Armed with powerful statistics and devastating personal anecdotes, a group of about 50 gathered Wednesday to partake in an “opioid dialogue.”
The get-together, sponsored by Thrive Allen County, drew professionals from all walks of life, from District Judge Daniel Creitz to Iola Fire Department ambulance crews, pharmacists, teachers and law enforcement personnel.
The aim, moderator Linda Whitworth-Reed explained, was to bring to light the growing opioid epidemic, stemming in large part from the abuse and misuse of prescribed drugs, and to determine if there are ways to collaborate and find solutions.
ONE POWERFUL story came from Nathan Fawson, executive director of the Southeast Kansas Mental Health Center, who spoke about growing up as a child and idolizing his uncle.
“I admired him,” Fawson said. “I adored him.”
His uncle eventually became a successful professional, got married and had five kids.
The story turned, Fawson said, when his uncle became addicted to prescription medicine.
The addiction soon spread throughout the family, to the point his uncle’s wife and son both eventually died of drug overdoses. He lost custody of his other children.
“I remember sitting by my uncle as a child on the couch,” Fawson said, “and I again remember sitting by him on the couch as an adult.”
The second occurrence wasn’t by choice. “It wasn’t because he wanted to be there, and it wasn’t because I wanted to be there. It was because he was in desperate straits, and it all began with an addiction to prescription medicine.”
DAVID TOLAND, Thrive CEO, noticed a recent uptick in young deaths in Iola and Allen County.
“We’ll read the obituaries, and see people who died at 47 or 52 or 33,” Toland said. “There’s all this talk quietly that something’s going on, but it’s never been brought out in a public forum.”
So he started looking at the statistics.
Sure enough, the rate of deaths in Allen County were triple the state average from 2012 to 2014.
At one point, Allen County registered 157 opioid prescriptions for every 100 residents. (That number has since been reduced to about 96 such prescriptions for 100 residents; still a staggeringly high number.)
“Something’s going on, and it’s affecting people’s lives,” Toland concluded.
AS PART OF the program, the audience watched a video from Johann Hari, who spent three years studying the war on drugs.
It’s been more than century, Hari said, that attitudes toward drug addiction grew more punitive, with prison sentences the norm instead of rehabilitation.
Hari’s 14-minute video contended that much of what Americans perceive about addiction is wrong; that a person’s need to bond is a key factor in whether some people turn to drugs.
DR. DOUG WRIGHT, who works with Fawson at SEKMHC, spoke about the history of opioid abuse, noting most incorrectly point to the Vietnam era as a key instigator.
Rather, the history dates back millennia, to 3,400 BC.
“Almost through the entire existence of man, opium has been an issue,” Wright said. “The people found this substance that treats pain, and not just physical pain, but emotional pain.”
Wright surmised the current wave of opioid abuse stemmed from a perfect storm that started in the early 1960s, when drug manufacturers realized the value of marketing their products directly to doctors.
“Instead of wasting your time doing a study, just get an 8×10 color journal, and send a representative from your company to the doctor’s office,” Wright said.
As a result, doctors were bombarded with information about various drugs.
Nevertheless the medical community was almost unanimous in agreeing opiates were addictive.
The next two dominoes to fall came in the 1980s, the first of which was a letter to the editor in the New England Journal of Medicine from a pair of doctors who claimed to have done an in-patient study covering 1,400 patients.
Under a controlled setting, with doctors overseeing the drug usage, and nurses controlling the doses, there were scant few addictions to follow.
The second came when another doctor published his results of a similar study in 1986, in which he hand-selected 38 of his patients to test them for opioid addiction.
“The results were the same,” Wright said. However, it wasn’t known until later the third doctor intentionally picked patients who were not prone to addiction.
Suddenly, doctors who knew that opiates were addictive, were hearing from seemingly authoritative studies that suggested the opposite.
“Did that create the storm?” Wright continued. “No, there’s more.”
It was also in the 1980s the American Pain Society began urging doctors to assess pain as a vital sign.
“Who hasn’t gone to a doctor and had to rate their pain on a scale of 1 to 10?” Wright asked.
“Suddenly, doctors are hearing that not only is it a good idea, but they must assess pain when treating a patient.”
That’s not all.
The final piece of the puzzle came, Wright offered, in the form of patient surveys, in which they were asked to rate their doctors and how they were treated.
“The funny thing about opium is that when you’re pulled from it, you experience greater pain levels,” Wright said. “So if you’re getting prescribed an opioid medication, and the doctor pulls it, are you going to be satisfied? No.”
Doctors then were being confronted by patients demanding satisfaction for their pain, with a tool they’ve been told was not addictive.
As a result, opioid prescriptions quadrupled from 1986 to 1996, Wright noted.
An epidemic was born and few people realized it.
To illustrate, Wright noted SEKMHC is the foremost local treatment center for drug addiction, so he pored through the center’s records to find out how many Allen Countians are being treated today for opioid addiction.
“The answer is six,” Wright said. “Six people are being treated.
“What it means, is it’s evidence that it’s a hidden epidemic,” Wright concluded. “That’s why it’s gone on for so many years.”
WHITWORTH-REED, who told the audience her family was not immune to the epidemic, asked the group to break into subsections to discuss five issues pertaining to opioid addiction:
— Assumptions: What do we know? What do we only think we know? How do we define these problems.
— Goals: What would be the ideal solution? If we could wave a magic wand, what is our end goal?
— Tools: What resources are missing that keep us from reaching those goals? Do we need better information to define goals?
— Partnerships: Who is missing from the table? How do we reach those people? What perspectives will be helpful to better understand the problem?
— Next steps and opportunities: What facts are missing? What information would better help us understand this issue?
The subgroups spent about 30 minutes going over each, and relaying those answers, such as seeking greater collaboration between agencies, seeking alternative treatments for pain, better educating the public and seeking more funding for treatment.
More nuanced answers are needed, all agreed.
“This,” Whitworth-Reed noted, “is a good first step.”
PHOTO: Dr. Doug Wright, above, of the Southeast Kansas Mental Health Center and the Rev. Linda Whitworth-Reed were among the speakers Wednesday during a discussion of the growing opioid epidemic, both in Allen County and nationwide. REGISTER/RICHARD LUKEN
