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‘We’re in danger of losing a generation’

By Bethany Bray April 5, 2017

When a person is prescribed medicine by a doctor, the common assumption is that it’s best to take the dosage until it’s gone.

In most cases, that’s true. But with opioids, a class of powerful, addictive and frequently prescribed pain relievers, dependence on the drug can begin within five days. Yet doctors often prescribe a 30-day supply, said Carol Smith, a licensed professional counselor (LPC) who spoke at an April 4 congressional briefing on Capitol Hill that was sponsored by the American Counseling Association.

“By the end of the 30 days, [the opioid] is not addressing their pain anymore. It’s a vicious, vicious cycle,” said Smith, a professor of counseling at Marshall University in West Virginia and past president of the West Virginia Counseling Association.

Carol Smith, LPC and professor of counseling at Marshall University, speaks at ACA’s congressional briefing on opioids on April 4. At left is panelist Larry Ashley, LPC, LMSW and professor emeritus of counseling at the University of Nevada, Las Vegas. Photos by Bethany Bray/Counseling Today

Smith, a member of ACA, was speaking as part of a panel that focused on the realities of America’s opioid epidemic and how professional counselors are well-suited to help change that trajectory.

“What counselors bring to the table is essential to any response to this crisis,” said panelist and ACA member Kevin Doyle, a professor of counselor education at Longwood University who also has a private counseling practice in Charlottesville, Virginia. “This touches everyone. … Virtually no element of society is immune to this.”

The opioid class includes heroin as well as prescription pain relievers such as oxycodone, Vicodin and morphine. On average, 91 people across the U.S. die every day from opioid overdoses, according the U.S. Centers for Disease Control and Prevention. The amount of prescription opioids sold in the U.S. has nearly quadrupled since 1999; deaths from prescription opioids have more than quadrupled since 1999.

In the U.S., more than 650,000 opioid prescriptions are dispensed every day, said panelist and ACA member Kirk Bowden, an LPC who chairs the addiction and substance use disorder program at Rio Salado College in Arizona.

Opioids should be for acute, not chronic, pain, Bowden said. He also stressed the need for more training for medical professionals on the dangers of dispensing opioids.

For example, patients who have had oral surgery to remove their wisdom teeth are commonly prescribed a 30-day supply of opioids, when in most cases the drugs are only needed for a few days of pain relief, Bowden said. Patients then leave the remaining pills in their medicine cabinets, easily accessible to anyone in the household.

“[With opioids] if individuals use it, even as prescribed, over time the individual will become addicted,” said Bowden. “Something drastic needs to happen. … Over half a million people died between 2000 and 2015 from opioids. That’s like the city [the size] of Atlanta.”

“We’re in danger of losing a generation,” said Smith, who lives in West Virginia, a state with one of the highest opioid overdose rates in the U.S.

“As [Bowden] succinctly put it, we need to remember that this issue is not a singular crisis but a chronic problem that demands that we marshal all available resources to combat,” said Art Terrazas, ACA’s director of government affairs.

Panelists told congressional staff members attending the ACA-sponsored briefing that solutions need to include more addictions training for medical professionals, better access to care and support programs for people struggling with opioid addiction, and the inclusion of professional counselors in response efforts to the opioid crisis.

Kevin Doyle, LPC and professor of counselor education at Longwood University in Virginia speaks as Dr. Melinda Campopiano of the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) looks on.

Counselors use a strengths-based approach and work to address the underlying reasons, such as past trauma, that individuals may turn to opioids to self-medicate, Smith explained.

“What counselors can bring to all of this is an attention to the whole person,” she said. “We come at it from a wellness perspective, and build on [a client’s] strengths. … We teach self-regulation and how to stay grounded in the here and now. We help people to know how to be sad in a healthy way, how to be angry in a healthy way and what to do with those emotions. Many people come to counseling and they can’t even identify that they’re angry. It’s been trained out of them by life experience.”

Counselors are uniquely skilled to support clients in their recovery goals – and in their possible relapses, Doyle added.

“We stick with them through the ups and downs,” he said. “We know that with treatment, recovery is possible.”




Watch a video of ACA’s Congressional briefing on opioids here:


Download ACA’s infographic on opioids here:



Dillon Harp of ACA’s Government Affairs team (far right) moderates the panel, from left to right Dr. Melinda Campopiano, Kevin Doyle, Kirk Bowden, Larry Ashley and Carol Smith.

About the panelists

Larry Ashley is a licensed professional counselor (LPC), licensed master social worker (LMSW) and professor emeritus of counseling at the University of Nevada, Las Vegas and addiction specialist at the University of Nevada, Reno School of Medicine. A U.S. Army veteran, he specializes in the treatment of military clients and issues related to combat trauma.

Kirk Bowden, an LPC and ACA fellow, is past president of NAADAC, the Association for Addiction Professionals, chair of the addiction and substance use disorder program at Rio Salado College, and consultant and subject matter expert for Ottawa University.

Dr. Melinda Campopiano is a physician and the chief medical officer of the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration. She is board-certified in family medicine and addiction medicine.

Kevin Doyle, LPC, is a professor in the counselor education program at Longwood University and chair of the department of education and special education. He has served three terms on the Virginia Board of Counseling and runs a private practice in Charlottesville, Virginia.

Carol Smith, LPC, is a professor of counseling at Marshall University and coordinates Marshall’s Violence, Loss and Trauma Certificate of Advanced Studies program. She is past president of the West Virginia Counseling Association, a branch of ACA.






Bethany Bray is a staff writer for Counseling Today. Contact her at


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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.







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