Pubdate: Thu, 26 Jan 2017 Source: Courier-Journal, The (Louisville, KY) Copyright: 2017 The Courier-Journal Contact: http://www.courier-journal.com/ Details: http://www.mapinc.org/media/97 Author: Madeleine Winer 'DREAMLAND' AUTHOR SAM QUINONES TALKS KENTUCKIANA OPIOID CRISIS Like most of small town America, Southern Indiana was unprepared for the opioid crisis. That's what Sam Quinones said, who is an expert on the roots of America's heroin and prescription drug crisis. "It's bad all over the country, but I would say it's probably particularly unkempt in areas such as Southern Indiana," he said. Smaller towns "never had to deal with the issues that come along with opiate addiction like how hard it is to kick, all the ancillary effects of having an addict in the family, aE& the lying, the destruction of family savings." Quinones is the author of "Dreamland: The True Tale of America's Opiate Epidemic," which follows people from all walks of life who found themselves as actors in the opioid crisis. He is in town to speak at an event during Drug Facts Week 2017, a week of addiction awareness, where he'll discuss how the nation's opioid epidemic is related to that of Kentuckiana. His speech is set for 10 a.m. Saturday at St. Augustine Catholic Church in Jeffersonville. Ahead of the event, the Courier-Journal caught up with Quinones to learn more about his take on Kentuckiana's heroin and opioid crisis. Courier-Journal: What seems to be the root of the problem in Kentuckiana? In what areas should there be change? Sam Quinones: The root of the problem is that we convinced out doctors through a variety of marketing strategies from both the medical establishment and pharmaceutical companies that we were a country in pain, which may or may not have been true. But the one way to treat that was with a tool that had never been used before and that was opiate painkillers. That began in the '90s and that gradually put down roots and became conventional wisdom and was taught in medical schools. It was the new conventional wisdom that convinced an entire generation of American doctors from coast to coast that they needed to be very aggressively prescribing those pills. . A lot of people got addicted to them and eventually sold them to the black market. And then those became too expensive for them, and they switched to heroin, which was now coming not from the far east, but from Mexico. In the 1980s, that's when it all changed. Mexico became one of our suppliers of heroin ... That is what created the problem today. This is the first time in our modern history that we have a drug scourge not created by mafias and drug dealers and street drug peddlers, but by pharmaceutical companies and strategies that those companies use. That's the root of it. CJ: What is the difference between the prevalence of heroin in rural and urban environments in the U.S.? Where does Kentuckiana fit into that in terms of its heroin and opioid use? SQ: I don't think inner city areas have this problem. In my experience, this is an entirely white problem. It is people in rural areas and suburban areas. It could be wealthy areas. It could be poor Appalachian areas. CJ: Both Clark and Floyd counties in Southern Indiana saw significant increases in drug overdoses last year. In Clark County, emergency room visits for overdoses tripled. Clark County opened a needle exchange program this week, where people can exchange dirty needles for clean ones. Do you think needle exchanges are helping reduce the use of heroin? SQ: I would say that we have run out of choices on that. ... But the problem is that we now have widespread addiction, and you need to understand that the alternative is very high rates of HIV, AIDS and Hepatitis C. There are no easy answers. This (needle exchanges) is something the counties have found necessary because they don't want to explode their budgets for the next 20 years in dealing with public health problems. It also happened to be, if done well, the only time during their (an addict's) day or their week where they encounter someone who is not addicted. It's also an opportunity for a user to encounter someone who could give them access to treatment or (pull) them in a direction away from addiction. But there isn't one answer to this. CJ: What would you tell doctors who see an increase in heroin overdoses per day about treating opioid addicts and users? SQ: One thing doctors need to do is to reassess how much pills they prescribe. They're valid medical tools, but they've been way overused. But we need to work together and figure out that this isn't a one solution problem. Law enforcement needs to be heavily involved, churches, PTA, chamber of commerce, public health ... all of these things need to gain muster in this fight. CJ: What is the most important thing community groups and individuals can do to reduce the use of heroin in their communities in order to eliminate the chance of someone dying from an overdose? SQ: There's only one way to defeat this and that is by coming together as a community. If you feel like you live in a small town, and you feel like you're all alone, to me, that's part of the problem. These are small towns .. supposedly everyone knows each other and everyone works together. But that's actually what you need to do. The important thing is not to do this alone. That's what heroin wants. - --- MAP posted-by: