What insights can be gleaned by examining the historical legacy of opioids in America to understand the present opioid epidemic? 

The historical legacy of opioids in America provides a root-cause analysis to better assess the needs of the communities affected, strategize preventive and recovery measures, and ultimately prevent death. Volkow & Blanco (2020) suggest that providing historical reference to the public and to providers helps to identify the social implications behind opioid use disorder (OUD), raise awareness of the resulting devastation, and help cultivate empathy and therefore encourage treatment of this treatable disease. OUD is a preventable and treatable disease, but it is also a multifaceted sickness that remains on the rise. Volkow & Blanco (2020) also indicate that OUD is dynamic and will require a dynamic public health approach to prevention and treatment modalities. The historical perspective gives insight into how policies may be used for protection and prevention, and provides guidance to improve practice to treat OUD and substance use disorder (SUD) moving forward. 

How does America compare to global figures on substance use?

The scorecard for substance use in the United States (U.S.) doesn’t look too hot presently. According to recent literature (Gumas, 2025), America ranks number one in the world for drug overdose deaths. While other high-ranking countries have noticed decreases in deaths related to drug overdose, the U.S. did not see a decrease until recent years. The U.S. Centers for Disease Control and Prevention (About overdose prevention, 2025) reports that drug overdose claimed the lives of 105,000 people in 2023. Opioids were the culprit in 76 percent of those deaths, with fentanyl and fentanyl analogs taking the lives of 69 percent, according to the same report (2025). 

How has the Opioid epidemic impacted families? 

Regardless of the trends in family structure, the opioid epidemic carries long-term ripples across the board. Zai’s study (2024) predicts a heavy burden on caregivers of those with SUD. Another recent study by Bloomberg American Health Initiative (2019) reported that already 240,000 children have experienced the death of a parent to OUD, and 4.3million children are expected to have OUD by 2030. 

How does stigma impact the issue of treatment and recovery?  

Stigma definitely presents as a barrier. A barrier to offering treatment, and a barrier to seeking treatment for SUD. Earnshaw (2020) indicates that stigma is another social factor affecting SUD, and it’s up to mental health professionals to turn the tide through addressing the stigma within the profession and systemically through research and public advocacy. 

What does treatment involve for patients with a SUD?

Besides medication-assisted treatment (MAT) in conjunction with behavioral therapy and counseling, community engagement is key. U.S. Centers for Disease Control and Prevention (2024) report medications such as Methadone, Buprenorphine, and Naltrexone are approved treatments under medical supervision. Harm reduction strategies such as distributing Narcan in the community, education on how to administer Narcan, syringe service programs, peer support groups, providing affordable housing and job re-entry programs are already proving to be effective according to a recent study (Salisbury-Afshar et al., 2024). 

What is your takeaway from Andrew's story? 

My takeaway from Andrew’s story is that not everyone will seek help. It’s up to us, as mental health providers, to mitigate the stigma, advocate through educating ourselves and the public, and coordinate care through connecting our patients with SUD and or OUD to community resources. Andrew encourages others to never lose hope, and that is my theme…Ahni ishi bilia which translates to “always have hope.”

Themes evident in the literature seem to be connectedness. We are all connected. The content that was most useful to me was listening to Andrew tell his story, and the information provided by Dr. Young, especially her mentioning of Adverse Childhood Experiences (ACES). I intend to serve Native American people, so the interconnectedness to all life is a fundamental concept in traditional ways of healing. Providing trauma-informed care and ACES also go hand-in-hand in Native American healthcare, but specifically in providing treatment for SUD in any population of people. At this point, the opioid epidemic has impacted us all. So each of us plays a role in this collective action to heal.

References

About overdose prevention. (2025, September 18). Overdose Prevention. https://www.cdc.gov/overdose-prevention/about/index.html

Bloomberg American Health Initiative. (2019, December 19). The opioid epidemic’s toll on children. Retrieved October 14, 2025 from https://americanhealth.jhu.edu/news/opioid-epidemics-toll-children?utm_source=chatgpt.com

Dr. Young. (n.d.). Substance use disorder and addiction. https://husson.instructure.com/courses/2099794/files/180129914/download?download_frd=1

Earnshaw, V. A. (2020). Stigma and substance use disorders: A clinical, research, and advocacy agenda. American Psychologist, 75(9), 1300–1311. https://doi.org/10.1037/amp0000744

Gumas, E.D. (2025, January 9). U.S. Overdose Deaths Remain Higher Than in Other Countries — Trend-Tracking and Harm-Reduction Policies Could Help. To The Point, Commonwealth Fund. https://doi.org/10.26099/ppdk-qy10

Interview with Andrew Allen. (n.d.). https://husson.instructure.com/courses/2099794/modules/items/44085976

Salisbury-Afshar, E., Livingston, C. J., & Bluthenthal, R. N. (2024). How should harm reduction be included in care continua for patients with opioid use disorder? The AMA Journal of Ethic, 26(7), E562-571. https://doi.org/10.1001/amajethics.2024.562

U.S. Centers for Disease Control and Prevention. (2024, September 26). Overdose resource exchange: Medication-assisted treatment for opioid use disorder. Retrieved October 15, 2025 from https://www.cdc.gov/overdose-resources/files/medication-assisted-treatment-for-opioid-use-disorder.html#:~:text=What%20is%20medication%2Dassisted%20treatment,Occupational%20Safety%20and%20Health%20logos

Volkow, N. D., & Blanco, C. (2020). The changing opioid crisis: development, challenges, and opportunities. Molecular Psychiatry, 26(1), 218–233. https://doi.org/10.1038/s41380-020-0661-4

Zai, X. (2024). Beyond the brink: Unraveling the opioid crisis and its profound impacts. Economics & Human Biology, 53, 101379. https://doi.org/10.1016/j.ehb.2024.101379