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opioids

Seeking answers in the opioid battle

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U.S. Rep. Gus Bilirakis wants all voices to be heard in the quest to combat the nation’s opioid crisis.

The congressman met with the Pasco County Alliance for Substance Abuse Prevention (ASAP) on March 27 to discuss the issue and listen to reactions to proposed federal legislation related to the opioid crisis.

The public meeting, held at the community center at Land O’ Lakes Heritage Park, attracted dozens of people who are interested in the issue.

U.S. Rep. Gus Bilirakis recently met with the Pasco County Alliance for Substance Abuse Prevention (ASAP), to discuss and solicit feedback on federal bills related to the opioid crisis. The House Health Subcommittee has heard 26 bills as a starting point related to opioid legislation that will be rolled into one large bill to be passed out of the House by the end of May. (File)

It piggybacked off a similar ASAP meeting in August, where Bilirakis provided an update on federal efforts to combat opioid abuse.

So far, the House Health Subcommittee has heard 26 bills as a starting point related to opioid legislation that will be rolled into one large bill to be passed out of the House by the end of May.

The bipartisan bill, CARA 2.0 Act, builds on the original Comprehensive Addiction and Recovery Act by providing $4 billion in additional resources for opioid prevention and treatment.

The funding was earmarked as part of President Donald Trump’s $1.3 trillion long-term spending bill, which passed March 23.

Throughout the 90-minute session, ASAP members shared personal stories and presented ideas to help solve the opioid crisis.

Opioid overdoses accounted for more than 42,000 deaths in 2016, more than any previous year on record, according to the U.S. Department of Health and Human Services. An estimated 40 percent of those deaths involved a prescription opioid, the agency says.

Members of ASAP, including Beth Piecora, advocated for additional peer support specialist programs. In this type of program, people who have significant personal experience with struggles pertaining to mental health, psychological trauma or substance abuse provide support to people who are currently struggling with those types of issues.

Piecora, a representative for Central Florida Behavioral Health Network, said federal dollars are needed to train and employ an increased number of those peer specialists.

Peers often can be instrumental in leading someone to pursue treatment, Piecora said.

She also suggested background check screenings be eased when hiring such specialists. “Some folks that have that lived experience sometimes have those certain things on their record,” she explained.

Others mentioned Narcan — a life-saving emergency opioid treatment — should become more readily available for addicts and their families.

The medication is the first and only FDA-approved nasal form of naloxone, which helps blocks the effects of opioids on the brain and restores breathing.

Besides enhancing distribution efforts, ASAP members said Narcan should be subsidized for consumers, particularly those uninsured. Without a prescription, the medication can cost more than $130.

One speaker even suggested requiring doctors to provide Narcan as part of prescribed pain medications.

While grant programs are available to receive free Narcan through nonprofits, barriers still remain in getting quick, easy access, ASAP coordinator Monica Rousseau said.

“You can access Narcan for free, but it usually involves a lot of paperwork…and it’s kind of obscure. It’s also very difficult to get it in a moment when you have people struggling,” she said.

Crisis needs to be attacked on many fronts
Meanwhile, Pasco Sheriff’s Office Sgt. Art Rowand inquired about creating a policy to allow law enforcement to place addicts into treatment, without arrests.

The law enforcement officer said such a measure could help eliminate the cycle of drug abuse, and cut down on overdoses and deaths.

“Basically, the only thing we have to take care of the situation…is to arrest them,” Rowand said.

Some ASAP members stressed that Bilirakis and other policymakers continue to address comprehensive addiction issues, including alcoholism.

“Opioid is now the new kind of thing, and everybody’s aware of it, but I don’t want to leave out treatment for alcoholism,” said Dena Lynch, who spoke on behalf of Alcoholics Anonymous.

“It goes hand in hand, and there’s a lot of people using drugs that also drink, so I think you can’t disregard that as far as treatments. A lot of people in all walks of life have alcohol problems, and it’s really easy to focus on opioids.”

Other suggestions included:

  • Additional measures to help juveniles with addiction treatment
  • More impactful opioid and drug education in schools for younger-aged children
  • New educational opportunities for parents of drug addicts
  • Additional ‘sober living’ houses that also are affordable
  • An increased number of child and adolescent psychiatrists
  • Improved access for psychological services and treatment for the LGBTQ community
  • Mandatory needle exchanges
  • Additional faith community nursing programs

Bilirakis said he wants to schedule a discussion next month with a handful of stakeholders, to continue to brainstorm about possible legislation related to fighting addiction.

Addressing the audience, the congressman said, “We can get your voice heard up there and really get these things into law, but we’ve got to find out what works.”

He continued: “You can throw all the money in the world at something, but if you don’t do it right and it’s not effective, then it doesn’t do anybody any good.”

Published April 11, 2018

Town hall sheds light on opioid overdose prevention

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Cesar Rodriguez spent 17 years of his life as a heroin addict.

He overdosed on five separate occasions, only to be saved by first responders who administered him naloxone, or Narcan, an emergency treatment that counteracts the life-threatening effects of opioid overdose.

“If I didn’t have Narcan,” he said, “I wouldn’t be able to sit here and share my experience. I would’ve never had a shot to recover.”

Pasco County Sheriff’s Cpl. Sherry Johnson Tandy demonstrates how to use the Narcan nasal spray to counteract the life-threatening effects of opioid overdose. She said her agency has deployed the medication 60 times, each of which has been successful in preventing an overdose-related death. (Kevin Weiss)

Parent Lisa Conca also has observed the Narcan’s life-saving effects when her son overdosed on heroin.

“I had never even heard of Narcan until that day he overdosed and was taken to the hospital,” Conca said. “Narcan saves lives and gives our kids another chance to help them on the road to recovery.”

These comments came up during a community discussion on opioid overdose prevention on March 8 at North Tampa Behavioral Health, which is located in Wesley Chapel. The event was organized by the Alliance for Substance Abuse Prevention.

The panel discussion was part of a community-wide effort to provide education about opioid overdose and what individuals can do to save the lives of those suffering with the chronic illness of addiction.

Much of the panel addressed how to access and administer Narcan.

Narcan is the first and only FDA-approved nasal form of naloxone for the emergency treatment of a known or suspected opioid overdose. The medication helps blocks the effects of opioids on the brain and restores breathing.

Opioids include heroin and prescription pain pills like morphine, codeine, oxycodone, methadone and Vicodin.

“Often the reason (over-dosers) end up passing is because the brain does not have oxygen. This medication helps alleviate that,” said Szilvia Boos Salmon, a pharmacist with Tampa Poison Control.

Along with the nasal spray, naloxone is available in an injectable form.

The Pasco County Sheriff’s Office is one of a number of growing law enforcement agencies to carry naloxone for possible overdose calls.

Pasco Sheriff Cpl. Sherry Johnson-Tandy said the agency has had over 60 deployments of Narcan. Each deployment was successful in preventing an overdose-related death, she said.

In addition to reversing overdoses, the medication is also for deputies and first responders who may become exposed or have incidental contact to illicit fentanyl or heroin at a particular crime scene.

Johnson-Tandy demonstrated how to safely and effectively administer both the nasal spray and injectable forms of naloxone. Free samples of Narcan were later distributed to the audience.

Johnson-Tandy said it’s onset time is anywhere between 1 minute to 3 minutes.

“It works almost just like an EpiPen,” she said.

Narcan is the first and only FDA-approved nasal form of naloxone for the emergency treatment of a known or suspected opioid overdose. The medication helps blocks the effects of opioids on the brain and restores breathing. Opioids include heroin and prescription pain pills like morphine, codeine, oxycodone, methadone and Vicodin. (Courtesy of Amphastar Pharmaceuticals)

“The best thing about this is, if you give it to someone and they don’t need it, it can’t hurt them,” she said, adding if someone overdosed on cocaine or stopped breathing for another reason, it won’t have adverse effects.

The Narcan medication might be needed more than ever.

Opioid overdoses increased by roughly 30 percent across the U.S., in just 14 months between 2016 and 2017, according to a new report by the U.S. Centers for Disease Control and Prevention (CDC).

The CDC called the data a “wake up call to the fast-moving opioid overdose epidemic.” It recorded 142,000 overdoses in hospital emergency departments across the nation, between July 2016 and September 2017.

Although not all overdoses in the study were fatal, they are part of the unsettling toll of opioids. Nationwide in 2016, illicit and prescription drug overdoses killed 64,000 people.

The problem is growing locally, too, experts say.

Pasco County had the highest rate of hospitalization in the Suncoast Region for opioid overdoses, according to 2016 data from the Agency for Healthcare Administration.

Additionally, Pasco has tied for fifth highest out of the state’s 67 counties for drug overdose mortality rates over the last few years, according to county health rankings.

There were 165 overdoses in Pasco in 2017— matching numbers from the 2010 and 2011 prescription pill crisis, said Capt. Mike Jenkins, who oversees the narcotics unit for the special investigations division at the Pasco Sheriff’s Office.

There’s also been a gradual rise in fentanyl and heroin use in the county over the past year, he said.

Other topics covered during the session included how to prevent opioid addiction and avenues for long-term treatment of people who are dependent on opioids.

Speakers agreed it starts with education and advocacy.

“We can’t arrest our way out of this issue,” Jenkins said. “It takes comprehensive, strategic partnerships to really move forward.”

“Start in the schools early, and educate kids as to how dangerous mom and dad’s pill bottles are,” said New Port Richey-based attorney James Magazine.

Communities must find ways to effectively integrate recovering addicts back into society after they receive treatment, Magazine said.

Rochelle Zwicharowski, a support specialist with the St. Petersburg-based Recovery Epicenter Foundation, said those who have been rehabilitated need to share their experiences.

“There’s 23 million people in recovery, and how many people do you know? We’re too quiet about it. If you’re in recovery, don’t be afraid to speak out about it because we do have to smash that stigma,” she said.

Revised April 3, 2018

Pasco joins lawsuit seeking opioid settlement

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Pasco County has joined the national trend for municipalities to fight back against distributors and manufacturers of opioid medications.

County commissioners voted to become one of several plaintiffs in litigation that seeks to replicate the kind of payouts attorneys won in the late 1990s against the tobacco industry.

Pensacola-based Levin Papantonio will represent Pasco County. The law firm is part of a consortium that is pursuing lawsuits in several states including West Virginia, Ohio and Kentucky.

Pasco County Sheriff Chris Nocco (File)

At stake is money that could be made available to the county for drug addiction treatment and the costs to law enforcement.

Pasco County Sheriff Chris Nocco spoke in favor of the lawsuit, prior to the county commissioners’ vote on Jan. 23 in New Port Richey.

“We feel the epidemic every day,” Nocco said.

In 2016, Pasco County had 165 drug overdose deaths, and 120 were related to opioids.

This is a legacy of marketing strategies that promoted prescription opioids as safe and nonaddictive, the sheriff said.

“It’s actually a pill that made them addicts,” Nocco said. “Someone is accountable for it. They should be sued,” the sheriff said.

Nocco noted the unexpected consequences from the state’s successful closure of pill mills, which distributed the opioids. He said people addicted to prescription pain medications turned to other sources, including heroin and fentanyl.

The sheriff recalled an instance when officers found a man beating on the chest of a homeless man. Initially, it appeared to be an assault. Instead, Nocco said it was a heroin overdose.

“He was trying to revive him,” Nocco said.

Pasco County deputies routinely carry Narcan, a medication that can help reverse the effects of an overdose.

In December, Pasco County commissioners heard a workshop presentation from attorney Jeff Gaddy, of Levin Papantonio.

The local law firm of Lucas/Magazine initially approached the county about the lawsuit proposal.

No upfront costs will be charged to the county. If a settlement is reached, attorneys would be eligible for a maximum 25 percent contingency fee from the county’s share of the settlement.

The lawsuits are filed against drug distributors and manufacturers. They allege that false claims were made about the safety of opioids, and excessive pill distribution that amounted to a “public nuisance.”

The lawsuits also allege that distributors failed to report suspicious orders to the federal Drug Enforcement Administration, as required by law.

Any settlement would seek to establish abatement funds that would be used to recoup public dollars spent battling the opioid crisis.

Published January 31, 2018

Medication can reverse effects of opioid overdoses

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As communities across the nation struggle with an opioid epidemic, there’s a medication — that’s not widely known — that can reverse the effects of an overdose and save lives. Its generic name is naloxone.

About 75 people attended a June 15 seminar on opioid addiction and the benefits of naloxone moderated by Judge Shawn Crane, who presides in the sixth circuit.

Law enforcement officers, health care providers and a local pharmacist shared their expertise during a panel discussion. People recovering from addiction or helping family members to recover also shared their insights.

More than 75 people attended a seminar on opioid addiction and the medication, known as naloxone, which can save lives during overdoses. Pasco County Alliance for Substance Abuse Preventions sponsored the event. (Kathy Steele)

Pasco County Alliance for Substance Abuse Prevention (ASAP) sponsored the seminar at St. George Greek Orthodox Church in New Port Richey.

The opioid epidemic is widely known.

Data from the United States Department of Health and Human Services estimates more than 650,000 prescriptions of opioid pain pills are dispensed daily. While the United States accounts for about 5 percent of the world’s population, Americans consume more than 80 percent of the world’s opioid supply.

China is a major manufacturer of illicit opioids, such as fentanyl and its derivatives.

Since 1999, the rate of deaths from opioid overdoses has quadrupled, including deaths from illegal use of heroin and other opioid synthetics, according to health and human services statistics.

On average 78 people in the country die every day from an opioid-related overdose, the department reports.

Health care providers and law enforcement officers are trying to spread the word that naloxone can reverse the effects of an overdose.

While the medication doesn’t eliminate the need for emergency medical care and treatment, it can save lives.

Naloxone is available to anyone at area pharmacies, and can be administered as an injection or through a nasal spray.

Crane and law enforcement officers agreed that the most prevalent drug of choice among addicts is methamphetamine.

“It’s cheap,” Crane said.

But, there is an increase in opioid pain medications from prescriptions or their synthetics. The use of heroin also is on the increase.

“It’s important that people know law enforcement understands that we can’t arrest our way out of the problem,” said Sherryl Johnson-Tandy, a corporal with the Pasco County Sheriff’s Office. “Drug addiction is a public health issue.”

Every Pasco deputy, as of April, carries naloxone as a nasal spray – sold under the name Narcan. The deputies can use the spray as first responders on the scene, without waiting for emergency medical personnel to arrive.

“We have a unique opportunity to make contact with people who are in their greatest need,” said Pasco Sheriff’s Capt. Michael Jenkins. “In an overdose, every second counts. It was a no-brainer for us.”

Johnson-Tandy said Narcan also is a protection for first responders.

During investigations, officers, or their K-9 partners, can inadvertently ingest or inhale opioids. Especially dangerous are the opioid synthetics, fentanyl or carfentanil. They could have an overdose and need Narcan immediately. Emergency medics also are at risk.

Cesar Rodriguez is a recovering addict, and serves on the ASAP Recovery Committee. He used heroin for about seven years, and nearly died from an overdose. Naloxone saved him, he said.

There is a stigma attached to addiction, but Rodriguez said, “We do recover and become productive members of society. We can turn around and help the next recovering addict.”

Naloxone also saved Lisa Conca’s son, who has been in and out of rehabilitation programs for about eight years. In years of seeking help, Conca said no one ever told her about naloxone. “I just want to pay it forward and help our community,” she said. “It’s a disease of the brain, not a moral failing. Every life deserves a chance.”

Kent Runyon likened naloxone to the automated emergency defibrillators. The portable devices save people who are having heart attacks, and can be found in public places, such as offices, gymnasiums or shopping malls, he said.

People can keep naloxone doses at work, at home, or in a purse.

“We need to do everything we can to put every tool in the box to help people live,” said Runyon, who is vice president of community relations for Novus Medical.

Asking for naloxone at any pharmacy is easy, said Ashley Huff, a Walgreen’s pharmacist.

Some health insurance plans pay for it; others don’t. But pharmacies treat naloxone requests in the same way as flu shot requests, she said.

“We don’t ask any questions,” Huff said. “Anyone can get it, and get as many prescriptions as you want, as long as you are willing to pay for them.”

A nasal spray kit, with two nasal sprays, can cost about $135. But, doses for injection can be about $20 each, although two doses are recommended, Huff said.

In some cases, one dose won’t be enough and a second would be administered soon after.

The most expensive medication is sold as Evzio at a cost of more than $4,500. It is an auto-injector, similar to the Epi-pen that is sold to people with asthma.

People with addictions aren’t the only ones who should get naloxone, Huff added. Anyone who gets an opioid prescription should consider naloxone — as a precaution against an accidental overdose, she said.

Published June 28, 2017