February 22, 2021 - Podcast

Episode 94—Opioid policies, and activists

In response to the increase in opioid overdose deaths in the United States, many states have implemented supply-controlling and harm-reduction policy measures aimed at reducing those deaths. But a recent study from Indiana University found the policies may have the unintended consequence of motivating those with opioid use disorders to switch to alternative illicit substances, leading to higher overdose mortality. The study, led by IU Professor Byungkyu Lee, suggests that the so-called opioid paradox — the rise of opioid-related deaths despite declines in opioid prescriptions — may arise from the success, not the failure, of state interventions to control opioid prescriptions. Researchers looked at drug overdose mortality data from 50 states and claims data from 23 million commercially insured patients in the U.S. between 2007 and 2018. They then evaluated indicators of prescription opioid abuse, opioid use disorder and overdose diagnosis, and the prescription of medications-assisted treatment and drug overdose deaths before and after implementation of six state-level policies targeting the opioid epidemic. They found that supply-controlling policies were associated with a lower proportion of patients who take opioids, have overlapping claims, receive higher opioid doses and visit multiple providers and pharmacies. They also found that harm-reduction policies were associated with modest increases in the proportion of patients with overdose and opioid use disorder. The proportion of patients receiving medications-assisted treatment drugs also increased following implementation of supply-controlling policies. In terms of overdose mortality, the study found that all overdose deaths increased following the implementation of naloxone access laws, especially deaths attributable to heroin, synthetic opioids and cocaine. The IU researchers say to resolve the opioid paradox, policies must be designed to address the fundamental causes of overdose deaths, such as lack of economic opportunity or persistent physical and mental pain, and designed to enhance treatment for drug dependence and overdose rather than focusing on opioids as the cause of harm.

In other news, as Black Lives Matter protests spread during 2020, IU Professor Dé Bryant knew one thing was coming: burnout. Bryant says although burnout happens in the activist world, no one talks about it. A longtime social justice advocate herself, Bryant is a teacher and founder of the Social Action Project, a nonprofit organization focused on building social justice in neighborhoods in the U.S. and Africa. She says living while African American in a country that attacks one’s personhood can be a relentless burden. Among activists who face off against systemic racism, the emotional and physical drain can become crippling. To help racial justice activists find ways to sustain themselves and their work, Bryant worked with the Black Lives Matter organization in South Bend, Indiana, to launch an Arts and Justice project. The project centered around a series of podcast episodes, each of which focused on an aspect of psychological development under threat as activists work on justice issues, such as identity, power, belonging, and loss. Participants created artistic responses to the episode topics and shared them with online. Bryant says the art encouraged expression and allowed everyone to delve more deeply. Building on the success of the first Arts and Justice series, which attracted hundreds of people, Bryant is now planning a new series that will run in spring 2021. With the inauguration of President Joseph Biden, Bryant wants to focus on new realities, especially healing and progress. She also hopes to use findings and stories from the Arts and Justice series to build out a website that will serve as a robust resource for visitors seeking to process trauma and pursue mental wellbeing.