It’s been more than a decade since my cousin’s 23-year-old son — my godson — died of an accidental overdose of the opioid painkiller Fentanyl.
I had never heard of Fentanyl before Jake died.
As a veteran “cop-shop” reporter, I was very familiar with other illicit drugs like crack cocaine and crystal meth. I even knew a little about heroin from my days in healthcare media relations.
But words like “Fentanyl” and “opioid” were not in my lexicon back then.
Today, I am all too familiar with them and their effects. It’s something I see during days in court and hear on our newsroom police scanner at night.
Last week, I attended a conference sponsored by the Ohio News Media Association and the Ohio Association of Broadcasters for journalists covering the current opioid epidemic.
Attorney General Mike DeWine was the keynoter. Panelists included an emergency room physician, drug treatment experts and the sheriff of Lucas County, who has taken an unorthodox approach to dealing with users.
All characterized the current epidemic of opioid abuse as the worst drug crisis in the country’s history. And Ohio is at its epicenter.
Ohio, the heart of it
A Cleveland TV reporter presented a documentary on Ohio’s dubious distinction as the centerpiece of the opioid epidemic. It went something like this:
In the 1990s, some southern Ohio physicians began prescribing painkillers like Oxycodone and Vicodin indiscriminately. It wasn’t entirely their fault since easing all pain — regardless of how minor — was the common medical practice of the day and “Oxy” had been marketed as “non-addictive.”
Southern Ohio developed a reputation as an easy place to get prescriptions. The state’s network of interstate highways, especially U.S. Route 23, made access to the area easy.
But legally-produced drugs like Oxycodone and Vicodin get expensive after a while.
Enter cheap Mexican heroin and its narco-traffickers.
Colombian cocaine waned from the drug landscape in the early 2000s due to an international crackdown on its manufacture and distribution.
As the Columbians were forced out of business, Mexicans stepped in to fill the void. They had already developed a process for turning their home-grown poppies into cheap, black tar heroin. Its effect mimicked painkillers like Oxycodone and Vicodin — but for less money.
In addition, the Mexicans were savvy marketers with a business plan centered on customer service. Users could order heroin via cellphone and have it delivered to their homes within an hour.
Today, that heroin costs about $6 a hit, while Oxycodone runs $1 per milligram on the street, according to Cheri Walter, who represented county ADAMH boards at the conference.
Add to all that a belief among young people that pills are not dangerous and a social acceptance that no longer sees heroin as an inner-city drug used by “junkies” and the end result is growing numbers of overdoses and deaths that continue to bog down emergency rooms and occur in such unexpected places as a grocery store in Upper Arlington and the restroom of the London Public Library!
London Police Chief Glenn Nichol recently told me that users are beginning to get high in public places more often, as it minimizes the risk in case something goes wrong. After all, someone will surely find them!
A deadlier Fentanyl
Much of the lethal nature of today’s heroin comes from additives like Fentanyl that dealers use to “stretch” their supplies.
But today’s Fentanyl is a far cry from the drug that killed my cousin’s son.
The new, synthetic Fentanyl is extra strong and more dangerous than previous versions. Two salt-sized grains will kill, Walter said.
Another heroin supplement, Carfentanil, is even worse. Developed as a sedative for zoo animals, Carfentanil was responsible for a surge in deaths and overdoses in Cincinnati last year, an editor from WLW-TV noted.
DeWine anticipates at least 5,000 Ohioans will die of heroin and pain pill overdoses this year, despite the increasing availability of the antidote Naloxone.
With the addition of Fentanyl and Carfentanil, it takes multiple doses of Naloxone to reverse a heroin overdose.
Dr. Ryan Squier said the plague is leading to compassion “fatigue” among emergency personnel who are simply tired of dealing with repeated life-threatening situations — often involving the same individuals.
Some even say “let the users die” and shift attention to saving the children of users. Those children are often neglected or abandoned.
But Sheriff John Tharp of Lucas County observed few would apply that philosophy to a diabetic who can’t lose weight or eats improperly. He said addiction must be viewed as a disease like diabetes that can be treated and cured.
I would agree. But it’s difficult for many non-users like me to understand how heroin and other opiates take hold of people and become the only thing that matters to them.
The 21 officers in Sheriff Tharp’s DART (Drug Abuse Response Team) respond to overdoses in unmarked cars. They no longer arrest those users for possessing drugs, but work at building positive relationships that encourage treatment and education — and in some cases, lead to “bigger fish” dealers.
Every panelist last week agreed that drug treatment does work. But it isn’t quick.
Dr. Squier said it takes as much as seven times through treatment to reach success. Chances of remaining drug free improve 70 to 80 percent if a user remains “clean” for a year.
It’s true that jails have become detox centers where staff are ill equipped to handle the problem. And there’s often a long wait at treatment centers.
DeWine said the Ohio General Assembly is toying with the idea of creating community detox centers staffed by medical professionals. However, the AG shied away from questions about using Ohio’s “rainy day” fund to establish those centers.
He encourages community and faith-based groups to step up to the problem, taking the children of users under their wings and directing their parents to education and treatment. He estimated 50 percent of children currently in Ohio’s foster care system have drug-user parents.
Like others at the conference, DeWine believes education about the effects of drug use must start early and be a continuum. If he becomes Ohio’s next governor, he will push for K-12 drug education programs in every school.
Not a bad idea since almost all users I’ve seen in court say they started abusing drugs at age 13.
It may be a matter of nipping the problem in the bud. Curtailing the prescription of opiates is a must since nine out of 10 heroin users say their addiction started with pain pills.
That’s another trend I’ve seen in our local court.
Dr. Squier advocates for more heavy-duty Tylenol to relieve moderate discomfort until new, non-addictive painkillers come on the scene. Several drug companies are now researching those medicines.
Cleveland’s MetroHealth System recently unveiled an advertising campaign that warns against taking even one narcotic pain pill.
The “Know The Risks” campaign addresses the fine line between use and abuse through billboards, posters and social media. The hospital system plans to make the campaign available free of charge to communities beyond Cuyahoga County.
Jane Beathard is a contributing writer for the Advocate.