By Sue Botos
Despite the statistics proving otherwise, experts still say the stereotype of a drug addict as a defeated individual on the fringe of society is one of the major barriers to awareness.
“This is highly complex and plagued by stigma. But no community is immune regardless of gender, race or economic status,” Allisyn Leppla of the Cuyahoga County Board of Health told an audience at Rocky River High School. Her appearance, along with fellow panelists, special agent Jeff Capretto of the Westshore Enforcement Bureau (WEB), Rocky River police Chief Kelly Stillman and University Hospital psychologist Christina Dellos Reyes, was part of a town hall meeting, sponsored by the city schools, called “Ohio’s Prescription Drug Overdose Epidemic.”
School board President Jon Fancher, serving as moderator, began the evening with sobering statistics about a complex issue. In August there were 52 deaths from heroin or fentanyl overdoses countywide, a record according to the medical examiner.
Between March and August of 2016, an average of 11 ODs per week were reported.
This year has not gotten off to a better start, with 46 heroin and fentanyl overdose deaths in January, and 14 suspected drug fatalities during the first weekend in February.
Leppla described several key terms including “opiate,” a naturally occurring sedative such as heroin, opium and morphine, and “opioid” which usually refers to a synthetic version like fentanyl and oxycodone. The two terms, she said, are often used interchangeably to describe these drugs, which in prescription form are used to ease pain.
“Fentanyl is 30 to 50 times more potent than heroin and carfentanil is 100 times more potent,” she said, adding the U.S. consumes 80 percent of opiates manufactured.
Leppla noted about 73,000 individuals in Cuyahoga County are identified as being addicted to painkillers. “You could fill The Q (Quicken Loans Arena; capacity 20,562) with the number of people who move on to heroin,” she said, adding the county is “on track for another record year” of overdoses.
Aside from stigma, Leppla reported another roadblock to controlling abuse of opiates is the practice of advertising medications. “The U.S. is one of the few countries that direct market drugs,” she said.
Like any disease, Leppla said addiction is preventable, treatable, changes a person’s biology, and if untreated, cannot be cured. Programs such as Project DAWN (Deaths Avoided With Naloxone) provide education and distribution of Naloxone, which reverses the effect of heroin or fentanyl overdoses.
Reyes agreed Opioid Use Disorder is a treatable brain disease which often is perceived like “six blind men and an elephant.”
“Their observation is based on the part of the elephant they are holding. They think they know it all and they are not all wrong and not all right,” she illustrated.
Comparing treatment of addiction to other diseases, Reyes asked, “Would we put people in jail for symptoms of other diseases?”
“The part of the body that is broken is the brain. The reward pathway is broken,” she said, adding one in eight people will suffer from some form of addiction, which can include alcohol or gambling. Symptoms, she said, are not always evident and masked by the person.
“Families shouldn’t blame themselves if they don’t recognize the symptoms,” she stated.
Reyes uses what she called the “three-legged stool” approach to working with those addicted to drugs. This includes programs involving the biological (sleep, diet, exercise), spiritual (sponsors, 12-step programs) and psychosocial (counseling and residential treatment.)
“They have to re-create their lives with new people, places and things,” she noted.
Looking at the issue from the law enforcement view, Stillman said that last year, his department received 21,540 calls, up from 14,000 in 2015. “The majority, unfortunately, are drug-related,” he said, noting a full jail and overtaxed municipal court are the result.
He echoed the other presenters, stating there is no longer a stereotypical user. “It can be anyone. Educate yourselves and know what to look for. Don’t be afraid to call police.”
Capretto, a 48-year veteran of law enforcement, over 30 with the drug unit, commented, “It’s a very different job now. I’ve never seen it this bad.”
His advice is communication. “I am continually talking to my adult children and grandchildren about drugs. To make a difference at home, talk openly.”
Noting the table of materials available to attendees, he added, “If you see something, say something. Call us. You can provide information anonymously.”