00:15:19:
When we hear about opioid overdose, we also tend to hear a lot about fentanyl. According to the CDC, fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. It is a major contributor to fatal and non-fatal overdoses in the U.S. So, we asked Sergeant Vause to talk a little bit more about how fentanyl fits into the picture.
Sgt. Vause - 00:15:41:
So fentanyl is a very, very, very bad drug. Does have some good medical qualities as in for pain control. If somebody is seriously injured and they need pain control. I myself I had an injury whenever I was in a car crash and it helped me. So, uh, I know the benefits of it, but too many people are abusing it. So it affects, it's a whole ripple effect and it's terrible. And then now also you got car fentanyl that you have to worry about and all the other types of fentanyls that they're coming out with. So, and this, this fentanyl stuff is not made in the stuff that the people are overdosing on. It's not made in some medical high grade medical grade facility somewhere. I mean, so it's, you got to really think about what you're putting into your body. Fentanyl is a very, very, very... Bad drug to abuse.
Juan - 00:16:34:
There are two types of fentanyl. There is pharmaceutical fentanyl and illegally made fentanyl. Both are considered as synthetic opioids. Pharmaceutical fentanyl is prescribed by doctors to treat severe pain. Especially after surgery and for advanced stage cancer. Most recent cases of fentanyl-related overdose are linked to illegally made fentanyl, which is distributed through illegal drug markets due to its heroin-like effect. Often, it is added to other drugs because of its extreme potency, which makes drugs cheaper, more powerful, more addictive, and more dangerous. Many people do not know about the NC Good Samaritan laws, which often protect people who are trying to help those experiencing an overdose.
Sgt. Vause - 00:17:12:
So the Good Samaritan Law is basically to let people know, don't be afraid to call 911. Whether you're there at a party, you're at someone's house or whatever, and you yourself, let's just hypothetically say that you are a user. Let's say that you do have some heroin on you. Don't be afraid to call 911. The Good Samaritan law is saying that you're not going to be arrested. In the state of North Carolina, if you have less than a gram of heroin, a gram less of cocaine. Or gram or less. Of myth. On your person, you cannot be arrested. Because you are in the process of calling 911, you're being a good Samaritan, you're trying to help this person. So... If there's drug paraphernalia around the house, there's needles, whatnot, don't be afraid to call. You cannot go to jail for that. Also, the other thing too about the Good Samaritan Law is let's hypothetically say that the person like the previous example that I gave. Where the person is having a diabetic emergency and you give them Narcan. They can't turn around and see you and say, hey, you gave me the wrong stuff. No, no. I'm being a good Samaritan. I'm helping you out. The Good Samaritan Law, it protects you. You can't give somebody too much Narcan, as long as you're in the process of trying to help them, you're getting them help, you're calling 911, you're doing everything like you're supposed to do. We want everybody to know, don't be afraid to call 911. That's the big thing. So many people that overdose and then their friends freak out and they load them in a car and then they go and drop them off at the front door of the hospital and by the time they get there, they're dead. And all they had to do was simply call 911. Because every agency near about around us carries Narcan. Every fire department and every EMS station carries Narcan. So don't be afraid to call 911 and don't leave your friend laying there dying. That's the main thing about the Good Samaritan Law and that we want to drive home to everybody is don't be afraid to call 911. The other thing, too, also, because you're in the college setting, I know sometimes there are some college parties that may or may not have alcoholic beverages and there might be some underage people there. You do not need to be afraid to call 911. They cannot be arrested if they they cannot be prosecuted or anything. If they're under the age of 21 and they've been drinking. But let's say somebody's there and they overdose on something and they call 911. Well, when the cops get there, they can't go, hey, are you 21? And if the guy goes, no, I'm not, well, you're under arrest for underage drinking. Wrong. Good Samaritan law protects you. You cannot be arrested. I understand people go through things. Everybody doesn't have a perfect life. So I get it. But... There needs to be other things that people need to be doing other than trying to go out here and overdose on fentanyl. Now, do people set out every day to go overdose on fentanyl? No. It doesn't happen. What happens is it goes from the user starting out. Maybe they'll do just one little line or maybe they'll do two little lines. And they'll have a. An event happened, they'll go to jail, something. But that tolerance that they built up, is here, right? Well, then as they're going through that event or they go to jail or whatnot, well, that tolerance starts coming back down. Starts coming back down. Well, then they said, well, wait a minute. Right before I went to jail, I could do two lines. So now I'm going to do two, two and a half lines. And so now your tolerance is low now. And so that's what happens. You do those two lines and then bam, you've given your system an overload of that. And that's where the overdose comes from. So your body's sitting there saying, your mind's telling your body, you don't have to breathe. Everything's great. Everything's great. And no, you do. And so that's... People don't realize that it's all about the tolerance too. So that's the other big thing, the other big myth. There's not a person right now that you probably know that has not been affected by use. Some know somebody that has either a overdosed B that is currently using opiates. People think that. Just because of your social economic background, your race, your upbringing, whatever, it's not going to affect you. It's not going to affect me. Wrong. I can tell you right now, I've been to some of the richest people in the world's house and their kid being over there overdosed. I've been to some of the poorest people in the world and their kids over there overdosing. This doesn't pick a race. It doesn't pick a social economic background. It just, it takes whatever it can and whoever it can. And that's what people need to realize that it's just because they had the great life and everything like that. You don't know the demons that people are fighting in their life. You don't know what everybody's going through in their life. So. Don't think that it can't happen to you and don't think that it can't happen to your friends.
Juan - 00:22:15:
What are the ways that friends and family can support someone they know who has opioid use disorder?
Sgt. Vause - 00:22:19:
Yeah. So find out from your local health department, find out, you know, different programs that they have. Find out, get some pamphlets. I know here at the Johnston County Health Department, we have pamphlets for Narcan and how to use it and signs and symptoms to recognize for overdoses and stuff. Give that to your people. Don't be afraid. Don't be ashamed. All you're doing is you're educating someone. And, you know, you never know. The life you save might either be your own or might be your friend's. So don't be afraid. Go around to different EMS stations. Ask some of the paramedics. Ask when you're at your family doctor. Ask them about that. Narcan, you can go to nearby any health department and they will give you Narcan. Don't be afraid. I got a friend of mine right now, and this is sad to say what I'm about to say. You know how most parents will tell you, make sure you have your mace with you, make sure you have your protective stuff with you, whatever. This guy, he says, make sure you have your cell phone and make sure you have your Narcan. Not because his kid's a user or anything like that, because he wants, if his kid goes to a party or something like that, he wants to make sure, A, if somebody overdoses, he can help them, or B, if his son happens to get a hold of something. They can help him. So I think that that's a big stigma. People are afraid, you know, being educated on Narcan administration because they think that, oh man, if I carry Narcan around, people are going to think I'm a heroin head or I'm going to overdose all the time or something like that. You can reach out to different types of groups, churches, whatnot. I mean, there's all kinds of people. Law enforcement, you can come talk to us. I mean, we're people too.
Juan - 00:24:03:
That was such an interesting conversation we had with Sergeant Vause. Next up, we talked to Juan Hincapie-Castillo, an assistant professor of epidemiology at the Gillings School of Global Public Health and a member of the Injury Prevention Research Center.
Intro/Outro - 00:24:17:
Yeah, sure. Thank you for having me on, Shruti. So I'm an affiliate faculty at IPRIC, or Injury Prevention Research Center. My research is really at the intersection of pharmacoepidemiology and legal epidemiology. In other words, what I do is I use real-world data to evaluate medication use and effectiveness, and also the impact of pharmaceutical laws and policies on health outcomes. My research has always focused on pain management, so my work with IPRIC really is at the intersection of preventing unintended harm to people with lived experience of pain who need access to medications. Through my research and my lab, I have conducted studies that evaluate policies and laws that seek to increase access to medications to treat opioid use disorder, OUD. So I published a study, for example, on... State laws that remove prior authorization requirements for prescribing of buprenorphine, and we saw increase in their use.
Juan - 00:25:11:
Buprenorphine is a medicine that helps people wean off of opioid use.
Intro/Outro - 00:25:15:
Another work by some students and trainees has focused on really evaluating other harms among OUD patients or people presenting and living with OUD, such as the risk for infections, which has been an understudied area. Overall, what I aim to do with my pain focus and also focus on OUD is to improve access to care and access to the medications that people living with these conditions need. There's been a lot of research, my own and that from many other researchers, in evaluating policies at the North Carolina level to improve access to. To OUD treatments, as well as evaluating the consequences of opioid restrictions. A lot of researchers in IPRIC, myself included, have been involved in setting up a research agenda to address the drug overdose crisis and understanding that. The overdose crisis is really not specific to opioids. It's really a polysubstance problem. And we're seeing even more and more contamination of the drug supply and a lot of fentanyl, illicit fentanyl.
Juan - 00:26:18:
Next, we asked about misconceptions about substance use disorders, especially related to what kind of policies could help this crisis.
Intro/Outro - 00:26:25:
So we have seen a significant decline in the prescribing of opioids. These are medications that you get prescriptions from your doctor and you fill in a pharmacy. We have seen a very significant decline of those medications in the past decade. At the same time, we have seen increasing rates of overdoses that are not stopping. I think a lot of policymakers have this misconception that the restricting prescribing and dispensing of opiates further is going to move the needle on overdoses. And we have seen that that has not been the case. On the flip side, what we have seen is very harmful effects on people living with pain who need these medications to function. These are people with severe disability, with history of failed surgeries, who do not present with the opioid use disorder. And they're taking opioids maybe at high doses, but they're able to function in their daily lives. So I think a lot of the misconceptions are that tighter restrictions are going to decrease overdoses. And we have not seen that. What we have seen is that restricting prescribing of opioids is having harmful consequences of people who actually need them. Safely managed opioids treatments are safe. I think the notion right now, the dominating narrative is that opioids are harmful. And yes, harmful, they could be harmful because they are addictive and taken in higher doses that can lead to death. So that's for sure an issue. But when they are managed appropriately, they are very, very beneficial. I think another thing that I push back is the notion that alternative to opioid. Medications that are alternative to opioids, such as NSAIDs, not steroidal anti-inflammatory drugs, such as lipoprofen, acetaminophen. I think there's this misconception that they are safer because people might find them in the pharmacy and they're able to find them without a prescription. Well, acetaminophen or Tylenol products are the number one cause of liver injury in the United States. NSAIDs, like in high doses, like ibuprofen, for example, in very high doses can lead to severe gastrointestinal bleeding. And I have interacted with people with lived experience of pain who have had their opioid treatment abruptly discontinue, have had to turn to NSAID over-the-counter prescriptions, and have had encountered some of these very adverse reactions. So I think there's also this misconception that that we have put opioids into this boogeyman category where we forget that if they're properly managed, they are actually very helpful. And that these other medications that we quote unquote safer actually could have very harmful side effects. So my work has focused a lot on advocating for people with lived experience with pain. So on another hat that I wear is president of the board of a national pain advocacy group who receives no industry funding. And our job in this national organization is to advocate at the national level for sensible policies that help these patients and these people living with pain have access to the treatments they need. So when we think about people living with pain and some of the inequities that we see, we really need to focus on the disability community. These are, again, people living with very debilitating conditions. That with proper management are able to live their lives and they're able to feed themselves, they're able to get out of bed. Through these obvious restrictions, what we have seen, and I mentioned earlier, is the unintended harm has really... Being shifted towards this community. And pain is the number one cause of disability in the United States. So under treating pain is a very big issue. And I argue it's a very. Central issue to health inequities. Because if we don't treat pain adequately, whether we use opioids or not, but we definitely have to try everything that is at our disposal. Can lead to very severe consequences on quality of life. It can have very deleterious effects on their personal lives of these people. Fentanyl right now, illicit sources of fentanyl are the number one causes of what we will call opioid-related overdoses. We have seen them penetrate the market and the street market for a while. Fentanyl is important to note that it is an approved medication and it's used almost in every surgery. So if the notion that one opioid leads to an opioid use disorder, if that's what we're going to continue saying, like we really need to push back against that because I got a surgery like less than a month ago, I received small doses of fentanyl for pain management. I was okay, my pain was managed. So fentanyl elicit once. It's not the same fentanyl that we would need for pain management or somebody, for example, with a terminal illness. Undergoing end-of-life care. That's where I think it gets tricky with the conversation of fentanyl, but we really need to separate what fentanyl are we talking about? Just as I don't like to say that we are in an opiate crisis, I feel that that's a very stigmatizing terminology for patients and people who live with pain, who need these medications. What I say is a drug overdose crisis. Fentanyl is a player in that. And when I write about my research, I talk about The main source of drug overdose deaths right now is illicit sources of fentanyl, not medically approved and used fentanyl.
Juan - 00:32:10:
Knowing his expertise on this subject, we wanted to learn Dr. Hincapie-Castillo's point of view on opioid use disorder and pain management.
Intro/Outro - 00:32:18:
Yeah, I think for opioid use disorder, I think it's important to know that there are effective treatments. One of the things or phrases that I really fight against is this idea of replacing one thing with another in relationship to, for example, let's use buprenorphine, which is an opioid. It's not a full agonist, but it's an opioid. To treat somebody with an opioid use disorder. I challenge that and I often use the example of, let's think about diabetes, somebody with very advanced diabetes, that person has to be on insulin. Can you make the argument that you are replacing insulin, one thing with another? Well, of course. And I think it's this notion that we need to treat opioid use disorder as a medical issue. It's not a moral failure. And in this country, we really need to do better at recognizing that and recognizing that there are effective treatments. Literature is overwhelming. So all the policies should aim to improve access, increase access, and make it affordable for people to take these medications.
Juan - 00:33:20:
Our next point of discussion was about what someone can do if they have a loved one struggling with opioid use.
Intro/Outro - 00:33:26:
Yeah, this is a very important topic and I think something that touches more people than we imagine. I think it's important to talk about it. I'm married to a therapist, so I always going to recommend talking to an expert and professional in therapy, seeking therapy. They are resources available for people who are struggling with this and their caregivers or like relatives. For example, the Substance Abuse and Mental Health Services Administration, or SAMHSA, has a national helpline, which is 1-800-662-HELP or 4357. They have services in English and Spanish. Also, findtreatment.org is a free available resource that connects people to care in their community. I think they're- Resources are there. I think we need to make people more aware of where to find them.
Juan - 00:34:17:
We want to thank Dr. Shauna Guthrie, Sergeant Justin Vause, and Dr. Juan Hincapie-Castillo for sharing their expertise on this topic of opioid use. With the insight they have given us on the opioid epidemic in the United States, we hope to demystify the use of Narcan to help stop overdose from occurring, and we want to encourage people to seek help if they or those they love may be struggling. Thank you for listening.
Host - 00:34:46:
Thanks for listening to The Pivot, brought to you by the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. Please subscribe wherever you get your podcasts. This show was edited and produced by Earfluence. We'll talk to you next time on The Pivot.