prescription addiction: small towns not immune to rising opioid epidemic, Part 1

Drug Overdose Deaths

By Jacki Wood, written for the Nodaway News Leader, March 2016

Editor’s note: the names in this story have been changed to protect their privacy.

Adrianna

The grass had just started to turn green that March and Adrianna could hear a tractor in the pasture, preparing for spring planting, as she pulled into her driveway after track practice.

It was, by most accounts, a beautiful spring day in Northwest Missouri.

For Adrianna, though, that brightness and hope of spring quickly turned dark as she found her mom lying on the lawn.

“I remember shaking her to wake her up,” she said. “I wanted to scream for help, but I didn’t want to cause attention to the situation.”

Her pupils were dilated and she reeked of smoke as she laid there limp.

After months of prescription drug abuse, her mom barely weighed 90 pounds. Sixteen-year-old Adrianna managed to get her into the car and drive her to the hospital.

“I had been waiting for something big to happen for awhile,” Adrianna said, “so I wasn’t surprised.”

Still, it wasn’t how the small-town teenager perceived life a few months before.

She and her mom loved shopping and getting their nails done together, trying new recipes, doing makeovers, talking until two in the morning, laughing, watching movies.

“My mom was my best friend,” she said. “She was the person who I told everything to and did everything with.”

***

Forty-four people die from prescription drug overdoses every day in the United States, largely due to prescription painkillers called opioids, the US Department of Health and Human Services reports.

Hydrocodone (Vicodin) and oxycodone (OxyContin) are the most common ones involved.

Since 2000, the death rate from opioid drug overdoses has increased 200 percent.

Senator Claire McCaskill has been bringing the issue to the forefront in recent months.

“This has reached epidemic proportions in our state,” she said at a hearing held February 8 in Jefferson City.

Missouri ranks number one in the rate of prescription opioids sold among Midwestern states and is the only state in the country without a prescription drug monitoring program.

***

Bethany

Bethany’s family went to church. Her mother was a teacher and she and her brother were on the honor roll. They said please and thank you, took their hats off when they entered buildings and wrote thank you notes.

On the outside, everything seemed normal. Charming, even.

But on the inside, there was a hidden addiction devastating their lives.

“Once in the privacy of our home, my step-father would be nothing short of cruel,” Bethany said, a Nodaway County resident who also grew up in the area during her teenage years.

Her step-father’s addiction to prescription pain medicine began in the late 1980s after he was in a car accident and was initially put on Demerol for pain.

“He kept returning for more, and when he couldn’t get his prescription filled, he’d go to the emergency room,” she said. “Since pain can’t be proven, the ER staff pretty much had their hands tied and he would leave with, at minimum, a shot of pain meds and usually a week’s supply of pills.”

Demerol, Morphine, Oxycodone, Percocet. Anything he could get a physician to prescribe for him.

“Unfortunately in a small town, where there were only a couple of doctors, it was easier to give him a prescription and send him on his way,” she said.

***

Opioids also include the illegal drug heroin.

Four in five new heroin users started out misusing prescription painkillers, according to the Drug Enforcement Agency.

From 2000 to 2013, the rate of heroin overdose deaths nearly quadrupled in the US.

And in a 2014 survey by JAMA, 94 percent of people in treatment for opioid addiction said they went from prescription painkillers to heroin because the prescriptions were “far more expensive and harder to obtain.”

***

Just a few months before, Adrianna would have described her family as normal. Her parents had good jobs and they were well-known and well-liked in the community.

And then her mom was diagnosed with a chronic illness and prescribed painkillers to help deal with the disease.

“She saw more than one doctor and was prescribed more than one pain medication,” Adrianna said.

It didn’t take long before she began to see changes in her mom.

“The disease, combined with the drug use, was taking control of her life at home as well as at work,” she said.

***

At a roundtable discussion on February 16 in St. Louis, McCaskill said: “We are drunk on pain medication in this country.

“There’s a reason that 49 states have implemented a prescription drug monitoring database — because the positives far outweigh the negatives.”

Last week, the Missouri House sent a prescription drug monitoring program bill to the Senate, where similar proposals have stalled in the past.

***

Bethany’s step-father’s addiction tragically led to verbal and sexual abuse in their home.

“Those physician-prescribed drugs ruled our life,” she said. “Everyone seemed to know — aunts, cousins, teachers, community members …

“But no one would talk.”

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