The Heroin And Opioid Crisis Is Gridlocked By Discussion

Talking about this epidemic is not saving lives.
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Sheriff Karl Leonard with participants of his womens Heroin Addiction Recovery Program HARP.
Sheriff Karl Leonard with participants of his womens Heroin Addiction Recovery Program HARP.
Sheriff Karl Leonard

Our nation is at a critical juncture regarding the opioid and heroin crisis we are in. Any further delay in getting beyond the rhetoric and taking tangible action to start to turn this continually rising problem will result in a catastrophic number of our sons and daughters, sisters and brothers, mothers, and fathers continuing to die in tremendously high numbers.

The National Institute on Drug Abuse (NIDA) states that every day, more than 90 Americans die after overdosing on opioids. That is one opioid death every 15 minutes of every hour of every day of every month. However, that doesn’t seem to be enough deaths to cause any great action on our parts.

Our government, from the president (current and past administrations), to Congress as well as many state governing bodies have done little as far as implementing constructive substantive action to even start to have this crisis merely level off yet alone begin its demise. What they have all done well is talk about the crisis and work to raise awareness. Talking about this epidemic is not saving lives.

Why is it that, as we find ourselves in the fourth or fifth or even tenth year of this deadly crisis, we have yet to do more than simply raise awareness? (Per the Drug Enforcement Administration (DEA) the threat posed by heroin in the United States has increased annually since 2007).

Raising awareness is a great first step. On that front, government has done well. I am sure there are very few people in the United States who are not in tune with the opioid crisis in this country. Great job! However, we cannot sit idly by and pat ourselves on the back simply because we raised awareness of the opioid crisis in the nation. Why not? Because an opioid overdose just took another life. And it will again in 15 minutes. And again 15 minutes after that. It’s time for second steps and third steps and as many steps as we need to take to combat this.

“We must stop treating the overdose as the ailment and more as the symptom.”

In addition, with the current widespread availability of Naloxone, I am fearful that we have lowered our guard, especially our state and federal governments who have taken on a more one-dimensional approach to this crisis perhaps because of the wide production and distribution of Naloxone. Yes, Naloxone is a miracle drug, no denying that. Almost all public safety entities and hospitals are stocking it and using it very frequently. And yes, it is now readily available to many Americans because of the open prescriptions several national drug chains now have.

However, in my opinion Naloxone is not saving lives but rather postponing deaths. All too often, hospitals treat opioid overdose victims with Naloxone and in short time, sometimes less than two hours, discharge the overdose victim back onto the streets. Often these overdose victims, so fraught with the disease that is their opioid addiction, go right back to injecting because the Naloxone “stole” the high they were just on. In some cases, these same overdose victims end up going right back to the hospital on another overdose. That is if they are lucky enough to get to a hospital before they die.

We must stop treating the overdose as the ailment and more as the symptom. If someone suffered a broken arm and went to the hospital in excruciating pain the hospital would probably administer a dose of morphine (or some other drug) to mask the pain for the patient. They certainly wouldn’t wait for the pain to subside and then send them off back on to the street still with a broken arm.

The pain the patient was in was only a symptom not the ailment. A person who overdoses is not suffering from overdoses, they are suffering from the disease of addiction. Much like a person with a broken arm when the overdose symptom is controlled, using such a powerful and remarkable tool like Naloxone, hospitals then should shift gears and look to treat the addiction before simply releasing the individual back onto the street.

Therein might be the very crux of our failure to start making any inroads with this crisis. How many hospitals are resourced and equipped to treat opioid ― or any other drug of choice ― addictions?

This is where our government must refocus some of their attention and energy to create a multi-dimensional response to this crisis. Since hospitals are the common first step of those who suffer an overdose, they also would be the logical place to implement real addiction treatment programs.

Hospitals should be resourced to provide immediate care and treatment after reviving an overdose victim which includes attention to the mental health matters that many addicts also endure. In many cases, addicts use drugs to mask pain, pain created by some underlying trauma or issue. To truly recover, addicts must get to the root cause of that pain and identify the trauma so they can then learn the proper tools to deal with that underlying issue so they no longer have the need to use drugs to mask it.

It can be done and recovery works, however, it requires an investment much more than the hour or two an overdose victim currently spends in the hospital. Treatment must start right then, right there. You can’t schedule an appointment for someone to come back in a month, or a week, or even a day to start treating the addiction. It must be at that very moment.

And yes, that would be costly to do, so how do we make this happen? How do we fund this capability? I don’t have the answer but I do know we must do it. Keep in mind though that this crisis is already costing us billions. The Centers for Disease Control and Prevention estimates that the total “economic burden” of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of health care, lost productivity, addiction treatment, and criminal justice involvement.

“The next time an opioid overdose claims a life, it will not be seeking to determine if the victim is a Republican or Democrat first. It simply wants to kill.”

Any multi-dimensional response must also provide services for addicts who have not overdosed. The same treatment mentioned above should be readily available and affordable to all addicts in their communities. Perhaps this would be an area our faith based groups could take the lead on. With the help of local, state, and federal government we could resource places of worship to serve as 24-hour help centers for opioid (or all) addicts.

If recovery treatment facilities cannot be launched in our cities, towns, or counties, then allow open access to the same programs I suggested above hospitals should have for overdose victims. Addicts should be able to come in off the streets to participate.

There is a critical need for “drop off centers” so that law enforcement isn’t left with the single option of incarceration when they encounter an addict. Our jails, which have become the largest repository for the mentally ill, now also serve the same purpose for those in the throes of addiction. Neither of which they are equipped or resourced to deal with.

State, federal, and local law enforcement agencies also have a large role in this crisis to stem the flow of heroin and illegal opioids into this country and our neighborhoods and schools by targeting the dealers and importers. Because heroin is readily available and inexpensive, many users also elect to sell heroin. These “sellers” are not the “dealers” that all our efforts should be focused on. Certainly they should be dealt with, however stopping the flow of large quantities of heroin into this country must be a top priority.

This is not an all-inclusive list nor do I have all the answers. I am doing what I can to address this crisis in my own jail, however that is limited. We must open the aperture on the lens we look at this opioid crisis through to see the bigger picture. There must be a way to make this happen and have it happen without being bogged down in lengthy debate and more rhetoric.

As non-discriminatory or “bipartisan” as the opioid addiction is to its victims, our response to it will only succeed if we approach it in a bipartisan manner. The next time an opioid overdose claims a life, it will not be seeking to determine if the victim is a Republican or Democrat first. It simply wants to kill. This terrible disease, which is consuming our nation, should certainly be a major part of any national health care program we put forth, as well as provisions for mental health care.

The Drug Enforcement Administration (DEA) states there has been a 248 percent increase in heroin deaths between 2010 and 2014 alone. Must we wait until it reaches 300 percent before we take constructive action? Or until an opioid overdose claims a life every 10 minutes rather than every 15? What will it take? Are we simply satisfied as to where we are today and comfortable with continuing the rhetoric? I would say the parents who lost a loved one to an opioid overdose just while you were reading this would say no.

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