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Monday, February 10, 2025

#RealDeal Interview: Understanding Opioid Addiction for LE & First Responders

Homeland Security Today Executive Editor Kristina Tanasichuk sat down to discuss the opioid crisis and some of its causes with Dr. Paul Christo, one of the world’s leading pain specialists and author of Aches and Gains, A Comprehensive Guide to Overcoming Your Pain. Dr. Christo is an associate professor in the Division of Pain Medicine at the Johns Hopkins University School of Medicine and served as director of the Multidisciplinary Pain Fellowship Program for eight years, and the Blaustein Pain Treatment Center at the Johns Hopkins Hospital for five years. He hosts an award-winning, nationally syndicated SiriusXM radio talk show on overcoming pain called Aches and Gains®

HSToday: Opiod addiction has truly captured the national interest – even the White House has a page devoted to the crisis on its site under Homeland Security. Thank you for sitting down with us to help our readers understand it better. What do you find are the factors associated with addiction in the opioid crisis?

Dr. Christo: There were over 42,000 overdose deaths involving opioids in 2016. That’s very high and there’s no question that opioid-related deaths have become a serious public health problem. Over the last 20 years, physicians and other healthcare providers have liberalized the use of opioids for chronic pain. This was done in a good-faith attempt to ease pain and suffering. The consequences of increased opioid use lead to patients receiving opioids who probably didn’t need them, and also misuse, abuse, and diversion. And, the non-medical use (e.g., getting “high”, reduce anxiety, get to sleep) of opioids has escalated by patients who don’t use them properly.

The non-medical use of prescription opioids can include combining them with other drugs such as benzodiazepines (e.g, valium) and alcohol. When this happens, the risk of death is higher from mixing opioids with these drugs. We’ve also seen prescription opioids being used by those for whom they are not prescribed. This practice has contributed to the rising number of opioid-related overdoses.

HSToday: What’s the typical “route” to addiction, in your experience? Is there one?

Dr. Christo: Addiction is complicated and not widely understood. It’s a chronic, neurological, and biological disease that has a strong genetic predisposition and is also influenced by environmental factors. Addiction takes hold when a drug with rewarding properties (e.g., opioid, alcohol) is introduced to a vulnerable person at a vulnerable time in life. We see impaired control over drug use, compulsive use, continued use despite harmful consequences, and craving.

The path to addiction may begin with a patient misusing an opioid (using it in a way that isn’t prescribed). This might mean using it five times a day instead of three, or using it to treat depression or anxiety. The misuse then progresses to intentionally using the opioid for a non-medical purpose such as “getting high”. This is now called abuse. Once the abuse spirals out of control, addiction can result.

People use substances to change their mood and these substances have reinforcing properties. In a susceptible and vulnerable person, this use can spiral out of control into the disease of addiction.

HSToday: Why is now different?

Dr. Christo: Today, we’re seeing a large increase in the use of street drugs such as heroin often laced with very powerful opioids called fentanyl and carfentanyl. The addition of these opioids to heroin or other illegal drugs makes the combination even deadlier. Due to the reduction in supply of prescribed opioids, some patients are going to the streets to buy opioids in order to get needed pain relief, or needing street opioids to ease withdrawal from prescribed opioids that were stopped abruptly.

HSToday: What advice do you have for state and local law enforcement?  How can state and local governments help?

Dr Christo: Law enforcement can carry an opioid reversal drug called naloxone. This drug is administered intranasally, intramuscularly, or intravenously. If a first responder like a law enforcement official administers naloxone, it can save the life of a person who has overdosed on heroin, or an opioid.

State and local governments can help ensure that policies are in place to make naloxone available to first responders such as EMTs and police officers. They can also support compassionate opioid tapering for patients using opioids. This reduces the discomfort of acute withdrawal, which can be debilitating and lead patients to the streets. Governments can support the safe storage of opioids for legitimate use so that friends and family members don’t have access to them, use them, and overdose accidentally.

HSToday: Do you see illegal opioids contributing to this epidemic?

Dr. Christo: Yes. A good number of opioid overdose deaths are due to their illegal use either from the street, or illegally obtained from family and friends. Remember that we’ve also seen deaths linked to combining opioids with other drugs such as alcohol and benzodiazepines. Together, these drugs depress our ability to breathe, leading to death.

HSToday: Who is the typical “addict”? Or is there one?

Dr. Christo: I think many view addicts as homeless, poor, or jobless. The media has also portrayed patients using opioids therapeutically to control their pain as addicts. Certainly, addiction can afflict people in these categories, but addiction, like pain, has no boundaries. It’s a disease and can strike anybody regardless of race, gender, or socioeconomic status.

The views expressed here are the interviewee’s and are not necessarily endorsed by Homeland Security Today, which welcomes a broad range of viewpoints in support of securing our homeland. To submit a piece for consideration, email [email protected]. Our editorial guidelines can be found here.

Kristina Tanasichuk
Kristina Tanasichuk
From terrorism to the homeland security business enterprise, for over 20 years Kristina Tanasichuk has devoted her career to educating and informing the homeland community to build avenues for collaboration, information sharing, and resilience. She has worked in homeland security since 2002 and has founded and grown some of the most renowned organizations in the field. Prior to homeland she worked on critical infrastructure for Congress and for municipal governments in the energy sector and public works. She has 25 years of lobbying and advocacy experience on Capitol Hill on behalf of non- profit associations, government clients, and coalitions. In 2011, she founded the Government & Services Technology Coalition, a non-profit member organization devoted to the missions of the U.S. Department of Homeland Security and all the homeland disciplines. GTSC focuses on developing and nurturing innovative small and mid-sized companies (up to $1 billion) working with the Federal government. GTSC’s mission is to increase collaboration, information exchange, and constructive problem solving around the most challenging homeland security issues facing the nation. She acquired Homeland Security Today (www.HSToday.us) in 2017 and has since grown readership to over one million hits per month and launched and expanded a webinar program to law enforcement across the US, Canada, and international partners. Tanasichuk is also the president and founder of Women in Homeland Security, a professional development organization for women in the field of homeland security. As a first generation Ukrainian, she was thrilled to join the Advisory Board of LABUkraine in 2017. The non-profit initiative builds computer labs for orphanages in Ukraine and in 2018 built the first computer lab near Lviv, Ukraine. At the start of Russia’s invasion of Ukraine, she worked with the organization to pivot and raise money for Ukrainian troop and civilian needs. She made several trips to Krakow, Poland to bring vital supplies like tourniquets and water filters to the front lines, and has since continued fundraising and purchasing drones, communications equipment, and vehicles for the war effort. Most recently she was named as the Lead Advisor to the First US-Ukraine Freedom Summit, a three-day conference and fundraiser to support the rehabilitation and reintegration of Ukrainian war veterans through sports and connection with U.S. veterans. She served as President and Executive Vice President on the Board of Directors for the InfraGard Nations Capital chapter, a public private partnership with the FBI to protect America’s critical infrastructure for over 8 years. Additionally, she served on the U.S. Coast Guard Board of Mutual Assistance and as a trustee for the U.S. Coast Guard Enlisted Memorial Foundation. She graduated from the Drug Enforcement Agency’s and the Federal Bureau of Investigation’s Citizens’ Academies, in addition to the Marine Corps Executive Forum. Prior to founding the Government Technology & Services Coalition she was Vice President of the Homeland Security & Defense Business Council (HSDBC), an organization for the largest corporations in the Federal homeland security market. She was responsible for thought leadership and programs, strategic partnerships, internal and external communications, marketing and public affairs. She managed the Council’s Executive Brief Series and strategic alliances, as well as the organization’s Thought Leadership Committee and Board of Advisors. Prior to this, she also founded and served for two years as executive director of the American Security Challenge, an event that awarded monetary and contractual awards in excess of $3.5 million to emerging security technology firms. She was also the event director for the largest homeland security conference and exposition in the country where she created and managed three Boards of Advisors representing physical and IT security, first responders, Federal, State and local law enforcement, and public health. She crafted the conference curriculum, evolved their government relations strategy, established all of the strategic partnerships, and managed communications and media relations. Tanasichuk began her career in homeland security shortly after September 11, 2001 while at the American Public Works Association. Her responsibilities built on her deep understanding of critical infrastructure issues and included homeland security and emergency management issues before Congress and the Administration on first responder issues, water, transportation, utility and public building security. Prior to that she worked on electric utility deregulation and domestic energy issues representing municipal governments and as professional staff for the Chairman of the U.S. House Committee on Energy & Commerce. Tanasichuk has also worked at the American Enterprise Institute, several Washington, D.C. associations representing both the public and private sectors, and the White House under President George H.W. Bush. Tanasichuk also speaks extensively representing small and mid-sized companies and discussing innovation and work in the Federal market at the IEEE Homeland Security Conference, AFCEA’s Homeland Security Conference and Homeland Security Course, ProCM.org, and the Security Industry Association’s ISC East and ACT-IAC small business committee. She has also been featured in CEO Magazine and in MorganFranklin’s www.VoicesonValue.com campaign. She is a graduate of St. Olaf College and earned her Master’s in Public Administration from George Mason University. She was honored by the mid-Atlantic INLETS Law Enforcement Training Board with the “Above and Beyond” award in both 2019 – for her support to the homeland security and first responder community for furthering public private partnerships, creating information sharing outlets, and facilitating platforms for strengthening communities – and 2024 – for her work supporting Ukraine in their defense against the Russian invasion. In 2016 she was selected as AFCEA International’s Industry Small Business Person of the Year, in 2015 received the U.S. Treasury, Office of Small Disadvantaged Business Utilization Excellence in Partnership award for “Moving Treasury’s Small Business Program Forward,” as a National Association of Woman Owned Businesses Distinguished Woman of the Year Finalist, nominated for “Friend of the Entrepreneur” by the Northern Virginia Technology Council, Military Spouse of the Year by the U.S. Coast Guard in 2011, and for a Heroines of Washington DC award in 2014. She is fluent in Ukrainian.

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