Bioethics in Faith and Practice, Volume 4, Number 1

34 Bioethics, the Law, and the Opioid Crisis use in the community. 15 More than half of the prescription opioids in the US are prescribed to the 16% of Americans that suffer from a mental health disorder of some kind. 16 These kinds of statistics should tell us that addressing mental health in America with regard to the opioid crisis is an extremely important topic. Further, the prescribing of opioid medications in patients with mental health disorders must be addressed and quelled in order to prevent those who are already at risk of problem drug use from getting their hands on the medications they could abuse. One issue that arises in discussions about the future of treatment and care for addicts across the nation is the use of supervised injectable opioid assisted treatment (siOAT) to aid the addict. Utilizing this kind of a program allows those struggling with substance use disorder to take their medications in a stable environment with the help of a medical professional. Literature has shown that siOAT is effective for several outcomes including “retention in treatment, reducing the use of street drugs, and reducing illegal activities.” 17 This brings with it ethical questions of whether treatment programs like this are enabling the user, along with the questions about the long-term efficacy of this and other similar programs. Further research must be done in order to establish justification for siOAT. While addressing incarceration and criminal justice programs is a great place to start when considering the opioid crisis, it is important to understand that the issue itself is complex and multi-faceted. There is not one solution that can fix the problem. The American Journal of Public Health describes the etiology of opioid addiction as addicts using opioids as “a refuge from physical and psychological trauma, concentrated disadvantage, isolation, and hopelessness.” 18 The article continues by saying that overreliance on opioid 15 Mark Sullivan et al., “Association between mental health disorders, problem drug use, and regular prescription opioid use.” Archives of Internal Medicine, 166: 2087-2093. 16 Matthew Davis, Lewei Lin, Haiyin Liu, and Brian Sites, “Prescription opioid use among adults with mental health disorders in the United States.” The Journal of the American Board of Family Medicine. 30, no. 4 (2017): 407-417. 17 Public Health Ontario, “Effectiveness of supervised injectable opioid agonist treatment (siOAT) for opioid use disorder. 18 Nabarun Dasgupta, “Opioid Crisis: No easy fix to its social and economic determinants,” American Journal of Public Health , 108, no. 2 (2018): 182.