Attorneys General from Ohio and Kentucky joined West Virginia Attorney General Patrick Morrisey in Huntington Thursday to discuss the opioid crisis…
Attorneys General from Ohio and Kentucky joined West Virginia Attorney General Patrick Morrisey in Huntington Thursday to discuss the opioid crisis plaguing all three states.
Attorneys General Mike DeWine, of Ohio, and Andy Beshear, of Kentucky, joined Morrisey at the New Life Church in Huntington. It’s one of a series of meetings being held to increase cross-border cooperation in finding solutions to problems stemming from the opioid epidemic. Beshear said the epidemic has touched everyone.
“These drug dealers don’t recognize state or county lines,” Beshear said. “We believe that the same bad batch of fentanyl that caused huge numbers of overdoses here in Huntington, in Mount Sterling, Kentucky and in Cincinnati, Ohio, so we have to be able to work together.”
Huntington is considered the epicenter for substance abuse in West Virginia. On one day alone in August, 28 people overdosed on heroin in Huntington. Just a few weeks later, 24 overdoses were reported in one day in Louisville, Kentucky.
West Virginia Attorney General Patrick Morrisey said he realized that the states didn’t work well enough together to fight the epidemic.
“There was a fundamental lack of collaboration across federal, state and local governments and within the communities,” Morrisey said. “And simply by communicating with one another on a regular basis, having these conferences and then following up after these conferences, that’s how you begin to change the problem within specific towns.”
Last year, more than 900 drug-related overdoses were reported in Cabell County, West Virginia, alone — including 70 deaths.
Governor Earl Ray Tomblin announced Tuesday that starting in January, doctors who prescribe pain pills will be required to follow federal prescribing guidelines.
The move was made in an attempt to lower state overuse and abuse rates. According to Rahul Gupta, the West Virginia state health officer and the commissioner for the Bureau for Public Health, West Virginia has the highest rate of prescription opioids per capita in the nation.
“The majority of the people who end up abusing these medications really start by getting these medications not from drug dealers but from friends, family and caregivers,” he said.
The Centers for Disease Control and Prevention released a set of guidelines in March that encourages doctors to not consider opioid medication as a first-choice pain medication, and to talk with patients about the risks of using opioids as a response to chronic pain.
The sound of sirens in Cabell County, West Virginia, has a good chance of indicating an overdose these days.The county’s Emergency Medical Service had…
The sound of sirens in Cabell County, West Virginia, has a good chance of indicating an overdose these days.
The county’s Emergency Medical Service had responded to 622 overdose calls this year as of September 24, according to ES Director Gordon Merry. Last year it was more than 900 overdoses, which surpassed the total of the previous three years combined.
“That many overdoses in that short of time was a challenge,” Merry said. “It just took us off guard there.”
Credit Aaron Payne / Ohio Valley ReSource
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Ohio Valley ReSource
Cabell County EMS Director Gordon Merry’s crews have responded to more than 1,500 overdose calls in the past 18 months.
All 26 victims that night survived, thanks in part to the medication naloxone. Naloxone, also known by its brand name NARCAN, is becoming more a part of everyday life due to the epidemic that’s gripped the Ohio Valley. The life-saving drug is a welcome addition for emergency responders but they caution that it is no silver bullet for the addiction crisis.
How It Works
To appreciate naloxone, one must understand what happens to the body during an opioid overdose.
“Opioids are depressants,” said Dr. Melinda Ford, who runs an addiction treatment clinic at Ohio University. “In the body, they slow everything down. It’s the respiratory depression that kills people. They depress their respiration to zero, where they just don’t breathe.”
Credit Aaron Payne / Ohio Valley ReSource
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Ohio Valley ReSource
Naloxone supplies are becoming more common in places affected by the opioid crisis.
If the victim can’t be resuscitated through emergency breathing, naloxone is administered via a shot or a nasal spray. Dr. Ford said the medicine essentially sweeps the opioids off receptor sites in the brain and puts the victim in immediate withdrawal.
“It won’t kill you, but you wish it would because it feels horrible,” Dr. Ford said.
The more potent an opioid, the more doses of naloxone must be administered. With the increase in illicit use of the powerful synthetic opioids fentanyl and carfentanil, it’s not uncommon for two or more doses to be used on one person.
It’s also not uncommon, according to Dr. Ford, for medical professionals to watch after a patient who overdoses well after administration. Even if revived, the naloxone could wear off before the opioid and the overdose could resume.
The Rise of Naloxone
Naloxone has been around since it was patented in 1961 but is getting public attention now because of the opioid crisis.
Director Merry has been with Cabell County EMS for over 40 years. He said he remembers a time around 20 years ago when they were approved to start carrying naloxone on the ambulance.
“Very little usage back when I was on the vehicle,” he recalled. “Unfortunately, as time goes by our use has increased dramatically.”
Credit Alexandra Kanik / Ohio Valley ReSource
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Ohio Valley ReSource
With overdose rates increasing in the Ohio Valley region in the last decade, governments have pushed for more access to naloxone.
Ohio passed a law in 2014 adding other first responders to the list of agencies carrying the medicine. West Virginia and Kentucky followed suit with bills in 2015.
Each overdose call in Cabell County today receives an ambulance, fire truck and police officer. And while EMS administers an estimated 90 percent of naloxone, according to Merry, the legislation helps to provide a safety net.
“I’d say it goes: We do the majority, fire, then police,” he said. “It’s not because they don’t want to, it’s because we’re there so fast.”
Kentucky is also now having naloxone supplies stocked in locations not previously thought of, such as factories, government buildings and schools.
Reading, Writing, and OD Training
The makers of NARCAN, Adapt Pharma, approached Kentucky’s Drug Control Policy Office about offering two doses free of charge to any high school in the state.
“We put together a training for school nurses representing almost every district in Kentucky and then gave them the option of accepting that NARCAN kit,” Drug Control Policy Director Van Ingram said.
Response from the community was mixed. Some questioned whether if it was needed with few students across Kentucky suffering from overdoses and even fewer actually overdosing while in the school building.
Credit Alexandra Kanik / Ohio Valley ReSource
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Ohio Valley ReSource
But schools bring in many different types of people. And that’s why Ingram said this is needed.
“Not just students, but staff and people coming to events at the school,” he explained. “They’re a natural gathering place of people and that lends itself to this type of program.”
Darkness Before the DAWN
Ohio worked to get naloxone in the homes of those at high risk for overdoses. In 2012, Project DAWN — which stands for Deaths Avoided With Naloxone– started with a pilot program in Scioto County.
Now at 50 locations across the state, anyone can get a simple 20-minute training and walk out with two free doses of Naloxone and a training video.
“I think it was an important part of making sure it was easy for that person to do so it could be replicated and people would not be nervous about administering it,” said Jolene Defiore-Hyrmer, an official with the Ohio Department of Health.
Credit Aaron Payne / Ohio Valley ReSource
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Ohio Valley ReSource
Jolene Defiore-Hyrmer (left) and Dr. Mary DiOrio conduct naloxone training for the Ohio Department of Health.
The workers also collect data on who comes in for training in order to find ways to make the program more effective.
“Not only looking at that process of how many kits are being distributed, how many people are we reaching, but the impact,” Defiore-Hyrmer said.
Early research indicates these programs are successful.
One study published in a 2013 edition of The BMJ looked at a pilot program in Massachusetts. The 19 communities there with public naloxone training were able to significantly reduce fatal overdoses compared to communities without the training.
Those on the front lines of the opioid epidemic, like Gordon Merry, want more people to take advantage of the training.
Credit Aaron Payne / Ohio Valley ReSource
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Ohio Valley ReSource
Materials in the training kit for Project DAWN.
“The people that are using this are addicted,” Merry said. “They need help. I think anything we can do to get them help is the right thing to do.”
No ‘Magic Serum’
But Merry cautions that naloxone is not a “magic serum.” It won’t incite a lifestyle change in someone struggling with an opioid use disorder.
The most frustrating thing for Merry is to revive someone, only to see that person check out of the hospital and overdose again, sometimes before his crew can even restock the ambulance.
“They have the right to walk away. And there’s nothing anybody can do,” he said. “Everything works great to that point.”
The day I interviewed Merry for this story his crews had already dealt with fatal overdoses.
“Two deaths today,” he said. “And the one house, we’ve been to numerous times.”
He says he doesn’t know what the answer is. Naloxone can save lives but it can’t change life habits or turn the tide of the epidemic. But at least it can give a person another chance.
A trial date has been set for an Ohio man who has pleaded not guilty to heroin distribution in connection to 27 overdoses in a five-hour span in a single West Virginia city.
The Herald-Dispatch reports 22-year-old Bruce Lamar Griggs of Akron, Ohio, pleaded not guilty Wednesday to drug distribution charges following the Aug. 15 spate of overdoses in Huntington. At least one man died.
His trial in federal court is set for Nov. 29.
An affidavit filed in court alleges that one of the victims who survived identified Griggs as the dealer, and police corroborated it with other witnesses and video surveillance near where the overdoses occurred.
Griggs’ indictment revealed that investigators believe the heroin was mixed with the powerful painkiller fentanyl.
The drug epidemic in West Virginia affects more than just the work force, or the number of people in a prison cell or treatment center. It’s also had a major impact on the state’s foster children. West Virginia Public Broadcasting introduces the Holben family who has seen the impacts of the drug epidemic first-hand.
Meet the Holbens
Alyssa Holben is 8-years-old and in second grade. She came to live with the Holbens as an infant; first as a foster child and was later adopted.
Alyssa’s older and biological sister, Aaliyah, was also adopted by the Holbens, at 2-years-old. She’s now 10, in the fourth grade, and is shyer than her little sister.
Both girls love church, gymnastics, Disney movies and their 2-year-old brother, Brayden.
You would never know, but all three kids were exposed to drugs or alcohol in utero.
Alyssa was born addicted to heroin. Her older sister, Aaliyah, was born with fetal alcohol syndrome. And their little brother, Brayden, who’s not biologically related to the girls, was born addicted to three different kinds of drugs.
Jen and Jamie Holben, the children’s parents, live in Kearneysville, Jefferson County, with their six kids, four of whom were adopted through the state’s foster care system. The Holbens have been foster parents for nearly 13 years and have fostered almost 30 children during that time – ranging in age from infant to 18.
“We wanted to help out in some way, I mean, because I think we’re all here to make a difference,” Jamie said, “and we were very driven, whether it’s from our past hurts from us growing up as kids, or just seeing this world be cruel to people, you know, just wanting to make a difference.”
Jamie is a police officer who works in nearby Loudoun County, Va., and Jen is a stay-at-home mom.
The Holbens say one of the biggest struggles they’ve found raising their three kids who were born addicted to drugs and alcohol is the medical and academic problems that come with it.
“The three children we have in this house that have been affected by drugs and alcohol are totally different,” Jen noted, “They all have their own different disabilities and struggles. Brayden has three holes in his heart; Alyssa had a heart murmur when she was little, and academically, both girls struggle in different places.”
Alyssa and Aaliyah see their doctor every six months. Both girls take medication for attention-deficit hyperactivity disorder (ADHD). Alyssa also takes medicine to help her fall asleep at night. And Aaliyah takes one for epilepsy.
While Jen said Brayden seems to be developing in line with other children his age, she and her husband, Jamie, wonder how the kids’ individual struggles will affect them when they’re older.
“I think one of our biggest battles is, is there gonna be a plateau? Are they gonna reach a certain limit, and then, that’s it?” Jamie said. “We don’t know, and there’s no doctor that can give you that answer, there’s no psychologist, psychiatrist that can give you that answer, just because they don’t know.”
Effects on the Foster Care System in West Virginia
Only about 1,500 of those children are available for adoption, according to the West Virginia Supreme Court. Justice Brent Benjamin said that’s because some are placed in foster care temporarily.
“In many cases, they’re in temporary situations because maybe mom or dad are going through an improvement period,” Benjamin said, “because there’s been an abuse-neglect issue, or there could be any number of issues there, but they’re in foster care on a temporary basis as opposed to something that is more long term.”
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Adobe Stock
But just how many of those children are in foster care because of their parents’ problems with drugs or alcohol?
Linda Watts, Deputy Commissioner for the Bureau for Children and Families at DHHR, said that number is difficult to track.
“Sometimes the reason that you’re removing a child for abuse-neglect is not necessarily the primary reason is substance abuse; it could be for another issue say physical abuse; it could be neglect, it could be some other related issue and then as you continue to do your investigation, it may then surface that it was substance use and abuse,” Watts said.
“What we’re seeing is that drugs may not be the primary issue in the abuse-neglect case, but it is certainly a driving issue in over 95 percent of those cases, so it’s a profound driving force in issues related to the welfare of children.” – Justice Brent Benjamin
Abigayle Koller is a clinical coordinator with the West Virginia National Youth Advocate Program, which is one of 10 specialized foster care agencies in West Virginia.
Koller said it can also be difficult to provide foster parents with the information they need to deal with the possible medical or developmental issues associated with substance abuse, because sometimes children’s birth or medical records are never provided to the agency and can’t be tracked down.
“So we often treat what we see,” Koller said, “which doesn’t do justice when a lot of the needs are underlying, and we have to dig, and we have to start with what we see in order to uncover what we don’t see.”
Being a Foster Parent
Jen Holben said she and her husband knew when they adopted Alyssa, Aaliyah and Brayden, that drugs or alcohol had been in their systems before birth, but she said that doesn’t always make addressing their needs any easier. While the demand for foster families in West Virginia is growing, Jen said it takes special people to do it.
“If you’re gonna go pick up a baby from a hospital, know that baby can scream for four months, because he’s addicted to drugs,” she said, “or know that, that child might have developmental delays, and be okay in accepting. You’ve got to be accepting of not just the children, but be accepting of their biological parents, and you have to support what that biological parent is doing to get their kid back.”
Jen and Jamie say they never expected to be where they are today, but they’re grateful for each of their kids — adopted and fostered. They hope the state can make the overall foster system better, especially for the kids who slip through the cracks.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.
A West Virginia city is teaming up police, schools, prosecutors, and community and faith-based groups for a first-of-its-kind approach to address drug…
A West Virginia city is teaming up police, schools, prosecutors, and community and faith-based groups for a first-of-its-kind approach to address drug abuse.
The Martinsburg Police Department and Berkeley County Schools announced The Martinsburg Initiative at Winchester Avenue Elementary on Monday.
Officials say the project will target at-risk children and troubled families, with a more specific focus on opiate and heroin prevention. They heralded it as the “first of its kind” in the United States.
Burke Street and Winchester Avenue elementary schools will serve as the pilot schools for the new initiative.
The program seeks to make schools the center of positive community life, anti-drug activity and learning.
Officials say the initiative relies on proven scientific research that connects adverse childhood experiences and likelihood of future drug use.
