Netflix shows like Narcos, Breaking Bad, and Ozark have caused internet frenzy over the years, and for good reason. What do all these shows have in common? The illegal drug industry.
Although they do an excellent job at depicting the illegal drug trade (with killer casts, I might add), they have glamorized the true extent of the overdose epidemic in the United States. The series, Painkiller (2023), brought a new perspective on addiction and its relationship to the pharmaceutical industry. The misuse and abuse of prescription narcotics is a leading cause of mortality throughout the country.
But what is the extent of the opioid epidemic here in Connecticut? There were 1,452 deaths related to drug overdoses throughout the state in 2023, with a total of 10,562 deaths between 2017 and 2023.
The primary cause of fatal overdoses? Synthetic opioids.
In December of 2023, 84.5% of drug overdoses in Connecticut were related to fentanyl. According to the DEA, six out of ten fake prescription pills are laced with a lethal dose of fentanyl. Recently, xylazine, a tranquilizer used in veterinary medicine, has been attributed to fatal drug overdoses when consumed, or injected, in combination with fentanyl prepared in illicit drugs. Since xylazine is not an opioid, naloxone (Narcan) is unable to reverse its effects, leading to deadly outcomes.
Chronic pain is a debilitating condition that plagues millions of Americans. Health care providers can treat patients with a variety of different pain management modalities, including narcotics such as oxycodone and morphine. These drugs are highly addictive and have a heightened risk for abuse. The series Painkiller portrays the lives of Americans living with chronic pain who are prescribed oxycodone and become addicted. As heart wrenching as some of the episodes are, these are true stories of normal people affected by addiction daily — all because of one little pill.
You may be thinking, why can’t we just stop prescribing opioids completely? Well, it’s not that simple. Opioid analgesics are highly beneficial in the treatment of chronic pain when taken as prescribed. Withdrawal symptoms are awful enough for someone to jump through hoops just to get another fix, including the purchase of street drugs. As a nurse, I’ve witnessed the gruesome effects of detox firsthand and let me tell you, it is not a pleasant experience for anyone. Aside from the constant nausea, vomiting, and irritability, I’ve had patients even tell me that they want to die from the excruciating muscle aches and pain. This reason alone is why it is so hard for many people to get clean.
Management of opioid use disorder (OUD) is a key step in the prevention of illegal drug use and avoidable overdoses. Medication assisted treatment, or MAT, is an effective method for decreasing the likelihood of relapse among addiction patients. MAT includes a combination of medication, counseling, and therapy to assist clients in reaching their goals. Buprenorphine, naltrexone, and methadone are effective medications used in the treatment of OUD and reducing withdrawal symptoms. This treatment plan is a long-term commitment, requiring oversight by a dedicated health care provider.
Even after the initiation of the Comprehensive Addiction and Recovery Act (CARA) in 2016, the number of overdose-related deaths has continued to rise. The legislation authorizes $181 million annually towards grants for education and prevention efforts, as well as expanded availability of naloxone, the opioid reversal agent. Although CARA is a step in the right direction for combating the opioid epidemic, there is a lack of urgency for change and preventative care. There is an increased need for primary care providers to supply accessible care, especially in rural communities with higher prevalence of opioid use disorder.
The Consolidated Appropriations Act (2023) now allows practitioners with DEA registration and Schedule III authority to prescribe buprenorphine, without the application for a prescription waiver. Although this policy change is a step in the right direction toward adequately addressing the opioid epidemic in Connecticut, there is still more to be done.
Nurse practitioners have the unique opportunity to participate in harm reduction through prevention, education, and treatment in underserved areas. MAT is not a quick fix — it is a lengthy process that includes frequent follow-up and external resources. Many people choose to reject treatment due to the stigmatization of addiction. APRNs work directly with clients to provide holistic, patient-centered care without judgment, encouraging commitment to the treatment plan, while offering effective education. State funding on education is critical in the prevention of drug overdose, especially among younger populations.
So the next time you’re binge watching that new Netflix docuseries, consider ways in which you can educate yourself and others on drug safety and prevention. Together, we can help to reduce the stigma around addiction and inch closer toward putting an end to the opioid epidemic.
Brittany Sendzik is a critical care nurse in Bridgeport and a master’s student in the Adult Gerontology Acute Care Nurse Practitioner (AGACNP) program at the University of Connecticut.