Articles

The Opioid Epidemic: Seeking Solutions in North Dakota

December 24, 2019


– [Narrator] Funding
for The Opioid Epidemic Seeking Solutions in North
Dakota is provided by Blue Cross Blue Shield North
Dakota Caring Foundation. Bettering the health and
well-being of North Dakotans and their communities. Bell Bank. Dakota Medical Foundation. And, the Members
of Prairie Public. – [Man] The problem
is staggering. The system is overwhelmed. I’m not an addict. Of course, I was. – [Woman] This is an all
hands on deck problem. People are dying,
enough is enough. (dramatic music) (siren) – [Dispatcher] (mumbling) – Once you’ve had that
experience, you’ve had that experience, you never
unknow the effect that an opiate had on you. – If you think that
this can’t happen to you or your family, it’s a naive thought. We’ve probably didn’t
think it could happen to us but it certainly did. – [Nurse] Clear. – And I hear people say, oh,
it’s another dead junkie. That’s someone’s child. That’s that’s not okay. I don’t want to live in a world where people are dispensable. – [Man] The opioid
epidemic, specifically, misuse of pain medications
including hydrocodone, oxycodone, and others, has gripped the nation and
now grips North Dakota. Deadly opiates like
fentanyl and heroin have resulted in overdose deaths which have tripled in the
North Dakota in recent years. Arrests and crimes related
to opiates are on the rise and health professionals
and counselors are fighting a tough battle. – Originally in these
opiates, which came from the opium poppy seed from
Afghanistan, primarily. And that was a term
that was used since then there’s the term opioids,
which are relative to opiates. So what we’re talking
about is heroin, morphine, and some of the
prescription medications that you hear about. Hydrocodone, oxycodone. – All of those drugs act in
a similar way in the brain in several places. One of the things that
opioids do is to block pain receptors, and that’s
how we started using opioids to treat pain. But they also actually
operate in, what we call, the reward centers,
or pleasure centers. And so, some people are
particularly vulnerable to feeling a great deal
of euphoria and pleasure when they take opioids. Kids can literally experiment
with this once, and die. – [Narrator] Experts
say people get addicted in a variety of ways. From kids starting
with pot and alcohol eventually leading
to opioid addiction. To ordinary people
who get in accidents prescribed powerful pain meds. Most only need the pain
meds for a short time but others become
addicted and desperate. – [Woman] Addiction
surprises all of us in terms of what it
causes people to do every day people, regular people just like all of us. And physicians do
find often, surprises about what their
patients are doing that doesn’t involve them. – [Narrator] And there’s
plenty of blame to go around when looking back to the
origin of the problem. – The medical community
certainly has a role both in terms of what’s
been going on but the solutions. And part of the
reason we got here was years ago, the
medical community was essentially criticized
for not managing non-cancer pain. So you see little round
smiley faces in every office, it says, how is your pain
today, rate your pain. So eventually, we got into
the habit of prescribing and probably prescribing
more than people needed. – We can go a long way
back in finding blame. We can look at a culture
that wants to be pain free and nobody promised
a pain free life. We are Americans, and
we want it right now when we want it. We want to be pain
free, right now. – Things that change our
habits or require lifestyle changes are really
challenging for us. And sometimes, the
management of pain kind of like obesity,
or changing diet, those are hard work. So if there’s an easier answer we tend to default to that. And so I think there
was a time when opioids were seen as a
sort of an easier answer. – [Narrator] Are
you or a loved one struggling with addiction? Pay careful attention
to these signs. Medications missing. Indifference and
lack of engagement. Dramatic mood change. Falling in and out of sleep. And change in friends
and unusual risk-taking. (siren) – [Dispatcher] (mumbling) – [Man] Some of the
prescription drugs we see on the street are hydrocodone, oxycodone, Vicodin. Those types of drugs. And the illicit drugs
we’re seeing on the street in the opioid class
are heroin, fentanyl, and then carfentanil. A small amount of fentanyl,
like the amount on a tip of a ballpoint
pen, can kill some users. Fentanyl is 50 to
100 times more potent than morphine and
then carfentanil is 100 times more
potent than fentanyl. (buzzer) – [Woman] They surveyed
the District Court judges and 70% of the District
Court judges indicated that they sent low-risk
non-violent people into The Department
of Corrections prisons just to access a
treatment program. There are people
that come to prison that need to be in
prison, that are addicts. But there are people
that are coming to prison only because they are addicts and there’s not a
continuum of care readily available in the state. And that needs to increase and I think there’s some
efforts to increase it. But frankly, we’re
behind the curve. About 80% of everyone
coming into prison has a drug or alcohol issue. Over the last couple
of years, we’ve seen a significant increase. It used to be fairly rare
that we saw IV drug users coming into prison. And now, in our adult females IV drug use is up to 45%. Punishing people, the
sheer punishment proponent, which is really why
people get incarcerated, doesn’t keep people sober. – The legislature
passed the bill called Justice Reinvestment and its seven million
dollars will be diverted towards people that are
going to be incarcerated, diverted for treatment,
instead of incarceration. And then that program
will be outcome based. Meaning, paying for wellness. Paying for getting
back into society. – [Narrator] Be responsible
with your medication. Lock, monitor, take back. Drop off unused medication
at local take back locations. They’re widely
available at pharmacies and law enforcement locations. – The gold standard,
or what we think of as is the treatment that
has the best evidence in targeting opioid
use disorders is the combination of what
is called medication assisted treatment. And psycho social treatment with treatment in
recovery support services. – [Narrator] Treating the
opioid addict is multi-faceted. Some facilities
favor abstinence only but the withdrawals
can be horrifying described as having
influenza for two weeks, but much worse. – [Woman] With opiates,
people get blindsided by them because they start out
getting it prescribed or they start out
and it’s just fun. They have no idea what
they’re getting into and all of a sudden
they don’t have it. And then their
body aches for it. And every cell in
their body wants it. That includes their legs,
they get this restless leg and they can’t sleep
and they’re depressed and they sweat, and they chill. And then they use again,
and that feeling goes away. – [Narrator] Currently,
there are three prescribed forms of medication
assisted treatment that can reduce cravings
and help the addict. – [Man] One is methadone,
which everyone has heard of and that requires
a special clinic. And usually daily
liquid dispensing. Methadone has the
best evidence, by far, of treatment for
opioid use disorders. The next replacement
therapy is buprenorphine. That requires a
waiver and training by either a physician
and now a PA or an advanced practice
registered nurse can prescribe. And that’s clinic based. And so that has allowed
people to not have to go necessarily to a
methadone clinic but maybe more flexibility. The last one is essentially
a blockade of opiod use. And that’s naltrexone. It was initially
approved for alcohol use in daily pill form. And now it’s approved for
both opioid use disorders and alcohol use in a
monthly injection as well. – If we had the options
available for cancer that we have available
for addiction and we did not make them
available through insurance or we did not make them
available through our health systems, we would
have an uproar. (gentle music) – There are medications that
are available that help. They are evidence-based. They are FDA approved. They are effective. What I tell my patients is,
as long as you’re compliant with the program, and
what I expect from you, you can stay on these
medications as long as you feel you need to. I do have patients that
have been on these medicines for six and a half
years with me. They’re doing great. – People get well,
families get well. The definition of
well can change. Recovery lifestyle is
an amazing lifestyle. – [Narrator] Medical
providers, you can help prevent opioid misuse and
overdose when prescribing and monitoring opioid
treatment for your patients. Have you considered getting
involved as a much needed medication assisted
treatment provider? [Woman] Show me how you can bounce that ball. Okay, ready? (gentle music) Whoa! Can you catch it? I was actually laying
right here on the floor with a six-month-old baby and I told myself
that day, I said, I’m either gonna die, right now, or I’m gonna get some help. Get the ball over there. Normally, I would drink
when I was 12 with friends. Friday, Saturday night. Try to find somebody
who had a couple beers. That’s how it started. And it was just
normal, I thought. But at 12, I was
sexually assaulted. And, my mom and dad gave
me some pain medication. And, I loved it. A lot of my early teen
years are a real blur. I’ve went to counseling to try to figure
some of that out. But at this point, I don’t
think I want to remember. I had three kids, from 16 to 19. And then I got divorced. I missed partying. I missed having fun. At 22, it was my
first time in prison. I went to prison
for stealing checks. Writing them to
get money to use. I went to a treatment in prison, I was in there for about
two and a half years. Clean. It lasted about a
week when I got out. Fentanyl scared me,
I’ve watched somebody overdose in front of my eyes. Fentanyl scared me,
but only to the point that I was a little more
cautious when using it. I still used it. Heroin was harder to
get, a few years ago, than I think that it is now. I definitely would use
it if I could find it. But opiates were definitely
my drug of choice. I was in a coma for a few days. They told my mom and
dad to plan my funeral. I don’t remember
a whole lot of it. But, I remember
going home with a they put a port in my heart. So I could have IVs antibiotics after I left. And my first thought
when I was leaving was, I don’t have to search
for a vein anymore. I was prostituting
myself out there to find drugs at this point. And I got pregnant. And, that’s when I
heard about suboxone. I called Heartview. And, unfortunately, they said,
“We don’t have any openings. “We can get you in
in a couple weeks.” And I hung up the phone
completely defeated. And, ready to just give up. They called back five
minutes later and said, “Can you come in right now?” And I did. After I got out of treatment and completed after care I had been clean and
sober about six months before I actually
had a court hearing. And at that court hearing,
looking at my record, they sentenced me
to three years. (gate closing) I wanted to give up
again, bu I didn’t. I didn’t. I really wanted it. I went to prison. I went to a halfway
house afterwards. And I went right back to
Heartview the day I got out. (gentle music) She is the love of my life. I’ll never forget looking
at her on this floor when I didn’t know if I was
gonna go in the bathroom and and kill myself because
she deserved better. She didn’t deserve a mother who couldn’t take care
of her, who loved drugs more than I loved her. She was she deserved a mom. Just because I went to treatment and I got clean and sober you still have cravings. I’m an addict. Suboxone takes
away the cravings. It actually helps
my thought process. It helps me feel normal. I do have contact
with all of them. We have a good relationship. But not the relationship that I would have had had I raised them and
been close to them. (phone ringing) Heartview Foundation, this
is Shila, can I help you? Every phone call
I take I wonder, if he doesn’t get in,
or she doesn’t get in are they gonna be the next one? It’s the hardest part of my job is saying, “I don’t have
an opening right now.” (gentle music) There’s help out there. But there’s not enough. There’s not enough
treatment centers. There’s not enough doctors. There’s not enough knowledge. And seeing people get
well, and that’s amazing. (kiss) (laughs) – [Narrator] Addiction
is a disease. Helping sufferers is not
a competition between treatment, medication
or recovery. Our response should
be rooted in science and tailored to
individual needs. (birds chirping) (duck sounds) – [Man] He was really good
on short reed goose calls. (gentle music) We thought we had a
pretty normal family. We were home every night. We went to all their activities. He was a good boy. He was a straight A student. He was a great athlete. Fantastic outdoorsman. But you could just
see it all just slowly slipping away. – [Mary Beth] We think
Matthew was around 14 when he started using. He’d like to smoke
pot, marijuana really was his drug of
choice for a long time. And then he got involved
in other things. I know he used pain killers. But, he said, well
that wasn’t my thing. And he did have a
friend of his who they don’t really
know what happened. But they found him dead. So then he kind of
quit the pain killers. – We’d get him in treatment,
we’d get him cleaned up and he’d be fine. He’d be okay. And then he’d go
right back to it and you could just tell
within a day or two when he was back using. His whole persona changed. It was such a devastating
thing to watch him just wither away and give up everything that he
normally loved and did. – [Mary Beth] He was
in and out of treatment all through high school. He ended up graduating
high school in jail. – [Mike] He had been really
sick the last couple years with a psychosis. We’d get him better but then he’d go
right back on it. And one of his doctors told him, “I can’t beat anything
you can get on the street. “That stuff’s gonna
win every time.” We sat in this room with
him all summer and all fall probably the year or two before, and he’d hear these voices. They would say, “You’re a loser. “Kill yourself.” You know, “No one loves you.” To him, they were real. – [Mary Beth] We both talked
about how it was almost we were fighting that
supernatural force. And no matter what we did,
it had such a grip on him. – [Mike] He came up
inebriated And I’m sure he was loaded. And, he wanted to go fishing in the
middle of the night. It was the opening
of the muskie season. It was a cold rainy night. And he was not in good
shape, and we said, “No you can’t do
that, it’s not safe.” When I got up in the morning
early and I found him. – [Mary Beth] He
took his own life. (gentle music) What we over this past year have comet to grips with what happened. But also, now, how do we live? – [Mike] I think the problem was he started so young your brain isn’t
fully developed then. He looked at things many times as an adolescent,
not as a 24-year-old. Did we make mistakes? I’m sure we did. We tried everything
we thought we could. And, it seemed like
no matter what we did we just kept running up
against a brick wall. I think about Matthew all the time. (gentle music) I think about him at work. (gentle music) When I’m doing all the
things that he loved to do. And the shadows
come out at night. Where you wake up and have a, I have that vision
of when I found him. I know I didn’t sleep for three months very
well after that. It’s gotten a little better. But the thing that
gets me through my day and my
minute and my second is, I know he’s in
a better place now. He’s not suffering anymore. (gentle music) I needed to do something at
the lake where I found him. So we built a shrine
there to the Virgin Mary. (dog barking) – [Mary Beth] There needs to
be more education for parents because with those
middle school, those kids in that age group you want them not
to even try it. – [Mike] They’re my
kids and your kids. They’re kids that
live in our community. And we don’t want
to lose any of ’em. – [Mary Beth] We
did a lot of praying throughout the time.
– [Mike] We still do. – [Mary Beth] Throughout
the 10, 12 years. And many times, I’d
say, “I don’t think “our prayers are
being answered.” But in the end we realized they were. ‘Cause Matthew would
come home safe. I just picture him
in God’s arms now. – I still want to
take care of him. But somebody else has
to take care of him now. And I know they’ll do a
better job than I did. (gentle music) – [Narrator] Even if opiod
use doesn’t touch your life or loved ones directly there are ways to be
part of the solutions. Many charities state why they’re
helping to raise awareness and resources to
fight addiction. Visit impactgiveback.org. (gentle music) – [Man] The sad
reality of this is that more of us die than make it. I’ve been to countless funerals in the last seven years. And I’m gonna keep
going to them. Those are my friends,
those are my family the people that are out there
dying from this disease. They truly are wonderful people who just don’t know any other
way to get through a day. And the first drug
that I ever did was definitely alcohol. And, that was at 13. And it became something that I realized pretty
quickly that when I was under the influence, things
were just a lot better in my head, and in my mind. And I spent three
years of my life living on the streets
of Minneapolis. I did all those things that
you see on TV, or hear about. I would sleep in dumpsters. There was a gas
station on Lindale that I knew that they threw their breakfast
food away at 10:30. That’s how I would eat. And I did whatever I
had to do to survive but mostly to get high. My toe was broken. So I go to the doctor and they gave me hydrocodone. That was my first
experience with pain killers any kind of opiate. My first experience with
hydrocodone was hey, this is, this is awesome. It’s pretty similar. You know, it wasn’t quite
the same as meth, but it gave me something. And what it gave me was
an escape from reality. It gave me the
ability to feel okay to just get through a day. And from that moment
on, oh my God, everything was crazy. I could quite easily
go into the doctor and say I had a toothache. And they would give
me more hydrocodone. And I had been doing
that for quite some time with no consequences
or anything. They just kept
giving them to me. I heard about something
called suboxone. And, I didn’t really
know much about it. But, from what I was
told from people, they said it stops you from
going through withdrawal. And I was like,
great, where do I? You know, how, sign me up. What it did for me was
it gave me the ability to wake up every day. I took my medication and I went about my day. I went to my meetings,
I met my sponsor, I did all the things
I was supposed to do. I went to work, and my
life started to change. I didn’t even really realize until much later, how lucky I was. How amazingly lucky I was to be that rare person that
was able to take it. And it’s only because of the
work I was doing on myself that gave me the ability to
be successful on that program. But suboxone did that for me. I started off on two a day and over time, I went to
my doctor and I said, “I want to get off of this.” “If you are on it for
the rest of your life “but your life is okay, then
that’s, you need to stay. “And I’d rather see
somebody take something, “take suboxone every day
for the rest of their life “and have a life, than not.” I’ll have seven years
clean, so I’ve been doing this for some time. Over the years, you
know, my mom, I mean she’s the person
who I’m closest to. And, I had lied to her so much and hurt her so much. And I now look back
and I don’t blame her for not trusting me. (gentle music) One of the things that
I’m grateful for is every single second that
I’ve suffered because it gives me the ability
to look at another addict and say, “I understand,
you’re not a piece of crap. “You’re just trying
to get through a day.” It doesn’t excuse the
things that we do, but it is a reason. We don’t just wake up and say, “God, I would love
to get fired today.” Only another addict can
really understand that. I do a lot of speaking
and stuff like that and I always say, “My life
today is nowhere near perfect. “But it’s just normal.” I have my dog, I
have my comic books. I have my passions
and my hobbies. I go to meetings. I work on myself
with my sponsor. I have people that I sponsor. My life today, it’s not perfect, but it’s the best
it’s ever been. Just don’t give
up, keep searching. If you keep looking,
you’re gonna find it the thing that will save you. – [Narrator] Treatment works. Reach out, get help, find hope. Find free addiction information resources and assistance at prevention.nd.gov slash stopoverdose by calling 211 or by reaching out to your
local public health unit. (gentle music) – [Woman] There is
no one solution. And I think it’s really
important for everyone to acknowledge that. And that we all have a part. – [Man] Healthcare
entities have really looked at their prescribers and giving less after a surgery not giving a whole
month’s worth. You know, just a few
days worth and call back. – [Man] Often times
politicians want a quick fix. And that quick press conference. That’s not the issue
we’re dealing with here. This is gonna be a
marathon to try to change the amount of treatment. The length of
treatment, to make a difference in our communities. (gentle music) – [Woman] We can de-stigmatize
the language around addiction and so that families
openly can talk about what it’s doing to their families. And openly seek
help and support. They need to go back into
a supportive community that actually helps
them in the recovery. And not pushes them
back into their usage. (gentle music) – [Woman] The addicts do
not want to be addicts. And, and path to addiction,
you know, there’s many many many
stories out there. But the earlier
these kids start this it’s really tough road. (gentle music) – I have seen so many
people get better. And they become
amazing human beings and families become functional. We need to talk about what
it has done to family systems to build a healthy
family lifestyle. People get well,
families get well. Families can be well even
if addiction never ends. It’s a disease that has
to be attended forever but people can get well. (gentle music) – [Narrator] We all have a role. Together, we will
make a difference. Never doubt the small
group of thoughtful committed citizens
can change the world. Indeed, it’s the only
thing that ever has. Margaret Meed. (gentle music)

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