County health official urges community to join the fight against opioid addiction,
Hopes emergency status will help
Pittsburgh Post-Gazette
Hours before President Donald Trump declared the opioid crisis a public health emergency, Allegheny County’s top health official outlined the dire situation here and urged that schools, community groups and anybody with a public bathroom join the fight.
“We are desperate to try to figure out how to get our hands around this epidemic,” said Karen Hacker, director of the county Health Department, at the start of a twoday Duquesne University School of Nursing symposium Thursday called “The Face of the Person with an Addiction.”
Dr. Hacker said she hoped that the president’s declaring an emergency would “liberate resources” from “bureaucratic obstacles,” allowing funds to flow more readily to drug treatment, awareness programs and distribution of naloxone, a drug that reverses overdoses.
The president’s declaration is expected to waive regulations, give states more flexibility in their use of federal funds and expand use of telemedicine treatment — but it won’t free federal Disaster Relief Funds for anti-addiction programs.
Dr. Hacker said she hoped the president’s declaration would somehow reduce the price of naloxone, which costs the state just $37.50 per dose but can run as high as $115 at pharmacies.
She said she feels “this intense drive to get as much naloxone out there as we can possibly get out there,” despite skepticism from people who believe the drug enables users of heroin and fentanyl.
“We’re in the midst of an epidemic right now, so to somehow deny people that help would be unethical,” she said.
Allegheny County recorded 650 fatal overdoses last year. The number had hovered around 230 annually through 2010, then started creeping higher and exploded as synthetic fentanyl became more prevalent starting in 2014.
“Fentanyl, as far as I’m concerned, has been a complete game changer,” Dr. Hacker said. Available from China via illicit internet sites or from supplies smuggled from Mexico, it is far more powerful and cheaper than heroin. Now heroin dealers, in order to be competitive, have to include fentanyl in their product, and it’s even being pressed into pills and mixed with cocaine, she said.
Whereas overdose victims a few years ago tended to be in the 35- to 44-year-old range, “that 25- to 34-year-old age group is the one that is increasing the fastest,” she said, suggesting that social barriers to the use of needle drugs are dissolvimg.
Just Wednesday, the Allegheny County medical examiner released the results of 25 autopsies, from deaths in June, July and August, in which fentanyl or the more powerful carfentanil were implicated in the deaths. The deceased ranged in age from a 1year-old girl from McKees Rocks whose death was blamed on carfentanil to a 67-yearold man from northeast Pittsburgh whose body contained heroin, three illegal synthetic narcotics and three prescription drugs.
And on Thursday, as part of the Justice Department’s anti-opioid effort, law officers raided a medical office in Irwin.
The U.S. Attorney’s office said a search warrant was issued for 905 Spruce St. in Irwin, the address of Primary Health and Wellness Centers. The medical practice has offices in Irwin and Greensburg. No one answered the phone at either location.
The U.S. Attorney’s office would not comment beyond saying the raid was part of a criminal investigation.
Also Thursday, the office announced that a former pain doctor in Richland, charged in federal court Oct. 4 with running a pill mill for cash, had been indicted by a federal grand jury.
Dr. Andrzej Zielke, 62, of Hampton, had run Medical Frontiers in the Richland Mall. The surgeon’s medical license has been suspended.
Federal agents, who began investigating him in 2014, said the clinic was handing out prescriptions to addicts for cash, including one who died of an overdose.
The Justice Department said the case is the first since Attorney General Jeff Sessions announced the formation of the Opioid and Abuse Detection Unit in August, a pilot program to target illegal opioid suppliers in 12 federal districts across the U.S. where the crisis is worst. The Pittsburgh region is one of the 12.
“These cases take on the supply of drugs and stop fraudsters from exploiting people suffering from addiction,” Mr. Sessions said in a statement. “We will file many more charges in the months to come — because the Department of Justice will be relentless in hunting down drug dealers and turning the tide of this epidemic.”
Dr. Hacker said many approaches will be needed to fight the problem.
“Given where we are in this epidemic, we really have to think outside of the box,” she said, acknowledging that there would be political backlash from anything perceived to be soft ondrug use.
“The Carnegie Libraries came to us and said, ‘We’re seeing one overdose a week, at least,’” often in the bathrooms. The Health Department then helped to train library personnel how to reverse overdoses with naloxone.
She said some areas are experimenting with drug-use “safe spaces,” including public bathrooms. Staff would be trained to react if someone were alone for more than a few minutes, and respond with naloxone if the person was found to have overdosed.
There are proven programs schools can use to improve student decision making and social skills, and to discourage risky behavior, she said. But many schools have been hesitant to add such programs to their busy schedules.
“I certainly cannot vouch for saying that all of our schools in Allegheny County are doing a really good job in this area,” she said. “You do an assembly, that doesn’t seem to make much of an impact.”
The opioid emergency, according to Dr. Hacker, may be part of something even larger.
Diseases of despair, which include overdoses, drug use, alcoholism and suicide, are rising among whites and Native Americans, while dropping among other ethnic groups, she said. “Some folks feel it’s because of the changes in the economy, that this is a population that feels it’s been left behind.”