Opioids Epidemic Explored

For nearly a decade, Stephanie, a Wooster resident, was an active heroin user.

“As a young person it kind of depletes your soul, it really took a lot out of me,” she said.

Stephanie, who requested her name be changed for this story, began her descent into addiction when she was only in middle school in the early 2000s.

“Some kids are able just to drink on the weekends or go to a party once in awhile and not like it, but that was not the case for me. By ninth grade, I was drinking regularly, I smoked pot regularly, I was getting in a lot of trouble and not doing so great in school and little by little I began to pick up other stuff,” she said.

In her sophomore year of high school, she experimented with cocaine and, in eleventh, she moved to heroin.

She barely graduated high school and dropped out of college because she could not get through class.

Her parents tried sending her to rehab; they were terrified.

For her mother, it became overwhelming.

“For a long time, my mom wouldn’t even speak to me. She wanted to, but she eventually said she needed to distance herself because it was hard for her to watch me destroy my life,” Stephanie said.

For the next few years, she bounced in and out of prison and in and out of treatment.

“It just progressively got worse. I had to use everyday [and] I would go through withdraw,” she said.

In that time, she also had three children.

By 2012, she completed a year long stay at Beacon House, a residential recovery program run by the organization now called One Eighty in Wooster, which provides an array of services to those recovering from addiction.

She has been sober since then.

This has not been the end of the pain inflicted by opioids.

Her step-father died of an overdose nine months ago and a nephew two months prior; her husband and younger sister struggle with heroin addiction as well.

A Long Way Down 

Haeyoun Park and Matthew Bloch, of the New York Times, reported on Jan. 19 of this year that CDC data show drug overdose caused 15 deaths in every 100,000 in 2014 up from just nine in 2003.

This increase was driven by opioids, which now account for 61 percent of overdose deaths, according to the CDC data the journalists examined.

In 2015, the American Society of Addiction Medicine reported that 20,101 people died because of prescription opioids like oxycontin and percocets and 12,990 died from heroin.

The story is no different in Wayne County.

Data from the Wayne County Coroner’s office shows that in 2008, overdoses killed six people in the county. At press time, that number, in 2016, includes 24 confirmed deaths, and nine more who are suspected opioid deaths that have not been confirmed.

With two weeks to go before 2017,  as many as 33 people have died from overdoses in Wayne County.

Bobbi Douglas, executive director of One Eighty, a Wooster non-profit deeply involved with treatment and recovery of those with addictions, said that back-of-the-napkin calculations, extrapolating from numbers of those in treatment, suggest there could be 5,000 people in county with opioid dependency.

“It’s not like anything I’ve ever seen in a 30 year career. I was around for the first time with heroin and I never thought it’d come back,” Douglas said.

Heroin’s new lease on life in Wayne County was granted by a sharp rise in pain medication prescription.

Lieutenant Greg Bolek, who heads up the Wooster Police Department’s response to the opioid crisis, reflected, “It really started with the increase in prescription drugs years ago, we were seeing a lot of falsification to obtain dangerous drugs, your prescription drugs, your oxycontins.”

The Wooster Police Dept. was experiencing a national trend.

The American Society of Addiction Medicine report found that heroin and painkiller use rose in tandem with four in five heroin addicts starting with pain medication.

Douglas said that when hospitals began to be ranked based on pain management, they began to prescribe more painkillers, which were being aggressively marketed as safe solutions to pain.

“Use them long enough and anyone gets increased tolerance and a lot become addicts. Then, when they can’t get it, it’s easier and cheaper to get heroin,” Douglas explained.

It can happen to anyone.

Wayne County Coroner Amy Jolliff said overdose victims represent people of all ages, races and classes.

Most of the people dying from overdoses are long time users, and many die from newer heroin mixtures that contain Fentanyl and Carfentanil, animal tranquilizers, according to the coroner.

A Community Responds 

Todd Carmony, Chairman of the Wayne County Opiate Task Force, said almost two years ago he was eating dinner with county prosecutor Dan Lutz when the subject of heroin had come up.

The prosecutor was meeting with various law enforcement agencies and judges on what to do about the rising tide of opiate related crime, Carmony remembered.

Soon Carmony, an area businessman, was brought in as an outside voice to lead the Task Force, which soon grew beyond law enforcement and the courts to include social services, government and healthcare.

As the epidemic worsened in early 2016, the Task Force brought in Kyle Putinski, of United Way, to coordinate their efforts.

“I can get a bunch of people together, and we can talk for hours and nothing can get done,” Putinski said.

He immediately set about collecting data on the epidemic so that they could measure if they were being effective.

He then made sure each of the Task Force’s five committees, Prevention, Treatment, Intervention, Support and Evaluation, had clearly defined goals and a plan to achieve them.

Putinski says the overall goal is to end overdose deaths in the county.

Beyond deaths, Putinski explains, “With addiction, 95 percent of the people relapse, so I can’t say staying clean is a measure of success because I’ll be shooting myself in the foot. But, if I can say, ‘Let’s look at the person holistically on a continuum.’ and if they’re making positive life progress in these indicators, as noted by employment, education, run-ins with the law, abstinence rates, things of that nature. If they’re making positive strides…We know we’re being effective.”

Caleb Alexander, the co-director of the Johns Hopkins Center for Drug Safety and Effectiveness, says the promise of a task force is that it brings together all the most important stakeholders in the community to coordinate their efforts.

“All of us are smarter than any of us when it comes to tackling this epidemic,” Alexander said.

One of the Task Force’s first initiatives was the distribution of naloxone, or narcan, to first responders; the drug that can prevent someone from dying because of an opiate overdose, according to Putinski.

Putinski figures they distributed upward of 200 doses around the county, and said that one or two doses are administered each day.

“If we didn’t do that, those would be deaths,” Putinski said.

Among other things, the Task Force has spearheaded a collection campaign for unused painkillers, developed an opioid addiction education curriculum to be introduced in Wooster City Schools in the coming months and worked with Wooster Community Hospital to develop a procedure for dealing with people who come in with opioid related maladies, Putinski says.

Drug Court

On a sunny Tuesday in July, about 20 people stand outside one of the courtrooms in the Wayne County Courthouse.

Inside the room, three probation officers discuss each of the cases, of the individuals outside, with Judge Corey Spitler.

Once they have finished,  they call everyone into the room, and each person takes turns speaking directly with Spitler.

This is the Wayne County Drug, a special court to which drug addicts could be referred after they are arraigned for a crime, usually in their pre sentencing hearings, says Court Administrator James Fox.

The court has been greatly impacted by the opioid epidemic, “I started with this court six years ago, and we had very few heroin addicts. Now, it’s not 100 percent, but it’s easily over 80 percent,” Spitler said.

The court does not put addicts in prison, but instead puts them on probation and in a program of treatment at One Eighty.

This could include meetings, counseling and medication assisted treatment.

The participants’ progress is monitored by their probation officer, weekly sessions of drug court and weekly or spot drug tests.

Spitler explained, “When I send someone to prison, it’s because I believe they are such a threat to society they need to be locked away. Just placing [drug addicts] in prison, warehousing, them doesn’t work. They’ll just come out and commit again.”

If a drug court participant fails a drug test, Spitler can punish them with time in the jail.

At that July session, one woman had done just that, but Spitler scheduled the jail time to ensure it did not interfere with the job in which she was working or her counseling sessions.

He congratulated another participant for the extra meetings and focused on the positives with participant.

“The judge will even go to their weddings,” said Fox, reflecting on the close bond built between participants and judge.

Drug courts have faced criticism nationwide and the Wayne County Drug Court is no different.

John Roman of the University of Chicago, who studies drug courts, examined data provided by Fox and said in an email that “The graduation rates are about half of the typical graduation rate, meaning fewer people successfully complete this program than a typical drug court.”

Roman also said the court’s small size made it less cost effective and noted it needs more emphasis on treatment and criticized the court’s policy or extracting fees.

Recovery

Many addicts first begin their path to recovery with a visit from the police.

Lt. Bolek said the Wooster Police have two officers specifically assigned to deal with the problems caused by opioids, and any police officer is likely to be the first on the scene responding to an overdose.

“I think all of our guys agree, whether it’s arrest or treatment, we want people off of drugs, because, ultimately, that reduces the number of cases that we do, the number of break-ins, the number of thefts. It’s a win for us the fewer people that are on drugs, so we’re not just about arresting people,” he said.

Bolek went on to say the state’s new Good Samaritan Law makes it so the police cannot arrest someone for calling in an overdose or overdosing if they seek treatment within 60 days.

One Eighty is one of two treatment providers in the county, along with Ana Zoa.

Douglas, the executive director of One Eighty, explains that when someone comes in with for treatment for opioid dependency, they are first given an assessment by the organization’s addiction specialist then prescribed a treatment.

These could include outpatient, intensive outpatient or residential treatment.

Douglas says that nine in ten clients who struggle with opioids, 41 percent of the total, are enrolled in intensive outpatient treatment, which includes counseling three times weekly or residential treatment, which involves live-in situations.

Treatment may also include medication with suboxone and vivitrol, both of which are called maintenance drugs that safely prevent the craving for opioids and allow users to live normal lives.

For Stephanie, it was the residential program that was crucial, One Eighty’s Beacon House program created what she felt was the right environment of support.

She was able to live with her children, and the connections she made allowed her to get a job.

Now she is working on her bachelor’s degree in social service and hopes to get a masters so she can help people in recovery like her.

One of her major struggles has been the stigma that comes with addiction.

“We’re people, we are moms, we are dads, and we’re grandparents and we’re someone’s children. None of us chose this. Nobody wakes up when they’re little and decides they want to grow up and be a heroin addict, or an alcoholic, or to destroy their families, or break the law.”

Stephanie says that with time, she and her mother have healed their divide, and she hopes shedding light on the opioid epidemic will help others move toward treatment and into recovery.