For the past two decades, the nation’s opioid epidemic has devasted the Appalachian region. As painkillers like Vicodin and OxyContin were overprescribed, these addictive drugs became readily available to this population.
Appalachia spans 420 counties in 13 states, and 29 of these counties are in North Carolina. This region’s economy largely relies on coal mining, tobacco and logging. However, as these industries decline, poverty plagues the region.
With many in this region working jobs that require manual labor, injuries are common in the workplace. As doctors prescribe painkillers, it creates the perfect storm by exposing this vulnerable population to opioids.
“Very stressful environments, with a paucity of alternative reinforcers, also increase the vulnerability to seek out drugs as a means to activate the reward circuitry,” said Dr. Nora Volkow of the National Institutes of Health in an interview with Dr. Johannes Czernin. “Repeated exposure [to drugs] can ultimately lead to addiction.”
The reward circuitry is affected by stimuli like food and phone screen time because of the good feeling they produce in the brain. Drugs also affect this system and create a sense of euphoria. And, taking drugs starts making previously rewarding stimuli feel less rewarding, leading to drug addiction.
Addiction is a hard habit to break, which is why targeting the root of the problem may be the solution. Data from 2019 show that for the first time in five years the overdose mortality rate in North Carolina dropped by 5 percent, and it is no coincidence.
The “NC Opioid Action Plan” emphasizes prevention, harm reduction and connection to care. These pillars have been implemented by cutting opioid prescriptions by 24 percent and by increasing the availability of the lifesaving medication called Narcan across the state.
Cutting the supply of opioids means fewer pills in the medicine cabinet. Having fewer pills decreases the chance of addiction because of less drug exposure on the reward system in the brain. It also decreases the number of pills illegally distributed in communities.
Mortality rates have also declined because of the nasal spray Narcan. When administered following an overdose, the life-saving medication quickly reverses the negative effect produced by the harmful drug. With these measures in place, overdose-related emergency room visits also decreased by 10 percent last year.
With a fifth of the Wake Forest student body from North Carolina, these measures help alleviate a problem many on this campus are affected by directly or indirectly.
“This is a problem people are working on,” said Dr. Katy Lack, associate professor of biology at Wake Forest. “Just decreasing the number of pills in a prescription is a measure taken that is doing something, and I know there is lots of research going on looking at alternatives to opioids for pain.”
Word Count: 456
Reporting Index:
- Dr. Katy Lack, associate professor of biology at Wake Forest University
- “A Conversation Between Nora Volkow and Johannes Czernin”
- Wake Forest University Fact Book – Undergraduate Geographical Distribution by Region & State, Fall 2013-2018
- https://www.ncdhhs.gov/about/department-initiatives/opioid-epidemic/north-carolinas-opioid-action-plan
- https://www.morepowerfulnc.org
- https://ncdoj.gov/responding-to-crime/opioid-epidemic/
- https://www.drugabuse.gov/related-topics/opioid-overdose-reversal-naloxone-narcan-evzio
- https://www.ncdhhs.gov/news/press-releases/nc-opioid-overdose-deaths-drop-first-time-5-years
- http://apps.webofknowledge.com/full_record.do?product=BIOABS&search_mode=GeneralSearch&qid=2&SID=7D1pqPCVypo1avJQUAS&page=1&doc=4
Lauren Berryman 