The opioid crisis is shaking the nation and greatly impacting young people. In just one year, 42,000 people died of drug overdoses involving opioids. That same year, 2016, 38,000 individuals died in car crashes or car-related injuries. There’s no question that this epidemic is affecting families, communities, and schools across the country. How can educators help support students impacted by the crisis? To help answer this question, Critical Window, a podcast by the Alliance for Excellent Education (All4Ed), turned to Dr. David Patterson Silver Wolf. As a professor at the Brown School at Washington University, in St. Louis, Dr. Patterson Silver Wolf teaches substance abuse courses and works to bring science and research to addiction services. He has over fifteen years of experience providing clinical services in the substance abuse disorder treatment field. This issue is also incredibly personal for Dr. Patterson Silver Wolf, who shares the story of his own experience dealing with substance abuse – from childhood into his twenties – on this episode. “I would look out on the world, and everybody looked good but me,” he recalls thinking as a young child. “I would compare my internal turmoil to people’s external life, and think, ‘Boy, everybody looks like they’re doing okay but me.’” Listen to his story of triumph and learn how to support students experiencing similar hardships on this episode of Critical Window. Critical Window is a podcast from the Alliance for Excellent Education that explores the rapid changes happening in the body and the brain during adolescence and what these changes mean for educators, policymakers, and parents. Subscribe to Critical Window on Apple Music, Stitcher or wherever you find podcasts. Expand Transcript Collapse Transcript Hans Hermann: Welcome to Critical Window, a podcast from the Alliance for Excellent Education that explores the rapid changes happening in the body and the brain during adolescence, and what these changes mean for educators, policy makers, and communities. This week on Critical Window, we’re learning more about the opioid crisis, how it affects adolescent students, and how educators can support students impacted by the crisis. Dr. David Patterson Silver Wolf is professor at the Brown School at Washington University in St. Louis. A faculty scholar in the Washington University Institute for Public Health, and a faculty affiliate for the Center for Violence and Injury Prevention. At the Brown School, he teaches substance abuse courses, serves on training faculty, and chairs the American Indian and Alaska Native concentration in the Master of Social Work program. He’s the director of the Community Academic Partnership on Addiction, which works with several St. Louis based organizations to bring science to addiction services. Dr. Patterson Silver Wolf has over 15 years of experience providing clinical services in the substance abuse disorder treatment field. He investigates how empirically support interventions are implemented in community-based services and factors that improve underrepresented minority college students, academic success, and American-Indian and Alaskan Native health and wellness, particularly issues related to college retention. He was recently appointed to the National Academies of Science, Engineering and Medicines Committee on Medication Assisted Treatment for Opioid Use Disorder. Welcome to the show, Dr. Patterson Silver Wolf. David Patterson: Thank you. Hans Hermann: I would like to set the stage before we get into questions. While the opioid epidemic has received a great deal of press coverage and has been repeatedly called out as a top priority of both the Obama and Trump administrations, I think it’s good to revisit some facts and figures to appreciate the scale of this issue. According to a 2014 report, “A Nation in Pain,” the US consumes approximately 80 percent of the world’s prescription opioid drugs, while making up only 5 percent of the world’s population. The CDC, the Center for Disease Control, said that nearly two-thirds, 42,000 or 66 percent, obviously, of drug overdoses in 2016 involved prescription opioids, illicit opioids, or both, which was an increase from 27 percent in 2015. In comparison to those 42,000 deaths, 38,000 individuals die in car crashes or car-related injuries in 2016. According to the CDC, opioid overdoses continue to rise in 2016 to 2017 by 30 percent, across 45 states, and it’s been estimated that this opioid-related cost exceeds $78 billion for the US economy. So, needless to say, this is a crisis, and a growing one. Could you explain how we got to this point as a nation? David Patterson: Right, thank you. So, the latest numbers of ODs are about 70,000, so we’re about 70,000, and continuing. I think how we got to this problem depends on who you ask, and let me just say I’m here speaking as myself, not behalf of any other person or community. So, I would say it’s a few issues. One, pharmaceutical companies have a big responsibility in this epidemic, and if you’ve watched 60 Minutes or the news, you’ll see that pharmaceutical companies pumped out a lot of opioids into our communities. There was, just on 60 Minutes last night, there was, again, they reported a small town in West Virginia had millions of pills shipped to that one small town that had a few thousand people who lived there. And so, pharmaceutical companies have responsibility, but also, prescribers. And how do you deal with people who say that they have pain? And a lot of times, doctors are in a position to either tell their customers, and that’s how they see patients now, as customers, they went to a rating of how satisfied are you as a physician? And so, are you gonna upset your customer or are you gonna do something for them that would keep them coming back? And so, when patients or customers say that they have pain, obviously, the next move is to prescribe medication. There’s other people who say the responsibility lies with those who take the medication, and in some sense, that could be true. But these are very addictive medications, and so, there’s a lot of data that show once you start taking these medications, it changes your brain, and you quickly become addicted to these. Hans Hermann: This epidemic is impacting individuals, families, schools, communities across the nation, as you said. Are there areas of the country or specific demographic groups that are more at risk of substance abuse, specifically use of opioids? If so, where, and whom? David Patterson: I would say large amounts of people who express pain, obviously, are prescribed opioids, and they become addicted to them. Not all of them, but a lot of them do. But I would say ground zero for America’s addiction is West Virginia. They have more ODs than any other state in our country, but nobody’s immune to this. There used to be this idea that back several years ago that this was an urban problem by minority folks. Now, we’ve seen on the news that young, non-minorities are dying from this crisis, this epidemic, and so, it’s spread across our communities to where anybody could really be impacted by this. But a lot of older age folks are high risk. And obviously, minority communities, underserved communities are high risk for this problem. Hans Hermann: You’ve personally dealt with substance abuse from early on in your childhood and into your 20s. Could you take a moment to share your story for those who aren’t familiar? David Patterson: Sure. There’s still some hesitation about me, or anybody else, sharing loudly that they’re a person in recovery. There’s still a lot of stigma around it, and even me now, I’m saying reaching 60, and a tenured professor, there’s still some reluctance to talk about this part of my life. And so, I could say I grew up in a home with a father that was an alcoholic, and very violent, and you grow up, speaking for me personally, you grow up in a home like that, you have these issues, you try to figure out why these things happen to me, what’s wrong with me? I always felt like I was a square peg in a round hole. I would look out on the world, and everybody looked good but me, and I would compare my internal turmoil to people’s external life, and think, “Boy, everybody looks like they’re doing okay but me.” And so, it’s easy to be talked into trying different, what we would consider medications, to make myself feel better, or the same, or to fit in. And so, I was taught very young on how to drink alcohol. I was allowed to smoke cigarettes, and so it was – I don’t wanna say it was a predetermined path, but it made my path a lot of easier to continue to take risk with other drugs. And before too long, I was taking medications. I had prescription drugs, I was smoking marijuana, drinking alcohol, and it just led to a life where I couldn’t imagine my life with or without alcohol or drugs. And so, I eventually went to treatment. I was 26, I went the old-fashioned way. I was forced to go, and was allowed to – with a very structured program, allowed to find my path into recovery. Hans Hermann: Well, thank you for sharing, we really appreciate you being open and I’m sure other folks who may or may not be able to relate, but I think it says a lot that you’re able to be open about that, and we appreciate it, again. You started getting into how you eventually overcame your substance abuse issues. What other individuals or support systems helped you do that? David Patt