Today’s guest was Darcie Miller, Orange County Commissioner of Social Services and Mental Health, who spoke on the rising opioid problem in Orange County and the country at large. She began her talk with some startling statistics: in 2012, when the crisis was first beginning to be recognized, fifty people in Orange County died of opioid-related overdoses. By 2017 that number had risen to ninety-nine. Ms. Miller asserts that addiction is a chronic disease, no different in its essentially physical basis than something like diabetes.

Dopamine, a compound produced in the brain’s pleasure center--and, in fact, directly related to the experience of euphoria--is vastly increased by the presence of opioids in the body. As an example, Ms. Miller asked the members of the club to think of how we would feel on the best day of our lives. Now multiply that by over a hundred: that’s how dramatically opioids raise dopamine levels in the brain. As the brain gets accustomed to the artificially high levels of dopamine subsequent to longer-term opioid use, the body produces less and less of the compound naturally. This leads the opioid user down the path of addiction because now they must ingest a substance to raise their dopamine levels to a point that allows them to get out of bed in the morning.

 

Ms. Miller is a strong advocate for the medical management of addiction. Medical treatment (medication) coupled with cognitive-behavioral therapy has an efficacy rate of around 75% while treatment without these modalities has about an 8% chance of success. Ms. Miller feels strongly that a major obstacle for people getting the treatment they need can be traced back to misguided societal stigmas attached to drug use and addiction. People need to be educated that addiction is a physical disease requiring a medical response, deserving just as much compassion as any other malady. We must get past the traditional narrative of addiction as a moral failing and see it for what it is, a physical illness that can respond well to the right kind of treatment.

 

If you, or somebody you know is struggling with addiction, please contact the Orange County Mental Health Department at 845.291.2600.