‘They’re your neighbors’
Local efforts under way to help curb opioid abuse
Opioid drugs have been in the national spotlight for the negative impact they have on communities, individuals and families, and Central Iowa is not immune from those struggles.
“It seems like a lot of [patients] have had some sort of an injury, and they started getting prescribed the medication, and then they started over-taking it,” said Primary Health Care – Marshalltown Medical Clinic registered nurse and substance abuse counselor Andrea Storjohann. “Opiates are awful.”
Commonly-prescribed pain medications, like hydrocodone, are among the opioid class of drugs; heroin is also in this family. Whether attained by prescription or through unlawful means, opioids can be highly addictive.
Right now, Storjohann said she sees many cases involving prescription drugs. Along with hydrocodone, other opioids that can be prescribed include oxycodone and morphine.
“I would say pills, there is some heroine though,” she said of opioid abuse among her patients, who come from Central Iowa and from cities like Albia, Des Moines, Waterloo, Mason City, Grinnell and others. “These are our neighbors, these are people who are working in middle-class jobs … these are our doctors, our lawyers, our nurses, our manufacturers, they’re your friends.”
Sgt. Jim Gibson of the Mid-Iowa Drug Task Force (MIDTF) said the agency sees prescription opioid abuse, but added heroin use is on the rise. The MIDTF covers Marshall, Tama, Hardin and Grundy counties.
“Heroin is becoming more and more prevalent,” he said. “Over the past few years, it went from nobody talking about it … and people are starting to gradually be more aware.”
Gibson said heroin is more powerful and addictive than it’s prescription counterparts, and many people who get hooked start out with opioids prescribed to them by a doctor.
“A lot of people that we’ve talked to that have used or are addicted to heroin, it started with prescription medications, prescription opioids,” he said. “At some point, whether it be because it’s cheaper or easier to get, they transition into heroin.”
Storjohann said over-prescribing opioids has, at least in part, led to many of her patients becoming addicted. She said medication-assisted treatment, or MAT, is most effective when it comes to fighting opioid addiction.
Many of the drugs used for opioid addiction treatment are opioids themselves. Storjohann said many work by attaching to the same receptors as hydrocodone or oxycodone, which can reduce withdrawal symptoms and cravings. Once they get medical treatment, people with addiction issues can begin getting better.
“That’s what the medication allows them to do, is focus and be able to participate in life; it prevents the agonizing withdrawal,” Storjohann said. “There aren’t enough prescribers for the [treatment] medication.”
She said it’s harder to prescribe treatment medications because of heavy regulations, adding the drugs can only be prescribed by certain doctors, must have prior authorization, and often can’t be picked up the same day as an appointment.
Opioid pain medications, Storjohann said, are much easier to prescribe and are often cheaper than treatment drugs.
To help combat the abuse of opioids, Substance Abuse Treatment Unit of Central Iowa (SATUCI) Executive Director Vickie Lewis said steps are being taken to come up with a strategic plan.
“We got some funding from the Iowa Department of Public Health to respond, in our four-county region, to issues surrounding the opioid use and abuse,” she said, adding the money was allocated specifically to fund such an effort. “We’re in the process of putting together a needs assessment … out of that will come a strategic plan.”
Along with community partners, she said SATUCI staff are “looking at tons and tons of data” to do the needs assessments.
Storjohann said the outlook for the problem doesn’t seem positive.
“I think it’s getting worse,” she said. “The problem is going to get bigger, and we’re going to have more people coming in for treatment.”
More people getting treatment isn’t a bad thing, Storjohann said. It’s the lack of professionals to help those in need that will be a concern, in her opinion.
Many people who have a problem with opioids choose not to self-report and get treatment because they fear there will be serious consequences if they do. Storjohann people need not be afraid to seek treatment, as they would not be reported to authorities for doing so.
Gibson said it’s possible that tighter restrictions on prescription drugs may cause those with an addiction to seek heroin. However, he said education and other efforts, like drug drop-boxes, can help the problem.
“The drug drop-boxes have been a huge success,” he said. “The task force covers a four-county area: Marshall County, Tama County, Hardin County and Grundy County, and we’ve got drug drop-boxes at law enforcement centers in all of those counties.”
There are two such drop-boxes in Marshall County: one is at the Marshall County Sheriff’s Office and the other is at the Marshalltown Police Department. Use of either does not require contact with law enforcement.
“People need to know that we’re aware of it, and we all feel very strongly about it,” Gibson said of issues with opioids in Central Iowa. “We’re prepared to do whatever it takes to help save people and get people help.”
Contact Adam Sodders at (641) 753-6611 or firstname.lastname@example.org