wellness

World Day of Social Justice

“Social justice is an underlying principle for peaceful and prosperous coexistence within and among nations. We uphold the principles of social justice when we promote gender equality or the rights of indigenous peoples and migrants. We advance social justice when we remove barriers that people face because of gender, age, race, ethnicity, religion, culture or disability.” -United Nations, WDSJ webpage (1)

In 2007, the United Nations General Assembly declared that February 20th be celebrated annually as World Day of Social Justice. A product of rising globalization, World Day of Social Justice encourages nations to devote the day towards the eradication of poverty, inequity, exclusion, and unemployment. While we know these goals cannot be achieved in a day, World Day of Social Justice provides us with a chance to look around our community, locally and globally, with extra purpose and passion. GlobeMed at Tufts and PHASE Nepal share a drive to collaborate and eliminate global health inequity, and we find inspiration in the action taken by the international community in support of global health equity. February 20th has become a day to rally, to dream, to energize, to learn, to grow, and to come together. Especially in the current national climate, it is increasingly important every single day to take action and to create hope.

This February 23rd, GlobeMed at Tufts will be hosting a film screening of Vessel, an award-winning documentary following the work of Rebecca Gomperts, founder of Women on Waves. Dr. Gomperts, a Dutch physician, activist, and artist, made it her life’s work to end the health risks associated with illegal abortions. Dr. Gomperts and her organization work on a ship-turned-clinic that sails to areas where women cannot access legal and safe abortion. Once in international waters, Dr. Gomperts and her crew are trained and authorized to administer abortions and provide contraceptives. They also train local women to administer safe abortions using non-surgical WHO-researched protocols. Through a network of empowerment, Women on Waves has given countless women access to safe abortions, birth control, and invaluable knowledge.

We find this documentary especially relevant after the reenactment of the U.S. Mexico City Policy, also known as the Global Gag. First enacted by President Reagan and most recently reenacted by President Trump, this policy blocks federal funding to NGOs that provide abortion services or counseling as well as those that advocate for the decriminalization or expansion of abortion services.

GlobeMed at Tufts is devoted to social justice, nationally and abroad, and aims to emphasize the importance of self-education and community discussion. Please join us on February 23rd at 6 PM in Tisch 304 for a free screening of Vessel with snacks, discussion, and good company! We hope to foster an open dialogue about the film and World Day of Social Justice, so all thoughts, feelings, and opinions are welcome.

Vessel trailer: https://vimeo.com/106489346

Women on Waves website: http://www.womenonwaves.org/


(1) http://www.un.org/en/events/socialjusticeday/

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Overprescription of Opioids Epidemic

opioidsStarting at the turn of the century, an increased amount of data has shown, over an array of studies, that deaths by caused by drug overdose have increased for the fourteenth consecutive year, mostly due to opioid analgesics, which are “derived from the poppy and used for pain relief,” and include Hydrocodone, Morphine, and Oxycodone. Opioids are more readily being prescribed in the past decade than ever previously before by doctors to patients, often without consideration of the severity of their condition, their state of mental health, and alternative medications and options.Though providing therapeutic pain relief to millions of Americans, this staggering number of drug overdoses is now higher than the number of deaths from motor vehicle accidents.

Additionally, a logical presumption would be that the rise in opioid prescriptions would correlate with a decline in chronic pain and even illnesses; however, this is not the case. The Center for Disease Control went on to state that there are noticeably “clear correlations between national trends for prescription opioid sales, admissions for substance abuse treatment, and deaths.”   According to a 2012 JAMA article, the specific amount of overdose deaths attributable to prescription opioids exceeds those attributable to cocaine and heroin combined. This rapidly-emerging and pervasive epidemic is gaining visibility, yet despite this increased awareness of the problem there is not much action being done towards beginning to solve it.

The lack of change and continual abuse of prescription opioids, is largely due to a higher demand from patients, particularly those with mental disorders and a history of substance abuse, to treat chronic pain that has fostered a powerful industry that grosses in billions of dollars each year. The increase in opioid overdoses correlates with the increase in opioid prescriptions, highlighting the leniency on the care provider level with prescribing opioid analgesics, a lack of regulation of patients prescribed to opioids, as well as proper education and warning being provided to these specific patients. Cross-prescribing and pill mills also play a vital role in the easy access to opioids and the increase in abuse. The number of overdoses due to opioids is especially high among individuals with mental diseases and those with a history of substance abuse, meaning that increased precautions must be taken when prescribing these individuals to opioids.

As stated by JAMA’s 2012 article, “Patients with mental health or substance use disorders are at increased risk for nonmedical use and overdose from prescription painkillers as well as being prescribed high doses of these drugs.” One of the primary causes of the heightened susceptibility is that the process is cyclical: chronic pain can cause depression, as well as a multitude of other mental health disorders, and depression and other mental health disorders can cause pain. This community is also exposed to a high vulnerability due to a lack of specialized regulation—which includes intricately keeping track of the medical and behavioral backgrounds of each patient and using that information when determining the dosage, level of precautionary information, and amount of follow-up visits—in the amount and level of opioids they are prescribed, frequent hospital visits with multiple doctors, multiple prescriptions, and a higher accessibility to prescriptions as a remedy for their disorders including depression, anxiety, and posttraumatic stress disorder. Also, because opioids suppress pain and can create a euphoric relaxed sensation, they can provide a release from stress which is particularly higher in individuals with mental health disorders or a history in substance abuse.

Action against this epidemic could include an increase in repercussions for mal-practicing physicians, the implementation of mandatory online databases across the nation to regulate what doctors are prescribing opioids to which patients, and an option for alternative pain treatments. With these implementations there will be less of an incentive to inappropriately prescribe opioids and, consequently, a decreased amount of unqualified patients who have access to prescription opioids. Social determinants are impactful, particularly for the population I described including the genetics they were born with, the families in which they were born into, as well as their conditions in which they live. However, even if they are unable to modify their situation, the regulation of patients on a care provider level can aid in decreasing opioid abuse and, in turn, the health of patients in spite of these outside influences.

Sources:

http://www.cdc.gov/homeandrecreationalsafety/rxbrief/

httpp://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/oxycontin/Pages/opioids_dyk.aspx

http://www.ncbi.nlm.nih.gov/pubmed/24211157

http://www.ncbi.nlm.nih.gov/pubmed/21668754