Opioid abuse being battled on many fronts


By Wendy Byerly Wood - wbyerly-wood@civitasmedia.com



In a test of knowledge, Karen Eberdt provides medicines and candies to show people who similar they look and how easy it is for children to mistake one for the other. In this photo, a yellow sweet tart sits beside a pain pill. Can you tell which is which?


Image courtesy of Karen Eberdt

In the darkest shades of purple, the map from the National Center for Health Statistics shows the counties in this region with the highest numbers of overdose deaths due to medications.


Image courtesy of National Center for Health Statistics

In the darkest shades of purple, the map from the National Center for Health Statistics shows the counties in the nation, including locally in the northwest corner of North Carolina, with the highest numbers of overdose deaths due to medications.


Image courtesy of Karen Eberdt

Children ages 1 to 4 are brought in the most to emergency rooms for accidental overdoses in North Carolina, according to statistics provided by school health educator Karen Eberdt.


Image courtesy of Karen Eberdt

Elkin Police Chief Monroe Wagoner, left, and Lt. Mendy Peles hold a banner designating the police department as a medicine drop-off point in the area.


Image courtesy of Karen Eberdt

Karen Eberdt, school health educator in Surry County, speaks to the Elkin City Schools Board of Education earlier this year about her projects, including the medicine cabinet that compares candy to prescription drugs.


Wendy Byerly Wood | The Tribune

Karen Eberdt, school health educator in Surry County, discloses items that can reverse the effects of opioids, especially in overdoses. The blue box to the right is a kit that contains a type of naloxone that is administered nasally, while the plastic bag includes what’s needed for a naloxone injection. The other item on the table is an Evzio trainer, used to provide verbal instructions for naloxone use.


Civitas Media | File photo

Since 2004, community members in Wilkes County have been working to bring awareness to the issue of opioid abuse and overdoses resulting from its use and to make a dent in the number of resulting deaths. Those efforts have spread across the nation, including to Surry and Yadkin counties, who also are struggling with the issue.

As the former hospice director for Wilkes County, Fred Brason, who is president and CEO of Project Lazarus, said he became increasingly aware of problems with patients’ medications in their homes. “That’s when I started asking questions that 12 years ago most people weren’t even looking at the problem,” he said.

He compiled data, and then worked with groups such as the county’s health department to “mobilize around the issue as a community,” which was the start of developing awareness and education pieces for the various sectors of the community, such as law enforcement and medical.

In 2007, Wilkes County had the highest overdose death rate of any country in the county, according to the Center for Disease Control statistics, Brason reported, “and 2009 was our highest year, but that’s when we started to drop.”

Over the past five years, the number of deaths has continued to drop, and Brason said they are seeing a 50-percent decrease in overdose deaths. “Each year the number goes up and down, but overall we’ve had a 50-percent decrease,” he said.

“No one knew how bad it was, so they started documenting numbers, and 21 people had died in one year in Wilkes County from opioids,” said Ken Boaz, Project Lazarus coordinator for Yadkin County. “They discovered it was a problem in other places.

“Project Lazarus is a grassroots effort to try to do something about it,” he added.

Project Lazarus also has had an active presence in Surry County in recent years, and now members are working to form a coalition which will focus on prescription drug abuse, but also have the ability to shift to other focused community needs as efforts become successful to curb the high number of overdose deaths occurring, explained Karen Eberdt, school health educator for Surry County Health and Nutrition Center.

Opioid-based medications and heroin, which has been on the increase in the region due to it being a cheaper and now a more easily accessible option for those addicted, are being seen in all population groups, Brason said. “It is all ages, all ethnicities although it is primarily white males who are dying, but it is women, it is every profession. You can’t isolate it in one section of society.”

“It can happen to anyone, you can’t stereotype it and put a stigma on it,” said Eberdt of the addiction.

Boaz said the way to face the epidemic of overdose deaths and addiction is going to “take a community response.” Law enforcement, the medical community, schools and seniors, all age groups, he said of some of the people who need to be touched by the education and awareness of the problem.

He said there are four basic steps everyone can take to help combat the issue — they can take the proper doses of their medication as subscribed; store them securely, lock them up if need be; dispose of them properly, through a number of publicly accessible dropboxes in law enforcement stations around the region so they are less likely to be stolen or used by the wrong person or disposed of in a way that would contaminate waterways; and never share them with others.

Eberdt said nationally 143 people a day die due to opioid or heroin overdoses. “It is the number one cause of accidental, unintentional deaths in the nation now,” she said, adding in the 11-tier breakdown, Surry County is in the top tier for deaths.

“We’re sitting in a sink hole of huge main counties affected by this,” she explained as she shared a map provided by the National Center for Health Statistics, which gives a breakdown of numbers for every county in the nation. “It is a perfect storm, all of a sudden these pain killers were out there and doctors could keep their patients from being in pain.”

“I can remember when morphine wasn’t subscribed to anyone except people dying like cancer patients,” said Boaz. “The resistance was built down over time. When you go to the doctor, they ask your pain level from zero to 10. It’s part of your vital signs now, but there is no way to measure it like a heart rate or pulse. If you say, 8, then the doctor is obligated to treat that.”

“I don’t think you can blame the patients, or blame the doctors, or blame the pharmaceutical companies, or blame the government singularly. It is a perfect storm,” said Eberdt. “The strengths of these medicines are so much higher to trigger addiction.”

Boaz explained that the opioids don’t actually cure the pain. “They are just making you not feel it, and then you become more dependent on it and build up a tolerance,” he said. “Eventually if you take too much, it shuts down your respiratory system.”

According to a recent report by Castlight Health, Surry, Wilkes and Yadkin counties aren’t the only regions of North Carolina with major issues. Four municipalities in the state were in the top 20 cities in the nation for opioid abuse, with Wilmington being ranked first in the nation, followed by Hickory at fifth, Jacksonville at 12th and Fayetteville at 18th.

One of Eberdt’s focuses as a school health educator is working to provide age-appropriate teaching tools such as the candy versus pills medicine cabinet, which provides youth with an opportunity to see how closely candy looks like a pill, and encouraging them to ask a parent or adult before eating anything.

She also goes around the county “tattooing” youth with temporary tattoos, in hopes that when the children return home their parents will ask them about the tattoos and it will open a dialogue between the adults and the children about the seriousness of medications and getting prescription drugs disposed of properly.

“We need to start talking in the family at a young age about the seriousness of medication,” Eberdt continued.

This past school year, Elkin City Schools partnered with Elkin Police Department to have a medication take-back in the carpool drop-off line at Elkin Elementary and Elkin High schools, and Eberdt hopes to do the same at schools in the Surry County Schools in the coming year.

Another message being sent in Surry County to youth is to call 911 if a friend overdoses or is in need of help. With the Good Samaritan Law, they will not get in trouble for getting someone help, Eberdt said.

“Another group we’re so thankful to have on board with our coalition is hospice. That’s where many of these very high dose pain killers end up,” she said.

Boaz added that society has “become convinced a pill can fix everything,” and Eberdt added, the pharmaceutical companies pushing their medications through television commercials and advertising campaigns isn’t helping, instead they should be advertising to doctors, not the general public.

Locally, Eberdt said a first hospital protocol meeting was held recently which brought together representatives from Hugh Chatham Memorial Hospital, Northern Hospital of Surry County and Dr. Jason Stypora, the county’s back-up medical examiner, to discuss consistent ways of handling patients with chronic pain and to eventually post in the hospitals information about the levels of pain they will treat.

Brason said holding community forums are just a small piece of what a community needs to be doing. He said it will take action plans, working with law enforcement and other groups to make sure those who need help are getting it and they aren’t just being arrested, incarcerated and then released back to the same problem with no help.

He also said teaching people in the community about the science of addiction has begun. “Traditionally, addiction has been stigmatized as a moral behavior, but it is classified as a disease. There are some people who are more genetically inclined to be addicted, and that could be to anything, food, pornography, video games. We need to help people understand substance abuse is an addiction disease. In recovery, one of the hardest things for people to overcome was how people treated them or responded to them because of their disease,” said Brason.

“It’s a community response to addiction. In our area, if someone has a heart attack and there is a need, there is an outpouring of help with food and assistance. We need to have the same response to someone using and seeking recovery,” he said. “It is a disease that burns bridges, so it takes restoration and healing surrounding all the effects from the disease.”

Eberdt said another concern is the length of available treatments for those who need it. “Most treatments are short-term. It’s like taking a tree out of bad soil, putting it into good soil for five to 10 days and then putting it back and expecting them to flourish in the bad soil.”

Boaz also said, “We can’t incarcerate them out of this problem, it just doesn’t work.”

“It is going to take a culture change, and it doesn’t happen overnight,” Eberdt said. “The community needs to look this square in the face, it’s not something to brush under the rug anymore. We need to keep this in the forefront.”

“We’re not going to have a drug-free society. As long as there are prescription and nonprescription drugs around, but we need to have the discussion, out in the open, and we don’t need to vilify addiction,” Boaz added.

“There is hope. It is not beyond the realm of possibility we can make a better place,” Eberdt said.

Wendy Byerly Wood may be reached at 336-258-4035 or on Twitter @wendywoodeditor.

In a test of knowledge, Karen Eberdt provides medicines and candies to show people who similar they look and how easy it is for children to mistake one for the other. In this photo, a yellow sweet tart sits beside a pain pill. Can you tell which is which?
http://yadkinripple.com/wp-content/uploads/2016/07/web1_FullSizeRender-1-.jpgIn a test of knowledge, Karen Eberdt provides medicines and candies to show people who similar they look and how easy it is for children to mistake one for the other. In this photo, a yellow sweet tart sits beside a pain pill. Can you tell which is which? Image courtesy of Karen Eberdt

In the darkest shades of purple, the map from the National Center for Health Statistics shows the counties in this region with the highest numbers of overdose deaths due to medications.
http://yadkinripple.com/wp-content/uploads/2016/07/web1_county-breakdown-mortality.jpgIn the darkest shades of purple, the map from the National Center for Health Statistics shows the counties in this region with the highest numbers of overdose deaths due to medications. Image courtesy of National Center for Health Statistics

In the darkest shades of purple, the map from the National Center for Health Statistics shows the counties in the nation, including locally in the northwest corner of North Carolina, with the highest numbers of overdose deaths due to medications.
http://yadkinripple.com/wp-content/uploads/2016/07/web1_drug-map.jpgIn the darkest shades of purple, the map from the National Center for Health Statistics shows the counties in the nation, including locally in the northwest corner of North Carolina, with the highest numbers of overdose deaths due to medications. Image courtesy of Karen Eberdt

Children ages 1 to 4 are brought in the most to emergency rooms for accidental overdoses in North Carolina, according to statistics provided by school health educator Karen Eberdt.
http://yadkinripple.com/wp-content/uploads/2016/07/web1_ER-visit-graph.jpgChildren ages 1 to 4 are brought in the most to emergency rooms for accidental overdoses in North Carolina, according to statistics provided by school health educator Karen Eberdt. Image courtesy of Karen Eberdt

Elkin Police Chief Monroe Wagoner, left, and Lt. Mendy Peles hold a banner designating the police department as a medicine drop-off point in the area.
http://yadkinripple.com/wp-content/uploads/2016/07/web1_Elkin-Sign.jpgElkin Police Chief Monroe Wagoner, left, and Lt. Mendy Peles hold a banner designating the police department as a medicine drop-off point in the area. Image courtesy of Karen Eberdt

Karen Eberdt, school health educator in Surry County, speaks to the Elkin City Schools Board of Education earlier this year about her projects, including the medicine cabinet that compares candy to prescription drugs.
http://yadkinripple.com/wp-content/uploads/2016/07/web1_20160321_184216.jpgKaren Eberdt, school health educator in Surry County, speaks to the Elkin City Schools Board of Education earlier this year about her projects, including the medicine cabinet that compares candy to prescription drugs. Wendy Byerly Wood | The Tribune

Karen Eberdt, school health educator in Surry County, discloses items that can reverse the effects of opioids, especially in overdoses. The blue box to the right is a kit that contains a type of naloxone that is administered nasally, while the plastic bag includes what’s needed for a naloxone injection. The other item on the table is an Evzio trainer, used to provide verbal instructions for naloxone use.
http://yadkinripple.com/wp-content/uploads/2016/07/web1_Drug-talk-2.jpgKaren Eberdt, school health educator in Surry County, discloses items that can reverse the effects of opioids, especially in overdoses. The blue box to the right is a kit that contains a type of naloxone that is administered nasally, while the plastic bag includes what’s needed for a naloxone injection. The other item on the table is an Evzio trainer, used to provide verbal instructions for naloxone use. Civitas Media | File photo

By Wendy Byerly Wood

wbyerly-wood@civitasmedia.com

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