Opioids | KNKX

Opioids

Will James / KNKX

Paramedics in Tacoma are giving out plastic bags full of lifesaving nasal spray to people who survive overdoses of heroin and prescription opioids. 

Gabriel Spitzer

You could make a pretty good case that the epicenter of the opioid crisis in all of North America is British Columbia.

 

Just five years ago overdose deaths there had been holding steady at under 300 a year -- about the same as car crashes. Then it spiked -- last year 1,422 people in British Columbia died of a drug overdose.

 

Charles Krupa / AP Photo

 

Most people who use heroin as their main drug want to reduce their use, or completely stop, according to a new report released by the University of Washington’s Alcohol and Drug Abuse Institute. It also shows methamphetamine use is on the rise throughout the state.

The opioid crisis is front and center at the Washington Legislature this week. On Monday, lawmakers heard testimony on three bills aimed at preventing and treating opioid addiction and reducing overdose deaths.

Washington Gov. Jay Inslee wants state lawmakers to declare the opioid epidemic a public health crisis.

On average, two people die each day in Washington from opioid overdoses. That includes deaths from prescription and synthetic opioids, as well as heroin.

Top Philadelphia officials are advocating that the city become the first in the U.S. to open a supervised injection site, where people suffering from heroin or opioid addiction could use the drugs under medical supervision.

But the controversial proposal aimed at addressing the city's deadly drug crisis must first overcome resistance from top city police officials, community residents and the federal government.

"Mt. Rainier from Orting, WA" by Lana_aka_BADGRL is licensed under CC by 2.0 http://bit.ly/2Bslcqu

The nation's opioid addiction epidemic is a challenge for small, rural communities, where the fatal impacts can overwhelm local resources and treatment may be lacking. 

Toby Talbot / Associated Press

Those trying to tackle the opioid crisis say solving it will take more than money and government help. It will take a change in attitude. 

Lauren Davis, with Washington Recovery Alliance, says the stigma attached to addiction makes it less likely that people will seek treatment.

It has the power to save lives by targeting opioid overdoses — something that kills more than 140 Americans every day. And now Narcan, the nasal spray that can pull a drug user back from an overdose, is being carried by all of Walgreens' more than 8,000 pharmacies.

Updated at 2:50 p.m. ET

President Trump declared a public health emergency to deal with the opioid epidemic Thursday, freeing up some resources for treatment. More than 140 Americans die every day from an opioid overdose, according to the Centers for Disease Control and Prevention.

"We are currently dealing with the worst drug crisis in American history," Trump said, adding, "it's just been so long in the making. Addressing it will require all of our effort."

"We can be the generation that ends the opioid epidemic," he said.

Darryl Dyck / The Canadian Press via AP

A King County judge has voided a ballot measure that would have banned safe injection sites for drug users.

Superior Court Judge Veronica Alicea Galvan ruled Monday that Initiative 27 extends beyond the scope of the initiative power. She ordered that it not be placed on the February ballot.

Ashley Gross / KNKX

The legal troubles facing makers of prescription painkillers continue to grow as the City of Seattle and Washington state have each filed lawsuits against opioid manufacturers, arguing the companies downplayed risks of the drugs and deceptively marketed them to boost profits.

Vincent Milum Jr., Tacoma Fire Department / Flickr

Tacoma is suing Purdue Pharma and two other companies, Endo and Janssen, that make prescription opioids.

In its lawsuit, Tacoma says it’s had to bear the financial costs of the opioid crisis in many ways – in terms of fire and police response to overdoses as well as paying for the prescription drugs for employees who get health insurance from the city.

Darryl Dyck / The Canadian Press via AP

The fight over safe drug-injection sites is underway in King County.

Earlier this year, county leaders moved to open two of them as part of a larger plan to deal with the opioid crisis.

Opioid abuse is a crisis, but is it an emergency?

That's the question gripping Washington after President Trump's Commission on Combating Drug Addiction and the Opioid Crisis recommended that the president declare the epidemic a national emergency.

Toby Talbot / AP Photo

Tacoma’s City Attorney’s Office is exploring ways to hold the makers of opioid painkillers accountable for the city’s growing homelessness crisis.

The city is gathering information from law enforcement and other city officials to determine whether to move forward with a lawsuit against drug manufacturers.

Last January, the city of Everett filed a lawsuit against Connecticut-based Purdue Pharma, the maker of OxyContin, alleging the company knowingly allowed pills to be funneled to the black market.

An advisory panel convened by the Food and Drug Administration to evaluate the health risks of the powerful opioid painkiller Opana ER says that the danger it poses as a drug of abuse outweighs its benefits as a prescription painkiller.

The time-release opioid was reformulated in 2012 to make it harder to crush. The goal was to reduce abuse by snorting it. But users quickly figured out that the new formulation could be dissolved and injected.

As the toll of the opioid epidemic grows, scores of doctors have lost their licenses and some have gone to prison. Pharmacies are being sued and shuttered. Pharmaceutical manufacturers are under investigation and face new rules from regulators.

But penalties against companies that serve as middlemen between drug companies and pharmacies have been relatively scarce — until recently.

It took a lot of convincing to get John Evard into rehab. He was reluctant to give up the medications that he was certain were keeping his pain at bay. But ultimately he agreed — and seven days into his stay at the Las Vegas Recovery Center, the nausea and aching muscles of opioid withdrawal are finally beginning to fade.

"Any sweats?" a nurse asks him as she adjusts his blood pressure cuff.

"Last night it was really bad," he tells her, "but not since I got up." Evard, who is 70, says he woke up several times in the night, his sheets drenched with sweat.

On the final day of June 2015, Colin LePage rode waves of hope and despair. It started when LePage found his 30-year-old son, Chris, at home after an apparent overdose. Paramedics rushed Chris by helicopter to one of Boston's flagship medical centers.

Doctors revived Chris' heart, but struggled to stabilize his temperature and blood pressure. At some point, a doctor or nurse mentioned to LePage that his son had agreed to be an organ donor.

"There was no urgency or, 'Hey, you need to do this.' I could see genuine concern and sadness." LePage says, his voice quavering.

Toby Talbot / Associated Press

The word epidemic is often used when discussing opioid use in King County. In fact, a task force was formed earlier this year to come up with recommendations addressing the issue. Those suggestions are being released this month. But ahead of that report, 88.5’s Ariel Van Cleave sat down with senior researcher Caleb Banta-Green at the University of Washington’s Alcohol and Drug Institute to ask if we’re talking about drugs, drug use and treatment in the right ways.

Once people realized that opioid drugs could cause addiction and deadly overdoses, they tried to use newer forms of opioids to treat the addiction to its parent. Morphine, about 10 times the strength of opium, was used to curb opium cravings in the early 19th century. Codeine, too, was touted as a nonaddictive drug for pain relief, as was heroin.

Those attempts were doomed to failure because all opioid drugs interact with the brain in the same way. They dock to a specific neural receptor, the mu-opioid receptor, which controls the effects of pleasure, pain relief and need.

Some arrive on their own, worried about what was really in that bag of heroin. Some are carried in, slumped between two friends. Others are lifted off the sidewalk or asphalt of a nearby alley and rolled in a wheelchair to what's known as SPOT, or the Supportive Place for Observation and Treatment, at the Boston Health Care for the Homeless Program.

Health care claims for people with opioid dependence diagnoses rose more than 3,000 percent between 2007 and 2014, according to an analysis of insurance records.

The findings illustrate that the opioid problem is "in the general mainstream," says Robin Gelburd, president of Fair Health, a nonprofit that analyzes health care costs and conducted the study.

In a big hotel conference room near New York's Times Square, six doctors huddle around a greasy piece of raw pork. They watch as addiction medicine specialist Michael Frost delicately marks the meat, incises it and implants four match-sized rods.

"If you can do it well on the pork, you can easily do it on the person," Frost tells his audience.

MOLLY MCGUIRE

A University of Washington report on drug addiction in King County confirms that heroin use is still on the rise. But for the first time, researchers say opioid-related deaths are leveling off.

Zac Talbott sees the irony of running an opioid treatment program from a former doctor's office.

"The funny thing is, a lot of patients are like, 'This is where I first started getting prescribed pain pills,' " Talbott says.

Now, the Tennessee native says those same patients are coming to his clinic in Chatsworth, Ga., a small city about a half-hour south of the Tennessee border, to fight their addiction to those very pills.

Dr. James Gill walked through the morgue in Farmington, Conn., recently, past the dock where the bodies come in, past the tissue donations area, and stopped outside the autopsy room.

"We kind of have a typical board listing all of the decedents for the day," Gill said, pointing to the list of names on a dry-erase board. "Overdose, overdose, overdose, overdose, overdose. That's just for today."

Editor's note: This story was updated on June 2, 2016, to reflect Prince's autopsy results.

Prince died of a drug overdose, the medical examiner in Ramsey, Minn., reports. The iconoclast musician, 57, self-administered a deadly dose of the opiate fentanyl by accident. Opioid overdose in his age group is all too common.

In response to the opioid epidemic that has swept the country, the Centers for Disease Control and Prevention released long-anticipated guidelines on prescribing opioid painkillers such as OxyContin and Percocet.

They were published Tuesday in JAMA, the Journal of the American Medical Association.