America's opioid epidemic is not going away. It is affecting men, women, children and even new-born babies and the health of the next generation of Americans. Its demographic is non-Hispanic white Americans, Native Americans and the working class, and it is shortening life expectancy for the first time in a century. As Nicholas Eberstadt wrote back in 2017:
"the opioid epidemic of pain pills and heroin that has been ravaging and shortening lives from coast to coast is a new plague for our new century."
Opioid overdoses claimed more than 64,000 lives in America in 2017, more than guns or car accidents. New research from RAND Corporation finds that synthetic opioids are of increasing concern, with deaths increasing from roughly 3,000 in 2013 to more than 30,000 in 2018, two-thirds of all opioid deaths. This rise is fuelled in large part by the drug fentanyl, a synthetic opioid painkiller that is 50 to 100 times more potent than morphine and 30 to 50 times more potent than heroin.
RAND's report implores policymakers to seriously consider new approaches to responding to the current crisis in parts of the country where synthetic opioid use has become entrenched, such as the Northeast, Midwest, and Appalachia, and do everything they can to prevent their use becoming entrenched elsewhere. Its suggestions include creatively disrupting online transactions, supervised consumption sites, and novel evidence-informed treatment modalities, such as heroin-assisted treatment.
The epidemic has been accompanied by an exodus out of the workforce. In 2017, for every unemployed American man between 25 and 55 years of age, there were another three who were neither working nor looking for work. In what esteem do such men hold the value of their lives? Why do so many Americans feel they need to take an opioid in the first place?
Many blame pharmaceutical companies for getting people hooked. Purdue Pharma, the company whose signature opioid, OxyContin, is seen as an early driver of the epidemic is currently facing a court battle in an attempt to make it take some responsibility for the havoc its product has caused to thousands of lives.
What is most heart-breaking is that the opioid epidemic is not just affecting American adults, but the future generation too. A baby suffering from opioid withdrawal is born every 15 minutes. Recent analysis showed that an estimated 32,000 babies were born with this syndrome in 2014, a more than 5-fold increase since 2004. I imagine the numbers have increased further since that time as adult dependency continued to climb.
Many of these new-born babies endure the pain of intense drug withdrawal symptoms in their first hours and days of life, including high-pitched crying, tremors, seizures, sweating and fever. They are also more likely to be diagnosed with learning disabilities and developmental delays in later life. Opioid exposure is devastating to these babies' lives, and it is costly for the health system and costly for society.
In response to the epidemic, many hospitals have introduced volunteer programs which train people to serve as "baby cuddlers" for babies experiencing painful withdrawal symptoms. The volunteers provide human connection, touch, comfort and attachment when the baby's own parents are absent and hospital staff are busy. In some cases volunteers also provide an additional source of emotional support to the babies' mothers.
Vicki Agnitsch, a former nurse who is now part of the 22-person Cuddler Volunteer program at Blank Children's Hospital in Iowa, told ati that cuddling and physical touch has a direct correlation to fewer required and administered medications. The human connection provided through these programs literally supports the immune systems of these babies:
"When they know someone else is touching them, it gives them that warmth and safety and security that they crave. They had that inside the mom, and then they come out into this cold, bright world. They don't have that, so all of that swaddling, touch, and talk helps their development."
If you are interested in becoming a 'baby cuddler', hospitals across the world are increasingly starting similar programs. While a small measure in the face of a large and complex crisis, it is life-changing for the babies involved and a future generation of Americans.