Opioid epidemic best addressed through partnerships and education, task force says
By Richard Gaw
The way to defeat the escalating rise of opioid abuse in Chester County and beyond is to engage the medical profession and Big Pharma with hard questions, partner with community organizations, and do the hard work of educating the public, one presentation at a time.
These talking points steered the course of “Opioid Epidemic: Past, Present and Future,” a 90-minute presentation held on March 13 that illuminated a severe and sweeping scourge and also shone small rays of hope for the future.
Conducted by the Chester County Overdose Presentation Task Force in partnership with the Kennett Township Police Department, the presentation was broken down into the history of what led to the epidemic; possible solutions that may lead the county away from the problem; treatment services and resources that are provided to those who are struggling with addiction; and the effectiveness and availability of Naloxone, which is administered to accidental opioid overdose victims as a means to reverse the effects of the overdose.
The statistics, both in Chester County and across the nation, are startling, but behind each one of them is an individual's story, said task force member Michael Noone, who also serves as the first assistant in the Chester County District Attorney's Office. Prescription opioids like Vicodin, Percoset and Oxycodone cause more deaths than illegal drugs, and accidental opioid overdose deaths have overtaken motor vehicle accidents as the leading cause of accidental deaths in the U.S., to the tune of 72,000 in 2017, alone.
“To put that into perspective, that's a sell-out crowd at an Eagles game [at Lincoln Financial Field],” said Noone. “I've never met anyone who said, 'I hear that drug use is a good thing. Today's the day I'm going to start.' They fall into patterns for several reasons. They may have had a sports in jury or been in a car crash or had a fall or surgery, and they were given pills to help them with their pain, and it spiraled into addiction.
“These are our fellow Chester County citizens, who have hopes and dreams and want to live meaningful lives, so what do we want to do to educate ourselves and move forward as a society with this?”
The opioid epidemic is right on top of us, Noone said. Pennsylvania ranks fourth highest nationally in drug-related deaths – about 40 people per 100,000 – and from 1999 to 2017, there were 5,434 state citizens who died as a result of accidental overdose.
“This is something that hits wealthy suburban counties, like ours,” he said. “We live in a county that's the wealthiest, healthiest and happiest county in Pennsylvania, but we are not immune to this. We may be doing better than many of our regional partners, but this is something that is very real and very serious, as well.”
The economics of this epidemic have their roots in supply and demand. In 1998, there were 11.5 tons of Oxycodone produced worldwide. By 2013, that number had grown to 138 tons, and 90 percent of its consumption that year was by Americans.
In 1992, there were 112 million legal opioid prescriptions in the U.S., but by 2012, that number had risen to 282 million. In the past few years, there has been a concerted effort on behalf of physicians to help reduce those numbers, which were reflected in 2016, when the number of legal opioid prescriptions dropped slightly to 236 million in the U.S.
So how did a problem become an epidemic? Noone said that the pharmaceutical industry must accept some of the blame.
“Pharmaceutical companies are critical in analyzing ‘How did we get here?’ and are ultimately responsible for getting us into this epidemic we’re dealing with,” Noone said. “This county has expressed an intent to do that.
“Leading up to this, doctors didn't quite realize that what they were being sold was a magic bullet. [They were told] these pills were not going to be addictive and were going to help heal everyone's pain. Well, that wasn't true, and led in large part, to the epidemic we're dealing with.”
The widening swath of the opioid epidemic may have begun in doctor's offices, but it's now in the streets and in the back alleys of our towns, Noone said, due largely to cost. Once an opioid addict's prescription runs out, he or she has an option to purchase the same drug on the street, but because the per-pill value is often astronomical, the addict seeks other, less expensive options.
“Where do you go?” he said. “You still have this addiction. You're popping multiple pills per day, but you're starting to run out of money because you can't afford that kind of a habit. Where do you go? Heroin.”
Often, it comes down to simple economics, Noone said; while the cost of an Oxycodone pill on the street is $30 per dose, a bag of heroin can be purchased on the street for between $5 and $10. For local heroin addicts, supply is meeting demand; Philadelphia has become one of the largest import cities for heroin in the U.S., because of its easy access to other major cities, an international airport, and the I-95 corridor.
“All of those things are great for legitimate businesses, but they're also great for international drug organizations who want to get their product to the end consumer.”
Noone said that the newest opioid on the market– and the least expensive – is Fentanyl, a synthetic drug that is 50 times more potent than heroin. Fentanyl was present in 72 percent of people in Chester County who died of an accidental drug overdose in 2017, a rise from 43 percent in 2016.
“The insidious thing about addiction to heroin and opioids is that the more you use it, the more you need it,” Noone said. “The end user is seeking the thing that will produce the effective high, because they're really chasing that first high. They seek Fentanyl because they think that's going to be the powerful high.”
Overall, accidental drug overdose deaths in Chester County rose to its highest level in 2017 with 144 deaths, but in 2018, that number decreased to 111.
“That's still too many – one is too many – but we are making progress,” said Noone, who pointed to the work of the task force, which was formed five years ago and now works with over 50 community partners to bring experience, knowledge and perspective to helping to solve the problem of drug abuse in Chester County.
It’s more than merely handing out pamphlets, Noone said. These partnerships are engaged with the District Attorney’s office in a full-scale battle of prevention and education, and the presentation at Kennett Township is just one of several hundred events the task force has conducted around the county. They’re about raising awareness.
“We have any aspect of society that you can think of that might be able to contribute to our efforts to turn the tide,” Noone said. “We’re here to share information that perhaps you didn’t have before, so hopefully you learn something from the presentation, and talk to your friends and family and your neighbors. Because that awareness is going to be critically important to save lives.”
Task force member Kate Genthart discussed several outpatient and residential forms of treatment for opioid addiction that are available in the county. For those without insurance plans, she said that there is access to funding for drug treatment through the Chester County Department of Drug and Alcohol Services. (See sidebar.)
Project Naloxone Director Ethan Healey said that the use of the medication – which can reverse an opioid overdose when applied – continues to save lives in Chester County. Of the 310 applications performed from 2015 to 2017, 292 were successful, he said. In addition, he said that the medication is now readily accessible to the public. (See sidebar.)
To learn more about the Chester County Overdose Prevention Task Force, visit www.stopodchesco.org.
To contact Staff Writer Richard L. Gaw, email firstname.lastname@example.org.
How to get naloxone
- You can get naloxone at most pharmacies. Although naloxone may not be available for same-day pick up, it can often be ordered and available within a day or two.
- Use Pennsylvania’s standing order (a prescription written for the general public) issued by the Pennsylvania Physician General.
- Ask your doctor for a prescription.
- Chester County residents can request naloxone at no charge from two of our community partners, Kacie’s Cause and PRO-ACT (while supplies last).
- Kacie’s Cause: Residents can submit a request by visiting www.kaciescause.com.
- PRO-ACT: Residents can submit a request by calling the PRO-ACT Malvern Office at 484-325-5990.
For those seeking drug treatment who do not have insurance, the locations below can help you. Funding assistance is available from the Chester County Department of Drug and Alcohol Services.
- In Coatesville: Gaudenzia Coatesville- 610-383-9600
- In Exton: Mirmont Outpatient- 484-565-1130
- In Kennett Square: Holcomb Behavioral Health Systems- 610-388-9225
- In Phoenixville: Creative Health Services- 610-933-1223
- In West
Chester: Gaudenzia West Chester- 610-429-1414
Source: Chester County Overdose Prevention Task Force