Every May, public health advocates and leaders raise awareness about mental health concerns in the country through Mental Health Awareness Month. This year’s theme is “Tools 2 Thrive,” and Allied Against Opioid Abuse’s (AAOA) national partner, Mental Health America, provides several resources to help people improve their mental health and understand the challenges that those with mental health conditions and their families face. AAOA interviewed Bruce Cruser, Executive Director of Mental Health America of Virginia, to learn more about the connection between mental health and prescription opioid abuse. With access to mental health services being even more important during the COVID-19 pandemic, Cruser shared what his organization is doing to support Virginians experiencing both mental health and addiction challenges.
AAOA: How is the opioid epidemic affecting individuals served by Mental Health America?
Bruce Cruser: Mental Health America of Virginia provides recovery education and support services for adults who have experience with substance use and mental illness. Even though we’re called Mental Health America, half the people we work with are recovering from substance use. If an individual’s mental health has a setback (for example, death of a loved one or a broken relationship), the prevalence of prescription opioids makes the situation very risky. At Mental Health America, we use peer recovery specialists as part of our programming. These are people with their own lived experiences who can support others going through similar problems. Too often, a relapse in a mental wellness plan means a relapse in addiction and we want to prevent that from happening.
AAOA: What are challenges when it comes to prescription opioid use and people with mental health conditions?
Bruce Cruser: The relationship between addiction and mental illness is very complex. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), over half of opioid prescriptions are used by people with a mental illness, leading to much more risk for abuse. There is also a greater likelihood of misuse and overlap with other prescriptions.
That’s why healthcare providers need to be aware of a consumer’s whole health and care needs, and the person receiving care should be fully involved in the process. Care must be coordinated to be safe and effective.
AAOA: Research has shown that adverse childhood experiences (ACES) increase the likelihood of developing mental illness and addiction — how can we address these factors at an early age?
Bruce Cruser: Often what we see in addiction starts in childhood and with trauma that happens at an early age. Experiences like child neglect and abuse can lead to serious problems when it comes to mental illness and addiction to prescription opioids and other drugs. What’s encouraging fortunately is that we know a lot more about the research now and we know that improving factors in a child’s life can have a positive impact down the line. As a community, we need to make sure that children can play, they are connected to activities and they have a nurturing adult in their lives — those interventions make a significant difference in long-term health.
AAOA: What are gaps in education and awareness around prescription opioid misuse and abuse?
Bruce Cruser: Even with all the attention that’s been paid to opioid abuse in recent years, there are still misconceptions about what is safe. We often see that the person who prescribed an opioid may not be aware of the whole health of the person who got it. We need more resources for providers to coordinate with the mental health community and for patients to notify their healthcare providers about current prescriptions and conditions. Similarly, care is often episodic for mental illness and patients do not feel that there is coordination across sites of care or a long-term plan for their health and wellness. Addressing these gaps can make a significant difference in education and awareness around prescription opioids and overall health.
AAOA: What more can be done to educate people with mental health conditions and caregivers about the safe use of prescription opioids?
Bruce Cruser: More groups should be posting consumer guides and sharing everything that AAOA puts out. The resources are there but we need to do a better job of sharing them, so everyone is aware of them. We also need to break the stigma around mental health, so people are more willing to talk about it. There is no health without mental health, so we need to encourage consumers to get help sooner and in the right kind of way.
AAOA: What resources do you and your colleagues highlight for preventing the misuse and abuse of prescription opioids?
Bruce Cruser: In addition to AAOA resources, SAMHSA provides great tools about prescription opioid abuse prevention and also overdose treatment. Locally, we partner with public mental health agencies engaged in treatment and recovery support. We also partner with Alive RVA, which is a peer recovery support warm line. Peer recovery specialists are staffing the phone lines and have state-certified training that includes substance abuse and mental health. We always encourage individuals to call the warm line at 1-833-4PEERVA if they need any support at all.
Answers have been edited for brevity and clarity.