A Human Rights View on the Opioid Epidemic Strangling Our Nation
Ten years ago, my cousin and best friend, Justin, died from an opioid overdose. Before his wife found him cold and unresponsive in the early morning of that fateful August day, he had taken several prescription opioids (the toxicology report showed oxycodone) and had been heavily drinking the night before. Substance abuse had become a staple of Justin’s life — used to mask the pain and trauma from earlier childhood experiences.
At the time we didn’t realize that Justin’s death came in the midst of a growing national epidemic that in 2016 claimed the lives of more than 42,000 Americans. More than 17,000 of those overdose deaths were directly caused by commonly prescribed opioids. In that same year, 11.5 million Americans had misused prescription opioids and 116 people died EVERY SINGLE DAY from an opioid overdose.
In real terms this means that 116 American families, like mine, woke up on a given day in 2016 to receive a call that no one ever wants to get. It means that 232 mothers and fathers were told EVERY SINGLE DAY that their sons or daughters were no longer in this world. It means that countless Americans never got the chance to say “I love you” one last time or to tell their loved one how much they meant to them. It means that 116 people will never get the chance to realize their full potential, to achieve their dreams, and to contribute to our country in ways that we will never know. We don’t know the extent of what we’ve lost these past two decades. And for this, we should all weep as one American family.
Yet, for all we’ve lost, we are still struggling to adequately respond to this national tragedy. One reason we are failing, I believe, is because we don’t fully understand the genesis of people’s addiction, which often times begins in childhood. To understand why Justin died of an oxycodone overdose, you have to understand Justin’s life.
I first met my cousin when we were little boys. Justin and his brother were living with our grandmother and uncle. At the time, Justin’s father was serving a lengthy prison sentence and his mother suffered from severe schizophrenia. Several years later, during our first year in middle school, Justin’s mother was killed by a hit-and-run driver. A few months later our grandmother died due to her alcoholism. With his father still in prison, Justin and his brother were facing the prospect of placement into the foster care system when my parents decided to move them from Long Beach, California to Las Vegas to live with us.
As Justin and I grew into adolescence the impact of these early childhood traumas began to manifest in Justin’s life. He began smoking, drinking, and experimenting with drugs which later became life-long addictions for him. He did poorly in school, was frequently truant, and ran away from our home on occasion. He dropped out of school after the 11th grade when he moved to live with his father in Texas who was then out of prison.
A few years later Justin returned to Las Vegas where I saw his addiction up close and personal, but he always assured me that “he knew what he was doing.” By all appearances it seemed like he did know. He maintained a steady job, was in a committed relationship, and we always had fun together. But appearances can be deceiving; Justin’s addiction had begun to spiral out of control. In the following years I received calls from his wife asking for help and telling me about how bad his addiction had become. Those calls were followed up by texts from Justin describing how desperate he was becoming and how “very lost” he felt. During one of the last calls I remember having with him, he confided in me that the uncle he lived with at our grandmother’s house had physically and sexually abused him for years. I listened to him and cried with him. He died on August 24, 2008.
The reality is that Justin’s addiction and eventual death were set in motion years earlier stemming from adverse childhood experiences. The impact of childhood abuse and neglect on adult health and social development has been broadly studied, culminating in a large epidemiological study, the Adverse Childhood Experiences (ACE) Study. Justin had experienced every negative category of harm connected to a person’s ACE Score: physical, sexual, & emotional abuse; physical & emotional neglect; family violence & parental separation; and household substance abuse, mental illness, and incarceration. Given Justin’s lived experiences and society’s failure to adequately address them, his negative life outcomes were the most likely eventuality.
He is far from alone. In the original study, a male child with an ACE Score of 6 had a 4,600% increase in the likelihood of becoming an injection drug user later in life. Subsequent studies have found that each ACE increases the likelihood of early drug use 2- to 4-fold and individuals with an ACE Score higher than 5 were 7 to 10 times more likely to be addicted to illicit drugs. These studies estimate that 50 to 66% of serious problems with drug use are attributable to ACEs. The subsequent impact of ACEs later in life is a human rights abuse issue — where it metastasizes from the child, to the immediate family and multiple generations, community and society at large. In other words, the suffering and human rights abuses that people like Justin experience as a child, have an enduring impact leading inextricably to drug addiction, and in the case of my cousin, to early death.
If we are serious about ending the opioid epidemic gripping our nation then we must get serious about alleviating the suffering our children experience. It is their suffering that overwhelming leads to drug addiction later in life as an attempt at masking the pain we as a society have failed to prevent or adequately address. While it may seem daunting, we can draw from the lessons of those who have overcome their addictions to prevent the spread of this epidemic any further. The first step is always the hardest. In our case, it is admitting we have a problem nationally: our children suffer from a significant amount of early childhood abuse and trauma and we have yet to meaningfully respond to it. Until we do, another child like Justin will continue to die from their opioid addiction. Another family will grieve the loss of their child. And we will be deprived once again of the not-yet-realized contributions of another American.