Carol Costa: Facing Down the Opioid Abuse Monster
Thursday, February 20, 2014
Because they are prescribed and for all intents and purposes are present in our daily lives and reside in our medicine cabinets, it is only a quick step to the cheaper highs provided by the heroin readily available on the streets. Once that spiral has started, it is extremely hard to stop. Has the last decade of (in my view) the utter overprescription of these opioid medications, combined with the folly we call “the War on Drugs”, brought us to what we are now, as we face a reemerging heroin and pain killer crisis? I think so. So what is next?
Prescription abuse: is it fueling the opioid crisis?
Study after study make the link between the availability of prescriptions, overprescription of opiates, and the rise in heroin addiction. The National Institute on Drug Abuse cites overdose as a leading cause of accidental death in the United States. Many in the field are concerned that the overprescription of powerful painkillers and the lack of awareness about the danger connected to them will continue to fuel the problem.
Right there on the very first page of the FDA website the stats are staggering: “More than 15,500 people died in the United States in 2009 after overdosing on narcotic pain relievers. That’s a 300 percent increase over the last 20 years. And for each death, there are an additional ten treatment admissions, 32 emergency department visits and 825 nonmedical users of these drugs. The FDA is extremely concerned about the inappropriate use of opioids, which has become a major public health challenge for our nation.” The really scary part is that these drugs are so often invited guests in our homes; hanging around bathrooms, kitchens, and night tables like old friends.
We are barely 47 days into a new year, and RI has recorded 38 deaths from illicit drugs. Some were laced with the synthetic additive Fentanyl, which is combined with the main ingredient to increase the high. In RI the number of deaths is on a steady rise, as in 2009 the number was 53 and rose to 97 in 2012. This represents a near tripling of drug deaths since 2009, which are huge statistics for our small state. This should shock us. This should be a wake up call. Yet I do not see or feel the fervor. This problem will cost us in money and lives and it will take a village to hold back this tide. But drawing attention to the issue is step one.
Philip Seymour Hoffman’s tragic death reveals ugly truths
Substance abuse is a terrible reality. It strikes randomly and without aim. It steals life, career, passion, family ties, health, and stability from its victims. As a court clerk I remember well the times when people visited by these demons would stand less than three feet from me, so often robbed of youth and sapped of strength. I recall thinking to myself, this girl or boy is ten years my junior and looks so old and haggard. Looking out into the gallery the parents and loved ones of these affected people were all too easy to pick out. The look of weariness and pain was unmistakable as they witnessed their little babies withering away. It was truly gut wrenching, and the images remain a powerful reminder of the human impact of drug abuse. These addictions know no socioeconomic class, no age, no gender, no ethnicity or race—they are indiscriminate assailants. These drugs often start off as friends relieving a pain, but can quickly become a parasite siphoning life from its host. Everyone is susceptible.
Each time I hear of a person sucumbing to this curse, it brings back those tragic courtroom images that live in my head. Each death is a person, not a number. Each victim had loved ones, friends, and life stories. When we discount this wave of abuse we devalue humanity. I know too well it can happen to anyone. To witness the diminution of a human life is something you don't soon forget. Philip Seymour Hoffman, John Belushi, Amy Winehouse, River Phoenix, Janis Joplin, and Elvis are a mere snippet of a tragic celebrity list of people eaten alive by drugs. Perhaps their deaths can help to bring awareness to the issue. In the meantime, it is up to us and our policy makers to attack the problem with new found tools and a re-energised mission.
Leadership void of judgment
We are fortunate to have leaders serving in RI government ready to take the lead on this and at the same time deal with the impact on the ground. Among them are Col. Stephen O’Donnell, Dr. Michael Fine and Craig Stenning. In a recent press conference, state officials indicated the RI State Police will be carrying naloxone or (narcan), an antidote type drug that can flush opiates from the system in order to prevent death. This measure will help to fend off deaths on the streets. Craig Stenning, Director of the RI Department of Behavioral Healthcare, Developmental Disabilities and Hospitals and Dr. Michael Fine, Director of the RI Department of Health are very public about exposing avenues to help people battle these addictions by urging addicts to seek treatment, noting that under the Affordable Care Act, people will now be covered for this type of addiction. Legislators have also put a tool in the kit with the passage of 2012's Good Samaritan Overdose Prevention Act, protecting people who call for help from arrest and prosecution for possession.
These measures hopefully will assist in cutting into these tragic deaths, but it is the organizations in the grassroots that can be the conduit to information and messaging in order to prevent these addictions in the first place. Teachers, parents, aunts, uncles, grandparents, and friends are all stakeholders in this crisis. The notion that because a drug is prescribed, that it is safe and comes without potential problems, is one that needs to be thrown away. Every pill, every liquid, everything that collides with the the human body has the potential for damage, and if it is in the category of opioid it should be treated with the utmost care. After all, it is akin to a time bomb, and proper storage is essential. I, for one, am glad that the decisions and outreach by the RISP, RIDOH and RIBHDDH have garnered much attention, as it sheds light on that monster we must drag from the shadows and defeat.
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