Rise in county’s opiate drug use is alarming

By Union Democrat staff March 15, 2011 05:18 am
    When the older among us were growing up, the mere mention of heroin would have our blood running cold.
    It was the most addictive and most dangerous of the wide spectrum of drugs that began permeating our culture in the 1960s.
    But it wasn’t the province of hippies, college students or those searching for spiritual enligtenment. Heroin addicts were instead inner-city derelicts whose minds and bodies were being eaten alive by a drug pushed in the darkest corners of society.
    On the other hand, we didn’t worry much about heroin. It wasn’t in better parts of cities, it wasn’t in suburbs and it certainly wasn’t in the Mother Lode.
    Until now.
       In his annual report to the Tuolumne County Board of Supervisors, District Attorney Donald Segerstrom had the unsettling news: Use of heroin is here and on the rise.
    What’s more, he added that illegal drugs such as methamphetamine, cocaine or ecstasy were not the stepping stones that were leading users to heroin. Instead, said Segerstrom, those stepping stones are often Vicodin, OxyContin and other opiate painkillers available by prescription.
    When abusers of these prescription drugs can no longer get them from a doctor, the DA said, they are likely to turn to heroin instead.
    Meanwhile, the abuse of these prescription drug is reaching record levels.
    What Segerstrom said was a “huge rise” in illegal use of painkillers has brought a spike in overall drugs arrests. In 2010, the short-staffed DA’s office handled 629 drugs cases, a jaw-dropping 68 percent increase over the 375 filed in 2009.
    Segerstrom didn’t explore the causes of the prescription drug-abuse epidemic, but a grinding economy, chronic unemployment and depression may all play a role.
    A more overreaching factor was suggested by Sonora physician Ralph Retherford in a guest opinion that appeared in The Union Democrat last November: the sheer proliferation of methadone and other opioid painkillers.
    Locally, he said, they are used and abused at a frightening rate. One pharmacy Dr. Retherford surveyed was ordering up to 6,000 methadone pills a week, along with 32,000 Norco pills and tens of thousands more of Vicodin, OxyContin, Lortab and other potentially addictive painkillers.
    That, he reckoned, was about 100,000 painkillers a week for just one Sonora pharmacy.
    Use often starts innocently, with a middle-age or older patients taking painkillers for sore ankles, backs or knees.
    Then consequences begin to snowball: Patients become dependent on the pills, need ever-increasing amounts of them, and ask for renewal after prescription renewal. Pills fall into the wrong hands, often those of juveniles, and are abused. Overdoses follow, as do arrests and, yes, deaths.
 Dr. Retherford, medical director of Maynord’s Recovery Center in Tuolumne, said the Coroner’s Office reports that opioid overdoses claim from one to three Tuolumne County victims a month. If heroin becomes the drug of choice for the desperate and deprived, this toll will only grow.
    The answer?
    Doctors should prescribe these effective but highly addictive and potentially lethal painkillers with great caution and graphic warnings. Patients should take the smallest amount possible over the shortest period possible.
    Users should set an example for their teen children, both through moderate use and by removing any temptation by locking the pills away or destroying them after use.
    Law enforcement should redouble efforts to stop prescription drug abuse and nip the nascent heroin market while it still can. Schools should educate students on the inherent danger of pills that, if in name only, are legal.
    And the county and those in the health-care field should explore affordable options for helping those who want to kick their addiction.
    One thing we can’t afford to do — is stand still. As Segerstrom’s report and Retherford’s guest opinion make clear, the price of complacency is far too high.