From Opioid Prescription to Heroin Use – The Local Response to the Stigma

By Sue Greene, Prevention Specialist

Some call it the largest man-made epidemic of its time: opioid addiction. It impacts every aspect of the population—nobody is immune—and this public health problem is not something we can “arrest our way out of.”

Most opioid abuse starts with prescription pain medications, which have the same chemical makeup as heroin. Many begin innocently and use the meds correctly, trying to treat a sports injury or taking them in response to a medical or dental procedure. The problem comes when people use pain medication over time, becoming physically dependent upon it. If and when that prescription is no longer an option, the user seeks out heroin as a replacement to avoid suffering from severe withdrawal symptoms. These symptoms have been described as “the worst flu you’ve ever had—multiplied by 100,” and include sweats, chills, diarrhea, vomiting, insomnia, restlessness, tremors, bone pain, and even seizures.

This epidemic is sweeping across the country and is hurting us locally. Dubuque County has seen a surge in heroin use and deaths. According to the Dubuque Drug Task Force, since March 1, 2016, 22 community members have overdosed, and 9 of those ended in a fatality. Many of those deaths were associated with heroin tainted with fentanyl, a synthetic opioid a hundred times more potent.

Concerned community members and groups have partnered with us and other agencies to develop a local response to this national epidemic. As a Prevention Specialist at Helping Services, I began working this year with a variety of local partners to break the stigma related to opioid addiction. My passion for being involved comes from my relationships with people addicted to heroin, as well as my personal experience of physical dependence upon opioid pain medication. This year I became the coordinator of the Dubuque Chapter of Community Resources United to Stop Heroin (CRUSH), a group originally established in St. Louis in response to the heroin epidemic there. CRUSH is a community action team, comprised of concerned citizens and, hopefully soon, law enforcement, the medical community, and pharmacists. We want to stop the stigma of opioid addiction, increase awareness of the epidemic, and provide solutions to the problem. Ideally, CRUSH will become the go-to resource for information on how to react if and when a loved one is impacted by opioid addiction. The group recognizes the need for a crisis team, who can be available when a person is in the ER being treated for an overdose; a local opioid detox facility; and a partnership with medical professionals, to educate and increase awareness of the issue and prevention techniques on a region-wide scale. Efforts are underway to require all prescribed opioid medication to come with information about the dangers of opioid dependence. Helping Services will be working to increase the number of medication disposal sites and providing information on opioid use disorder to community members. This next year, our team plans to continue partnering with CRUSH and others to begin meeting those needs and prevent future opioid addictions and deaths.

Since 2000, overdose deaths related to opiates, opioids, and heroin have increased by 1000% in Iowa (National Safety Council). Heroin and other opioid addictions are here, and anyone can be impacted by this issue. However, people are not sitting by and letting the epidemic run wild. Rather, they are uniting to help addicts and their families get the help they may need. We all can and must help break the stigma and end the opioid addiction era.

Numbers are from July 1, 2015 to June 30, 2016.

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