Physician: We have contributed in varying degrees to opioid crisis

I am a physician trained in the mid-1990s. Part of my training included messaging that people with “real pain” cannot get addicted to pain medication. In the past 10 years, I have learned the truth about prescribing opioids. We physicians along with our dental colleagues have contributed in varying degrees to our current opioid crisis.

We have prescribed too many opioids, often in inappropriately large quantities. Our prescriptions became a gateway for addiction. Our culpability in this issue has been marinating in my consciousness for a while. With the help of Sam Quinones, a brilliant journalist and author of “The Least of Us,” it has come to the forefront.

In an effort to learn more and perhaps figure out how I could help be a part of the solution, I attended the first annual All Hands Whatcom Opioid Summit on June 27–28. This free event, organized by the Chuckanut Health Foundation and Whatcom County Health and Community Services, was co-sponsored by many local businesses. It was well attended by all sectors of our county including many local leaders.

At this event, parents shared vulnerable stories of what it was like to learn of their son’s death from a drug overdose. They narrated frustrations felt in the years leading up to their child’s death, trying to navigate our complex siloed systems. Already difficult circumstances were made nearly impossible when a child had a dual diagnosis of mental illness in addition to substance use disorder. Families urged us to “see these vulnerable humans as us,” and “work together to fix our broken siloed systems.”

Medical experts in our community gave us the facts. Drug Enforcement Administration and Centers for Disease Control and Prevention data show half the tested counterfeit oxycodone pills have lethal doses of fentanyl in them, 65% of youth overdoses had no prior opioid use and two-thirds of the time a bystander is present at youth overdoses. Narcan is available to everyone in the community and is lifesaving for opioid overdoses. A new website, whatcomoverdoseprevention.org, went live during the week of the summit and provides fantastic resources.

Members of the community shared challenges at the interface with people addicted to opioids. Professionals, including police, EMS and emergency department physicians, interacting with those there under involuntary conditions, talked about finding a balance between harm reduction and enabling law enforcement to keep the public safe from drug-related crime and provide both leverage and a respite from drugs.

An emergency physician shared the reality of drug dealers in Bellingham offering free drugs to children in middle and high school to create addiction. Physicians at SeaMar emphasized the importance of having relationships with individuals in homeless camps to help, for example, bring a pregnant mom using methamphetamine into the medical system to provide wrap-around prenatal care in an effort to serve both mother and child.

Members of the Lummi and Nooksack nations had an opioid summit this spring, providing a message of “radical welcome.” Ideas from their summit helped inform this one.

Tribe members, including talented artist Jason LaClair, shared stories of addiction and recovery, providing hope. An addiction medicine physician described the recent launch of a pilot program offering a temporary seven-bed stabilization and withdrawal recovery center for Lummi members early in recovery. These communities have models of care from which to learn.

Young people in the community provided wisdom beyond their years. They emphasized to us the importance of both providing third space options (first space, home; second, often school) and having one trusted adult mentor present in their lives.

Participants gathered for a round table following panel discussions. Lively conversations led by organizers generated ideas. Community Contribution Boards were set up to capture important themes. Wisdom from the summit will be shared with community leaders, policymakers and elected officials. 

More than 300 people attended this two-day event to listen, learn and exchange ideas. This remarkable forum reminded me why Bellingham is so special. After living many other places, I know this is a place where people care deeply about one another, and are willing to show up, listen, learn and figure things out.

My takeaways are that the current systems are not human-centered, and the silos and gaps in wrap-around care make the difference between recovery or death: the opportunity to contribute to society or a path toward incarceration and homelessness — and ultimately, whether we have a healthy and thriving community, or one in which far too many people are falling through the cracks. It’s clear that it’s time to reimagine how we all work together — law enforcement, treatment providers, policymakers, physicians, teachers, parents and community members.

An evening with Sam Quinones on Tuesday, Aug. 1 offers another opportunity, free of charge, to continue these conversations in community. I hope you’ll join us in this movement and opportunity to rebuild community for the least of us, and all of us together.

Nancy McAllister is a practicing pediatric oncologist. She has been a Bellingham resident for the past five years. She serves as a board member of the Chuckanut Health Foundation.