[Editor’s Note: This issue’s editorial is from special guest Allison-Scobie Carroll, President of NASW-MA chapter. A version of this editorial was previously published in the July 2017 edition of NASW-MA’s Focus magazine. Archives of Focus articles can be accessed (by NASW members only) here.]
In recent years the disease of opioid addiction has claimed thousands of lives throughout the Commonwealth, with a staggering four-fold increase in opioid overdose deaths since the year 2000. The loss is so brutal and heartbreaking, and the suffering so profound, that we defend ourselves against its truth. The statistics alone provide a distancing mechanism. The numbers of the afflicted, their ages and geographic locations may serve to help us feel safe; to feel that those who suffer are “other” and that “we” can remain insulated from the grave realities of those we keep at arm’s length.
Other strategies for creating that separation from the injustices that have created and continue to sustain the opioid epidemic are those disavowed but sometimes deeply held beliefs about the culpability of those who struggle with addiction. While relapse is an expected part of a recovery process, the frustration that providers and families feel with the disease, the system that offers inadequate treatment, and the pain that both the addicted and their loved ones endure are all often foisted squarely upon the afflicted party’s shoulders. There is no benefit to this ill-placed blame, but still, there it lands. When blame offers cold comfort, a profound sense of powerlessness is often what is left. In our role as social workers, we too may feel powerless.
Preparing social work students and interns for the rigors and the weight of the multiple roles that our profession occupies in the effort to eradicate this epidemic requires a combination of just-in-time revisions to our curricula and a focus on the essential activities within and beyond the provision of clinical care for those suffering in its wake. In the clinical realm, we need not wait for the development and provision of substance use disorder electives or field placements solely focused on the treatment of addiction and those impacted, but rather, may seek to include the fundamentals of assessment and treatment of substance use disorders in all of our core clinical practice curricula. Ideally, prepared social workers will come away not only with an understanding of evidence-based interventions and standards of care, but will also understand the broader systemic issues that have created this crisis and the social justice work required to bring it to its conclusion. Mobilizing coalitions and shaping policy aimed at addressing the far reaching social, economic and racial justice issues that have contributed to the opioid epidemic is something that can happen both in and out of the classroom. This work is informed by a deep appreciation for the human impact of the policies that have allowed the epidemic to take root. Ideally, truly prepared social workers will come away from their academic and field experiences with the critical eye that approaches such complex social problems in a way that deconstructs the simplistic narratives that blame those afflicted for their plight and the paradigm to imagine a road to construct solutions built on the foundation of social justice.
As social workers in the field know, there are multiple social and economic drivers that have created the opioid epidemic as it exists today. These include the overprescribing of opioids, the absence of adequate treatment all along the path to recovery, poverty and the perpetuation of use within communities where a higher prevalence of opioid addiction exists, among many others. Social workers, with our awareness of the systemic contributors to health and well-being, are uniquely poised to work alongside public health professionals, health care providers, and child welfare agencies to play a substantive role in putting an end to the opioid epidemic. But are we prepared?
At a recent meeting at the MA State House, NASW-MA Executive Director Rebekah Gewirtz and I joined with MA Secretary of Health and Human Services Marylou Sudders, MA Department of Public Health Commissioner Monica Bharel, MA Department of Mental Health Commissioner Joan Mikula, Director of the Bureau of Substance Abuse Services Allison Bauer, and several area social work deans and directors to consider how schools of social work could best prepare BSW and MSW students to provide care to patients and families living with opioid addiction. This effort is just one part of a broad systemic approach being undertaken by the Commonwealth to address the epidemic. All agreed that preparation must be incorporated into the curriculum and work to that end is currently underway. For those already working in the field, as is consistent with our Code of Ethics, we are called upon to prepare ourselves through training, literature review, and supervision to be competent in our field of practice. There is no area of practice that is not touched by this epidemic. Social workers undoubtedly have a crucial role to play in its eradication. Those impacted by the epidemic are relying upon us to honor their dignity and self-worth, to accurately assess risk and provide treatment, to navigate the system of care, and to hold on to hope at times when it is understandably so elusive.
Hope is essential. Just a few weeks ago, Rebekah Gewirtz and I met with MA Department of Children and Families (DCF) Commissioner Linda Spears, where we discussed the many initiatives underway at DCF to improve its response to children and families. The developments at the agency are nothing short of herculean. The changes described at the Department were truly inspiring. Among many other topics, we discussed the impact on children who have parents with opioid use disorder. Children are placed in unsafe situations when parents are using, children are losing their parents to incarceration and overdose, and there are long-term challenges that children face as parents seeking treatment are often unable to access what they need to initiate and sustain recovery. These stories inspire a sense of heightened urgency, and I hope, a call to action.
Each day the epidemic continues in the backdrop of a culture of blame and socioeconomic and racial injustice with a system that provides too little access to treatment, these vulnerable children remain acutely at risk for exposure to neglect, trauma, parental loss, and placement instability. Well prepared social workers can literally play a role in changing the odds for these children, their parents, and all those impacted by this epidemic.
Reference for original publication:
Scobie-Carroll, A. (2017). President’s message: Social work and the opioid crisis. Focus, 44(7), 2.