“People have been trying to get high forever. Since the beginning of recorded history people have been doing what they can to get high,” Dr. Brad Lander, clinical director of addiction medicine at The Ohio State University Wexner Medical Center, says to me. “They are just getting more and more potent and powerful drugs to do it with.”
A veteran of the drug addiction science field for 34 years, Lander has more or less seen everything imaginable.
“First it was phencyclidine, then Quaaludes, then crack cocaine, club drugs, ecstasy,” he says. “Even OxyContin, which was designated for terminal cancer patients and then they gave it for a lot of different reasons like back pain, arthritis. It was never meant to be for that. It’s way too strong.”
Now, it’s heroin.
Once reclined in the pop culture of rock star overdoses and drug gangs, heroin and opiate use has been settling uncomfortably into communities across the nation in an unprecedented nature. In fact, between the years 2002 and 2013, the number of heroin-related deaths quadrupled nationwide.
“Most of the patients in our facility are … (in for) a lot of heroin, with some prescription drug addiction,” Lander says of the addiction medicine facility at OSU. “The average age of the patient admitted is 25 years old.”
Twenty-five years old.
“There are two groups of people that become addicted: people on pain medications, then once they were cut off they went into withdrawal, or recreational heroin from self-medication,” Lander says. “It doesn’t take much to get addicted.”
About 23 percent of people who try heroin become dependent on it.
Roughly five years ago, the heroin epidemic became a reality, something of an “overnight transformation,” says Lander. But the path to the heroin epidemic didn’t start overnight.
In the 1990s, Lander says a culture that perpetuated the nonexistence of pain, that pain needed to be eradicated completely from life, began. In response, physicians overprescribed pain medication. Slowly but surely, this practice led to patients’ dependencies on painkillers as physicians increased dosages.
“It’s gotten better in some respects, but really, it’s a shift from prescriptions to more drugs. The number of patients really hasn’t changed. The availability of the drugs is so widespread, groups that have set up business here in West Virginia (and) Ohio, and they have an actual business model of bringing the heroin to you, very discreet, in $20 increments, and there is very low risk of getting caught,” says Lander. “They are more than willing to make it as easy as possible for you to get it. It is easier to get heroin than it is to get prescription pills now, which explains the transition.”
A sobering fact: If this drug – one that has the ability to destroy so many lives – is so ubiquitous, why isn’t it more visible?
“A lot of the people are still productive,” says Lander. “A lot of them have not lost their jobs, but they spend a lot of money on their drugs, so they don’t have any savings. Physically, they sometimes look pretty beat up and have a loss of productivity and steal things.”
What is perhaps most surprising is the fact that this drug abuse is not only affecting disenfranchised communities, but affluent ones equally.
New Albany, named the “best suburb in America” last year by Business Insider, is a community affected by this phenomenon, although not as much as others. Franklin County’s overdose death rates are still below the Ohio state average. However, as the city is surrounded by communities with significant numbers of overdoses, there is concern that New Albany may begin to see more heroin overdoses. In late September, central Ohioans were shocked when 27 heroin overdoses were reported in just 24 hours in Columbus.
“We get patients from New Albany. A lot of our patients are the young people are coming from the suburbs,” he says. “Predominantly Caucasian (suburbs) like Upper Arlington and New Albany have more than their fair share of people that are addicted.”
This saddening reality has mobilized the police and judicial system in more ways than one.
“The police are starting to treat this as a health issue. They are starting to use Naloxone kits to stop overdoses and getting them to the hospitals quicker,” Lander says.
Naloxone, brand name Narcan, is a drug that reverses the effects of an opiate overdose.
One of the even more successful moves has been the establishment of the drug corps, which orders people to treatment and supervision instead of jail time.
“Someone goes into the drug court, the treatment becomes mandatory to get out, they get a lot of help, get assistance to not go back,” says Lander. “They use a lot of Vivitrol (another reversal drug), (which is) easier to manage. … For people coming out of jails, that is … the first choice for medications.”
Coupled with overdose death rates and how quickly the drug can spread to surrounding communities, the idea can seem daunting and hopeless. However, Lander has suggestions for how communities can combat the problem.
“You should petition for a drug corps and for more public education,” says Lander. “A lot of people don’t understand the relationship between pain and prescription medication, and this can be fixed through a lot of community education and a lot of workshops.”
Starting a positive and proven-effective drug prevention program in schools is key, and the younger the children to whom the program is exposed, the better. One of the most important factors, unsurprisingly, is always making sure that young people perpetuate negativity toward drugs, and with New Albany-Plain Local Schools’ partnership with the American College of Emergency Physicians, New Albany is combating the problem head-on.
“The main thing about kids is the culture of the school,” says Lander. “Social acceptance is a big deal.”
David Allen is a contributing writer. Feedback welcome at gbishop@cityscenemediagroup.com.
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