Opioids in Indiana: Personal and political

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The Department of Health and Human Services announced that it will award grants to combat the opioid epidemic in the United States for the second year in a row, as of April 18. According to hhs.gov, $485 million is being distributed via 57 grant awards to all 50 states, the District of Colombia, four U.S. territories and the free associated states of Palau and Micronesia. Indiana, specifically, will receive close to $11 million to combat the opioid epidemic.

From 2015 to 2016, there was a statistically significant 23 percent increase in drug overdose deaths in Indiana, according to the Centers for Disease Control and Prevention. According to the Indiana State Department of Health, the most recent data show 785 drug overdose deaths involving opioids in 2016, as compared to only 36 in 2000. Since then, the number of the deaths has increased each year.  There also were 1,430 non-fatal hospitalizations and 2,977 non-fatal emergency department visits, due to opioid overdoses in Indiana in 2015 alone, according to the Indiana State Department of Health.

Graphic by Erik Cliburn

Last year’s federal funding was used to promote the use of naloxone—a medication designed to rapidly reverse  opioid overdoses—often sold under the brand name NARCAN—and build sustainable systems of recovery support services, according to the Department of Health and Human Services. The
Substance Abuse and Mental Health Services Administration will also award $1 billion in grant money later in 2018 to the states most affected by the opioid epidemic, according to hhs.gov.

Indiana Sen. James Merritt (R-Indianapolis) has led much of the legislation to help eliminate the opioid epidemic in Indiana. He issued a five-year plan in 2016 to “kill” opioids in Indiana. Merritt recently authored Senate Bill 139, signed into law on March 22, which requires county coroners to investigate thoroughly suspected overdose deaths and report on the specific drugs that were involved. According to Merritt, overdose deaths are underreported, which results in ignorance of the drugs that are killing users in Indiana.

“Many states around the country are in front of us in this regard,” Merritt said, “understanding that the cause of death is integral to finding out what is going on in our communities, what drugs are there, and what is actually happening in homes and neighborhoods throughout the state of Indiana. We need to understand what is killing Hoosiers.…”

Although statistics related to the opioid epidemic in Indiana are startling, the epidemic has more layers to it than just statistics and legislation. The opioid crisis has a deep, personal and tragic effect on the lives of the addicts and their families, according to Grace Paton, Moria Marcucci, Harold Floyd and Robin Farris, all of whom are all recovering opioid addicts who attend the Lafayette Chapter of A Better Life—Brianna’s Hope, a faith-based addiction support group. While each became addicted to opioids at different times and different points in their lives, each said that their addiction to opioids stemmed from the use of other drugs. Paton said that because of her experience with other drugs before using opioids, she knew early on in her experience with opioids that she was addicted.

“I knew I was an addict before I ever used a needle,” Paton said. “I said I would shoot up one time. Then that turned into every day. I quickly figured out that it really was a problem…. Being an addict was something I was familiar with, and it wasn’t hard to get to that realization.”

According to Marcucci, who said she has been clean for 18 months, the stigma of opioid addiction is still very strong in Indiana, and people often see addicts as lesser than others and disregard them because of their addiction.  She said that she felt compelled to tell her story so that people will not just see addicts as “junkies,” but as people who need genuine help.

“I think it’s important [for people to hear about stories of addiction] to kind of end the stigma [of addiction],” Marcucci said. “I hate when people say, ‘They’re just junkies, let them die. They don’t need NARCAN training,’ and stuff like that. We are all people. I was a year away from finishing my nursing degree and had a great life, had great parents and a great family. I just made some stupid decisions, and it ended up costing me a lot of my life. I think everybody deserves a chance at recovery. Just because we have been junkies, it doesn’t make us bad people.”

Most opioid addicts try to get clean several times before they finally stop using opioids for good, and they usually choose to get clean for the wrong reasons, according to Floyd. He said that many addicts, himself included, try to get clean for other people, but will never succeed in kicking opioids until they decide to do it for themselves. According to Floyd, even though he is clean from opioids now, he is still dealing with the repercussions of his addiction.

“All the fun that comes with the recreational use now isn’t worth all the pain and misery that’s going to come with it in the long run,” Floyd said. “It will destroy every area of your life: relationships, family, physically, mentally…. I started using to fit in and feel accepted. In the long run, those people I was trying to impress ain’t even in my life right now, but I still have all the pain and misery that comes with trying to impress other people.”

Level I Certified Addictions Peer Recovery Coach with the Indiana Counselors Association on Alcohol and Drug Abuse Mike Hornbeck said that one of the worst aspects of an opioid addiction is that it steals the addicts’ sense of dignity. He said that during the recovery process being able to empathize and relate to those struggling with addiction is important in order to let them know they are not alone.

“I hate when people say, ‘They’re just junkies, let them die…’ We are all people.”

“We have a saying here [at A Better Life-Brianna’s Hope], ‘A pain shared is cut in half. A joy shared is doubled,” Hornbeck said. “Unless you are one in 10,000, you cannot do this alone. It takes saying, ‘Hey man, I’ve walked a mile in your shoes. Let’s talk this out. Let’s sit down and see if we can come up with a solution for what you’re going through.’”

Paton said that those who are addicted to opioids often will not seek help because they feel that they are alone and no one else will understand what they are going through, even if the person has struggled with addiction, too. According to Paton, who said she has been clean for two years, said she had tried to give up opioids several times, but would always end up using again. She said, however, that she knew that she needed to quit for good after she became pregnant with her daughter about 18 months ago.

“I wish I knew I could be as happy as I am now,” Paton said. “I think a common theme among addicts [when they get involved with drugs] is that they feel different than everyone else. I always felt different, and I always felt uncomfortable…. A lot of people, when they are in it [active addiction], they don’t think that you can get better, or the people that did get better didn’t use as much as they did.”

Getting clean is not as simple as just quitting opioids, according to Farris, who said addiction runs in her family. Farris said she has been clean for six months and that her addiction to opioids was so strong that it took the Department of Child Services taking custody of her daughter for her to decide to finally to get clean.

“It took DCS’ getting involved, and at first that didn’t even make a difference,” Farris said. “When they took my daughter, I just got higher and higher and higher….”

Hornbeck said that he thinks major increase in opioid usage and deaths over the past two decades is because of the low prices and accessibility of heroin and synthetic opioids, such as fentanyl.

“Most of it is what I call ‘bathtub fentanyl,’” Hornbeck said. “There’s no control there. So what you think you might be taking could be much larger than that. What you think is going to get you high is going to get you dead…. It’s cheap and available. We’ve got 15- and 16-year-old kids, and younger, who can get that but couldn’t even get close to the liquor store.”

Although legislation concerning opioids and opioid addiction has been pushed in the Indiana General
Assembly during the past few years, there is not a simple solution to the opioid epidemic, according to Hornbeck. Hornbeck, Marcucci and Paton each said that they hope legislators will continue to focus more on a treatment-based approach, rather than on legal punishment.

“There’s nothing easy about it [solving the opioid epidemic], because you have to balance the illness and the criminal,” Hornbeck said. “It [addiction] is an illness, a disease, but there has to be some criminality to it [combating addiction] to help deter those that it [treatment] isn’t deterring. So there has to be a delicate balance there.”

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