LAUSR

The opioid epidemic has been called “not just an elephant [but] a herd of elephants, which touches on race, economics, health, politics, crime and stigma” (Hoffman, 2022, p. 15). This complex epidemic in the United States is not new, but overdose deaths are rising. According to Macy (2022), there were 108,000 overdose deaths during 2021. Volkow noted in a 2014 presentation to Congress that this country was the biggest consumer of prescriptions for opioids in the world. As the American public became aware of the potential for inadvertent addiction to these drugs (zealously marketed to doctors by pharmaceutical companies), these prescriptions became harder to obtain. Therefore, many dependent individuals turned to heroin and fentanyl, obtained from dealers not doctors, with a disastrous increase in overdose deaths. Then came COVID-19, which isolated vulnerable individuals, keeping them from their families, treatment, and support groups such as Narcotics Anonymous. I live in a part of America (Appalachia) that has been truly ravaged by the opioid epidemic, as depicted in Macy’s (2018) book, Dopesick: Dealers, Doctors and the Drug Company. I have doctoral students who have done their dissertations on various aspects of the epidemic. For example, Lingerfelt (2022) investigated acute drug withdrawal of pregnant women incarcerated in rural county jails, and Todt (2020) elicited Appalachian nurses’ stories of caring for patients with infective endocarditis that resulted from their use of intravenous drugs. And among my personal social circle, I know parents who lost a child due to fentanyl overdose and friends who are raising the children of their family members who lost custody because of substance use disorder. The epidemic is all around me. Despite the enormity of this problem, I do find some reasons for hope. I share them with you: