More than 130 people representing a cross-section of public health and safety agencies, schools, mental health treatment, the public and others attended Thursday’s Boone County Substance Abuse Symposium at the Boone County 4-H Fairgrounds.
The meeting was planned to develop a community response to sharply-rising heroin and prescription opioid abuse that has seen 17 county residents die this year from drug overdoses.
If not for the presence of Narcan kits in police vehicles, another 26 might have died over the last 18 months, Sheriff Mike Nielsen said to open the event.
The county is “very, very quickly” approaching epidemic levels of heroin and opioid abuse, Nielsen said.
Areas targeted by the task force include education and prevention, mental health and medical treatment, recovery and support, enforcement and rehabilitation and community engagement, he said. “We have to have a plan when we leave here today.”
The Boone County Jail is the county’s de-facto detoxification center for drug abusers, Nielsen said. While the jail provides hope for addicts, through a variety of programs, “when they leave our jail is when we fail them,” he said. “We fail them as a sheriff’s office and we fail them as a society.”
Addicts who fail at recovery end up in two places, he said. “They end up either back at the jail or in the grave.”
Dr. Jennifer Walthall, Indiana’s deputy health commissioner, was the keynote speaker.
Joining her on the podium were Ann Vermilion, administrative director of the medical staff at Marion General Hospital; Dr. Michael Knox, of the center for interventional pain at Witham Health Services; and Scott Hutcheson, of the Purdue Agile Strategy Lab.
Dr. Walthall said physicians have contributed to the prescription opioid epidemic, by failing to properly treat pain.
“We created an expectation of a pain-free existence,” she said. More than 90 percent of unintentional drug poisonings are attributable to prescription medication, she said.
Although she views herself as “a pathological optimist,” Dr. Walthall said deaths from overdoses are “the tip of the iceberg” of the opioid epidemic.
“This epidemic has continued to expand despite the increasing number of people being incarcerated,” she said. “We can’t arrest our way out of this problem.”
“Not one single entity will be the solution to this problem,” she said, “but all of us can be.”
Critical steps to take include increasing the access to programs, including medication-assisted treatment using methadone, suboxone and vivitrol; behavioral counseling therapy and recovery support; and decreasing the stigma of addiction and HIV, so more people will seek care.
Vermilion said Grant County police told the hospital that much of the prescription pills they were seizing had been dispensed by the hospital’s doctors.
A study, she said, found that opioids were being over-prescribed. “Twenty-one percent of our patients were getting an opioid,” she said. That represented 36,400 pills prescribed to 2,343 people. “Our doctors just shook their heads,” she said. “They couldn’t get over that number.”
Doctors were prescribing opioids for toothaches, she said. A change in the dispensing policy, including requiring photo ID of patients and scaling back the number of pills prescribed, has tightened the distribution.
The hospital’s patient satisfaction scores, she said, have tanked.
Prescription pain dispensing guidelines had been largely based on a now-discredited 1986 study, Dr. Knox said. “This all was very well-intentioned,” he said. But the liberal use of pain medication has “created a huge mess.”
Symposium attendees broke into planning sessions following lunch to develop a comprehensive community plan to fight opioid abuse.