I am one in the countless number of those affected by the newly released provisional data collected by the National Center for Health Statistics in conjunction with the Centers for Disease Control and Prevention (CDC), reporting that there have been 93,000 people lost to fatal overdose this past year (CDC, 2021). We lost our loved one in May of 2021 at 10:00 p.m. However, the truth is we lost our loved one years earlier to substance use disorder (SUD) and painfully watched them struggle over the past 14 years. The emotions we as a family have experienced over the past few months are indescribable. I am a nurse, and a nurse educator, whose concentration is SUDs. I am a certified registered addictions nurse whose research and writing is on SUD and the attempt to help those afflicted and affected by them. So, I find myself asking repeatedly, how did this happen to me and my family?

In the same hospital I worked at as a nurse for many years, the hospital I brought nursing students to for many more is the same hospital I witnessed our loved one's heartbeat slow to a stop on a machine that I have taught countless students to use. I did not notice during the haze of my first arriving to the intensive care room and seeing my family huddled at their bedside holding their hands and crying that it was two of my former nursing students taking care of them in their last hours. There was extreme comfort in this, when I knew my loved one was gone and that the preparing of their body for the morgue was going to be done, a task I had done countless times with my nursing students. One would think I would be better prepared for this type of loss and these types of experiences, but I was not, am not, and I had no clue what this was going to feel like.

Although there are many views for how we got here as a country, 93,000 lives were lost in a single year, with projections for even higher numbers for 2021. Some postulate it is the influx of fentanyl, or the triggers brought on by the pandemic; others postulate it as the lack of support and meaningful intervention for those having a mental illness and SUD, perhaps more likely a combination of factors (CDC, 2020, 2021). Although these are important questions to study and answer, I think the more pressing question to ask ourselves is where we go from here, how can we help those who have not yet succumbed to overdose with time of the upmost of significance? I wish there was a way I could project that question aloud in a printed article to get the importance of it across to everyone. People are dying daily, 240 to be exact, that is, 11 people an hour, and the people they leave behind are broken, I am broken (CDC, 2021). I will never again be the person I was in May of this year at 9:59 p.m.; that person is gone with my loved one, a water-loving, intense, compassionate human being who I will never again have the opportunity to try to help. However, there are many others out there who can still be helped.

I am aware of two missed opportunities for intervention for our loved one; they had two nonfatal overdoses last year in 2020 and were seen at an emergency department. Upon their death, in their belongings bag was a set of discharge paperwork from one of those encounters; under discharge instructions, it simply said follow up with the local substance use clinic. No phone numbers were provided, and there were no information regarding risk for reoccurring overdose, no information on medication therapy and harm reduction services, or no specific information for potential detox or recovery programs.

I ask each one of you, my colleagues, that you take a part, no matter how big or small, to help deal with this issue. There are many ways to help the person with SUD and their loved ones. Take a personal stand to end the stigma surrounding mental illness and substance use. Advocate for ending stigmatizing language (i.e., junkies, addict), and endorse the use of people-first language (a person with SUD; Zwick et al., 2020). Make sure the facilities you work at has protocols in place to help this patient population find meaningful help and direct them to care, to harm reduction, to detox or rehabilitation, and to support groups. A great resource to locate such information is Substance Abuse and Mental Health Services Administration's (SAMHSA) recovery and support website: https://www.samhsa.gov/find-help/recovery (SAMHSA, 2020). Another is the opioid overdose prevention toolkit website: https://store.samhsa.gov/product/Opioid-Overdose-Prevention-Toolkit/SMA18-4742 (SAMHSA, 2018). Find the facilities yourself if willing, as well as phone numbers and addresses, and hand them out or create a resource notebook for your facility. Navigating the system and feeling stigmatized are identified barriers for a person with SUD in finding and utilizing services. Cost of care (e.g., insured vs. uninsured), unreliable transportation, and developing trusting relationships with providers are a few self-identified barriers people with SUD face (Motavalli et al., 2020).

Urge qualified staff (physicians, physicians' assistants, and nurse practitioners, including currently in qualifying academic programs) to obtain a waiver to dispense and prescribe buprenorphine; more information can be found on the SAMHSA website: https://www.samhsa.gov/medication-assisted-treatment/become-buprenorphine-waiver (SAMHSA, 2021a). Medication-assisted therapy is a proven effective evidence-based therapy for persons with SUD (SAMHSA, 2021b). Upon discharge, advocate for the distribution of naloxone (an opioid antagonist used to reverse an opioid overdose), recommended to anyone who has experienced overdose or is knowingly taking or prescribed opioids (SAMHSA, 2021c).

Guilt, pain, anger, and my inability to save our loved one served as the catalyst for me to write this commentary. However, it will be the knowledge, compassion, and empathy of health professionals like you that will see us through these challenging times. Nurses please commit to helping those with SUD overcome barriers that can hinder their recovery and give them the tools and resources they need to save their lives.

REFERENCES