The Trump administration’s declaration of opioid addiction as a “public health emergency” recognizes and gives urgency to what the law enforcement, medical, and mental health communities have known and been increasingly dealing with in recent years. Few communities remain untouched by the consuming effects of these powerful drugs regardless of demographics and relative affluence, with medical and social services strapped for personnel and resources while trying to meet treatment demands, law enforcement addressing an increase in addiction-driven crime and overdoses, and families shattered by addiction and death. And in certain communities – often low-income, predominantly rural or rust belt, with declining economies tied to stagnant or shrinking industries – opioid addiction is epidemic, to the extent of dramatically shortening life expectancies of residents.
For most law enforcement officers, what comes to mind when the discussion turns to opiate addiction is most likely heroin. Cheap and ubiquitous, it turns up at crime scenes, on traffic stops, and during field contacts. Used needles are found in parks surrounded by million dollar homes, and stories of even highly promising lives derailed or cut short are easy to find. Heroin drives theft and burglary, prostitution, fraud, and violence. But above all of it are the overdoses and deaths, and that naloxone is becoming as standard issue for cops as are Tasers and patrol rifles.
But heroin and other illicit opiates are only the tip of the iceberg. Once the elephant in the room, but increasingly recognized for the dangers they present, are prescription opioids commonly and widely prescribed, predominantly for pain management. Generally speaking, as we are referring to them here, opioids are drugs that include opiates (narcotic substances containing natural alkaloids derived from the resin of the opium poppy, including semi-synthetic derivations) as well as synthetic compounds produced to act on opioid receptors to produce varying degrees of morphine-like effects. Although highly effective for moderate to severe pain, their action on opioid receptors and the euphoria produced at certain levels easily leads to addiction and increased use, including the risk of overdose. Overdose leads to respiratory depression and likely death.
The scope of overdose deaths due to prescription opioids is stunning; according to the Centers for Disease Control, between 1999 and 2015, more than 183,000 people have died in the US from legal prescription drugs, with the numbers expected to continue or even grow. The nonlethal effects of addiction and withdrawal can progress to debilitating levels, comparable to those experienced by users of illicit opiates. Also, with the relatively significant cost of prescription opioids, the likelihood of being “cut off” by prescribers, and difficulties inherent in obtaining controlled substances in enough quantity to feed a growing addiction through hustle and deception, for a great many users addicted to the proscription forms the slide over to heroin is simply easier and cheaper, and the danger only grows.
Prescription opioids and the personal risks for officers
Ask any police officer if they would ever try heroin, let alone get addicted, and most will scoff; of course not, it runs counter to everything they stand for! Heroin users are to be arrested and booked, their character suspect and the swath of chaos that follows them a source of so much of what officers contend with.
Ask them if they would use a prescription opiate and the answer is almost certainly, “Yes, of course, if I needed it and with a doctor’s script.” As to whether they would or could ever get addicted, an honest officer would at least take pause; as much as anyone might think, “Not me… never me!” the truth is that any of us are at risk, given the right circumstances.
Understand that none of this is to say prescription opioids for pain management, or other medically indicated conditions, have no legitimate time or place. We have both, and likely will again, been prescribed and taken certain controlled substance prescriptions for pain management including opioids. We’ve always done so, however, with respect for their addiction risks and an eye to discontinue their use as soon as possible and transition to alternative therapies to manage and alleviate pain. There are even times that pain is so severe, chronic, or related to a serious illness that a medically managed addiction is indicated and appropriate. Outside those exceptions where an ethical doctor weighs the risks and benefits and opts for long-term opioid-based pain management, we should all be aware of the dangers of accidental addiction.
A law enforcement career in a way seems to invite pain: Injuries are common, with officers called on to confront and subdue resisting and often violent suspects while wearing up to twenty or more pounds of awkwardly placed and balance-challenging gear; the job is largely sedentary, with long hours spent sitting, only to be occasionally interrupted by adrenaline-fueled bursts of activity; even though most officers start their career in excellent physical condition, and very often as experienced athletes, many carry with them preexisting and old injuries that are likely to resurface at inopportune moments, and continued working out and sports participation add the risk of causing new or aggravating old injuries; and the demands of life sometimes put physical fitness on the back burner, with predictable results. With injuries come attempts to alleviate pain and, should the pain be severe or long-lasting, turning to opioids seems a natural progression.
Add to this that many officers display tendencies of what are often considered “addictive personalities” and will want to stay or return to duty as quickly as possible, and the risk of developing an addiction increases. For most who work in law enforcement pain is, sooner or later, inevitable. Mismanaging it carries serious risks and, as the dangers of opioid overprescription have become clear and alarming, an increased focus has been placed on a number of alternative therapies and steps proven to more safely and effectively manage long-term pain.
Effective alternatives to pain management
When you are hurt (and just assume it’s a matter of when, not if) and find yourself in a doctor’s office post-injury, or seeking pain management because the cumulative effects of work, age, and life start adding up, be an involved, active patient. Ask about alternative therapies and their likely efficacy with your particular pain.
Additionally, the Centers for Disease Control (CDC) has been actively combatting prescription opioid addiction by issuing new and much more restrictive guidelines for physicians prescribing these highly addictive drugs; alternatives to drug therapy are likely to become “prescribed” instead. The following list includes options and activities that have proven highly effective for many:
Focus on preventive fitness
No matter how fit most cops may have started their careers, a passing glance at a lot of departments will reveal many veteran officers haven’t maintained their early levels of health and fitness. Whether due to injuries, genetic predisposition, lack of effort, or any other cause, diminished physical wellbeing of officers is a serious problem for a lot of departments.
Maintaining strength, stamina, flexibility, and cardiovascular wellness is ultimately up to you. Although many factors are beyond our control when it comes to our health, following a reasonable and comprehensive workout routine is one of the ways we do exercise control, with a focus on strength and flexibility one of the best ways to prevent injury and hasten healing when injures inevitably do occur.
Maintaining a regular stretching routine, even if it’s separate from a scheduled and structured workout, helps prevent the injuries common with the sudden bursts of activity common to law enforcement. A few minutes of daily prevention may ward off weeks or months of painful rehabilitation.
Practice yoga and/or Pilates
Yoga and Pilates are growing in popularity but still not always considered “real” workouts by adherents of more traditional weightlifting and running regimens, which is where many LEOs might fall. If this is what you think about these two unique practices, think again!
Both offer remarkable physical benefits, whether practiced by themselves or as part of a more traditional workout circuit, combine both strength and flexibility training, and incorporate mindfulness as a crucial component.
Yoga has even made inroads among professional and high-level college athletes, becoming mainstream workouts for a growing number of NFL and NBA players and their amateur counterparts, among others, or even incorporated into team workouts. The degree to which it builds core strength and balance, improves flexibility to prevent injury and hasten healing of existing injuries, and increases mental focus has caught the attention of the highest level athletes.
Ask about referrals or suggestions for different or more holistic treatments
The Federal Drug Administration has recently taken the lead in encouraging traditional healthcare providers to educate themselves about, and consider referrals to, practitioners who may have not have traditionally had the full respect of the medical community, such as chiropractors and acupuncturists. Increasingly, though, medical doctors (MDs) have become more open to, and willing to refer to, healthcare providers they previously viewed with suspicion.
An alternative to MDs are doctors of osteopathy (DOs). Trained much as MDs, and licensed to practice medicine in any medical specialty, DOs are generally trained in and approach medicine and healing in a more holistic approach and also have received extensive education in Osteopathic Manipulation Therapy.
Consider and explore acupuncture with your physician
Acupuncture is another practice gaining traction and respect among Western medicine. Originating in ancient China, where it was believed that disease was caused by disruptions to the qi, the body’s flow of energy, Chinese physicians used strategically inserted needles to correct them. Of course, for many years Western medicine viewed this with much the same suspicion it had for chiropractic and other alternative treatments.
But now, as with these other alternative treatment modalities, there is a growing willingness in traditional medical to consider acupuncture as a viable treatment option, and for many people it has proven to be an effective tool for pain management.
Make massage a regular part of your wellness strategy
A well-trained, licensed massage therapist can be a godsend for both chronic pain sufferers and those looking to prevent pain and injury. If you’ve never experienced a professional massage from one of these professionals, we highly recommend doing so.
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The opioid addiction crisis is real, and the practice of treating pain with opiates as a first-line strategy is destroying lives. Working in a profession where injury is more than a possibility, but rather an expectation, leaves you at risk of opioid abuse and addiction. The badge cannot protect you from this! Be proactive to avoid injury as much as you can, and active in your treatment for when it happens.
