It is hard to believe that we are at the one-year anniversary of the emergence of a health issue that has consumed so many of our lives, and sadly, taken some. It was a little over a year ago that we first started hearing of Covid-19, and in mid-March 2020, businesses, schools, churches, workplaces, etc., shut down. Many are still not performing their pre-pandemic activities. Recently, in my circle of friends, the discussions have centered on ‘do you have a vaccine appointment yet?’ or ‘what shots have you had?,’ or did you have any reactions to them?’ Although these thoughts and questions have been at the forefront of our being, there is another medical crisis that has not been at the forefront of public discussion in the past year, and that is the Opioid Epidemic.
As a Registered Nurse, I have taken care of many patients and families who have fallen victim to opioid drugs. Each death I witnessed, after all extraordinary measures were taken, is a true tragedy. Everyone is a victim, the patient, the family and friends, and society at large. We can only think of the possibilities of what these mostly young individuals could have chosen, worked for, and succeeded in career and life.
Which brings us to this month’s resolution.
Resolution CO37: Call to Respond to Opioid Epidemic
Resolved, That the 79th General Convention call all dioceses and parishes in The Episcopal Church to respond to the opioid epidemic with training, pastoral care, advocacy and liturgy; and be it further
Resolved, That dioceses and parishes be urged to: partner with First Responders and others in the medical community to host trainings on how to administer naloxone in the event of an overdose; partner with other faith communities and recovery programs in their local contexts to offer pastoral care to those affected by this epidemic; partner with other faith leaders to advocate with local and state government regarding policies and laws to promote healing and wholeness for those affected by this epidemic; and be it further
Resolved, That the 79th General Convention direct the Office of Government Relations of The Episcopal Church to advocate for the federal government of the United States to address this as a public health crisis, affirming that opioid use disorder is a disease, which needs adequate resources for treatment options; and be it further
Resolved, That the 79th General Convention direct the Standing Commission on Liturgy and Music to develop additional liturgical resources to address the needs and concerns of those whose lives have been profoundly affected by this epidemic; and be it further
Resolved, That the 79th General Convention concurrently acknowledge the purpose and value of prescription opioid medications in appropriately treating chronic, intractable, pain; or acute pain resulting from curable, short-term medical conditions; and affirm the work of the medical community to create established medical guidelines supporting people living with pain; and call all dioceses and parishes in the Episcopal Church to partner with the medical community and health nonprofit organizations to understand the realities, risks, and barriers to access to care and effective treatments and cures for people living with chronic conditions and otherwise untreated or undertreated pain; and be it further
Resolved, That the Church recognize that issues of substance use disorders, access to diagnosis and effective treatment, and lack of appropriate treatment for untreated or undertreated pain affect all communities, but especially those marginalized in poverty, racial, gender, and ethnic discrimination, persons with disabilities, and other minority communities; and be it further
Resolved, That congregations be urged to include in the Prayers of the People intercessions for patients, families and communities affected by substance use disorders and also by untreated and undertreated pain and chronic diseases; and be it further
Resolved, That the 79th General Convention to authorize the Presiding Officers to create a task force to assist in the curation and creation of resources for education, prevention, pastoral care, recovery, advocacy, and partnering with community organizations to be used by dioceses and parishes for the purpose of responding to the opioid epidemic and substance use disorders; and be it further
Resolved, that the General Convention request the Joint Standing Committee on Program, Budget and Finance to consider a budget allocation of $30,000 for the implementation of this resolution; and be it further
Resolved, That the membership of this task force will be appointed by the Presiding Officers and consist of no fewer than 8 nor more than 14 members; and that the task force be made up of bishops, priests, deacons, and laity; and be it further
Resolved, That the task force will complete this work within two years.
The estimates for the human cost to this epidemic are high. According to the US Department of Health and Human Services (HHS), over 176,000 Americans have died from drug overdoses since 1999. Two of every three deaths have involved an opioid. The national rate of opioid related hospitalizations, in 2016, was 297 per 100,000 population. In 2019, an estimated 10.0 million people aged 12 or older, misused opioids. Specifically, 9.7 million people misused prescription pain relievers, and 745,000 used heroin. These are staggering numbers. And this does not include the financial cost to individuals, families and society.
Individuals who misuse prescription opioids are not inherently bad, and did not start out with the intent to misuse the drugs. Often, the misuse begins with treatment for an acute pain condition. Before they know it, they are hooked. Historically, physicians were not as educated as they are now, in the topic of pain relief. Many looked to their pharmaceutical representatives to educate them on the efficacy, and safety, of new and improved pain relievers. According to HHS, in the late 1990’s, pharmaceutical companies reassured the medical community that patients would not become addicted to opioid pain relievers, and healthcare providers began to prescribe them at greater rates. Physicians believed they were safe, and would not lead to addiction, when used for pain. However, increased prescription of opioid medications led to widespread misuse of both prescription and non-prescription opioids before it became clear that these medications could indeed become highly addictive. But all is not doom and gloom. According to the National Survey on Drug Use and Health, the majority of people who take prescription pain relievers (87.2%), do NOT misuse them.
Since the declaration, in 2017, by HHS, that the opioid epidemic is a public health emergency, there has been more awareness among the public of this problem. There has been a sharp decline in the prescribing of opioids for both acute and chronic pain, with mixed results. Some chronic pain patients felt they were being punished when they were told to decrease the frequency of taking their medications, while others were encouraged to try adjuvant therapies such as massage, exercise, yoga and the use of TENS (transcutaneous electrical nerve stimulation) machines, which will assist in decreasing pain. In addition, the use of Naloxone for overdoses in the community is increasing, with more non-healthcare providers trained in the use of its administration. One area that is still lacking, though, is an adequate number of beds for inpatient substance abuse treatment. This is a definite area for improvement.
In some areas, there are specialized drug courts, where instead of sending an addict to jail, the judicial authorities, as well as mental health, social service and addiction treatment professionals, work together with the individual to determine the best course of treatment, often keeping the person employed. These are problem solving courts that take a public health approach, instead of a punitive one. Currently, the drug court in Macomb County has 50 participants.
This problem will not just go away, but with increased attention, and creative problem solving, we may put a huge dent in the numbers of overdose deaths.
Let us pray: Oh blessed Lord, you ministered to all who came to you. Look with compassion upon all who through addiction have lost their health. Restore them to the assurance of your unfailing mercy, remove them from the fears that have beset them, strengthen them in the work of their recovery, and to those who care for them, give patient understanding and persevering love. Amen.
The Book of Common Prayer, p. 831.
Submitted by: Shirley Lappi,, Resolution Review Committee, Diocesan Council