Small pills, huge problem

COEUR d’ALENE — Local experts came together Wednesday to tackle the opioid crisis in Kootenai County.

The North Idaho Prescription Opioid Solution Symposium was organized by the Panhandle Health District.

Kelsey McCall, Panhandle Health education specialist, said the goal of Wednesday’s event was to “develop a North Idaho-specific prescription opioid strategic plan.” With such a plan, local organizations could apply for funding to implement its recommendations.

Sen. Mary Souza serves as vice-chair of the Idaho Senate Health and Welfare Committee and is a member of the state’s task force on opioid abuse. She said the state and medical providers need to understand the difference between those in chronic pain who have become addicted, and those who are addicted because of social or mental health reasons.

“It is so important that providers create a plan to deal with a patient’s pain before they reduce the prescription,” she said.

Dr. William H. Miller of Kootenai Health framed a discussion about chemical dependencies by stating they should be viewed as diseases.

Like other diseases, addictions are preventable, treatable, they changes one’s feelings, and if untreated can last a lifetime, he explained.

Opiates are addictive because they stimulate dopamine in the brain, which provides feelings of well-being.

“People get addicted because they want to feel better. Who doesn’t want to feel better?” he asked.

Miller said the brain changes with opiate abuse but can recover if given enough time without drugs overloading its dopamine receptors.

The longer the period of abstinence from drug use, the greater the recovery. After three to five years, the brain can greatly heal, he explained.

However he said, a few weeks in rehab is not nearly long enough. People who are detoxing need support and a safe place to live in order to give their brains plenty of time to heal.

He also said stereotypes about the type of person who becomes addicted to opioids are incorrect.

“As society, we have to figure out how to treat them as we would any other illness. That kind of support is the only thing that will help. It won’t be a quick fix,” Miller said, but public attitudes need to change in order to see progress regarding opioids.

Kootenai County EMS Chief Chris Way cited an example from his own life to reinforce Miller’s point. A good friend of his from childhood developed an addiction to opiates and died of an overdose, said Way. This friend had suffered two herniated discs on the job and couldn’t get physical therapy and surgery. The medical system found it easier to give him pain medication, said Way. In the end, he was getting 400 hydrocodones per month.

Participants in the afternoon work session were invited to join one of four work groups for a brief discussion Wednesday, and committed to continuing their work over the next 12 months.

David Atkins, a licensed physician assistant with Heritage Health, started his career in Grangeville where he saw the effects of opiate addiction. He headed a work group on prevention, with a goal of educating physicians on safe prescribing, to increase awareness of risks, and to use a prescription monitoring program.

Way headed up a work group on harm reduction focused on safe storage and disposal, improved screening, associated disease testing, and Naloxone. Way said Naloxone has been overused and put into the wrong hands. It’s very appropriate for first responders to carry it, but not for partiers who use it as a backup plan, he explained. Way said while most of the county’s residents may not think opioids are a problem in North Idaho, those who work in emergency rooms and clinics see the problem clearly.

“We do have a problem. Unless we admit there is a problem, we’re never going to fix the problem,” he said.

Licensed social worker Lynne Clark led a work group on access and awareness of treatment. She has worked with pregnant, addicted women and with addicts whose families had intervened but had no active medical detox center to bring them to in Kootenai County. She said there is a lot of room for doing good work in the county.

Clark Richman of St. Vincent de Paul also led a work group geared toward community resources such as transportation, holistic person support, and making sure people don’t fall through the cracks in between agencies.

PHD health services administrator Don Duffy said “There are a lot of individual, positive efforts underway” in the area. “Bringing those all together in a community collaborative effort, we believe, can make a positive impact on the problem.”