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Understanding the opioid crisis

At a recent Greater Ketchikan Chamber of Commerce Luncheon, the opioid crisis was discussed, including how it happened, opioid abuse prevention, and how it affects the entire community.  The presentation was led by Reed Harding of the Ketchikan Wellness Coalition’s Substance Abuse Task Force, and public health nurse Lindsey Lamon.

Opioids are anything derived or synthetically created from
the opium poppy plant. This includes oxycodone, heroin and fentanyl. Harding
says opioids bind to receptors in the brain to block pain.

“If you have too much opioids, you have a reaction where it acknowledges the blocked pain, but blocks all the signals in your brain, which causes your breathing to slow down, which is what leads to that overdose stage which you can die in.”

Harding says the danger of opioids is that the body builds up
a tolerance, meaning more have to be taken to achieve the same pain relief. He
says tolerance also leads to dependence.

“Which basically means that your body becomes used to doing it, and once you stop using it, you no longer feel ‘normal’ unless you’re using opioids.”

Harding says dependence then leads to withdrawal. He says
those going through withdrawal have described it as ‘the worst flu you’ve ever
had, times 100.’”

“So if you’re a heroin user, there’s a really strong feeling that they want to just use that heroin again. As soon as they take that heroin again they feel normal again. If you’ve ever felt absolutely horrible, the worst flu you’ve ever had and you know you can instantly end it like that, by taking something, you’re going to do it. And that’s why it’s such a dangerous drug.”

Lamon says, for some people, it not only blocks pain, but
creates a sense of euphoria which can lead to addiction. She says building up
tolerance, especially with opioids, also can change the structure of brain and
spinal cord receptors.

“It’s not just that somebody wants more or ne more. There are actual chemical changes going on in the body – physical changes in the brain and the spinal cord that are occurring that are causing that tolerance to go up.”

Lamon and Harding say addiction is not just a “choice.”

“Your body really gets hijacked by this drug and you lose that control. It’s important to keep in mind that it’s really a medical issue and not just a moral failing on people.”

Harding says opioids are taken many ways – swallowed,
snorted, smoked and injected. Lamon says injection is related to many other
health concerns seen in the community.

“It’s associated with increases in HIV rates, hepatitis C rates. A lot of people that are using injection drugs end up getting bacterial blood infections. They end up having a lot of heart problems because of the bacteria traveling through the blood stream.”

Harding says this is driven by users sharing needles. Alaska
data shows an increase in opioid overdose deaths, especially from fentanyl. 

Lamon says it’s important to understand the social
consequences. Those include increased crime, finding used needles in public or
having someone overdose outside a business or home.

“It’s affecting our community at large, not just the people who are dying and not just the families of the people who are dying.”

Harding says one in 20 people in the United States use
opioids, so a business owner may have an employee who is addicted and not know
it.

He says the epidemic was caused by a high availability of
prescription opioids when they were introduced, and reassurance from drug
manufacturers that they were safe. Harding says doctors no longer prescribe
opioids readily, but people who are addicted are not getting treatment, so they
turn to street drugs.

To prevent misuse, Harding advises that people use
medication only as prescribed, not combine it with alcohol or other drugs, keep
medications safely stored and locked up if necessary, and dispose of unused
medication properly. A drop box for expired or unwanted medication is in the
lobby of the Ketchikan Police Department. Harding says drugs and paraphernalia
can be disposed of there, no questions asked. 

He says it’s also important to talk to children about drugs.

“Most teens say their parents haven’t talked to them about this type of stuff. Kids aren’t psychic. Parents sometimes think the kids just read their minds and just know what they want. They don’t. You need to talk to them…often.”

Harding says when talking to kids, you should focus on
quantity, not quality.

“Anytime your kid says, ‘I’m gonna go to a party,’ you ask them, ‘Is there going to be drugs or alcohol at that party?’ You let them know, ‘I don’t want you doing drugs or alcohol,’ every time. That’s what’s going to work. Mentioning it off-hand, one time, it’s not enough. You’ve got to keep on telling them.”

Lamon pointed out the message does not have to come just from
parents.

“We as a business community, we as neighbors, we as teachers, we as healthcare providers. We can all make differences in young people’s lives if we talk about these things from an early age.”

Ginny Clay, who is a substance abuse task force member and
employee of The Safety Specialists interjected, saying she has always sent the
message, “Don’t do drugs, they’re bad for you.” 
But…

“One day my son said, ‘Mom, you never say, ‘I’m proud of you for not doing drugs.’’ Or ‘It’s awesome that you guys don’t do drugs.’ So you need to remember, as a parent, to say those things too to your kids.”

Clay says noticing and acknowledging good decisions is
important.

Harding says whether or not you know someone using opioids,
all businesses should have Narcan kits to reverse the effects of an opioid
overdose. He also advises having a kit in your car. Harding says it could save a
life.

Lamon says kits are available from the Public Health Center,
TSS, Ketchikan Indian Community and the Ketchikan Police Department. They are
free, no questions asked. Lamon says a short training on their use takes about
10 minutes.

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