The opioid addiction epidemic: ‘This is tragedy. This is misery.’

Even though we’ve all heard of the devastating toll prescription opioid addiction is taking on our country, when public health researchers put the numbers on a display screen, it’s still tough to comprehend.

We’re talking thousands of deaths a year, and a tripling in the death rate in recent years for prescription opioid overdose deaths and a doubling in heroin overdose deaths. According to some research estimates, we’ve lost 300,000 people to overdose deaths in the past 15 years and will lose another 300,000 in the next five years without rapid and effective interventions. In some communities in some of the hardest hit states, there’s not a single family untouched by the epidemic.

“This problem is bigger than we thought it would be, and it’s more complicated than we thought it would be,” said Robert Pack of East Tennessee State University, one of the presenters at today’s Annual Meeting session on “Opioids in Appalachia: Perspectives and interventions in four states.” “This is tragedy. This is misery. This is all kinds of pain, for families, for friends, for loved ones.”

He and his colleagues are part of a interprofessional working group formed in spring 2012 that focuses on research, community outreach, education, resource development and systems thinking.

“Every meeting was, ‘how do we get someone else here? Who else needs to be here?” he told a standing-room-only audience. The group has grown to about 210 members now and meets monthly. And members represent an array of disciplines within the overdose prevention field, including community agencies, dentists, pharmacists, allied health professionals, anti-drug coalitions, law enforcement officers, physicians and public health professionals.

“The idea is that we would be a centralized clearinghouse for evidence-based solutions in the region,” he said. Those solutions can be controversial to some, like methadone clinics. But he and other presenters showed the need for a response to a problem that seems to be worsening each year.

Audra Gollenberg of Shenandoah University in Winchester, Virginia, shared findings from a study on the perceptions of the danger of prescription drug misuse and heroin use in one region of the state.

Findings from focus groups of 18- to 25-year-olds recruited from the Lord Fairfax Health District were chilling. When asked if using a prescription drug not prescribed for you is dangerous, some answered “only if you’re driving” or “it depends on what you take.”

On the intervention and prevention side, prescription drug monitoring programs have been touted as key in addressing overdoses, but they’re only part of the solution, said presenter Sara Warfield, a PhD candidate at West Virginia University. A study looking at opioid poisoning hospitalizations since the state mandated use of such a monitoring program in 2012 found a significant decrease in prescriptions for opioids but no drop in overdose hospitalizations. And there was a more than 200 percent increase in hospitalizations for heroin poisoning.

She pressed for expansion of programs that provide clean syringes to injection drug users and better outreach to address treatment gaps, considering only 22 percent of people who meet criteria for an opioid use disorder receive treatment.

All of the session presenters stressed the need to get buy-in from locals with any approach.

Another key: support, evaluate and expand local efforts that are working.

“That is organic, and those are passionate people who are helping run it,” Pack said. “Those are incredible colleagues if you can reach them.”