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The Journal Gazette

September 18, 2016 1:01 AM

Understanding opioids' lure aids in battle

Except that the goal is to save lives, not to take them, you could call the struggle against opioids a war. Knowing the enemy in that battle means understanding how and why so many people get addicted, the subject of seminars organized by the Allen County Department of Health last Monday.

“It’s a very powerful disease,” Amanda Wilson, founder of CleanSlate addiction and treatment centers, told local health workers. “It’s cunning. ... We have to start thinking about addiction like we do other chronic diseases.”

One hundred Americans die every day from drug overdoses, Dr. Gregory Eigner of the Fort Wayne Medical Education Program told the group. Death rates from poisoning, primarily from opioid medications and heroin, have gone up 550 percent since 1963. In Indiana, 21 percent of young people say they have abused prescription drugs. And in Allen County, a medical education panel that reviewed records from 2008 to 2015 found 418 deaths by overdose since 2008, most of them accidental.

The demographics defy stereotypes. The majority of the victims were white, male, older than 30 and employed.

In fact, because of increases in suicides, liver disorders and drug overdoses, the death rate for middle-aged white American males has actually risen in recent years, in sharp contrast to continuing drops in other countries, Health Commissioner Dr. Deborah McMahan told the group. “It’s really sad to me that we’re losing all the ground we’ve gained,” she said.

The problems of alcoholism and mental health disorders intersect with drug addiction, McMahan said. “Those with untreated depression and other mental illness are at higher risk.”

The risks are increased when opioids are mixed with alcohol, antidepressants or benzodiazepines, pharmaceutical specialist Nathan Stuckey told the group. Prescribed opioids or heroin in combination with benzodiazepines such as Valium or Xanax are particularly dangerous, he said; they work through different channels of the central nervous system to depress breathing. Stuckey said national statistics show deaths solely involving opioids haven’t increased over the last 10 years – but those involving benzodiazepines and opioids have more than doubled. Those who take five or more other prescription drugs are also at higher risk for opioid addiction, he said.

Stuckey and pain specialist Dr. Dan Roth urged the group to make sure they have good information on other drugs a patient may be taking. Roth told his audience how to screen patients for alcohol or mental health problems and to address underlying problems before considering opioid therapy for high-risk patients. He explained state guidelines for prescribing opioids and monitoring their use but urged prescribers to explore alternative ways of managing pain. “Always have an exit strategy,” Roth advised. “Don’t begin a treatment that you are not prepared to stop.”

Other presenters included Kristina Johnson of the Lutheran Foundation, which is offering information about mental health and drug issues at itslookupindiana.org site.

As our series of articles continues today, staff writer Sherry Slater examines how drugs affect the workplace. It’s a reminder that every aspect of life is endangered by the opioid crisis.

But we are finding much that is hopeful and positive about our community’s response. Slater reports that employers are recognizing the value of helping addicted workers shake their habits. And more than 200 people, mainly health professionals, left Monday’s seminars with a better understanding of addiction, an understanding that probably will help save lives.