Story, Graphic and Map by Brittany Ellis
Prescription drug abuse in 2014 cost 77 more people their lives than the year before, according to the Office of Drug Control Policy’s overdose fatality report.
Prescription drug abuse has become a widespread problem in Eastern Kentucky and lead to abuse of other illicit drugs, said psychologist and researcher David Mathews.
That was the case for Alex Elswick, a 24-year-old from Cincinnati who became addicted to heroin after oxycodone pills became less available.
Addiction began for Elswick when he was overprescribed oxycodone pills after having his wisdom teeth removed at age 18.When those prescriptions ran out, he started looking for them on the street.
Kentucky legislatures cracked down on pill use and thousands of people with prescription addiction turned to heroin to fill the void, Elswick said.
Start of abuse
The prescription drug abuse epidemic in Eastern Kentucky began in 1998, said Van Ingram, the executive director for the Kentucky Office of Drug Control Policy.
“The DEA identified Eastern Kentucky as ground zero for the prescription opioid epidemic,” Ingram said.
The overuse and over-prescribing of prescriptions seemed to begin with sedative drugs like Xanax and Valium, Ingram said.
Several of the prescription painkillers that are being abused contain morphine molecules. The most common drugs abused are Vicodin, Lortab and Oxycodone.
Heroin also contains morphine molecules and affects the brain similarly, which are factors that lead prescription drug abusers to heroin.
Prescription drug misuse and abuse is a different situation than dealing with other drugs, Ingram said.
“A 50-year-old can get injured and be given a prescription opiate, then become addicted,” Ingram said. “Some studies say between 30 and 40 percent of people that are addicted to prescription drugs got that way through a legitimate medical need.”
Mathews was director of adult services at Kentucky River Community Care for 15 years where he oversaw mental health and addiction treatment services.
Mathews saw the shift much earlier than Ingram, starting in the mid 1980s, saying that in the last 20 years we have seen a shift from concern about alcohol and drug abuse by teens to things like marijuana and LSD, and now to prescription drugs,” Mathews said.
The prescription drug problem in Kentucky started when Prozac became available, and soon after shifted to Xanax, Mathews said.
“From there we went to painkiller drugs like oxycodone and hydrocodone. Now, the shift is toward heroin and methamphetamine-illicit drugs,” Mathews said.
Kentucky has seen higher rates of illicit drug abuse than any other state in the nation, according to the 2011 Kentucky State Epidemiological Outcomes Workgroup report of Prescription Drug Trends in Kentucky.
Prescription drug abuse doesn’t only affect the abuser, but families as well.
Elswick didn’t think his drug use was a problem until it started affecting his relationships, he said.
“The family can either be a great support system or an obstacle,” Elswick said. “A lot of factors can conspire against someone who is trying to recover.”
Parenting skills decline significantly when you are actively addicted, Ingram said.
“Addiction affects everyone who cares about them in one way or another. We have too many children in Kentucky being raised by grandparents because parents are in prison or overdosed and died,” Ingram said.
Ingram described addiction as a daily process.
“When you are addicted, you wake up every morning thinking about how you will get substances you need. It takes over part of your brain, it wants what it wants.
Monitoring programs in Kentucky have made prescription drugs harder to access, Mathews said.
The cost of prescription drugs has increased and the cost of heroin has gone down making it more available.
The primary difference between drug addicts and those prescribed a painkiller for medical use is that the person prescribed may need the drugs to control their pain, Mathews said.
“However, it doesn’t take a lot to become addicted.”
Mathews treated middle aged alcoholic men when he first started at the River Community Care center, but says the population has shifted to younger women in their 20s.
Addictive drugs are most commonly being used in late teens to early 30s.
Treatment options can vary depending on the state of disease, Ingram said.
“It is a progressive disease. If you have been in active addiction for 10 years, an outpatient treatment might not work for you. It may take 6 months to a year to help you.”
Treatment options range from intensive outpatient to long term residential.
“I don’t think there is any one size fits all solution.”
Mathews said lots of different routes are available for treatment in Kentucky.
The easiest way to get started is to go to a hospital emergency room to determine if you need to detox, and have an assessment completed, Mathews said.
A person who is not motivated for treatment might not realize the severity of the problem until they are arrested.
“The criminal justice system can connect them with a treatment services. Children services can get involved if a woman is pregnant or already has children,” Mathews said.
An online assessment referral is offered in each region of Kentucky. The department of Behavioral Health also offers treatment services, along with Recovery Kentucky Network in each district.
After going to jail, staying in and out of rehabs and being homeless, Elswick finally got help from the Salvation Army.
He has been in recovery for more than two years now.
Once he got sober, he realized he wanted to be a family therapist. Elswick is pursuing his master’s degree in substance abuse counseling at the University of Kentucky.
“My brain was hijacked when I was on drugs,” Elswick said. “I have never been as happy in my life as I am today.”
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