Nationwide, the U.S. is suffering from a massive heroin and prescription painkiller epidemic. Alabama is no exception, garnering overdose statistics that sadly, are now deemed average.
How did this happen? The current thought process is this: the prescription painkiller boom that began in the 1990’s incited some to switch to the cheaper alternative, heroin. The drug cartels saw it coming, and began trafficking large amounts of heroin into the nation.
There wasn’t much discussion about this until recently. Currently, the Obama administration and lawmakers are busy pushing funding for addiction treatment and education about the dangers of prescription drugs. Prior to the major outbreak in rural and suburban communities, however, heroin was thought of as an inner city drug. Indeed, now middle-aged women in suburbia are often the hardest hit.
Story after story begins to sound about the same – an injury or pain problem leads to opioid dependence. When the patient loses access to the medicine or builds up a tolerance, they look for another source to ease the pain and fuel their addiction. Lives are ruined, and people are dying at an alarming rate.
In 2012, heroin-related overdose deaths in Jefferson County doubled – then doubled again in 2014. Sizable increases such as this closely mirror what’s going in the rest of the U.S.
According to the Centers for Disease Control and Prevention (CDC), heroin-related overdose fatalities in the nation nearly quadrupled between 2002-2014. Also, in 2014, overdose deaths by these drugs outnumber traffic fatalities in the U.S., making it the #1 injury-related killer. There were 10,574 overdose deaths via heroin, and almost 19,000 deaths related to a prescription painkiller.
By now, most of us have heard about the highly-addictive painkillers that have caused all this destruction – Vicodin, OxyContain, Percocet – just to name a few. According to the CDC, in 2012, health care providers wrote 259 million prescriptions for opioids, enough for every adult American to have a bottle of pills.
According to the National Center for Health Statistics, 80% of new heroin users were once addicted to prescription painkillers. And in fact, in 2012, Alabama came it at #1 in the nation for opioid prescriptions. Alabama physicians wrote 143 prescriptions per every 100 people.
Still, there is a reason why prescription painkillers exist – injury, medical procedures, and chronic diseases such as cancer. There is a legitimate need for these drugs. They have been over-prescribed, however, and patients were often not warned about the high potential for addiction. Even doctors had their doubts – these drugs were touted early on as being safe and not habit-forming.
Depression and anxiety are also at record highs in the U.S. While painkillers aren’t indicated for this, there’s little doubt that they can be a form of self-medication when it comes to emotional problems (not unlike alcohol). Add a benzodiazepine for anxiety, such as Xanax, and you have a potentially deadly combination on its own, regardless of dosage.
And sometimes, the cure can be worse than the affliction. Pain may decrease, but the resulting dependency and tolerance leads many to increase their doses…
…or worse yet, turn to unregulated illicit drugs such as heroin. And this increases the risk of overdose, due to the purity of today’s heroin.
Remember when crack cocaine was the biggest drug problem in the nation? Many heroin heroin are former cocaine dealers, and they are using the exact same methods to produce heroin. Purity levels can reach up to 98%, which can be fatal even for a long-term user.
Another trend seen in some areas is fentanyl-laced heroin. Fentanyl is most often prescribed for people at the end-of-life, as it is very potent and not appropriate for even severe pain in many circumstances. But just a small amount of this drug can cause an overdose, so when added to heroin, it is insanely risky.
Alabama law enforcement are collaborating with federal officials to fight the availability and use of heroin in the state. Alabama is part of a U.S. Drug Enforcement Agency (DEA) task force dedicated to shutting down drug distribution networks,
In September, 2015, the annual statewide law enforcement summit focused on drug abuse prevention and education. Almost 700 law enforcement officers attended the conference. There, they were informed of the most recent drug abuse trends. They receiving briefings on illegal drugs, such as heroin, and learned how federal and state agencies are handling the current drug crisis.
A bill known as the Comprehensive Addiction and Recovery Act (CARA) is national legislation which seeks to increase funding for drug prevention, treatment and recovery. Also, the plan would combat prescription painkiller addiction and increase education to potential prescribers about pain management.
The legislation would also increase the availability of naloxone (Narcan). This drug is effectively used to reverse overdoses, thus saving lives. It is currently used by law enforcement, emergency medical personnel, and other first responders to halt opioid overdoses in process.
There are many who believe, however, that naloxone should be easily allocated by addicts and those who care about them. It’s non-addictive, and has no notable side effects. It can easily be administered by a minimally-trained layperson.
Fortunately, in February, 2016, the pharmacy Walgreen’s announced that it would begin selling naloxone OTC in 39 states, including Alabama.