Julia Montag: To educate or not?

Monday, July 2, 2018 - 11:30am

“Even though the numbers don’t make it seem like there’s an epidemic here on campus, even if we have only two students that the opiate crisis affects, we still really care about making sure that we have referrals, resources and ways to support them.”

 

That’s how Wolverine Wellness Director Mary Jo Desprez described the approach taken by the University of Michigan’s campus wellness resource in tackling our nation’s growing problem. “Students might say, ‘I’ve taken some Oxycodone after the dentist,’ and we’re saying, ‘Well, do you want to know some more information about that and what the risks are?’ We want the students to have that information.”

 

Officially declared a public health emergency last fall, the opioid crisis continues to ravage our country. Opioids are a class of prescribed drugs that are usually used to treat severe pain. Some hide in common over-the-counter drugs, such as in Tylenol-Codeine or in Robitussin AC. Others are given names that may sound more familiar, ones that you and your friends may recognize — Vicodin, Percocet, Codeine — those “One pill every four hours for a week” painkillers that doctors prescribe for wisdom tooth recovery.

Clearly, if public health officials and medical professionals knew how to fix this problem they would have already. Instead, there have been many attempts at creating programs to curb the dramatic rise in addiction. Some aim to stop further drug use, like Michigan’s curb-side pill disposals, while some try to make that use safer, including New York City’s city-mandated drug injection sites. Among the ideas that spark controversy is the method used by Wolverine Wellness: spreading the word.

Incoming Wolverines need to complete an online course that informs and quizzes students on alcohol and sexual assault. This resource is under renovation and getting an upgrade, Desprez explained. “One of the courses that will be available in the Fall for all U-M students will be a course on prescription drug misuse,” she said. “We’ll use it as an educational tool.”

Programs like this are quite controversial because of previous efforts to prevent substance abuse through advertising campaigns — efforts that have frequently been ineffective and harmful. There’s a tricky balance between the idea of “normalizing opioid use” as a tool that’s beneficial for our community and as one that’s extremely detrimental; it can educate students and warn against harms, yet it can also perpetuate the bad behavior that contributes to the crisis by provoking doubt in the drugs’ dangers.

According to the 2016 University of Michigan National College Health Assessment, only 0.4 percent of U-M students responded positively when asked if they had used opiates in the past 30 days. This makes me wonder (and I am not the only one with this inquiry): What will come of the decision to promote? Is educating the masses, and thus “normalizing” drug use, helpful or hurtful to the 0.4 percent?

Many presuppose the intention of linking an overdose course to the current, mandated courses is to reach the minds of more students, which would not necessarily be such a good thing. When I brought this up with Desprez, she explained to me the class is not required for everybody. “When you have as low a rate as you do at U of M, one of the things that you don't want to do is require everybody to [take the course] because then it normalizes something that’s not normal. But you also want to be really strategic and make sure people know about how you reduce harm.” That’s why prescription pill misuse will be a small part of the original required course, and then exist in full as its own, optional online resource.

Desprez is familiar with the debate about whether or not we should educate non-users on the risks. In response, she says we are not opioid-free; just because the numbers aren’t there now doesn’t mean they never will be. “We’re not inoculated in any way. It can come, (the numbers) can increase.” Education also piques the curiosity of U-M Medicine, Public Health and Public Policy students and can inspire them to work on research that will aid in the crisis.

My conversation with Desprez emphasized that normalizing the problem can also make people feel less alone. Educating our campus will prevent users from feeling like they’re in the small minority of opioid users and could pull them away from the inclination to stay quiet about addiction, encouraging them to ask for help. Desprez pointed out how in comparison, people can normalize an alcohol issue much more easily than they can a heroin issue, attributing this to the fact that opioid use is still quite stigmatized. Along with this stigma is the fact that this use is often illegal. The undoing of this crisis requires programs that cost money, which trickles down to states from the national government, but the government made heroin illegal in the first place.

The way I see it is the crisis is going to be a crisis until prescription pills become something that we’re comfortable talking about. Until it’s as addressed as alcohol and marijuana, until it becomes something about which one would not lie on a survey, until our friends and coworkers can be open about addiction, until universities offer a class on painkillers along with a class on sexual harassment and alcohol (Go Blue): nothing’s going to change.

Maybe the first step is to decriminalize, or just destigmatize. I feel a tinge of doubt when looking at the data on opioid use on our campus, since illicit drug use is complicated to measure. Fibbing (understandably so) on a survey about something illegal can lead to skewed results, deficient response programs and problematic outcomes. To me, opioids feel more pervasive than the data suggests; I know people around me are that doing them, casually watching as others get addicted, and passing along horror stories of a friend’s friend who overdosed.

In addition to preventing future harm, teaching the student population about opioid risks may grab the attention of those who are not answering surveys honestly or haven’t yet come to terms with their addiction. One may argue educational techniques like the Wolverine Wellness course may be propagating the behavior that our country condemns. But in the midst of a crisis that is swallowing our nation, educating can be normalizing to the point where addicts feel open to ask for help.