Name: Rebecca Wyant
From: Galveston, TX
Stigma, Criminalization, and Lobbying
The United Sates is currently dealing with an unprecedented addiction crisis in the United States due to the stigma surrounding drug addiction and recovery within medicine, the criminalization of drug addiction, and the strength of the pharmaceutical lobby. I believe there are few medical students that can speak with the understanding that I have regrading the stigma of drug addiction within medicine. I have lost a husband, a best friend, and a grandmother to addiction and am a first-year medical student in an MD program.
The stigma is pervasive even within the mental health field. While working with recovering drug addicts, I have heard trained psychologists tell patients with almost a decade of sobriety that if they relapse, they could no longer see them. I have seen them dehumanized to the level of an animal, as a psychologist uses a snake metaphor to describe her feelings of trusting an addict. It breaks my heart when I hear uneducated mental health professionals describe 12-step programs as “useless,” or a “cult” clearly having absolutely no knowledge of the current research on the efficacy of mutual self-help groups, including those based on 12-step principles. Those groups have saved many lives of the those in addiction recovery when no medical professional could or would help them. As my marriage fell apart it was Al-Anon that helped me pick up the pieces of my life and move on. In contrast, while at the emergency room for my husband, I was scolded by the nurse for not doing enough for him.
Despite this, 12-step mutual self-help groups are frequently and egregiously discredited by health professional. They do not know it is many addicts’ and alcoholics’ last hope for compassion and help. How can we expect addicts and alcoholics to get better if health professionals do not have a desire to provide them with quality care due to bias, refuse to educate ourselves on the treatment options and their efficacy, and openly discourage and discredit mutual self-help groups due to ignorance?
My ex-husband relapsed after five years of us being together. He had one semester left in a top finance degree program. We lose so many contributing members of society to addiction everyday. It cost me not only my marriage, but the violence brought with his relapse cost me my safety, security, and sanity. It cost me sleepless nights of worrying about him finding me as I attempted to flee the marriage. It cost him his future.
When I think about the consequences of addiction, two loved ones that have died due to addiction – a significant loss for our communities – comes to mind. One is a dear friend that died in detox following a heroin relapse. The flowers his mother sent him for Valentine’s Day – the day that he died – arrived that morning.
In March of 2020 my best friend from my childhood committed suicide following an IV heroin addiction that began at 14. She was a 28-year-old widow with Hepatitis C and a felony record. The felony record prevented her from achieving quality employment– which directly prevented her from receiving quality mental healthcare and physical healthcare for her chronic condition. The last time I saw her she was in the hospital for cellulitis of a “cat scratch” which was very clearly an injection infection.
The criminalization of her drug addiction directly affected her ability to get sober and the dignity of receiving quality care for her drug addiction and Hepatitis C. Can you imagine choosing between suicide or a chronic condition that you cannot treat because you are a felon due to a severe mental illness? This does not even begin to consider the bias she must have faced as Hepatitis C positive, IV heroin user in the healthcare setting.
My grandmothers struggle with addiction exemplifies the issue with how we treat chronic pain in the United States. She was diagnosed with Ankylosing Spondylitis shortly after my grandfather, her husband, committed suicide leaving her with three children. The lack of a biopsychosocial and holistic approach to pain management led my grandmother into a decades long opioid addiction. Her ankylosing spondylitis combined with opioids that caused her to “nod out” in her chair, made her neck fuse completely to one side over the years. This was a complete failure of chronic pain care.
As the pharmaceutical lobby continues to top the list for lobbying spending, we see the flooding of opioids within the community followed by criminal charges against these companies for illegal business tactics specifically aimed at exploiting the suffering of the American people, like my grandmother. The access to opioids versus mental healthcare, Buprenorphine, Suboxone, or Naloxone is unconscionable.
In an effort to help increase access to opioid treatment, I created a prescriber survey for the Buprenorphine Medication Addiction Treatment (MAT) Waiver Training project as a member of Doctors for Change in conjunction with Houston Health Department, Baylor College of Medicine, and Harris County Public Health. The project aims to assess prescriber attitudes regarding Buprenorphine MAT Waiver Training and create a plan to increase training to reduce opioid deaths. This project is funded by The Center for Disease Control, Health and Human Services, and Substance Abuse and Mental Health Services Administration (2.07 million USD). Furthermore, I am spearheading a project to survey the opinions and beliefs of healthcare providers regarding drug addiction and its treatment. I hope to use this data to develop a plan of action and create effective messaging to reduce bias and educate health professionals on drug addiction and its treatment.
I believe educating our health professionals on their bias, decriminalizing drug addiction, and changing campaign finance laws to reduce the power of the pharmaceutical lobby on legislation are key to helping combat the current addiction crisis the United States is facing. As I continue to push for these things within my own community, I hope to expand my sphere of influence to a state and then national level in hopes of accomplishing this goal.