Study Links Overdose Deaths to Increase in Organ Donations

A new study finds that the epidemic of drug overdose deaths in the United States has led to an increase in organ donors. Despite previous stigma attached to using organs from overdose donors, the study indicates that outcomes from these transplants are highly successful. This news is hopeful for patients like Vicky Keene who desperately needs a lung transplant.

“I’m at 15 percent with my lungs, so that means I could live two to three years with my lungs. I need lungs to survive,” said Keene.

Keene worked for 13 years at a coalyard shoveling coal and performing other duties that involved close contact with dust. In those days she was a single mom. Seven years ago, she was diagnosed with Chronic Obstructive Pulmonary Disease, commonly known as COPD.

“I have no life. Because you can’t breathe, you can’t move around,” said Keene. “If my husband’s not here to put my oxygen in the car, then I can’t go anywhere. I’m sorry, I don’t mean to cry, but this disease just takes your life completely away from you.”    

There are more than 115,000 people waiting for an organ transplant in the United States. It’s difficult to know exactly how many West Virginians need a transplant, because the state only has one transplant center for one organ – kidneys. Everyone else, like Keene, has to go out of state and is listed there.   

Credit Kara Lofton / West Virginia Public Broadcasting
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West Virginia Public Broadcasting
Dr. Joseph Africa, head of the CAMC transplant program, stands in the halls of General Hospital in Charleston.

“Probably close to a third of our deceased donor transplants from last year came from overdose donors,” said Dr. Joseph Africa, program director of the Charleston Area Medical Center transplant program. “And for this year alone I think it’s even higher – it may be two-thirds of our deceased donors.”

The circumstances that allow a person to become an organ donor are fairly narrow. In West Virginia, donors need to die in a hospital and be declared “brain dead” or irreversibly stop breathing to be considered. According to the Center for Organ Recovery and Education (or CORE), only about 2 percent of all people who die worldwide can be organ donors.

“When somebody passes away from an overdose, just like any death that would result in brain death, the patient comes into the hospital and over the course of a few days there are various tests that are done that confirm that their brain has died and will never, ever be healed,”  said Katelynn Metz, the community outreach coordinator for CORE.

At that point, the donors are also tested for infectious disease such as hepatitis and HIV. Even with these tests, recipients have the option to refuse the organ and wait for one that doesn’t come from an overdose donor.

“The possibility of transmitting infection is a big factor that discourages transplant centers from transplanting these organs in the past,” said Dr. Africa. “But it turns out, especially with this recent study that came out from the Annals of Medicine, transmission rate really is very low. And those organs tend to come from younger donors unfortunately, so the quality of organs is really good and would benefit a patient on the list.”

The benefit extends not only to patients on the list but to the donors’ families as well who often are able to find a sense of closure and redemption in their loved one’s final act of saving others’ lives.

“My daughter’s name is Nadya Zitek. She was born in March 1980,” began Hilda Halstead.

Halstead’s daughter died two years ago. She remembers her as a headstrong young woman who loved horses, did well in school, had two sons, and yet struggled on and off with addiction.

Credit West Virginia Public Broadcasting
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West Virginia Public Broadcasting
Hilda Halstead holds a picture of her daughter Nadya Zitek riding a horse as a child. Zitek died of an overdose in 2016. All eight of her major organs were able to be donated.

“Her problems with addiction started when she went to WVU to college,” Halstead said. “And this child went from having a 4.57 GPA to a having .5 GPA and just running around with the wrong crowd.”

Eventually Zitek went into recovery, went to nursing school, and seemed to get her life back on track. Then it fell apart again.

“I got a call and I recognized the phone number as being the phone number at the ER. One nursing staff that knows me said, ‘I hate to tell you but your daughter is here. She was brought in unresponsive.’”

Zitek never woke up. CORE approached the family about the possibility of Zitek becoming an organ donor.

“She was a perfect match for all eight major organs. And they said, ‘That’s about the second time that’s happened in a ten-year period here.’ …It’s helped ease the pain somewhat, but you can tell it really hurts – you don’t get over it.”

Halstead said she feels a sense of connection with the people who got Zitek’s organs. And patients like Vicky Keene, who are waiting for lifesaving transplants, say any donor, whether he or she died from an overdose or not, is a hero.

Editor’s Note: This story was updated on 5/3/2018 to change Zytek to Zitek.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Marshall Health, Charleston Area Medical Center and WVU Medicine.

Who Overdoses and Why?

Most people who overdose on opioids have seen a health care provider in the last year, and many had recently been released from jail, according to a new study from West Virginia Department of Health and Human Resources.

This suggests that overdoses can be prevented with the right intervention.

Here are some of the findings, according to the Charleston Gazette-Mail:

  • Eighty-one percent of people who died of overdose interacted with at least one type of health care provider in the 12 months prior to their death.
  • Ninety-one percent of all those who died had a documented history within the West Virginia Board of Pharmacy’s Controlled Substances Monitoring Program. In the 30 days prior to death, nearly half (49 percent) of females who died filled a controlled-substance prescription in the 30 days prior to death, as compared to 36 percent of males.
  • Those who died of overdose were three times more likely to have three or more prescribers, compared to the overall CSMP population. Those who died were more than 70 times likely to have prescriptions at four or more pharmacies, compared to the overall CSMP population.
  • Seventy-one of those who died of overdose used emergency medical services within the 12 months prior to their death. Only 31 percent of those who died had naloxone administration documented in their EMS record.
  • More than half (56 percent) of all those who died of overdose had been incarcerated. They were at an increased risk of death in the 30 days after their date of release, especially in those with only some high school education.
  • Males working in blue-collar industries with a higher risk of injury might be at an increased risk for overdose death.

On this week’s Front Porch podcast, we discuss how we can intervene to prevent overdoses.
In addition, we talk about a proposal to log in W.Va. State Parks, and another to eliminate multi-member Delegate districts in West Virginia.

Us & Them : His Name's DJ

We revisit the story of “Steve,” a young New Hampshire man that we met back in the spring of 2016. In our episode called “The Changing Face of Heroin,” we followed him and his father as he reported for the last visit of a court ordered drug rehab program. As you can imagine, kicking a powerful opioid habit isn’t easy, but in many ways our guy remained committed to the program. Sometimes, it was nearly impossible and during those times the strain on his family and loved ones was immense.  For this new episode, we learn how everyone is doing more than 19 months later.

From West Virginia Public Broadcasting and PRX, this is “Us & Them,” the podcast where we tell the stories about America’s cultural divides.

Subscribe to “Us & Them” on Apple Podcasts, NPR One or wherever you listen to podcasts.

Share your opinions with us about these issues, and let us know what you’d like us to discuss in the future. Send a tweet to @usthempodcast or @wvpublic, or leave a comment onFacebook.com/usthempodcast.

This episode is part of a series made possible with financial assistance from the West Virginia Humanities Council, a state affiliate of the National Endowment for the Humanities.

And if you enjoyed this episode, join our community and sustain “Us & Them” with a pledge of support.

New Project to Study Prevention & Treatment of Opioid Abuse

Over $1 million in federal funding has been awarded to a project aimed at addressing the opioid crisis in West Virginia.

The project is based in southern West Virginia, and it’s spearheaded by West Virginia University. The goal is to develop comprehensive ways to prevent and treat the consequences of opioid abuse, such as overdose, HIV, hepatitis, and sexually transmitted diseases.

The project will be supported by a two-year $1 million grant from the National Institute of Drug Abuse, the Appalachian Regional Commission, and the Substance Abuse and Mental Health Services Administration.

The WVU team will work with state and local communities to develop the best practice responses that could be implemented by public health systems in the country’s rural regions.

President Donald Trump recently declared the opioid epidemic as a national crisis.

Drug Companies Profit from Opioid Epidemic While Regulators Look the Other Way

Drug wholesalers sent 780 million hydrocodone and oxycodone pills into West Virginia over six years, according to an investigation by the Charleston Gazette-Mail.

Meanwhile, 1,728 West Virginians died from overdoses of these two powerful painkillers.

Who let it happen? Investigative reporter Eric Eyre, of the Charleston Gazette-Mail, answered our questions about his series on The Front Porch.

(Caution: This week’s podcast contains a vulgar slang word.)

1. What was the biggest surprise for you?

Drug wholesalers shipped enough painkillers to provide 433 pills for every man, woman and child in the state, Eyre said. And in parts of the southern West Virginia coalfields, the numbers were even higher.

“I was surprised that some of the smallest pharmacies had some of the biggest numbers,” Eyre said. For example, nearly 9 million hydrocodone pills to one pharmacy in Kermit, W.Va., population 392.

“In Oceana, one pharmacy received 600,000 – 700,000 oxycodone pills a year. The Rite Aid six blocks away gets 6,000.”

2. Did the drug wholesalers do anything illegal?

“They have a legal obligation to report these suspicious orders to the (federal) Drug Enforcement Agency,” and to the state Board of Pharmacy, Eyre said.

For years, none of them did. But after a lawsuit was filed by former state Attorney General Darrell McGraw, some wholesalers began to send suspicious order reports to the Board of Pharmacy.

3. What did the Board of Pharmacy do with those reports of suspicious orders from the drug wholesalers?

They put them in a box, Eyre said. They did not tell law enforcement or even tally the information on a computer.

Eyre asked the board’s director about this: “He said the law does not prescribe what they’re supposed to do with the suspicious report, only that they’re supposed to be filed.”

Now, the board is considering sharing these with the State Police or Attorney General.

4. How do the drug wholesalers defend themselves?

“They say these are licensed pharmacies. These are licensed doctors. The responsibility should be with the boards that licensed those two groups,” Eyre said.

5. This investigation looked at the time period of 2007 – 2012. What’s happened since then?

On many levels, there’s been a crackdown on illegal use of prescription opioids, Eyre said. Hydrocodone was reclassified to make it harder to prescribe. State officials are tracking prescriptions more closely.

The number of overdoses from hydrocodone and oxycodone have leveled out and maybe declined a bit. But they’re being replaced by drugs like heroin and fentanyl.

6. What’s the relationship the flood of pain pills and today’s heroin epidemic?

“The pain pills set the stage,” Eyre said, for illegal drugs like heroin and more powerful synthetic opioids like fentanyl.

Now, those drugs are causing more and more overdoses.

7. What’s been the reaction to your story?

“Since this article came out, I have gotten emails from all over the country, saying they had an overdose in the family,” Eyre said.

“The other set is lots of emails from people who grew up in West Virginia, and worry about the state.”

8. What’s the historical context?

Front Porch co-host Rick Wilson says, “It reminds me of the Opium Wars, in which Great Britain went to war with China to have a free market in drugs.”

9. How did this even happen?

“When there’s a drug epidemic in a poor community, it’s not that big a deal.  But when it crosses over to affect middle and upper class people, it’s a tragedy,” Wilson said.

10. What Bible verse best sums up the lessons from this series?

From Wilson: Matthew 18:6 – “If anyone causes one of these little ones to stumble, it would be better for them to have a large millstone hung around their neck and to be drowned in the depths of the sea.”

“The Front Porch” is a place where we tackle the tough issues facing West Virginia and Appalachia with some of the region’s most interesting thinkers.

WVPB Executive Director Scott Finn serves as host and provocateur, joined by Laurie Lin, a conservative lawyer and columnist, and Rick Wilson, a liberal columnist and avid goat herder who works for the American Friends Service Committee.

Subscribe to “The Front Porch” podcast on iTunes or however you listen to podcasts.

An edited version of “The Front Porch” airs Fridays at 4:50 p.m. on West Virginia Public Broadcasting’s radio network, and the full version is available above.

Share your opinions with us about these issues, and let us know what you’d like us to discuss in the future. Send a tweet to @radiofinn or @wvpublicnews, or e-mail Scott at sfinn @ wvpublic.org

The Front Porch is underwritten by The Charleston Gazette Mail, providing both sides of the story on its two editorial pages. Check it out: http://www.wvgazettemail.com/

Fentanyl Blamed for Spate of Overdoses in Huntington

Authorities say the heroin that led 27 people to overdose in a five-hour span in a single West Virginia city had been mixed with the powerful painkiller fentanyl.

The Herald-Dispatch of Huntington reports that investigators for the first time detailed the potency of the concoction in a federal indictment Tuesday.

Twenty-two-year-old Bruce Lamar Griggs of Akron, Ohio, is charged with drug distribution in connection to the Aug. 15 spate of overdoses in Huntington. At least one man died.

Griggs was arrested by Tallmadge, Ohio, police officers late last month and is now in federal custody.

The Centers for Disease Control and Prevention says fentanyl is an opioid that is about 50 to 100 times more powerful than morphine.

The indictment does not mention whether Griggs has an attorney.

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