Lake and Sumter Style Magazine
04:52 pm
18 December 2018

No easy fix

The opioid epidemic spans the country, and statistics show Lake and Sumter counties are no exception to its reach.

 

From metropolitan cities to rural communities, the effects of the use of opioids are destroying families and killing people every day.

Florida is among the states with significant increases in opioid-related overdose deaths from 2015 to 2016, according to the Centers for Disease Control and Prevention (CDC). An estimated 72,000 people died from overdoses of all drug types in 2017 in the United States, the CDC says.

Lake and Sumter counties are part of the District 5 Medical Examiner’s Office, which also includes Marion, Hernando, and Citrus counties. Among 25 medical examiner districts, District 5 is fifth in fentanyl deaths between 2003-2016, according to the Florida Department of Health. Fentanyl is an analgesic and sedative, a fast-acting narcotic that is a powerful synthetic opioid.

In April 2017, Lake County Sheriff Peyton Grinnell posted a video warning to heroin dealers, going so far as to say murder charges would be made if a customer died from an overdose. The video went viral, receiving both praise and criticism. 

Opioid addiction and use has no pattern or particular location. According to John Simpson, chief operations officer of Lake Emergency Medical Services, there’s no one area that is more affected than another. “The problem migrates from one area of the county to another, where drugs are moving through the county,” he says.

His colleague, Chris Smith, clinical quality officer, adds, “Reason goes out the window with addiction.”

In an effort to reduce the number of overdose deaths, every ambulance with Lake EMS carries the drug Narcan (generic name: naloxone), a drug designed to rapidly reverse an opioid overdose. It binds to opioid receptors and blocks the effects. It quickly restores respiration when breathing has slowed or stopped due to an overdose of heroin or opioid prescription medication.

Chris says that in 2015, Lake EMS administered Narcan 645 times; in 2016, it was 921 times, and in 2017, 1,275 times. “That does not mean there were that many overdoses. Some people require two, three, or four doses to get them to be able to breathe on their own,” Chris says.

John says it’s unfortunate to see this happening. “Narcotics used appropriately are helpful, but when you begin taking too much, you stop breathing,” he adds. “Effects can be different from person to person, depending on weight or whether that person is a first-time user.”

Many times, those who relapse after going through detox and rehabilitation think they can take the same amount of the drug they did before, but their body has changed. “If they’re transitioning to heroin or fentanyl, they can take too much the first time,” John says.

Narcan is administered through IV, by injection, or through nasal spray. The IV method is most effective. The nasal spray is only as effective as the number of mucus membranes it adheres to when used and takes two to five minutes to activate.

In an effort to curb prescribed opiates, Florida’s new law concerning controlled substance prescribing went into effect July 1. House Bill 21 increases the legal requirements for doctors and other health-care practitioners who prescribe controlled substances, especially opioids, meaning that only so many pills can be prescribed and prescriptions are limited. Passing this bill was the direct result of the increase in heroin use in Florida since 1999.

Joy Stephenson-Laws, an attorney in the health-care industry, says studies, including a recent one by Johns Hopkins University Bloomberg School of Public Health, suggests payors—the private and public companies that pay health-care costs—have not done enough to combat the opioid epidemic. Three reasons for this conclusion: low price of prescription opioids, pain questions on patient surveys to increase their satisfaction-of-care score, and lax application of protocols (limiting quantities, step therapy, which makes opioids a last resort, and authorization from insurer).

The drugs in the category of opioids include Oxycodone (oxycontin, Percodan, Percocet), Hydrocodone (Vicodin, Lortab, lorcet), Diphenoxylate (Lomotil), morphine (kadian, avinza, MS-Contin), codeine, fentanyl (Duragesic), propoxyphene (Darvon), hydromorphone (dilaudid), meperidine (Demerol), and methadone. 

These names likely sound familiar because they’re frequently prescribed after surgery or for pain. Abuse of dosages creates the problem.

Be Free Lake was originally created to address the youth alcohol abuse problem in Lake County. According to Executive Director Delrita Meisner, in 2006, Lake County was sixth in the state for youth alcohol use within the previous 30 days. The coalition was created to address that issue.

“(In) a recent Florida Youth Substance Abuse Survey that came out in 2018, the county went from sixth down to 60th of the 67 counties,” Delrita says. “We were one of the top 10 counties, and in a little over six years, with prevention through education, through awareness, changing the perception of the community about underage drinking, we were able to decrease that number.”

Now, Be Free is facing a different issue with opioids. As a result, it has developed a Drug Death Task Force in the county comprising members of law enforcement, the medical examiner’s office, treatment providers, school board, and community providers.

“Every quarter, this task force provides updates about what’s going on in the county,” Delrita says. “The last quarterly meeting was in May, and we received statistics from all of these representatives.”

Those statistics included: District 5 Medical Examiner’s Office reported 71 drug deaths; Lake County Sheriff’s Office reported 99 heroin overdoses and 16 fentanyl overdoses.

According to a recent report from Sumter County, 557 narcotics-related cases were responded to from October 2015 to September 2016. The county has applied for a grant to create “an in-house, jail-based” 90-day program with detox, individual and group therapy, and psychosocial rehabilitation.

“What we have found is there’s an increase in young people being exposed to opioids due to sports injuries, and the increase in deaths is because they’re mixing the drugs heroin and fentanyl,” Delrita says. “Because of these numbers, we decided we needed to meet regularly and help educate our community now in this different day and age.”

For the Lake County Mental Health Substance Abuse Prevention Coalition, the first successful initiative was on April 28. South Lake law enforcement conducted a drug take-back day in collaboration with the DEA office and collected more than 100 pounds of unwanted prescription medications. 

Be Free Lake then purchased 13 prescription lock boxes, which have been strategically placed throughout Lake County at police stations, to help people drop off and dispose of medications 24 hours a day without any questions. Each quarter, those medications are collected and burned by the police department.

In addition, Be Free Lake also has Deterra Deactivation Bags for those in the 55-plus age group who may not be able to get out to police stations. These bags are created to destroy prescription drugs at home and deactivate them as a way to properly dispose of medication. The bags were purchased by the Lake County Sheriff’s Office.

The Florida Department of Health indicates a 137 percent increase in the rate of deaths from drug overdoses since 2000. That includes a 200 percent increase in the rate of overdose deaths related to opioids. These numbers are horrifying because each one represents a human being.

There are many who believe the problem began with the “pill mills” that were prominent in Florida. However, due to the prescription drug crisis, legislative action was taken to close them down, forcing addicts to move to street drugs, which are often impure, fake, synthetic, and designer combinations. 

One problem occurring with designer drugs is their potency. They are so strong, law enforcement officers must be wary of touching them and may have to be treated with Narcan if the drugs get on their hands. 

“Our medical director is collaborating with local law enforcement so they have nasal Narcan as well,” John says. “If an officer has accidental exposure to a drug and it’s absorbed through the skin, they need Narcan close by. Any contact means they run the risk of absorbing it through their skin. The medical examiner’s office also has large doses on hand.”

The Behavioral Risk Factor Surveillance System, based on phone surveys done by the CDC, has found that poor health behaviors are on the rise in Lake County. LifeStream, a behavioral health and social services organization headquartered in Leesburg, said in its annual report that services were provided for 13,908 unduplicated clients in 2017 based on total visits of 321,003.

Karen Rogers, adult clinical services director, says LifeStream received state funds from the Florida Alcohol and Drug Abuse Association to support a program for administering and aiding recovery with Vivitrol (generic name naltrexone). 

“This is a medication that blocks receptors for opioids and alcohol, and it enables people to manage their addiction,” Karen says. “One injection lasts up to four weeks. It reduces cravings and prevents the euphoric effect addicts want. Before receiving it, however, they must be substance-free; they must detox.”

The drug is very expensive and is given to people who qualify for state-funded treatments. Karen adds, however, there are some insurance companies that will approve payment for the drug. 

“Like any other drug, not everyone can take it,” Karen says. “And not all addicts can be given this medication. This is the only program available in this area. There are no methadone clinics here.”

LifeStream reports these designer combinations, synthetic marijuana, and bath salts have become a low-cost alternative for adolescents and young adults. In northeast and south Lake County, there are many local sources for methamphetamines. However, alcohol abuse remains the major reason people seek help from LifeStream.

Karen stresses, however, that medical treatment alone is not enough. It must be done in combination with therapy, counseling, and peer support services. Due to the increase in the need for treatment, LifeStream has added more facilities and is moving into Sumter County.

“Coming back around to the things that worked in the past,” Karen says. “Peer counseling helps. People relate to other people who have had their experience. This is a very tough group to engage. We might open 100 cases and only 50 continue the program. We provide all the options, but not everyone is ready.”

 

Stories of Reneé and Julie

In an unobtrusive neighborhood in Clermont is a place for women to find help with addiction. Victoria’s Haven is a nonprofit organization headed by Reverends Victoria Johnson and her husband, Cecil, both ministers who have opened their home to people who are addicted, homeless, need re-entry to society, and need transitional or emergency shelter.

“I knew addiction. I was an addict,” Victoria says without hesitation. “I spent 13 years as a crack addict, and God delivered me. My promise to him was if he could pull me out of the mess I was in, I would work every day to help somebody overcome addiction.”

She did just that, working 11 years on and off at First Baptist Church Leesburg in the Christian Care Center. When she was no longer happy with the work, she left, knowing the Lord was calling her to preach, something she was hesitant about as a Southern Baptist because the church does not believe women should be in pastor positions.

“But I decided if I can help someone, I will,” she says. “We had a ribbon-cutting in December (2016) on faith along with my husband.”

Two of Victoria’s clients spoke about their journey with addiction and their life at Victoria’s Haven in recovery.

Reneé, 43, was born in Eustis and has a daughter and two grandchildren. She was addicted to opiates for two years after having a partial hysterectomy in 2009. After becoming addicted during a 90-day window for pain prescriptions, “I began eating them like candy. They weren’t that expensive so I was able to keep getting them.”

Her addiction brought about the end of her marriage with a divorce, and though she made good money as an X-ray technician, she soon owed a lot of money due to drugs. At one point, she stole her husband’s credit card to pay for her habit and borrowed money from coworkers.

When she reached the end of her rope, she contacted Victoria, who explained she had to go through a detox program with LifeStream Behavioral Center before completing her treatment at Victoria’s Haven. 

“My desire is to stay sober,” Reneé says. “Victoria provides tools and teaching to help us maintain sobriety.”

According to recent report from Victoria, Reneé left the program a week before her graduation due to a difficult personal situation. “Right now, she is still doing OK,” Victoria says.

Julie, 57, is originally from Jacksonville. She moved to Lake County to be closer to her mother in The Villages. 

“My marriage got bad, and I chose crack cocaine over family. I left them,” Julie says. “My husband didn’t understand why I had been in and out of rehab since 1992. I hope this is my last one. My addiction to opiates brought me here. I’d been off crack for 10 years, and I was prescribed drugs for chronic back pain from scoliosis.”

Julie. Photo by Anthony Rao

Julie admits she had no idea how many pills she was taking and she overdosed for the first time in 2014. Due to the Baker Act, which allows involuntary admission and examination of a person, she was admitted to The Vines in Ocala for three weeks and then moved in with her mother. When it was obvious she was using drugs again, her mother told her to move out. When she couldn’t stop dipping snuff, drinking alcohol, and using heroin, she says even her dealer stopped selling to her.

“I got on the phone and tried to find help and was offered outpatient services at LifeStream Behavioral Center. They evaluated and accepted me, and then I had very high blood pressure,” Julie says. “After seven days at (Leesburg Regional Medical Center), I had a phone interview with Miss Victoria. I knew I was going to die if I didn’t get help.”

Julie entered Victoria’s program on May 17, 2017, and  is doing “excellent,” according to Victoria. She is in the transitioning phase of treatment.

“I’m going to continue to stay as long as I can work the program and build a relationship closer to God,” Julie says.

Contact Victoria’s Haven at m.me/victoriashavenlsbg for information. 

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