Pubdate: Sat, 11 Jul 2015 Source: Standard-Examiner (UT) Copyright: 2015 Ogden Publishing Corporation Contact: http://www.standard.net/ Details: http://www.mapinc.org/media/421 Author: Jamie Lampros PAINKILLER ADDICTIONS LEADING TO WAVE OF HEROIN OVERDOSE DEATHS OGDEN - Mark Kastleman got a call this week from a 65-year-old woman who started on pain pills for back surgery recovery and now, a year later, has turned to heroin to feed the opiate addiction she developed. Unfortunately, her situation is not unusual. "At our facility we've seen a big increase over the last year or so in the number of clients coming to us for heroin addiction," said Kastleman, partner and director of operations at Action Recovery Group in Ogden. The use of heroin has increased dramatically over the past decade and overdose deaths have soared, according to a new report by the U.S. Centers for Disease Control. Between 2002 and 2013, heroin deaths have nearly quadrupled in the United States. In Utah, from 2002 to 2013, the state has seen a 42 percent increase in heroin deaths, said Anna Fondario, injury epidemiologist for the violence and injury prevention program at the Utah Department of Health. In 2002, Utah had 64 heroin deaths. In 2013 there were 91 and preliminary data for 2014 shows 116 heroin-related deaths. That's a 27 percent increase from 2013 and an 81 percent increase from 2002. On average, 81 percent of the deaths were males and the age group with the highest number of deaths was 25 to 44 years old, Fondario said. Across the United States, the CDC says the increase occurred among a broad range of demographics, including men and women, most age groups, and all income levels. Much of the increase is attributed to people who started using prescription painkillers before moving onto heroin. Kastleman said there are several reasons people here are turning to heroin in such large numbers. "Many people start out on prescription pain pills like Oxycontin for legitimate reasons - post-surgery pain, back injuries, etc. Over time, some become dependent on the painkillers, even after the original reason for the prescription has passed," he said. "Then, when the prescription runs out, or they can no longer afford it, they turn to the far cheaper and readily available alternative of heroin." Most pain pills and heroin are derived from the same poppy plant, Kastleman said. They are very similar in chemical makeup and bind to the same opiate receptors in the brain. Prescription pain pills cost around $1 per milligram or about $60 for a 60 mg pill. Sixty mg. of heroin costs about $6, or one tenth the cost of prescription pain killers. "Many teens report that it is easier for them to get heroin on the street than alcohol or even cigarettes," Kastleman said. Heroin addiction crosses all religious, ethnic, socio-economic and age boundaries, he said. Because it is so cheap and instantly available, anyone from anywhere can get it and afford it. "We know of grade school children who get hooked, all the way up to senior citizens." Kastleman said pain pill prescriptions are so common that many Utah families have them sitting in their medicine cabinets. Some teens will take their parents' or grandparents' pain pills and then sell them at school. "This is how many kids are getting their first exposure to opiates. Then when the supply runs out or is too expensive, kids will turn to the far more available and cheap heroin alternative," he said. "A shocking statistic is that the U.S. consumes 80 percent of the world's pain pills with only 5 percent of the world's population." The CDC reported that the use of heroin is affecting people in urban and rural areas, white, black and Hispanic, low, middle and high income. Kastleman said people also turn to heroin because it has a powerful pain-numbing effect. It not only helps physical pain, but also emotional pain. Heroin also produces a very strong and enticing feeling of euphoria - a high that many addicts say is like nothing else they've ever experienced and once experienced is very difficult to stop seeking. Symptoms of heroin use can include small pupils, sudden changes in behavior and disorientation, dry mouth and a cycle of hyper-alertness followed by a sudden nodding off. "They will also often have a droopy appearance, like their extremities are heavy and lethargic. In addition, substantial increases in sleep time, slurred or garbled speech, wearing long sleeves or long pants to hid needle marks, even in warm weather," Kastleman said. "Some of the paraphernalia from heroin use can include things like needles or syringes, burned silver spoons, aluminum foil or gum wrappers with burn marks, missing shoelaces, used as a tie for injection sites on the body, straws with burn marks, small plastic bags with a white powdery residue." Kastleman said his biggest advice to parents is to be aware and notice what is going on with their teens and young adults. Assuming that "my kid would never be involved with pain pills or heroin" could be a dangerous assumption. Talk openly and honestly with kids about addiction issues and don't be afraid to ask questions when you notice something that's not quite right, he said. Also realize that pain pill and heroin addiction is not just a teen and young adult issue. Parents and grandparents must be very aware of their own use and abuse of prescription painkillers. "It's far too easy to justify and rationalize the overuse of opiates until the individual wakes up one day to find themselves trapped in dependence and addiction," he said. The Utah Legislature passed two laws in 2014 to help reduce drug overdose deaths. Naloxone Law (House Bill 119) permits physicians to prescribe naloxone to third parties (someone who is usually a caregiver or a potential bystander to a person at risk for an overdose). It also permits individuals to administer naloxone without legal liability. Good Samaritan Law (House Bill 11) enables bystanders to report an overdose without fear of criminal prosecution for illegal possession of a controlled substance or illicit drug. "The Utah Department of Health developed pocket cards informing the public of how to prevent deaths from an overdose," Fondario said. "It includes information on how to recognize overdose warning signs, information on naloxone, how to administer naloxone, and who is at risk for an overdose." Ten thousand pocket cards have been distributed in the last six months. To obtain one, got to: http://www.health.utah.gov/vipp/pdf/RxDrugs/rxdrug-overdose-pocketcard.pdf All Intermountain community pharmacies stock and can fill prescriptions for naloxone and locations can be found here: http://intermountainhealthcare.org/facilities/results.html?brand=img&type=Pharmacies The Use Only as Directed website also has some information regarding drug overdose, who is at risk, where to get help, and information on Naloxone: http://useonlyasdirected.org/get-help-now/ - --- MAP posted-by: Jay Bergstrom