The opioid epidemic rages on precisely because we're focusing on the wrong things: genetics, the addictive power of the substance itself, and whether something is prescription or illicit. While those are important, they're not the central issue. We are missing the target completely.
The Adverse Childhood Experience study by the CDC and Kaiser, clearly links people's emotional experiences as children to their mental and physical health as adults - even 50 years later, including addiction. For example, results revealed those with adverse childhood experiences are 4,600% more likely to inject intravenous drugs compared to those without. This is one of the strongest relationships in medicine. If we continue to ignore the ACE study, we will not solve the opioid epidemic. What's driving people's addiction is pain. We live in a country of pain, but not only physical pain - emotional pain. The ACE study reveals 87% of Americans have had more than one ACE event. Until we as psychiatric pharmacists take emotional health and mental health - people's life experience drives disease - as seriously as their blood pressure, cholesterol, and monitoring parameters, we will miss the bullseye. For example, a Harvard study with 75 years follow-up found that loneliness was the biggest predictor of quality of life, physical health and longevity. Another study from Brigham Young University Utah revealed that while obesity increases the risk of death by 30%, loneliness does so by 50%. There's also a meta-analysis showing loneliness increases all-cause mortality by 45%. University of Maryland study found for fibrosis of the heart, smoking and loneliness were independent yet equal risk factors. As psychiatric pharmacists, we must try to think more from an integrative, behavioral medicine perspective of mind and body.