Virginians have been heavily affected by the opioid crisis. How can the community rally around this problem?

How long can someone watch an epidemic before they feel compelled to take action? For Don Holman, the breaking point was when his son was found dead.

Garrett Holman died Feb. 9, 2017, after he overdosed on heroin laced with the super-drug fentanyl, which according to the Drug Enforcement Administration is a hyper-potent substance 100 times more powerful than morphine. This drug has helped the number of opioid-related deaths skyrocket within the last five years.

The opioid epidemic has been declared as such by the federal government, and though much attention has been given to the crisis, the problem is still growing.

According to the National Institute on Drug Abuse, every day more than 115 people die of a drug overdose in the United States. The study says anywhere between 21 to 29 percent of people on prescribed opioids end up abusing them.

According to a report released by the Virginia Department of Health, three-fourths of all drug overdose deaths in the state were from opioids, because of fentanyl, which is usually laced with heroin to give the buyer a cheaper and better high. Due to the high potency of the drug, even a dose as small as three milligrams can prove lethal, compared to the lethal dose of 30 milligrams of heroin, which shows the danger.

The report shows many counties in the state are suffering, whether that be for lack of funds, size of the population or ease of accessibility of the drugs. According to the report, based on the size of each of the counties, the heaviest hit are Richmond City, Culpepper, Fauquier and Orange.

The state governments have also gotten involved. According to WSET13, the state of Virginia has received a $9.7 million grant from the federal government to combat the opioid crisis from former Virginia governor Terry McAuliffe. Additionally, according to WTOP, former governor Terry McAuliffe set a budget of $78 million to fight the epidemic in the state.

But the death toll is still rising.

The Center for Disease Control and Prevention said opioid overdoses went up 30 percent in 45 states from July 2016 through September 2017.

Despite the best intentions of the federal government and those involved, counties and common people are not being relieved. What is stopping counties from being able to treat their residents?

 

Resource Distribution

John Shinholser, board member emeritus and president of the McShin Foundation, a recovery foundation for drug addicts, said one of the reasons the crisis is only getting worse is because the resources being released in the state are not being allocated properly.

“Politicians make a decision based on special interest groups more so than what’s needed, so if you work for a police association or sheriff’s association or commonwealth attorney’s association, or any association that makes money off of addiction and correction, the laws that are going to pass are going to favor increasing the size of those industries,” Shinholser said. “Nowhere is there any funding to cover community support providers, which is scientifically proven to reduce addiction by about 40 percent.”

The McShin foundation is located in Richmond, which according to the Virginia Department of Health report had 67 overdose deaths per 100,000 citizens from heroin in 2016.

Shinholser said despite the scant funding, the operation is still taking in as many people as they can. All people need to do is ask to be put in a recovery unit.

“When (former addicts) re-enter the community, that’s where so many people fall through the cracks,” Shinholser said. “Our systems are designed to fund criminal justice services, but they’re not designed to fund recovery support services when they need it. We don’t have the resources for everyone who needs it, so they end up in jail, emergency rooms, or they end up dead.”

Shinholser said the weaknesses of the programs is the fact they are understaffed, underfunded.

Chief Operating Officer of the McShin Foundation Jesse Wysocki agrees, saying that the government is not supporting the local recovery options and the community has not helped much either.

“It’s terrible,” Wysocki said. “It’s not like (anybody) is getting rich off of it. I know I’m not, and I know the staff, they’re not either. We just want to help. The localities just won’t give the funding. It’s terrible that all of this money is being sent nationally, but it won’t get down these (Recovery Community Organizations).”

Wysocki recounted a story of a recovering addict being released from prison. They were remanded to the McShin foundation, but the foundation is not supported by the government and the addict could not pay.

“There should be a better way of allocating it to these RCOs or to the participants that need help, giving them grants so they can get in, giving them scholarships,” Wysocki said. “That and education.”

 

Education

Despite the media being saturated with stories of the opioid crisis and the efforts to combat it, many believe the community is still undereducated on the subject.

“I know more about everything now than I could have imagined I would know 16 months ago, prior to losing my son,” Holman said. “At that time, I probably didn’t know what an opioid was. If a doctor prescribed the medication I felt like they knew what they were doing, and it was our job to listen to them… Most of the education I got, unfortunately, has been since I lost my son.”

Holman said people will unwittingly take opioids for situations they do not need them.

“I don’t think the questions are being answered,” Holman said. “People now are going to get in a car accident, they’re going to get their wisdom teeth taken out, they’re going to have some issue where they’re going to be prescribed a painkiller that is potentially addictive.”

Some believe the crisis is due to the over-prescription of opioids by medical professionals. According to a study on Politifact, the United States, which accounts for approximately 4.4 percent of the world population, has consumed 30.2 percent of the world’s opioids.

Lynchburg Sheriff Don Sloan said that in his experience, doctors have prescribed opioids too readily.

“I think a big problem is the availability of the opiates through your doctor,” Sloan said. “When you have a surgery or whatever, they’re automatically dispensing opiates.”

Sloan recounted when he had an appendectomy, he was offered opiates but did not take them out of fear of addiction.

“The doctors automatically give that stuff, and they’re doing it locally,” Sloan said. “I think the first thing we need to do – whether legislatively or not – to help all of us is we need to get our medical facilities on board with backing up off of this stuff.”

According to the Centers for Disease Control and Prevention, prescription opioids are risky, and resulted in over 165,000 deaths from 1999 to 2014. As of 2016, there have been more regulations placed on prescribing opioids.

“I think they’re doing a good job of dialing back the prescription opiate addictions,” Shinholser said. “They’re cracking down on doctors. A lot of prescriber education is taking place with a lot of talk about these doctors immediately prescribing. A lot of doctors, they’re not prescribing as freely as they used to.”

Holman said he believes that educating the younger demographic will help prevent people from falling into addiction, and that there needs to be real discussion on the subject with people who can fully relate to the youth.

“I think it would be more effective young person to young person than someone like me trying to connect with the parents of these young people, because the stigma attached to this is the worst thing,” Holman said. “You never hear parents and kids… talk this way.”

Holman said that PSAs and warnings are all being targeted at the wrong demographic and that to make a real change in the situation people need to reach out to those most at risk – youth.

“I think we have to hit it from every angle,” he said. “You think about commercials on TV but kids these days are not watching ABC, NBC, CBS, they’re watching Netflix and YouTube. You have to better identify your target and you have to better identify the mode in which that information gets across.”

 

Community outreach is difficult

Addiction is an uncomfortable topic for many, and the stigma against people in recovery can be a difficult obstacle.
Sallie Morgan is the executive director of the Mental Health Association of Fauquier County, an area of Virginia that, according to 2016 statistics from the Centers for Disease Control and Prevention, had 18 heroin deaths per 100,000 residents.

Morgan said stigma can be very damaging to those seeking recovery.

“We deal with stigma in terms of mental health issues but the stigma around addiction is even stronger,” Morgan said. “Historically, they’re looking at addiction as a failure of willpower, almost a moral corruption or something, so helping people understand the nature of addiction is really important.”

Wysocki experienced this stigma in his own battle with opiate addiction.

Wysocki began using heroin at the age of 15. He became addicted when he was put on morphine after a serious leg injury while playing football.

Wysocki continually tried to receive help from the community services offered and was put on different medications to help with his addiction, but he was not able to overcome it until his mid-thirties. He would detox in hospitals but then would relapse when he was sent back out and ended up getting incarcerated at the age of 19.

“I went away for a couple of years,” Wysocki said. “That was my first touch of trying to get any help.”

Wysocki felt the weight of being labeled as an addict, which has seeped into all aspects of his recovery.

“To be a heroin user, to be an opiate user, I was shunned,” Wysocki said. “Seeking help was a hard thing for me to do, but when I did do it, a lot of times I just didn’t know what to do. The resources weren’t there. As far as funding and having the money to do it— I didn’t have insurance and didn’t have the money to pay for a lot of these things, so they didn’t offer any kind of resources when it came to that either.”

In addition to trying to overcome the stigma against recovering addicts, educators have had problems getting the attention of the community. Holman described an opioid community meeting he attended in Alexandria where the bulk of attendees were a part of emergency services or local support. Very few citizens attended.

Some of the educators have spoken about the value of personal experience, saying programs that get people who have recovered to speak with young kids generally have an impact.

Morgan talked about hosting former NBA player Chris Herren who struggled with opioid addiction. Morgan said the message was powerful.

“You could have heard a pin drop,” Morgan said. “Personalizing the experience and talking about what that has done to him and what he sees are ways that we can help deal with the crisis.”

 

Treatment methods

Those looking to fight the opioid epidemic and save lives also need to be looking for new treatment methods for those struggling with addiction.

A popular drug that revives people who have overdosed is naloxone, more commonly known as Narcan. Although this has saved many lives, it does not take away the addiction or withdrawal symptoms, and people who have received an injection usually relapse.

Nationally certified volunteer firefighter Elizabeth Lapp has seen the drug in action countless times.

“There are certain addresses where we get text messages that there’s a fire call cardiac arrest and we recognize the address like ‘This is a Narcan call,’” Lapp said. “It’s even to the point where we know where they hide their stash in their bathroom, and we go in and we get it for the police officer.”

Morgan said the drug is useful for saving lives, but it does not fix the problem.

“It doesn’t solve the person’s problem, but it keeps them alive to have a chance to work on their problem,” Morgan said. “So (we have to focus on) not only saving them but having the resources there to support them long term.”

One such resource that is popular among educators is medication-assisted treatment for addiction. This method gives the recovering addict an opioid that does not get them high like Methadone. This prevents them from going through withdrawal symptoms.

Douglas Brown, an addiction treatment specialist in Williamsburg, said while the medically-assisted treatments are beneficial, the recovering addicts need to be helped long term.

“(The methods) are successful but it has to be coupled with therapy,” Brown said. “If you don’t do that and just treat them with the medication, give them a vivitrol injection for 28 days, your success rate is very low.”

Brown said the physical aspect of recovery is important, but mental care also needs to be addressed. Many drug addicts are trying to cope with some sort of trauma, and the sooner the community addresses that, the sooner people can recover.

“We need more training in trauma counseling and the techniques of that,” Brown said. “(Recovering addicts) need a specialized type of counseling so they can desensitize (trauma) and relive this to really help them with that. That’s huge.”

 

Future

Looking at the rising number of opioid deaths is concerning experts, and there is no definite answer in sight.

“If I knew how to do the right thing my son would still be here,” Holman said. “I think we’ve got a long road to go.”

According to the Richmond Times Dispatch, opioids have been the biggest killer in Virginia since 2017, surpassing gun and automobile-related deaths. An article released by CNN said as of 2016, opioids kill more people than breast cancer.

The large numbers are a concern, but they are not disheartening, according to Morgan.

“I have heard people say that it’s likely to get worse before it gets better,” Morgan said. “I feel hopeful that we can reduce the problem, but I think it’s not easy. Things like Narcan are at least helping people get through an overdose situation and have an opportunity to get into treatment.”

Brown said the problem needs to be addressed from all aspects to turn the tide in communities.

“The crisis is going to have to be attacked multifactorially,” Brown said. “Between more educators being willing to do this, more education and more government funding for what needs to be done.”

Holman said if the local community takes an adequate interest in the situation, change is attainable.

“We’re still going to lose people,” Holman said. “The number of people dying is going to go up before they go down, and in my opinion that’s just a fact of where we are.”