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Opioid epidemic: ‘Enough is enough’

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One day after U.S. Surgeon General Vivek Murthy toured a local rehab center as part of a national tour to “focus energy and attention on the opioid epidemic that we have all across the country,” nearly two dozen experts gathered in a public forum at the Albuquerque Journal to discuss what they agreed is a crisis.

Opioids – drugs that include illegal heroin and prescription drugs such as oxycodone, hydrocodone and fentanyl – are highly effective painkillers, but they’re also highly addictive.

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For much of the past decade, New Mexico has been either No. 1 or No. 2 in the nation for drug overdose death rates. In 2014, the most recent year for which complete statistics are available, about 47,000 people died of drug overdoses nationwide – the majority of which are attributed to opioids.

New Mexico had 540 drug overdose deaths that year, despite declines in the previous two years.

As prescription drugs became more expensive and harder to obtain, many users turned to cheaper and easily available Mexican heroin distributed through an efficient criminal network described by one federal lawman as akin to a “pizza delivery system,” exacerbating the crisis.

In an effort to address the state’s opioid crisis, the Journal and KANW-FM Radio hosted the Heroin and Opioid Prevention and Education public forum Wednesday evening. Co-hosted by U.S. Attorney Damon P. Martinez and Richard Larson, vice chancellor of the University of New Mexico Health Sciences Center, the two-hour forum included advice and discussion from recovering addicts and parents who have lost children to drug overdoses, along with experts from law enforcement, health care, state and local government and community organizations. Forum moderators were Journal editor Kent Walz and Journal investigative reporter Mike Gallagher, who has covered New Mexico drug issues for decades.

“Last year in New Mexico, more people died of drug overdoses, accidental drug overdoses, than the death toll for vehicle accidents and homicide gun deaths combined,” Walz said in opening the forum. “Those are just numbers. Those don’t measure the human loss, the economic loss, the attendant crime that comes with some of the drug issues that you’re going to hear about tonight.”

Here are selected excerpts from other forum participants as part of their presentation or in response to questions submitted in advance by Journal readers.

For more information on the HOPE initiative, visit www.hopeinitiativenm.org For more information on HAC (Healing Addiction in Our Community, visit www.healingaddictionnm.org.

 

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Richard Larson, vice chancellor, UNM Health Sciences Center:
“We all know we can’t incarcerate our way out of this problem.” The medical profession is taking a three-prong approach: Education; medication-assisted treatment; and co-prescribing of naloxone — a fast-acting drug that reverses overdoses. “It’s going to take all of us partnering to be able to accomplish our shared goals of reducing deaths from opioid overdoses and reducing the burdens of morbidity and extraordinary personal and social costs.”

 

Hector Balderas, New Mexico Attorney General:
“As a community, we have now come together to say enough is enough, and that we are now going to take control of our destiny as New Mexicans. We are going to educate ourselves on how to avoid heroin and opiate addiction, or what to do if one is already addicted.” “Even in our best efforts of collaboration and resources, even on our best day, we know that we don’t have a law enforcement solution to this epidemic.”

 

Shammara H. Henderson, assistant U.S. attorney and Heroin and Opioid Prevention and Education, or HOPE, initiative prevention and education presenter:
“We understand that we can’t just attack the supply of prescription opioids and heroin by prosecuting those who are selling these drugs illegally. While that is a huge concern, we must also educate so that we prevent future generations from becoming addicted to opioids, and therefore reduce the demand.” “We’re (also) working very hard to attack the huge problem of ‘worst-of-the-worst’ defendants.”

 

Gorden Eden, Albuquerque Police Chief:
“We’re seeing homicides and larcenies up. Home invasions and pharmaceutical robberies are up,” along with child abuse. “There are things out there that work, and work well. It just seems like the … funding at the federal level, as it funnels down to the state level, isn’t really reaching the problem.”

 

Lou Duran, prevention specialist with Healing Addiction in our Community:
“I’m the mom that did everything she was supposed to do,” but still could not save her son, Michael Duran Jr., who died of a drug overdose in April 2011 at 19. “It’s OK to look through your kid’s bedroom. If it’s going to save their life, then it’s OK.”

 

Dr. Dion Gallant, medical director for primary care services, Presbyterian Healthcare Services:
“People on the front lines of this (opioid epidemic) are balancing compassion and caution. … When we supply massive numbers of opioids, they find their way away from the people we prescribed them to and into the community. We have to be part of the solution.”

 

Dr. Steven A. Seifert, professor at the UNM School of Medicine and medical director at the New Mexico Poison and Drug Information Center:
“It’s not just people who misuse or abuse these medications,” who are susceptible to an overdose. “If you’re taking a potent opioid at relatively high doses chronically, you are also at risk of acute opioid overdose.”

 

Sean Waite, assistant special agent in charge at the Drug Enforcement Administration:
“On a national level, 47,000 people died (from drug overdoses) in 2014. … If I could put that into perspective … that would be equivalent to wiping Farmington or Roswell off the map every single year.”

 

Diane G. Gibson, District 7 Albuquerque city councilor:
“I’d like to encourage everyone who is either prescribed painkillers or who has a loved one who is in the throes of addiction to also stock” naloxone, which is sold under the brand name Narcan and can reverse the effects of an overdose.

 

Dr. William Wiese, retired physician and co-chairman of the Bernalillo County Opioid Accountability Initiative:
“Until that larger body of the health care provider system — including primary care, nurse practitioners, counselors, (etc.) — are configured in a team, we’re not going to get our arms around the long waiting lists (for treatment) that exist. Right now, it’s very hard for patients to get the care.”

 

Ava McGuire, a recovering cocaine and oxycodone addict, now a community advocate:
“I knew that something was really wrong when I found myself one night counting out dimes, nickels and pennies from my son’s piggy bank just to be able to pay for one more pill.”

 

Dr. Steven Jenkusky, New Mexico Medical Board member:
“We want pain treated. … There are probably 2 million folks in this country that are either misusing or addicted to opiates, (but) there are 100 million with chronic pain. … It is incumbent on physicians and other providers to properly assess and learn how to treat pain properly.” He said that sometimes includes methods such as acupuncture and chiropractic.

 

Michelle Brooks, parent of two young adults in heroin recovery, and a volunteer at Healing Addiction in our Community:
“New Mexico needs more (treatment) facilities and dollars to run them. We need to look at this (addiction) as a disease, not a moral failing.”

 

Dr. Snehal R. Bhatt, medical director of addictions and substance-abuse programs for the UNM Psychiatric Center:
“Too often a patient would go to a psychiatrist and the psychiatrist would say, ‘Well, go have that addiction taken care of first.’ … Or they may go to an addiction psychiatrist … who would say, ‘Well, you’re too depressed for psychiatry.’ What the data has consistently shown is that treating the two together — the mental illness and the addiction — is really important and yields better outcomes.”

 

Michel Disco, assistant dean for external programs at UNM’s College of Pharmacy and faculty adviser for Generation Rx, the college’s outreach program:
Patients having difficulty obtaining needed pain medications “need to work with their pharmacies. … The pharmacist is their health care provider, and they want them to be out of pain and to be taken care of.”

 

Dr. Lionel Candelaria, New Mexico Dental Association member and dental pain management instructor:
A main goal when working with children who need oral surgeries “is to try to decrease their exposure to opioids” by using ibu-tylenol and PO tylenol. “It’s quite astonishing how often a child can leave the hospital without ever taking an opioid.”

 

Lisa Simpson, Bernalillo County adviser on jail population management and alternatives to incarceration:
“About 75 to 80 percent of the people in the (Metropolitan Detention Center) are people with substance addiction. … It’s much more expensive than treatment, but the community as a whole is having trouble shifting those resources from incarceration to treatment.”

 

Jennifer Weiss-Burke, executive director, Healing Addiction in our Community and Serenity Mesa. Weiss-Burke lost her 18-year old son, Cameron, to a heroin overdose in 2011:
He became addicted to prescription opiates after several sports-related injuries and then turned to heroin.”I cashed out my 401(k), mortgaged my house (to pay for treatment) and did everything I possibly could to save him. … The toughest thing for a parent to realize is that there is really nothing you can do to save your child from these addictions that are slowly killing them.”

 

Maggie Hart Stebbins, District 3 Bernalillo County commissioner:
“We consistently see that our criminal justice system is really failing people who suffer from mental illness or substance use disorders. … We’re really working to build a comprehensive network, a continuum of care — services outside the jail walls so that patients can start treatment and continue their recovery post-release and break that cycle of crime, incarceration and substance abuse.”

 

Dr. Christopher Manetta, medical director for Behavioral Health, Presbyterian Healthcare Services:
“Relapse is a part of recovery. So we need to look at harm reduction as opposed to absolute abstinence 100 percent of the time. … People who suffer from both … psychiatric conditions and substance disorders are at higher risk for suicidal and homicidal behaviors, poor treatment adherence, higher relapse rates and higher hospitalization rates.”

 

Dr. Mauricio Tohen, chairman of UNM Health Sciences Center’s psychiatry department:
“Patients with psychiatric conditions are more vulnerable than the general population” to drug abuse. “I think if there’s a take-home message today it’s that addiction to opiates is not a ‘bad behavior’; it is an illness. Another important point is that age matters. Most psychiatric conditions develop in adolescence. In fact, it is the adolescent brain … that is the most vulnerable.”

 

Katrina Hotrum, director of Bernalillo County’s Department of Substance Abuse Programs:
“The folks that we deal with at MATS (Metropolitan Assessment and Treatment, the county’s detox facility) are primarily chronic users (of illegal substances). … Until we start putting the components together, from abstinence to harm reduction, and trying to stabilize these individuals’ basic needs, we’re going to struggle to get ahead of this problem.”

 

For more information on the HOPE initiative, visit www.hopeinitiativenm.org For more information on HAC (Healing Addiction in Our Community, visit www.healingaddictionnm.org.

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