Efforts to fight drug addiction in Delaware ramp up

Michael Barbieri

DOVER — They’re all across Delaware and, indeed, the country. They’re fathers and husbands, girlfriends and sisters, friends and neighbors. They hold many different jobs.

They’re ordinary people, but they all have a shared experience: They’ve battled drug addiction.

It can be hard to determine just how many Delaware residents have struggled with drugs, but addiction appears to be on the rise: In 2016, 308 people fatally overdosed, up from 228 a year before.

In 2014, according to the Division of Substance Abuse and Mental Health, Delaware ranked ninth in the country with an overdose rate of 20.9 deaths per 100,000 people.

Many people know someone who’s been impacted by addiction.

“This is something that affects people from all walks of life,” said one former addict, who did not want his name used.

For people who are frequently around former addicts, the stories are all too common.

Someone might be given opioids to handle the pain as he or she recovers from surgery. From there, it can be just a matter of time before the user becomes dependent on the drugs.

Others might start off using softer drugs and then move on to pills or heroin.

That’s similar to what happened with the former addict, who began using drugs around age 15. He is now 28 years old and will be five years sober in the fall.

“It all came to a head until I reached a point where I didn’t think it would be possible for me to get sober, and I just wanted to die,” said the man, who is now working and attending college.

Heroin is especially common because it is generally cheaper than pills and can be easier to obtain on the black market.

The opioid issue, which many have called an epidemic, in large part stems from what Division of Substance Abuse and Mental Health Director Mike Barbieri described as the liberal dispensing of prescription opioids.

According to the Centers for Disease Control and Prevention, four times as many opioid prescriptions are written now as in 1999. That’s especially bad because, per the U.S. Department of Health and Human Services, 80 percent of new heroin users first used prescription opioids.

All across the country, legislators and advocates are working to combat the spread.

New laws

In recent years both Delaware and the federal government have issued stricter guidelines for doctors. Delaware’s new regulations, released earlier this month, limit the supply for first-time users to one week and require doctors to inform patients of the risks of the drugs.

“A major impediment to families being stable and successful is the opioid crisis plaguing our state and country,” Gov. John Carney said in a March address to the General Assembly. “When last measured, Delaware had the nation’s fifth highest overall rate of opioid sales. And in too many cases opioid abuse contributes to our state’s tragic heroin problem.”

In that speech Gov. Carney pledged to expand treatment options and make the Prescription Drug Action Committee a permanent council that can help develop a plan to fight the epidemic.

The Delaware General Assembly has passed laws in recent years to combat the spread of heroin and increasing number of overdoses. Importantly, advocates say, many people have come to see addiction not as a crime needing punishment but as a disease needing treatment.

David Humes, a board member of  atTAcK addiction, cited two specific changes legislators have made in recent years as important. One grants immunity in the event of a 911 call made to save someone suffering a drug overdose or alcohol poisoning. The other allows people to use naloxone to counteract the effects of overdoses.

Naloxone can block the effects of opioids and generally works within minutes, making it, supporters say, a useful life-saving tool.

In 2014, the legislature approved proposals allowing police to carry naloxone and doctors to write prescriptions for it for people with addiction. Lawmakers also created a program to make naloxone available for a low price.

Legislation currently making its way through the General Assembly would grant immunity to pharmacists who dispense the medication.

“In many respects, we have been ahead of the curve,” Mr. Humes said of Delaware. “We have been in a leadership position.”

The General Assembly has expanded the Delaware Prescription Monitoring Program, which seeks to prevent misuse of medications.

Last year, members made drug dealing resulting in death a specific crime and established the Drug Overdose Fatality Review Commission. More treatment facilities exist too: The state now has 95 beds in such facilities.

Mr. Barbieri said Delaware will pick up the cost for treatment in some cases. If a person is denied a long-term stay by his or her insurance but can present a compelling case as to why care is needed, the state government will provide the funds.

But, Mr. Humes said, the state is just “at the tip of the iceberg” in treatment and prevention.

More to do

He hopes the state can create a permanent funding source to allow smaller police agencies to purchase naloxone. Currently, about half of Delaware’s law enforcement bodies have the medication, and there are documented instances of it saving lives in Delaware.

Additional — or perhaps different — drug education programs are needed as well, Mr. Humes believes. “Scared straight” programs have been denounced by many advocates and experts, and some believe new methods of instructing children about the dangers of drugs would help.

Delaware also needs longer-term treatment programs that allow addicts to stay in safe environments for six months or more, Mr. Humes said.

In one weekend at the end of March, four people overdosed in New Castle County, and heroin is believed to have been involved.

More people are using fentanyl, a synthetic opioid that can be 50 times more powerful than heroin. Fentanyl is sometimes sold as heroin, and when the unsuspecting user takes what would be a normal amount of heroin, their system is instead flooded by a fatal dose of fentanyl.

Fentanyl was involved in 120 of the state’s 308 overdose deaths last year.

In some cases, people hoping to get treatment are unable to get needed medication or see a doctor right away.

“There’s that lag time and for the person who is struggling with addiction any delay is a problem,” Mr. Barbieri said.

Personal messages

Above all else, there’s one message that advocates hope to spread: Addiction is a disease, and it can impact anyone. No one sets out to become an addict, and yet it happens, time and time again.

Mr. Humes’ late son, Gregory, died in 2012 from a heroin overdose at age 24. Greg Humes, Mr. Humes said, was an intelligent and kind person who experimented with drugs and eventually found himself addicted to heroin.

His son did manage to fight his addiction but later relapsed. By the time he was found by authorities, it was too late.

Mr. Humes has thrown himself into combating the opioid epidemic in Delaware, and atTAcK addiction, which was formed in 2013 and has chapters in all three counties, has been effective in expanding treatment and prevention efforts, he said. The nonprofit is named for Tyler Armstrong Keister, who battled addiction for years before fatally overdosing in 2012.

While a stigma still surrounds addiction, said the former addict who did not want his name used, he said it impacts people across racial and class boundaries.

The former addict is now working to help others become and stay sober and because he has once been in the shoes of the people he advises, his words are particularly impactful.

“I have the ability to connect with them because I’ve actually been there,” he said.

For now, preventing the number of deaths from increasing would be a good start, Mr. Barbieri said.

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