Introduction
Opioid abuse is a severe problem in Worcester, Massachusetts. According to available statistics, the city has the highest percentage of drug use in the entire state (Tehan, 2023). The most common cause of opioid addiction in Worcester is the inappropriate use of prescription drugs. Lack of proper monitoring of prescription drugs is leading to rising rates of overdose-related deaths. It demonstrates a serious public health problem in Massachusetts and Worcester. Therefore, this paper seeks to compare critical indicators of opioid abuse in the state and city and identify the root causes of the problem and opportunities to solve it.
The Issue
In Massachusetts, the problem of opioid abuse, particularly heroin, is particularly acute. While nationally, about 1% of people report using heroin at least once in their lifetime, in Worcester, about 5% of residents answered yes to this question (Trainor, 2021). Researchers have named different factors as the main reasons for such a statistic. However, the most common cause is inappropriate opioid prescribing practices, often associated with increased overdoses (Stopka et al., 2019). This situation is a problem at all levels, including health, social protection, and the economy.
The city’s health crisis resulting in a lack of control over prescription drugs is often considered the main reason for substance abuse. However, the researchers note that this is not only a health problem but is primarily due to the low socioeconomic status of many city residents. Risk factors that contribute to the high rate of opioid addiction in Worcester include high levels of poverty, discrimination in the community, high unemployment, significant drug traffic in routes through Massachusetts, and the impact of incarceration (Trainor, 2021). Consequently, city residents are more at risk of substance abuse and dependence.
Importance of the Problem
Opioid abuse has devastating consequences for both individuals and society. First, heroin addiction has one of the highest overdose mortality rates (Burke et al., 2019). According to statistics, in 2020, more than 2,000 people in Massachusetts died from an overdose (Office of the Attorney General, n.d.).
As a result, the state has been declared an opioid epidemic, and the government is taking proactive measures to address the crisis. It includes developing programs and policies to improve public health and prevent substance abuse. However, the implemented programs do not achieve the desired results. In Worcester, opioid overdose deaths rose to 331 in 2022 (Tehan, 2023). It confirms the need to find practical solutions to this problem.
Secondly, the lack of proper control over prescription drugs, including opioids, leads to specialized care and rehabilitation. It strains state and city health services (Clark, 2021). Moreover, the prevalence of substance abuse in Worcester increases educational program costs. These programs are necessary to attract public attention to the problem, educate the community about the potential risks, and prevent the spread of opioid addiction.
One of the most critical factors regarding opioid abuse is stigma (Bureau of Justice Assistance, 2019). Due to the low public health and community awareness of the problems, social stigma regarding addicted people is quite common. As a result, people who require emergency care do not seek it. Such a situation reinforces social inequalities in health care and makes it impossible to solve the problem.
Moreover, the urgent need to address the problem is due to the impact of opioids on humans. Opium addiction is a severe and common form of addiction that leads to personal destruction (Burke et al., 2019). Opioid addicts cause enormous suffering to their families and loved ones, often commit serious crimes, and also become infected with HIV due to using contaminated needles for injecting drugs.
In addition, opioids and their uncontrolled use affect all the body’s vital systems. First, the central nervous system is affected, including confusion, paranoia, hallucinations, mood swings, anxiety, and personality changes (Burke et al., 2019). Due to clouding consciousness, such people become potentially dangerous to society. Second, long-term opioid use affects the respiratory and cardiovascular systems (Burke et al., 2019). It is another reason for the high mortality rates among people with substance use disorder.
Demographics
One of the critical factors in understanding Worcester’s opioid abuse problem is the concept of its widespread prevalence. It affects all population groups, regardless of their demographic characteristics. Opioid addiction affects people of different age groups but is particularly severe among young and middle-aged adults (Burke et al., 2019).
Often, these populations receive prescriptions for opioids after significant injury or surgery to relieve pain. Moreover, in some cases, the prescription of this type of medication could have been avoided (Wood et al., 2019). However, instead of looking for alternatives that could help eliminate the problem, doctors use outdated approaches to treatment.
Moreover, opioid abuse is independent of an individual’s socioeconomic status. While some populations are legally prescribed opioids, people from low-income communities access this type of drug illegally (Wood et al., 2019). However, people’s socioeconomic status determines their treatment options. Less affluent Worcester residents are at greater risk for long-term abuse and overdose deaths (Evans et al., 2022).
Moreover, parental abuse often results in their children being transferred by social services to the foster care system. This factor creates increased risks of opioid addiction for new generations due to the lack of necessary social guarantees (Wood et al., 2019). Children and adolescents are more vulnerable to environmental influences, which increases the likelihood of opioid abuse.
Characterization of the substance dependence problem must take into account geographic factors. In Massachusetts, rates of opioid use disorder are among the highest in the country. According to the Massachusetts Department of Public Health, “one in 25 people in the Commonwealth has an opioid disorder use” (Opioid misuse, n.d., para. 2). A Public Health Data Warehouse (PHD) was created to track case data in the state. While this change to Massachusetts’ public health system has significant potential to identify and address the problem, it has significant limitations. Evans et al. (2022) note that this system collects only official information based on visits from people with an addiction to healthcare institutions. It reduces the size of the problem because data on illicit substance use is not captured.
Furthermore, PHD does not provide real-time information, making it impossible to effectively address the issue (Evans et al., 2022). Collecting and processing information takes time, and during this period, the situation with opioid abuse may change significantly. In Worcester, overdose deaths increased by 36.6% from 2021 to 2022 (Tehan, 2023). However, PHD cannot recognize and respond quickly to such changes. It highlights the critical public health problem in the state and city.
Distinguishing Characteristics
The problem of opioid abuse has several characteristics that distinguish it from other public health problems and increase the importance of addressing it. Firstly, it appears because of the influence of various factors, so it is pretty challenging to predict its occurrence and prevent it (Opioid misuse, n.d). Identification of risk groups contributes to more effective addressing.
However, given the lack of specific demographic characteristics of the population susceptible to opioid addiction, the risk groups appear too broad. While previous data showed a greater susceptibility of men to the problem, current information shows that the number of Black and Latinx women experiencing this problem has increased by 32% and 68%, respectively (Clark, 2021). It expands the scope of the required impact and requires the development of new approaches.
Second, a key difference with opioid abuse is the high level of stigma. Injecting drug use is subject to widespread marginalization, which can discourage people from seeking help (Opioid Misuse, n.d). This problem is a type of mental disorder and requires appropriate practices for rehabilitating and reintegrating the individual into society. Even though the stigma around mental health problems is gradually decreasing, and more and more people are turning to professionals, substance abuse disorders remain a pressing public issue.
Increased social pressure and isolation of people with addiction worsen their condition and often cause polydrug addiction (Burke et al., 2019). Alcohol is most often used together with opioids, which increases adverse health effects and accelerates the deterioration of a person’s cognitive and social skills. Moreover, polydrug addiction is challenging to address since it requires an integrated approach and consideration of many factors.
Finally, opioids are prescribed to patients by physicians, and potentially inappropriate opioid prescribing practices (PIP) are among the leading causes of overdoses. According to Stopka et al. (2019), “more than half of the adult population were prescribed opioids” (p. 37). This statistic demonstrates the significant prevalence of PIP and the need to address it at the state healthcare system level. Moreover, physician prescription of opiates is legal and does not pose a problem for law enforcement systems. It limits the ability to influence society to reduce abuse.
All of these factors make opioid abuse a severe public health problem, demonstrating dysfunction in the system. The scope of the issue incorporates inappropriate medication prescribing, limited ability to track the spread of addiction, and ineffective policies implemented to address it (Wood et al., 2019). Moreover, it highlights health inequalities and the impact of social determinants of health, such as social conditions and environmental factors, on population health.
Public Health
In general, studying public health helped me to understand the complexity of its problems. Demographic characteristics, morbidity, and mortality rates are assessed on their scale. Moreover, public health considers the social context since it aims to improve citizens’ quality of life. Demographic indicators characterize the health of the population based on socioeconomic factors. These factors include the prevalence of diseases depending on age, gender, and social status (Wood et al., 2019).
Furthermore, the definition of public health problems is inextricably linked to morbidity and mortality. Because opioid addiction causes significant deterioration in people’s physical and psychological health and high mortality rates, it has been identified as a significant public health problem (Trainor, 2021). Understanding these issues requires complex data analysis to identify common trends and causes.
Opioid abuse as a public health issue demonstrates one of the most important tasks of public health, which implies identifying the nature of the complex influence of environmental factors on public health. It involves looking for social determinants of public health and identifying ineffective policies that require government intervention at both the federal and local levels. The main problem with opioid abuse is its geographic disparity. Because of this, federal programs can often be ineffective for individual states and cities because they offer generalized solutions (Bureau of Justice Assistance, 2019). Policies and programs addressing public health issues must consider local statistics to develop more effective solutions.
Therefore, addressing the problem of opioid abuse in Massachusetts and Worcester is a challenge for local governments. The effectiveness of addressing the issue is determined by a complex of factors, including the promotion of relevant legislation, reducing discrimination and inequality in health care, providing access to services to all groups of the population, and constantly educating the community to increase their awareness of the issue (APHA, n.d.). Moreover, engaging citizens in collective action to combat pressing public health problems is critical to its success.
Conclusion
In summary, opioid abuse is a federally recognized severe national problem. However, its uneven geographical distribution creates an increased need for urgent action in certain regions. Some of these regions are Massachusetts and the city of Worcester. Due to the city’s location on drug trafficking routes and socioeconomic factors affecting citizens’ standard of living, the statistics of drug use and death from overdose increase annually. It creates a critical situation in the public health system and requires taking the necessary measures to reduce the rate of spread of the problem and solve it.
The development of effective programs requires an integrated approach taking into account available data, as well as evidence-based forecasts. However, various factors, such as social stigma and low income of citizens, causing the inability to receive the necessary care, lead to the impossibility of collecting up-to-date information regarding opioid addiction. As a result, there is an urgent need to transform the city’s healthcare system and implement an enhanced control system for the city’s healthcare system, particularly regarding the prescription of medications.
References
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Wood, E. S., Kerkach, J. W., Guzman, M. K., & Mey, S. P. (2019). Public health campaign for stigma free Worcester app. Web.
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