This article by Aliyah Bolden, a rising senior at Cleveland State University, is the 20th in NEOMED’s Halting a Crisis series about the epidemic of opioid addiction and how NEOMED is training future physicians and pharmacists to help.
I grew up in Ohio, surrounded by an opioid epidemic. I knew that it severely impacted my community (the West Boulevard neighborhood of Cleveland), since addicts would regularly congregate around my local recreation center to seek shelter. But I never was able to fully visualize the reality of it until I was given the statistics and heard from people who had been through opioid recovery programs. Spending time with people who are trying to overcome dependence on opioids brought this issue from my rearview mirror to front and center of my perspective.
As a student in Cleveland, I wanted to do my part for the community and serve on the front lines, which is what brought me to AHEC (Area Health Education Center), a national program for students with offices at Northeast Ohio Medical University and Cleveland State University.
While attending Cleveland State University (CSU), where I am a rising senior, I earned an EMT certificate from Cuyahoga Community College, then served in a Promote. Educate. Prevent. (P.E.P.) program during the summer of 2019. P.E.P. is an educational community outreach program (run by AHEC) that focuses on mental health and substance use disorders. I was interested in P.E.P. because of the parallels between EMT and the goals of the program. P.E.P. was developed for students like me, who are interested in performing community service, particularly in underserved communities where health disparities are prevalent.
Through the P.E.P. program, we educated adults on how to store their medications (in dry, dark environments, away from children, unless instructed otherwise on the bottle); how to correctly dispose of medications; and the dos and don’ts of taking prescriptions. Understanding these things can help people practice safe disposal and management skills to avoid having people take prescriptions that are not prescribed to them – which could contribute to the start of someone’s addiction.
Substance abuse and mental health
I was further educated on suicide prevention, mental health issues and drugs – and how these issues overlap. I was shown how to use a Narcan kit and educated on the signs and symptoms of an overdose, as well as on addiction’s correlation to mental health.
For example, I learned that many people who become addicted to drugs start off taking prescription medications. Their pain or anxiety or other mental issues causes them to start to abuse these medications as a way to relieve them of this pain. Over time their addiction grows and their mental health worsens.
Through a partnership with the City of Cleveland Department of Public Health, the other P.E.P participants and I were also trained on a TINAD Program (This Is Not About Drugs). This program focused on the correlation between drugs and mental health and geared most of its information toward the younger population. I was able to educate middle and high school children about the importance of mental health and its correlation to substance abuse.
P.E.P. expanded on the information that I’d received from my EMT training and taught me that drug addiction is more than a psychological issue, but a biological one as well.
Knowing the audience
Through this program, I learned how important it is to present information in a way that is tailored to each specific audience. For example, to a middle schooler, I spoke about opioid dependence in a practical way — something that they could relate to their life. I would relate withdrawal to getting your favorite game taken away from you and you just can’t stop wanting that game. Or I would relate cravings to not being able to look at your phone at the dinner table when you know you are receiving notifications. Your desire to see who is texting you is great, so it’s painful if you can’t relieve that craving by looking at your phone.
To an adult, I would explain opioid dependence in a biological way, so that they could understand the science behind addiction. I would explain that there are certain receptors in your brain that have a higher affinity for the drugs that are being taken. When drugs enter the brain there is a release of dopamine, a neurotransmitter that causes us to experience pleasure. Increased amounts of this drug cause the brain to stop regulating the production of dopamine, so the brain becomes dependent on the drug for this pleasure, and pleasure is no longer naturally regulated
In the end, the summer AHEC program was a memorable and rewarding experience, because I felt like I had impacted others’ lives in a way that they might not have experienced. With the training I was given, I learned to converse and to lead others toward a healthier and safer lifestyle. Having been made more aware of common preconceptions about people with substance abuse issues, I learned to more consciously avoid being influenced by them.
After this experience, I wanted to continue to work in underserved areas, so I became a member of the AHEC Scholars Program, for health professions, students in their last two years of college. NEOMED’s AHEC Scholars program has taught me how to recognize health disparities in communities and how to combat those issues. As a Scholar, I am learning to think critically about community needs and ways to address those needs. From my experience so far, I’ve learned about health disparities, public health issues, social determinants of health, and how to conduct community service events. I hope to continue with the AHEC program throughout my senior year at Cleveland State.
Being able to connect with those who experience addiction or relay medical information to them has been very rewarding. Understanding how mental health and addiction are related has broadened my perspective. So has learning about the sociological and systemic roots of the disparities in the care received by more privileged patients compared with the underserved.
I’ve become so interested in community service and public health that I’m considering pursuing a Master of Public Health degree or Master of Modern Anatomical Sciences degree. Whether I’ll do that while in medical school or prior I’m not sure, but these experiences have shown me the importance of understanding issues from multiple perspectives.
I am more passionate than ever in my desire to help my community manage its way through the opioid epidemic and other issues that disproportionately affect it. I hope that health care will be the way I can help.