Ohio River Valley Communities Respond to Opiate Crisis

Ohio, Kentucky and Indiana are seeing an increase in heroin use as pain clinics known as “pill mills” have begun to shut down, making prescription opiates more difficult to obtain. Ann Barnum, Senior Program Officer, Substance Use Disorders at The Health Foundation of Greater Cincinnati, says several communities in the Ohio River Valley are taking steps to fight opiate abuse.

According to Barnum, four people died every day of an opiate overdose in Ohio in 2010. Officials responded by cracking down on pill mills, the minimally regulated pain clinics that prescribed a tremendous number of prescription opiates. Barnum notes in rural Scioto County, Ohio, the 10 pain clinics along the banks of the Ohio River prescribed 35 million pain pills a year, equivalent to 460 pills for every man, woman and child in the county of 76,000 residents.

“We’ve been slammed by the prescription drug epidemic,” Barnum says. “Now that we’ve closed down pain clinics, people who used to use drugs such as OxyContin, Percocet or methadone that were prescribed for pain relief have turned to shooting or snorting heroin.” In Hamilton County, which includes Cincinnati, one person dies every other day from an unintentional drug overdose, she says.

“Some of them are young, and some are older adults who get a prescription for a narcotic and don’t understand their tolerance level, and don’t know they can’t use these pills with other medications, or mix them with alcohol.”

In the past several years, treatment programs in the area have seen a shift from predominantly cocaine, methamphetamine and alcohol, to heroin and prescription drugs, according to Barnum. “It’s only taken two or three years to go from 20 percent of clients being on heroin or prescription drugs to 80 percent,” she notes.

Treatment centers have begun responding to the shift by changing their programs. “Detox from heroin and prescription drugs is very different from detox from other drugs,” she states. “It’s become a necessity to use medication-assisted therapies.” Many patients addicted to heroin won’t stay in treatment without it, she adds. “In our area, many people have relied on abstinence methods, based on models that have been used for years, but they have never been as successful with heroin as they were for alcohol, cocaine or methamphetamine.”

The entire community needs to be concerned about treating opiate addiction because of the costs associated with heroin addiction, says Barnum. “There are increases in burglaries and purse snatching, and increased costs for the police and the criminal justice system.” In addition, communities must bear extremely high medical costs associated with heroin use, she points out. People using heroin are much more likely to contract hepatitis C, an inflammation of the inner lining of the heart chambers known as endocarditis, and other blood-borne illnesses.

In Portsmouth, Ohio, considered the center of the state’s opiate epidemic, practically everyone in the community has been personally affected in one way or another, Barnum observes. “They’ve been extremely motivated to do something about this,” she says. Residents have banded together to push for legislation to allow the closing of pain clinics. They have established needle exchange programs to reduce illness and infection from injection drug use, and have opened programs to distribute the opioid overdose antidote drug naloxone, through a program called Project DAWN. They have increased treatment capacity, and instituted screening, brief intervention and referral to treatment (SBIRT) to catch early cases of substance abuse and treat them. Clinicians are being trained in better ways to recognize and treat pain.

In Hamilton County, a women’s substance abuse treatment program has opened a maternal addiction program for pregnant women who are addicted to opiates. They are working with local hospitals and physicians to ensure that babies are healthier, the mothers receive treatment, and spending on neonatal intensive care decreases. Another agency is working to distribute naloxone to opiate-addicted clients who are leaving detoxification and intensive treatment services. These clients are significantly at risk for overdosing if they relapse.

“These communities are leading the way in telling the rest of us what needs to be done, and what barriers are in our way,” Barnum says. “We are developing responses that are driven by and accountable to our communities.”

3 Responses to Ohio River Valley Communities Respond to Opiate Crisis

  1. Bob Vinson | November 11, 2012 at 10:07 am

    I will agree that help needs to be provided but don’t run it out of one county and have it spring up in another. It appears to me that all of the money your governor gave to scioto county should have been spread out. In Lawrence county and in other neighboring counties there was none given. Could that have been because of terry johnson who is employed by the counseling center, in scioto county, But don’t worry about us in Lawrence county we will survive. I am the director of the agency called Spectrum outreach Services,Ltd. We are located in Ironton, Ohio but if you answer me the way everyone else has in Columbus i will never hear from you at all. We will still be here working with the addicted population as we always have for years and always will be. Hope i have not wasted my time in responding to your comments.

  2. Sharon Blair | November 12, 2012 at 7:50 pm

    We also need to add to this topic: amending legislation of involuntary commitment such as The Jennifer Act. Visit my website to read more about The Jennifer Act in Indiana and Florida.www.TheJenniferAct.com

    Kentucky has Casey’s Law founded by my good friend, Charlotte Wethington.

  3. kathy newman | November 30, 2012 at 1:46 pm

    As a recovering addict from scioto county I have been touched by the disease of addiction in more than one way, I have lost my sister,family,friends and almost myself to the opiate problem in Portsmouth. I am one of the fortuante ones that by the grace of god was able to go to treatment in this town. The counceling center is a blessing to men and woman from all oveer the state. They have saved many lives and desearve every dime that they have received in grants. The money that has been invested is not just for scioto county it is to get the pill mills shut down and open up beds for people in treatment that do not have insurance. when I was in residental treatment there were 60 girls and only a handful was from portsmouth. We had girls from Cleveland, Chillicothe, Pike County, Adams County, Cincinnati, Dayton, Ironton, Athens, Huntington WV, and many more areas. It is very misinformed to say that the money should be spread out more, give it to what is making a difference. I have 17months without drugs or alcohol, if one dime would have been spent somewhere else I might not be alive today. I believe god has put TCC in my path and God doesn’t make mistakes.

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