In nearly every community across the United States, the footprint of addiction has left its mark. The overdose-related death rate in this country has increased astronomically over the past eight years. According to the National Center for Health Statistics (NCHS), drug poisoning is now considered the leading cause of death in the United States – surpassing deaths by firearms, motor vehicle crashes, suicide and homicide.
Commanding national attention for better part of this decade, the use of opioids (such as heroin, hydrocodone, and oxycodone) has reached epidemic levels. Meanwhile, the amount of methamphetamine coming into our country across the Mexican border over the last five years has nearly tripled, the use and availability of cocaine has significantly rebounded, and the landscape of marijuana legalization continues to evolve.
Adding fuel to the fire, synthetic opioids, such as Fentanyl (legally used as an anesthetic, as well as a painkiller for terminally ill or critically injured patients), are being produced and distributed illegally. More and more frequently, Fentanyl is being mixed with other controlled and illicit substances, such as methamphetamines, cocaine, marijuana and most often heroin, or is being counterfeit and disguised as prescription pills. Some suppliers and distributors will cut heroin with fentanyl to extend their heroin supply, or may dilute Fentanyl and sell it as heroin, with no actual heroin being present in the product at all. While some drug users are purposely seeking Fentanyl-laced product due to its increased potency and desired effects, many users are unaware of the presence of Fentanyl in their purchase, which has contributed to the sharp rise in unintentional overdose-related fatalities. According to the Centers for Disease Control (CDC), synthetic opioids are now involved in more deaths than any other illicit drug.
Over the past few years, Ohio has consistently ranked as one of the top overdose states in the nation. According to the CDC, in 2017, Ohio reported 5,111 overdose-related deaths – demonstrating an 18.4% increase from the previous year.
In effort to combat overdose deaths, Ohio enforced greater use of a prescription drug monitoring program that was originally implemented in 2006. The Ohio Automated Rx Reporting System (OARRS) is a tool used to track the prescribing and dispensing of controlled prescription drugs to patients. Databases like these are being utilized in almost every state and not only track doctors’ prescription-writing, but also pharmacy prescription-dispensing, and patients’ prescription filling. This provides medical professionals with complete information (versus patient self-report or agency record sharing) about their patients’ controlled substance history, including prescriptions written by other doctors prior to their relationship with the patient.
OARRS also provides law-enforcement with a tool to identify medical practitioners who overprescribe, illegitimately prescribe without medical validity, and/or violate prescribing guidelines resulting from new or revised legislation. The result? According to the Ohio Board of Pharmacy, the total number of opioids dispensed to Ohioans dropped by 325 million from 2012 to 2018, representing a 41% decrease overall. It is worth asking if this decrease in medically prescribed and dispensed opioid drugs is somehow linked to the recent increase in illicit opioid use by a larger segment of the population than previously.
Additionally, twice per year, the DEA hosts "National Prescription Drug Take Back Day". Multiple locations are set up in communities across the nation, and citizens are encouraged to bring unused, unwanted or expired medications to these sites to be properly disposed of. It is an unfortunate reality that the elderly have increasingly become targets, and are often exploited so that users can gain access to their prescribed medications. With 11% of 12th grade students reporting personal misuse of prescription drugs on the 2017 Monitoring the Future survey, it is evident why removing these medications from the home is imperative. Furthermore, it is not uncommon for an individual who becomes addicted to prescription opioids to graduate from pharmaceutically produced prescriptions to the much cheaper and easily acquired version, heroin or arguably worse, Fentanyl.
With no clear end in sight, multiple systems MUST work together to address addiction in their area. The legal system attempts to protect the public via law enforcement authorities through the deployment of drug task forces, in an effort to interrupt and incapacitate the organization, flow and profitability of the illegal and illicit drug trade by removing players, product and profit from the game; and also via court systems through diversion, court mandated treatment programs, incarceration and community supervision. Meanwhile, treatment centers attempt to keep up with the growing demand for services that not only promote the cessation of drug use and drug related activity, but also (and possibly more importantly) promote recovery and wellness.
Locally, efforts to address addiction can be seen throughout the community. Schools are tasked with prevention and early-intervention efforts, while court systems and treatment facilities provide responsive and reactive solutions to addiction. Guernsey County’s Common Pleas Adult Probation Department developed and administers the community’s C.A.R.E (Court Assisted Recovery & Education) program. This program provides non-violent, chemically-dependent offenders and/or offenders at high-risk of becoming dependent an opportunity to receive treatment and develop the skills necessary to live drug and alcohol-free lives.
In response to observed gaps in service, stakeholder pleas for responsive and innovative programming, and the increasing complexity of local drug-related issues and the collateral consequences, Cedar Ridge Behavioral Health Solutions (CRBHS) was born in 2014 and joined Alcohol and Drug Services of Guernsey County (ADSGC) as a community provider of addiction services. CRBHS pioneered the area’s integrated care approach by providing both mental health and addiction services all under one roof. In just 5 years, CRBHS has grown to provide a full continuum of comprehensive care and services for those struggling with addiction including: outpatient services, intensive outpatient programing, recovery housing, medication-assisted treatment, employment services and residential treatment.
Additionally, in recent years the CHOICES (Community, Hope, Opportunity, Independence, Change, Empowerment, Success) coalition was formed to bring together key players including law enforcement officials, treatment providers, health department and local hospital administrators, and the mental health & recovery services board in an effort to facilitate a more collaborative approach, leverage additional resources to focus on identifying actionable solutions, and ideally putting those solutions to work locally. The coalition’s board of directors’ report that they are hopeful to reconvene with coalition members this spring.
Despite differing opinions and frequent debate regarding drug use and individuals who struggle with addiction, one thing remains clear: it is a problem that we can no longer ignore. This problem is here, it is now, and it is devastating communities across the country, including our very own. It is not just a problem that affects the user. It is affecting our first responders, our friends, our families, our co-workers, our neighbors, and our children. Each one of us, no matter what our profession, education, background or circumstances can either contribute to the problem or to the solution. Every action or inaction fuels one side or the other. If you or someone you know is struggling with drug use or addiction, please encourage them to seek treatment, as it can be overwhelming, seemingly impossible and even deadly to quit without appropriate treatment.