Report: Opiate Crisis - A Community Forum

Overflow crowd at Opiate Forum
Photo courtesy Shoreline Schools

By Donna Hawkey

A forum to educate the community about the opiate crisis was well-attended on January 23, 2018 at the Shoreline Conference Center.

Sponsored by Shoreline Public Schools, the City of Shoreline, and the City of Lake Forest Park, speakers were passionate about getting their urgent messages into the community. This is a crisis like we have never seen before and last year for the first time, drug overdoses surpassed automobile accident-related deaths. Each minute, 144 overdose deaths take place throughout the nation.

LFP Police Chief Steve Sutton
Photo courtesy Shoreline Schools

Opioid use disorder was the main topic of discussion. Many get addicted after taking pain medicines prescribed by their physician or doctor.

Prescriptions began to be written in large amounts after a 1999 New England Journal of Medicine reported a study that found opioid drugs were not addictive. This was the only study done, it was a small sampling, and it was obviously flawed.

Before this 1999 study, physicians did not have much in the way of treatment for pain, nor were they trained about pain management in medical school. The doctors started showing lots of empathy for their patients when they finally had a solution with opioids, and that started a trend in writing these prescriptions so frequently.

Also, in 1996 Purdue Pharma introduced OxyContin and began to market it very aggressively including large sales bonuses to the pharmaceutical representatives and also doctors, pharmacists, and nurses were recruited to serve on the Purdue Pharma’s speaker bureau circuit. These 1996-1999 occurrences are considered the two biggest factors in this opioid crisis.

Patients were just following their doctor’s recommendations and trusted that no harm would come from them. Opioid for pain relief is generally safe when taken for a short period of time and under a doctor’s supervision, but since the physicians were lead to believe they were non-addictive, they also increased dosages in patients when they continued to complain about pain.

We have natural opioid receptors in our nerve cells and our brain. When you add in a prescription opioid, those receptors are increased and tolerance levels to the drug increases too, so the patient may start craving higher amounts. The addiction cycle can start due to not only the pain relief, but many patients experience a feeling of euphoria as well.

Now considered a medical disease, opioid use disorder often has one behavioral component and one genetic component. Medicine stabilizes the patient by alleviating the drug cravings. Today, opioid use disorder is often compared to the diseases of diabetes and hypertension.

A panel of experts spoke at the forum
Photo courtesy Shoreline Schools

The forum panel included health experts talking about how this drug addiction is very challenging, but with the right fit and long enough treatment plan, it’s not impossible to treat it successfully. Also expressed was the importance of a loving family, friends and other social support networks.

Current treatment is a very lengthy process though and all addiction data are grouped together under one umbrella, so it can be difficult to find out which treatments are working the best for this specific addiction. Insurance companies are also finding ways to reduce benefits for treatment due to the large increases in the number of patients diagnosed with opioid use disorder.

When prescription drugs are not available or become too costly, those with opioid use disorder can find a cheap street substitute with heroin which is now available everywhere and this leads to many overdoses.

Most of these drugs coming into the Pacific Northwest are from Mexico, however, Yakima has also become a big problem in illegal drug distribution. Drugs are entering the United States from all modes of transportation - automobiles, ships, airplanes, trains. This is a huge black market industry with an estimated size of between $200-750 million dollars per year.

Shoreline Police Chief Shawn Ledford
Photo courtesy Shoreline Schools

Everyone needs to be educated about this crisis. The importance of the community working together to combat this problem is key and was stressed by law and drug enforcement officials and healthcare professionals.

Here are further tips and other resources.

• Young athletes can become addicted to opioids with sports pain management treatment.
• Many children who become adult addicts started taking pain medicines at the ages of 12-13 years old. Most of these prescription drugs are taken right from their parent’s medicine cabinets and some are sold to friends, too.
• 53% of pain relievers are obtained for non-medical use by a relative or friend.
• Drug dealers like to give out samples to hook youth into addiction.
• Lots of synthetic heroin is being manufactured that look like prescription drug pills and users are often unaware that these drugs are 50 times more potent than heroin.
• Children and teens should be taught to never accept or ingest medications or pills unless it is from their parent or a health care provider. Also, parents should warn children about not inhaling any type of powders.
• If someone suspects they were offered drugs, they should call 911 if they can and report it to the police, or get the information to a school authority or parent or guardian right away.
• Review your medicine cabinets and either lock-up your pharmaceuticals, especially any pain relievers, or dispose of them at your local police department, just drop them off, no questions asked.
• Prescription drug abuse can also start with ADHD drugs such as Adderall. An increase in the abuse of these drugs is being seen on college campuses as students try to stay up late to study. 

The Washington State Department of Health reports that between 2012-2016, there were 3,460 overdoses and 285 of those were between the ages of 15-24.

Over 40 overdoses per year take place in Shoreline. 

All police cars in Lake Forest Park are now equipped with Naloxone, the nasal drug spray used to attempt to reverse an opioid overdose.

Washington State has the “Good Samaritan Law” so pharmacists can dispense Naloxone to someone even without a prescription. Albertson/Safeway Pharmacists are well versed in this.

There are resources available: 

• If you need to put together an information program for a group, Alison Newman, MPH, Center for Opioid Safety Education, University of Washington can help. She can be contacted at alison26@uw.edu
• More about overdose and prevention
• Seattle Area Alcohol and Drug Helplines and Treatment Resources

From the Centers for Disease Control and Prevention (CDC)

*We now know that overdoses from prescription opioids are a driving factor in the 16-year increase in opioid overdose deaths. The amount of prescription opioids sold to pharmacies, hospitals, and doctors’ offices nearly quadrupled from 1999 to 2010, yet there had not been an overall change in the amount of pain that Americans reported. Deaths from prescription opioids—drugs like oxycodone, hydrocodone, and methadone—have more than quadrupled since 1999.”

Note: After writing the above, our State Legislators have announced plans to put the opioid reversal nasal spray Naloxone into public schools and on college campuses.

This makes sense because we know this is where most 12-13 year olds and older teens are located five days a week, so many lives can be saved. 

It’s ridiculous to think that the schools will be seeing an overflow of drug addicts outside their doors because the school has a supply of Naloxone.

No school is going to allow anyone to just hang around outside their school, that is what police are for. With our state having the “Good Samaritan” law, pharmacists can dispense Naloxone, often called Narcan, without a prescription and some will give it for free in certain cases.