Opioid crisis: prevention and intervention is program topic

By Caroline Rosacker

Helping Services' Jon Vagt of Decorah, who educates on opioids and stimulant drugs in order to increase awareness in the counties he serves, which include Clayton, Winneshiek, Allamakee, Fayette, and Howard, recently presented "Opioid Use at the Community Level." The event was held Jan. 11 in the Guttenberg Municipal Hospital & Clinics education room  as part of the Family Resource Center's Lunch and Learn program. 

 What is an opioid?

Opioids are a broad group of pain-relieving medications that work by interacting with the opioid receptors in your body. When they attach to the opioid receptors in your brain cells, the cells release signals that muffle your perception of pain and boost feelings of pleasure. 

What are opiods used for?

Opioid medications, when used as directed by a physician, safely help control acute pain, such as pain experienced following a surgery. An opioid's effectiveness for treating pain can also make them dangerous when the medications are used incorrectly.

Overdose risk and dependency

In lower doses, opioids can make you feel sleepy. In higher doses they can slow down your breathing and heart rate, which can lead to death. The feelings of pleasure that result from taking an opioid may cause a person to want to continue taking them.

Long term use of opioids may cause a person to develop a tolerance to the drug. When this occurs, people have a greater need for the substance to elicit the same response. Opioid use can lead to dependency where withdrawal symptoms occur if the person stops using the drug.

Purdue Pharma

Currently the opioid crisis ranks as one of the most devastating public health catastrophes of our time. It began in the mid-1990s when Purdue Pharma promoted, and the Food and Drug Administration (FDA) approved, the powerful drug OxyContin. The widespread availability of the drug through legal prescription triggered the first wave of deaths linked to the use of opioids. The second wave came from the illegal heroin market that quickly expanded to attract already addicted individuals. A third wave of deaths was created from the use of illegal synthetic opiods like fentanyl. 

Outside of the millions of preventable deaths caused by legal and illegal opioids, many of those affected lose their jobs, homes, and family connections – to list only a few. 

Purdue Pharma was later shown in a court of law to have presented a fraudulent description of the drug as less addictive than other opioids. The profit motive of the pharmaceutical industry still remains part of the opioid crisis. 

The number of drug overdose deaths increased by nearly 30 percent from 2019 to 2020, and has quintupled since 1999.  Nearly 75 percent of the 91,799 drug overdose deaths in 2020 involved an opioid. 

Addiction

Addiction is defined as a treatable, chronic medical disease that involves complex interactions among brain circuits, genetics, environment, and an individual’s life experiences. People with addictive tendencies use substances or engage in behaviors that become compulsive and continue despite detrimental ramifications.

Substance dependence

The medical term substance dependence is used to describe abuse of drugs or alcohol that continues even when significant problems occur related to misusage. 

Recovery options

Although limited resources are available in comparison to the number of individual seeking help, there are recovery options. Detoxification

The detoxification process seeks to minimize the harmful physical side effects caused by substance abuse. It is considered the highest level of care offered. 

Detox takes place in a 24-hour, 7-day-a-week facility with 24-hour nursing care, and physicians and practitioners who  meet with patients daily. Hospitals and treatment centers with detox units are equipped to treat patients whose needs require a higher level of care as there may be additional medical conditions. 

Residental treatment

Residential treatment is for clients in need of more intense, structured therapy. They provide 24-hour treatment programs with a set number of beds. At this level of care, a comprehensive assessment and plan of care is developed for each individual.   

Outpatient services

Outpatient services offer intensive group and individual counseling for nine or more hours per week. 

Continuing Care

Continuing care is the lowest level of care, is provided once per week and builds on established recovery tools and provides relapse information. 

MAT

Medical assisted treatment (MAT) provides individualized treatment programs that offer a combination of medication and counseling for greater long-term recovery.

Overdose treatment

Naloxone, when administered in time, is a life-saving medication that can reverse an overdose from opioids – including heroin, fentanyl, and prescription opioid tions. Naloxone quickly reverses an overdose by blocking the effects of opioids, and can restore normal breathing within two to three minutes in a person whose breath has slowed, or even stopped. More than one dose of naloxone may be required when stronger opioids like fentanyl are involved.

Easy to use and widely available 

First Responders, EMTs, Non-EMTs, Fire Departments and Law Enforcement may be eligible for free Naloxone provided by The First Responder Comprehensive Addiction Recovery Program (FR-CARP) in the Iowa Department of Public Health Bureau of Emergency and Trauma Services ​

Tele-Naloxone is a program of the Iowa Department of Public Health and University of Iowa Healthcare. You can visit with a pharmacy provider using a smartphone or laptop and have free naloxone mailed to you wherever you are. Call 319-678-7825 or visit www.naloxoneiowa.org/telenaloxone.

​ Community Based Access​ in Iowa enables someone to access naloxone at community based pharmacies without a prescription. 

​ As of July 2020, Iowa pharmacies may dispense Naloxone for free. 

Stay and call 911

​Iowa’s Good Samaritan Law encourages those who witness a drug overdose to stay and call 911, rather than fleeing out of fear of prosecution. 

There is hope

In the midst of this insurmountable crisis there is hope. Some progress has been made in services that are available for individuals seeking recovery in comparison to the number of those struggling with addiction to opioids.

More and more health professionals are using the term substance use disorder as opposed to substance abuse, which recognizes the condition as a medical issue and not a moral failure.  

Those addicted are no longer referred to as being “clean” or “dirty” instead  medical terms like “relapse” and “recovery” are more frequently used. 

Health care coverage

The Affordable Care Act has also started requiring that private insurance plans cover substance use disorder services as part of an essential health benefits. It has also facilitated expansion of Medicaid,  which is the largest payer of opioid use disorder services. This increase has shown evidence of decreased overdose deaths and an increase in treatment recovery.

Currently there are an estimated 25 million people who are in recovery, successfully rebuilding  relationships with people they care for, contributing to society, and regaining a sense of purpose and meaning in their lives.

5C Coalition

For additional information, contact the Clayton County Community Collaboration Council. 

The 5C works together to encourage awareness surrounding alcohol, tobacco, and other drugs that prevent community members from living their lives to the fullest. Visit http://claytoncountyccc.weebly.com/ or ClaytonCountyCCC@gmail.com.