James Walker: Opioids? The silent question nobody is asking
Where do we go from here?
I started writing this column understanding it was going to be a grim read for a lot of people as there are opposite sides and opinions when it comes to opioid addiction and how to fight and treat it.
It is a tough subject because opioids ruin more than the lives it steals: it leaves behind wrecked loved ones, many who could only watch as the person they loved spiraled into addiction and eventually, for many, toward death.
With more than 900 deaths in Connecticut alone, it is a testament to the power of opioids and their ability to fool their victims with an embrace of euphoria before tightening around them like a python, leaving them gasping for the fix with no other place to run and no place to hide.
Never before in the United States has so many people cast caution to the wind with such reckless abandon.
Mental health experts, lawmakers and law enforcement have responded, setting up clinics, treatment, services, funding, and are pouring over other ideas and implementing new strategies to get more addicts to come forward.
But despite this, I find there is not a lot of plain English being spoken when it comes to fighting the crisis that has gripped the nation and is spreading desperation from small rural communities to burgeoning metropolises.
I don’t mean to bring doom and gloom but what’s worrisome to me is what nobody is talking about given the massive crisis this has become and the massive response it’s going to take to fix it: the success rate in kicking substance-abuse-related addiction is very low.
Substance abuse programs do get some people through the rushes but even at their high end, the 12 steps don’t seem to lead enough people walking across the finish line to sobriety.
And the grim reaper is no longer a surprise from the shadows but breathing on every needle and every snort.
According to the New York Times, nearly 60,000 people in the U.S. died of overdoses last year. Drug overdoses are now the number one “cause of death among Americans under 50,” with overdoses on a 19 percent climb from 2015 — and 2017 is expected to be worse.
The Agency for Healthcare Research and Quality ranks Connecticut the 5th-highest among 30 states in the rate of opioid-related emergency department visits and 7th-highest among 44 states for inpatient stays — both above the national rate.
Those are pretty troubling numbers for a state that is broke, cutting services and dealing with a large unskilled workforce.
Right now, it is estimated that more than two million people nationwide are dependent on opioids and another 95 million used prescription painkillers in the past year.
With millions needing treatment for opioid abuse, the dollars are being vacuumed out of local and state budgets and the U.S. wallet will have to be a lot more generous to keep up with the demand.
That leads to the stark reality of what is happening now and what lies ahead: revive, treat and maintain.
And the sheer cost of that is drawing red lines.
Some lawmakers in Ohio are making it clear to addicts in their districts that they’re are only willing to go so far to help. They have decided that the strain on their constituents and employees along with decimated budgets that have affected other services can’t continue.
Butler County Sheriff Richard Jones will not let his men carry naloxone, citing cost and safety. He said besides the fact that people “can become hostile and violent” after being revived, it is a wasted effort.
“All we’re doing is reviving them, we’re not curing them,” he told NBC News. “There’s no law that says police officers have to carry Narcan (naloxone) … Until there is, we’re not going to use it.”
And from the same county, Councilman Dan Picard wants a three-strikes penalty so EMS will not have to respond to an overdose victim who has required two previous interventions. He is also looking for a way to recoup costs, suggesting people who overdose should be forced to perform community service to make up for the cost of treatment.
Those lawmakers may not display the compassionate nature we Americans are used to hearing. And it is certainly not happening here in Connecticut where police carry naloxone and pharmacists are hitting the streets to “prescribe and dispense” the life-saving drug to people on the streets.
But for how long?
The shift in attitude from the Ohio lawmakers may be ugly and dangerous but it also may show what could lie ahead if addicts, public health officials and lawmakers don’t get a handle on this crisis.
I can be accused of taking a dystopian look at the situation but I don’t think so.
Opioids have worked their yellow haze over too many to think the crisis will just wind down in an orderly way as so much depends on those addicted — and their numbers are growing.
But there is room for optimism.
According to cleanslate.com, an informational website about addiction, it sticks by a 2001 study that shows up to 75 percent of addicted people will eventually find their way to sobriety on their own.
Well … OK, that sounds good, but how long does that take?
These are high tech, deadly drugs and if they can’t kick the habit and that python keeps tightening its grip — it leads me back to the first sentence in this column: where do we go from here?
James Walker is the Register’s senior editor. He can be reached at 203-680-9389 or jwalker@nhregister.com. Follow him on Twitter @thelieonroars
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