Opioid abuse leading to increased heroin use in country, and locally local news joplinglobe.com electricity history united states


The federal Drug Enforcement Administration is enlisting health care providers, civic groups and parents of overdose victims in what it calls its "360 Strategy" to combat heroin and prescription drug abuse and related violent crime. St. Louis is one of four communities nationwide targeted by the new DEA program, along with Pittsburgh, Milwaukee and West Memphis, Arkansas.

"I had a bad back. I was given a script for light painkillers,” he said. "That was a good five to six years ago. It was not long after that I started buying really strong painkillers off the street. I was paying $30 a piece. I was spending hundreds of dollars a day — at least a thousand dollars a week. My house was in foreclosure. I almost lost my family.”

"Meth is just a nasty drug, but it’s not hard to get off. Heroin and painkillers are the two worst drugs out there. That’s why they use methadone to treat them. I was not tempted to use heroin, but it does not surprise me that someone would. They are almost the same thing.

"Ninety percent of the people or better came to heroin through prescriptions,” he said. "This could be a person who has been in a car accident, injured at work or were injured in the tornado. They become addicted and start looking for it on the street. They’ll turn to Xanax or meth to reduce the effect when they cannot get an opiate.”

"After we admit them as a patient, it takes at least a year. We give them medication that first day. It then goes to six days a week with counseling every week, then four days a week and then three days a week to once a month. They have to stay in treatment for at least a year.”

Getting on top of Missouri’s abuse of prescription painkillers is made more difficult because Missouri is the only state in the union that does not have a prescription drug monitoring program. Such a program would prevent a person from taking a doctor’s prescription for painkillers to more than one pharmacist.

Rehder testified that her daughter became addicted to opioids after cutting her thumb at work and was prescribed painkillers. It wasn’t hard for her daughter to find more painkillers once she ran out, Rehder said, and her next 13 years were spent in and out of rehabilitation programs and prison.

"We get it through the House every year, but the hangup is in the Senate where they are concerned about privacy,” she said. "On the House side, I’m concerned about privacy issues. However, what I think they fail to understand is that a prescription drug monitoring program — a PDMP — is no different than electronic medical records.

"The privacy concern is a red herring,” she said. "This is an additional tool for medical providers to prevent people from going to multiple doctors to get narcotics. Without this program in place, your population is being harmed and it’s harming the populations of other states. They come to Missouri to get narcotics that cannot be traced in Missouri.”

"That helped this doctor address this young man’s real problem — an addiction to narcotics,” she said. "That’s when you want to recognize the situation in its early stage. Because if you don’t, it’s a natural progression to go from prescription pills to heroin.”

When that progression starts, she said, "Heroin is the boogieman. Nobody wants to do that. But when their body increasingly needs that euphoric feeling, heroin is not the boogieman anymore. They have to do something to stop the withdrawals.”

"We’re going to let Holly Rehder pass it out of the House first. We think we will have a better chance of getting it through the Senate if that happens,” he said. "The people who are opposed to it are afraid the data system would be hacked. It has never been hacked in the other states that have this system.

Tim Mitchell, the owner of three drug stores in Neosho, said he has been advocating for the database for years because "there are individuals trying to get medications by pharmacy hopping and doctor shopping. If they are from out of town and they want to fill a prescription for a narcotic, it immediately throws up a red flag.”

"We’re required to protect those records; if someone wanted something, I would have to have a medical release," he said. "It’s not a privacy issue. It’s bigger than that. We have to be able to have a common platform to communicate about patients. We have to know what people are being prescribed for safety purposes. People are overdosing. We’ve got deaths occurring.”

The opioid problem is so serious in Missouri that six of the state’s leading health care provider organizations recently took a stand on the problem. They urged the adoption of a core set of actions to reduce variation in opioid-prescribing practices to reduce opioid painkiller abuse.

State-specific research released earlier this year found that hospital treatment for commonly prescribed opioid painkillers — where overuse is a primary or contributing factor for inpatient or emergency care — increased 137 percent in Missouri between 2005 and 2015. Additionally, separate research suggested a strong link in opioid abuse and heroin addiction. The research found that as many as three out of four prescription opioid abusers would eventually use heroin as a less expensive source of opioids.

The recommendations are backed by the Missouri Academy of Family Physicians, Missouri Association of Osteopathic Physicians and Surgeons, Missouri College of Emergency Physicians, Missouri Dental Association, Missouri Hospital Association and Missouri State Medical Association.

“Missouri doesn’t have a comprehensive policy to address opioid misuse and abuse,” said Christopher D. Howard, president of hospital operations at SSM Health in St. Louis, and board chairman of the Missouri Hospital Association, in a statement. “There are limited options available to identify inappropriate use of these necessary but powerful painkillers.”

Last year, the Ozark Drug Enforcement Team, which covers 20 communities in a four-county area in Southwest Missouri, seized 19,000 grams of meth, which was a record, 65,000 grams or 144 pounds of marijuana, and 20 grams of heroin, said Chad Allison, spokesman for the team.

He added: "This is the way the drug world works in our area. It starts in St. Louis and spreads down the Interstate 44 corridor to Springfield and then to Joplin. Springfield is just now starting to see heroin. We are at the beginning stages of something. Of course, any amount of heroin is alarming.”

According to the National Institute on Drug Abuse, Americans are responsible for consuming 80 percent of the entire world’s prescription opioids despite making up less than 5 percent of the global population. Some reports have suggested that 2.1 million Americans abuse these prescriptions, which has led to a 153 percent increase of inpatient hospitalizations for opioid abusing adults over the past two decades. Experts have also found that Americans younger than 30 are responsible for the fastest increasing rate of addiction or abuse.