The heroin epidemic
4-Pillars approach begins with prevention
Part one: Understanding the problem

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[March 02, 2016]  LINCOLN - On Thursday, February 25th, a large group came together at Abraham Lincoln Memorial Hospital for a ‘working lunch' meeting to start the process of creating a strategy to fight the growing issue of heroin use in Logan County.

The meeting was the second of an ongoing initiative that will create a strategic plan based on a 4-Pillar approach to fighting addiction. The pillars of the plan are prevention, treatment, enforcement, and harm reduction. This new movement is being driven by the Healthy Communities Partnership Alcohol, Tobacco, and Other Destructive Behaviors (ATOD) Task Force.

For the meeting last week, Nadia Klekamp of Chestnut Health Systems and a member of the ATOD served as the emcee/moderator.

Klekamp began by sharing some statistics on a PowerPoint presentation.

  • Heroin use has increased significantly in the past few years, and it continues to rise.
  • The number of people who die from heroin-related overdoses in the United States is nearly four times what it was a decade ago.
  • Heroin use and overdose has increased significantly in Logan County over the past ten years.
  • Twenty-three percent of people who use heroin become dependent on it, making it the most addictive drug.

Klekamp said that the mission of this group was to reduce the use and overdose statistics in Logan County through the Four Pillar approach.

She then told a story of three men blindfolded and led to an elephant. Each man placed their hands on the elephant on different parts of its body. She said that each man had a different perspective as to what they were dealing with, but at the same time, they were all three touching the same elephant. She went on to comment that in Logan County, several agencies are “touching” the heroin issue locally, but they see it from their own viewpoints, their own perspectives. What needs to happen now is that all those views and perspectives need to come together into one strategic plan.

Klekamp said that as time goes on, there will be additional meetings, each focusing on one of the four pillars. For this meeting, the focus was going to be on prevention.

She said there would be three components involved;

  1. Prevent heroin use altogether
  2. Prevent substance misuse from developing into serious problems.
  3. Prevent serious harm and death to individuals who are addicted to heroin.

Klekamp said they would kick off this portion by hearing from someone who could speak first hand to the pattern of addiction.

Joe looks like any young man you might find in any small, rural, farming community; caucasian, mid-thirties, not a punk, a hood, a rapper, just a regular Joe. He grew up in a small, rural community. He said he came from a good family. He noted that like any family, there were ups and down, but there was never any abuse or traumatic events that led to his addiction. As a youngster, he did not get in with a “bad crowd.” But at the age of 13, he began experimenting with drug and alcohol use.

Joe said that in high school, “pot and booze” was the small town “normal.” As a teenager, he wanted to feel “cool” and “needed acceptance” from his peers. So he started with alcohol and pot but then worked his way into painkillers.

Through his young life, Joe said he always had this feeling of want. He wanted to be needed; he wanted to be important to his family and others. He said he felt a certain kind of emptiness that could not be satisfied. Even his drug and alcohol experiences weren’t giving him the gratification he needed.

Then, at age 26 he tried heroin. Joe said the drug instantly took hold of him. It gave him the feeling he was looking for, and when he was high, he felt good. And he was hooked.

Soon after that first heroin experience, he got another new experience; prison. His first stay was one-year. Joe said when he was released, he was back on his drug within 72 hours. Thus began a cycle. Between 2003 and 2012 he was imprisoned five times.

Joe said he was living on a rollercoaster, he knew it was wrong, he knew he wanted to get rid of his habit, but the drug called to him. "It was always calling, saying, ‘I’m always here.’” He said that traditional therapy and treatment didn’t work for him. He went through the motions but always went back to his drug.

He said he lost count of the number of times he overdosed. He lost friends, twelve to be exact, that died of overdoses. He stole to support his habit. He stole from his family, he stole from his friends. In 2013, desperate to escape his cycle, he attempted suicide.

Joe went on to say that once he was tagged as an addict, society looked at him differently, and the support to quit wasn’t necessarily there. He said that he was labeled, and it seemed his destiny was set; he had no alternative than to continue being what he was, an addict.

He said people in his community looked down on him, “when your community shuns you, you’re like screw it,” and he returned to his habit. There was also paranoia in play. Joe said he imagined what people were saying about him, was suspicious of how they looked at him, and it all added up to the only good thing he had was his drug.

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What is notable now, is that for the last six months, Joe has been drug-free. Like an alcoholic, he will always be an addict - in recovery. But one day at a time, he is learning to live without heroin, and it is changing his perspective on life. He noted that the paranoia he experienced as a user is now diminishing. He doesn’t imagine that people see him in a negative way. At the same time, he said he never goes a day without his drug calling to him, trying to get him to come back, but this time, he has a better support system and a different attitude.

When asked how and why he gave a good deal of credit to Kim Turner of the Logan County Probation office. He said when he met her the first time he told her flat out, “you cannot keep me clean.” He said he knew it wasn’t going to work, but soon learned that it wasn’t her job to keep him clean; he had to come to the realization that he wanted to stay clean and that there were people who would help him reach that goal.

Though he had gone through treatments and therapies in the past, he said, this time, it was different. He said the help he got came with a different attitude toward him. He said he felt like he “was not just another brick in the wall.”

Joe was also asked what society could have done differently to prevent his addiction, how anyone could have helped him avoid drugs. He said he didn’t really know that anyone could have. But at the same time, he said where he grew up, success was all about sports and the kids who weren’t into sports had no alternate activities. He said communities need more diversity for kids, things they can get involved in and become a part that doesn't lead to addiction.

He also said after that first time in prison, he was marked by society. He said that his addiction was his fault, he knew that. But once out of prison, he felt that people were saying, “Now we have to deal with you when we really don’t like you and we really don’t care.”

After Joe finished speaking Klekamp returned to the front of the room. Choosing Lincoln Mayor Marty Neitzel and New Holland-Middletown School Superintendent Todd Dugan as the subjects, she told the following story.

“A river flowed closely by a village, two fishermen; Marty and Todd were fishing on the river when they saw a man in the water. He was struggling to stay afloat, so Todd drops his pole, jumps in, and pulls the man out of the water. Marty gets help for the man, and they go back to fishing.

“Pretty soon they look up river again to see a woman in the water. She was struggling too, so once again Todd drops his pole and pulls her out of the water. Marty gets the woman help.

“They return to fishing when they look up the river and see a whole group of people in the water. Once again Todd jumps in to start hauling people out of the water. Marty starts walking away, up the river. Todd calls out to Marty to help pull these people out. Marty responds she’s going up the river to find out why all of the people are ending up in the water.”

The moral of the story, helping people after the fact is not going to solve the problem. We have to find out why the problem exists.

Klekamp explained that heroin addiction is a process. One doesn’t just wake up one morning and decide to start doing drugs. She went on to present a Logan County statistic from a 2012 survey of junior high and high schools students.

In the survey of local eighth-graders, seven percent said they began drinking at age 13. Nine percent said that by age 13 they were also smoking marijuana. The same questions were posed to the 12th grade students that same year. Only 1 percent said they began drinking at age 13, and only 5 percent said they were smoking pot at that age.

Klekamp asked if anyone could explain why the statistics dropped for the 12th-graders. One of the school officials in the room answered instantly “drop-outs.” Klekamp said that was correct. The majority of young people who start doing drugs at ages 12 and 13 (8th grade level) will not stay in school through the 12th grade.

Because of this, the goal has to be to start teaching prevention before children reach the point of experimenting with drugs and alcohol.

The balance of the meeting was devoted to a break-out session. Attendees were divided into groups and given three questions to answer that would begin outlining what this community has in place to prevent drug addiction and what it needs, or could be doing better.

The break-out discussions will be covered in part two.

[Nila Smith]

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