Youth said to be key to heroin-free county

On Jan. 29, 70 youths from 15 different schools gathered together in the Cuyahoga County Medical Examiner’s Office to discuss one of the most concerning and deadly influenzas hitting the county, and the rest of the nation – the heroin crisis.

Five strong presences were in the center of the circle the students formed: county medical examiner Dr. Tom Gilson; Katie Bolan from the Lorain ADAMHS Board (Alcohol, Drug Addiction and Mental Health Services); Jaclyn Brandt, whose brother died of an overdose; Monica Robins, who is the health reporter for WKYC-TV and has experienced heroin deaths within her own family; and Aaron Marks, who has been in recovery from heroin and sober for 11 years.

“The goal today is to get you to engage. This is one of our last chances to impact a group who will face this problem," Dr. Gilson told the students in his opening remarks.

“Beginning in 2009, drug overdoses overtook car crashes [as the leading cause of] accidental deaths in the country," Gilson said. "I’ve written 'heroin overdoses' on more death certificates than car crashes, homicides and suicides [this year]. We’re not unique. We’re just ahead of the curve with addressing it.”

Bolan then explained the catalyst for heroin addictions. The majority of cases began with prescription pain pills that were prescribed to the patient by a doctor for legitimate reasons, such as surgery or teeth pullings, but 15 percent of people have the gene in the brain that causes addiction to this medication.

It starts with prescribed pain medications, then advances to prescription pills and, when cut off by the doctor, eventually heroin, due to its cheapness and ability to provide a greater high.

Marks could relate to this, as his addiction started after being prescribed Percocet after getting his teeth pulled.

“When you first start, it’s a feeling you enjoy and you want to get back. But you never get back there. The [craving] goes up, but the ability to get back there decreases,” Marks said. "You wake up with cold sweats in a panic, and all you can think about is getting more. When I was addicted, I didn’t even think I had a problem; it was like sitting in the back and watching my life unfold.”

Brandt’s brother went through a similar experience, becoming addicted to pain medication given to him after oral surgery. He died from an overdose due to fentanyl being mixed into the heroin he received, something that occurs commonly and attributes to a large percentage of overdoses.

“Heroin is a roll of the dice," said Gilson. "You never know what’s going to be in this bag compared to the last. A lot of overdoses this year have been fentanyl mixed with heroin.”

Added Robins: “These drugs were originally meant to treat people with cancer and terminal illnesses. But doctors didn’t want negative reviews, so they started prescribing them for other pains. Prescription use took off in the early 2000s.”

This pressure on doctors stemmed from pain being used as the fifth vital sign in the ‘90s. Patients' biggest concern was ridding themselves of this discomfort, and as a result doctors adopted this view in order to save their jobs.

This is when prescription drug use and commodity in the U.S. blew up. Currently 97 percent of prescription drugs worldwide are used by Americans. In more focused numbers, if the amount was placed in relations to Ohioans only, that would be 67 pills for each, infants included.

A large theme of the summit was the relation between drug abuse and mental illness.

“People who are addicted to drugs aren’t losers; they are psychologically inclined to addiction,” said Gilson. “No one wakes up in the morning and says 'I’m going to be a heroin addict.'"

“Mental illness, including addiction, is a brain disease," said Bolan. "Drugs can cause your brain chemistry to change, resulting in addiction."

But recovery and addiction are a similar issue in our brains.

“What happens to your brain as you recover makes it so that taking the same dose as you used to kills you instantly,” said Bolan. This a grim reality, as many have been found dead with the needle still in their arm.

But, a positive twist existed within the summit as well. Physicians have begun addressing pain management differently. They are more aware of a patient’s doctor history and abuse. Refills on certain prescriptions need a justification from the doctor before it is filled.

The stigma of addiction is also in the process of being broken down.

“When do we start talking about the flu?” said Marks. “Why do we view this illness as so secretive and different?”

“It could be your sister or dad, or yourself,” said a student who was present. “Everyone thinks 'not me'."

“Tell someone. You need to fight for them, because they can’t fight for themselves,” said Brandt, who never thought her brother or herself would experience such an issue in the small town of Olmsted Falls.

The focus for this generation needs to be to remove the stigma, talk about it, and bring it out of the shadows, according to all the speakers.

“Share it with your peers, because what people are trying to do is mop the floor while the shower is still on. We need to get ahead of the problem and prescription drug abuse,” said Gilson.

The summit’s goal did not fall short, as many students present found themselves informed and affected by it.

“I thought it was nice to know everything," said Ajah, a student from Laurel School. "It’s not just a stigma. Knowing that there’s a way out helps me to help others.”

“I was shocked at the idea that addictions could start with injuries or prescriptions. I always thought they were regulated and could only help you,” said Bella from Magnificat High School.

“I think we are going to take this to SADD meetings and incorporate it in the activities we already do,” said Christine from Westlake High School.