An article in the St. Louis Post-Dispatch last year called it an “epidemic.” A Riverfront Times piece referred to a growing sense of “fear and desperation.” Just this month, in media outlets from Illinois to Wentzville, word of the death toll continues to spread.
Assumed just a few years ago to be the province of only a few unfortunate addicts, the once-low-profile problem of heroin overdoses has begun to explode onto local front pages around the region with a vengeance in recent days as area police, policymakers and the families of victims struggle to come to terms with the increasing prevalence of one of the most addictive drugs known to man.
The human cost is disturbing. The Post found that 99 people in St. Louis County perished from taking too much of the opiate over an 18-month period with 30 more across the river in Madison County where a serious problem seems to be in the making. Some were teenagers. Others in their late 50s. Married and unmarried, childless or parents, the victims came from all walks of life, from adult dancer to mechanic. Even health care occupations like paramedic or nurse weren’t immune. This month KMOX found that 19 deaths from the illicit drug have been recorded in St. Charles County so far in 2012, a figure it says is likely to represent a twofold increase of what it was ten years ago.
Nationally, the statistics on heroin are no more comforting. A Fox News piece earlier this year found that nearly 3,300 people nationally died of a heroin overdose in 2009. That’s nearly twice the number from a decade before.
The pull of narcotics on those who become hooked has long been documented but opiates are particularly dangerous targets for overdose since, by its very nature, the euphoric high caused by heroin consumption is hard to duplicate with repeated usage and often induces users to employ larger and larger doses of the drug. Worse, dealers on the street are in competition for market share and each tries to make his or her product the most high-octane batch on the block. There’s simply no way to know just how potent or powerful a given purchase might be meaning that accidentally pushing too far for a bigger high is tragically easy to do.
So how can we bring down the number of deaths and ensure that more people have a second chance to end their addiction and turn their life around?
Obviously, the easiest way to stop overdoses is to prevent dependence in the first place and that process gets underway far from the dealer on the street.
In fact, a surprising number of heroin horror stories begin at the bathroom medicine cabinet since dependence on opiates often has its genesis with legitimate use of legally obtained pain medication. It’s also not uncommon for children or teenagers to stumble into addiction after sampling mom’s or dad’s prescription.
Such prescriptions themselves can be dangerous when used recklessly. In 2008, the Centers for Disease Control found that nearly three-quarters of the more than 20,000 prescription drug overdoses involved opioid pain relievers. In fact, 2007 figures showed that overdose deaths from these synthetic versions of opium, such as oxycodone, methadone and hydrocodone, occurred more than five times as often as those caused by their illegal cousin heroin.
Moreover, Americans consume four-fifths of all the opioid prescription medications on the planet, part of a stunning fourfold increase in sales over the last decade, according to British newspaper, The Guardian, which estimated that doctors in the U.S. prescribed enough opioids in 2010 to keep the entire adult population of the country medicated with hydrocodone for a month.
Statistics like these show that inappropriate use of legal drugs can be every bit as damaging as any illicit narcotics habit. Prescriptions aren’t licenses to abuse pills nor do they shield the user from crippling dependence. It’s important for individuals to know that they should seek help for any form of addiction, including that received over the local pharmacy counter, before misuse progresses into a deadly overdose or graduates the victim into an equally pernicious heroin habit.
Public policymakers can also play a vital role. During a visit this summer to St. Louis, the White House’s drug czar Gil Kerlikowske urged Missouri to set up a program to monitor prescription drug abuse. Sadly, our state remains the only one in the country which has yet to create one.
In addition to keeping a vigilant eye on prescription misuse, another prong of the effort to reduce overdose deaths means education. The National Council on Alcoholism & Drug Abuse (NCADA) has made great strides here with their “Not Even Once” campaign. The initiative, which includes anti-heroin rallies and town hall meetings, has worked hard to combat the curiosity that drives young people to sample opiates.
But preventing overdoses can’t stop with preventing usage and sometimes just saying no simply isn’t enough. While initiatives like NCADA’s send the right message about the dangers of trying heroin, help must also be available for those who, despite our best efforts, choose to experiment with the drug and become trapped in the cycle of addiction.
To prevent deaths, we must first stop stigmatizing the problem, which only makes it more difficult to detect and treat. Those who find themselves hooked, particularly young people, may be reluctant to seek help for fear that friends or family will now think of them as a “junkie.” That leads to longer relationships with the drug and the longer dependence continues, the greater the chance an overdose will occur. Once they’ve crossed the line, it’s vital that they know they can still come back without being labeled or shunned. Those who have fallen into dependence should look at all their treatment options and then see what works best for them.
There are also steps we can take to prevent an overdose from becoming a death sentence. One is to encourage individuals to seek professional help when an incident occurs. Unlike many other medical issues, drug-related emergencies often have legal implications that make friends or family reluctant to call an ambulance or take an overdose victim to the emergency room. Instead, many try ineffective “home remedies” like cold baths or other useless measures which do nothing to help. Others simply abandon overdosing victims at the doorstep of an urgent care facility or the parking lot of a hospital, hoping they will be found and treated before it is too late.
Passing “good Samaritan” laws which ensure that those who seek help for a victim won’t themselves be charged with a crime would go a long way toward alleviating the fear of prosecution. Illinois has such legislation in place. Missouri does not.
Finally, we can put life-saving tools in the hands of those who need it most. One product, Narcan (naloxone) is extremely effective at countering opiate overdose. While EMTs and others on the front lines of emergency medicine have long employed the drug, it’s also important for addicts themselves to have access to it and in some areas, distribution of anti-overdose kits is underway. The idea, which has spread to include some 188 locations across the country, may have saved as many as 10,000 lives since its inception in 1996.
That’s 10,000 people who had a second chance.
Heroin dependence can start with a simple mistake, a casual experiment or indulgence of an idle curiosity with consequences that can shatter lives. But with a few simple steps on the part of parents, doctors, peers and public policymakers , that first mistake doesn’t have to be the last one an individual ever makes.