A recent analysis article published by The Heights and authored by Nathan Thomas analyzed the American opioid crisis through several different perspectives. Moreover, to examine why the opioid crisis is overlooked in Washington, the author interviewed Professor Shveta Parekh of Boston College’s psychiatry and neuroscience department. Specifically, Dr. Parekh’s research focuses on how chronic opioid use impacts the immune system and neuroimmune signaling during withdrawal.
According to the National Institute on Drug Abuse, 75% of people entering treatment for heroin addiction in the 2000s reported that their first opioid was a prescription drug. “As soon as someone takes an opioid, they feel that euphoric feeling within minutes,” Parekh said. In addition, Parekh explained that because opioids act quickly, the brain rapidly develops tolerance and dependence, and the resulting need for higher doses to achieve the intended effect or function normally often drives individuals from legitimate medical use to substance abuse.
Although the opioid crisis is often seen only as a drug problem, it is deeply intertwined with mental health struggles, homelessness, and pain management, and lower-income communities are particularly affected due to higher exposure to chronic stress and trauma and limited access to healthcare and mental health services that might have prevented these issues.
In her interview, Dr. Parekh emphasized that while medication-assisted treatment (MAT) is the gold standard for opioid use disorder, the rise of potent drugs like fentanyl has made the crisis more lethal and complex, showing that MAT alone cannot quickly solve the problem. Moreover, she explained that many overdoses surged after fentanyl-laced heroin entered the market, as users often unknowingly purchased heroin mixed with this far more lethal substance.
During the COVID-19 pandemic in 2020, lockdowns and isolation caused opioid overdoses to surge, while xylazine (“tranq”) and later medetomidine (“rhino tranq”) began appearing as dangerous additives in fentanyl. According to Dr. Parekh, fentanyl test strips can reveal the presence of fentanyl in drugs and may deter some people from using them. She also noted that supervised consumption sites provide a safer, supervised space for using drugs with proper sanitation and naloxone available, though they remain highly controversial.
Moreover, Dr. Parekh highlighted that stigma around substance abuse is reinforced by criminal-focused policies and media portrayals, which dehumanize people with addiction and emphasize punishment over treatment. She explained that addiction is a medical and neurological condition that hijacks the brain, making it much more than a matter of willpower. She added that Boston College students can help reduce stigma by recognizing addiction as a neurological issue, using respectful language, and treating individuals with substance use disorders with dignity.
“Ultimately, addressing the American opioid crisis begins not with public policy, but with perspective, understanding, and humanity,” concludes the article.
