At the 29th Intercourt Conference presentation on ‘Understanding Ohio’s Opiate Epidemic and Treating Adolescents with Addiction’ the presenters (Orman Hall, Director ODADAS, Dr. Steven Matson, MD Nationwide Children’s Hospital) explained in data adapted from the Ohio State Board of Pharmacy 2012 that ‘Ohio’s average per capita rate of Opiod doses from 1/1, 2010 to 12/31/2010 was 67.3 doses.’ What’s so dangerous about the addiction problem is the ability to destroy lives, families and communities and take over brain and body, enslaving them chemically.
Opiates are a class of analgesics (painkillers), which includes Hydrocodone (Vicodin), Oxycodone (Oxycontin, Percocet), Oxymorphone (Opana), Propoxyphene (Darvon), Hydromorphone (Dilaudid), and Meperidine (Demerol). The National Survey on Drug Use and Health for 2009 reported 5.3 million nonmedical users and 9.0 million medical users in the past month.
Heroin use is also on a dramatic rise in Ohio. Because of the lower cost and ready availability, some users are going directly to heroin, bypassing so-called ‘gateway’ drugs like Marijuana or Percocet. Obviously, unintentional fatal drug poisoning is a consequence. Admissions for Opiate abuse and dependence are high. (The percentage of ODADAS Clients with an Opiate Diagnosis chart showed 28.5% in 2012.)
In one example, the presenters showed Jail Days in Fairfield County by Age and Opiate Status in 2008; 53.6% had opiates present in the age 18-25 group. In the teen and young adult population, bodies and brains are still developing. The criminal connection is significant. Here are some statistics:
• A July 2011 white paper on Ohio’s Opiate Epidemic by ODADAS, reported, “Ohio’s opiate epidemic is a crisis of unparalleled proportions with devastating, often deadly, consequences. The most culpable substances are the opiate family, which includes heroin and prescription pain reliever medications. In fact, these substances accounted for nearly 40 percent of the state’s 1,373 overdose deaths in 2009.” http://www.odadas.state.oh.us/public/OpenFile.aspx?DocumentID…74cf…
• “On average, four Ohioans die each day as a result of drug overdose.” (Source: Ohio Department of Health)
• “The Ohio Substance Abuse Monitoring (OSAM) Network reports a move from prescription painkillers to heroin among opiate abusers. Heroin is highly available in all regions of the state.”
(Source: ODADAS, OSAM Network, 2011)
• A study in the Journal of Managed Care Pharmacy estimates that the medical expenses of a person who is abusing opioids are eight times those of a non-addict.
In the 29th Intercourt Conference afternoon session, “Treating the Opiate Addicted Adolescent”, Lorain County representatives outlined the development of a Drug Court starting in 2000. Judge Debra Boros explained why a drug court is different, ‘The team approach is inclusive of judge, probation and treatment with juveniles and their parents. Both juveniles and their parents are held accountable.’ She explained that in addition to constant daily contact there is random drug testing and monitoring peers and parents of participants. A special challenge is when parents are unaware, don’t care, or abuse drugs themselves.
She explained the several levels of treatment from the outset, at level one where clients are seen weekly and start on house arrest. It typically lasts 4 weeks to level two. There is a clinician for the teens and a clinician appointed for parents, daily contact with the court staff, weekly consultation meetings and weekly team meetings.
Judge Boros said ‘Drug court forces them not to use and/or face things they’re in denial about.” The presentation concluded with some final thoughts: “You don’t recover from an addiction by stopping using. You recover by creating a new life where it is easier to not use. If you don’t create a new life, then all the factors that brought you to your addiction will eventually catch up with you again.” Measured 90 days after program completion, there is a 9% recidivism rate; since level 5 was implemented it’s 0%. Out of 165 drug court participants 38% graduated; 62% terminated.
For teens who are facing mental and behavioral health issues, dabbling in opiates is a losing proposition. Pomegranate therapist Dinni, LSW says, ‘Prolonged opiate use can manifest in psychotic break with episodes of hearing voices, seeing hallucinations, or perceiving things that are completely fictitious. One’s entire framework of reality becomes distorted and affects their ability to function in society. On top of say, a depressive disorder, or a conduct disorder, there can be some very negative outcomes the adolescent wasn’t anticipating, or never intended.’ Pomegranate doesn’t treat primary addiction as Talbot House does, but does conduct AOD group for teens with mental and behavioral health disorders with a dual diagnosis. ‘It’s best not to experiment in the first place,’ concludes Dinni.
[Photo credit: Empty drug pack photo by Kaisa Sarolainen, Dreamstime.com 18670802]