GREENVILLE — Charles Powers stood on the stage telling an audience of strangers about his son, Michael, a lump forming in his throat as he talked.
Charles spoke about how Michael did well in school, had friends and was involved in theater. He said he never thought of his son as someone who would become an addict.
Michael was 22 years old when he died of a heroin overdose nine years ago.
Charles told his son’s story during Saturday’s Prescription Drug Abuse & Prevention Symposium at the Greenville Area Community Center. The event was hosted by sponsor YOUTHINK Montcalm and the Montcalm Care Network, Cherry Health, Sheridan Community Hospital and the Mid-Michigan District Health Department.
The focus of the program was the opioid addiction problem running rampant across the nation, the state and Montcalm County. There have been six heroin overdose-related deaths in Montcalm County since June.
Charles told his family’s story of loss to the gathered audience of about 50 people from the community, including healthcare professionals, addiction specialists, law enforcement, concerned citizens, family members of addicts and some people somewhere in the process of recovery.
He talked about how Michael started by experimenting with more accessible things, such as alcohol, and eventually found his way to prescription drugs, which in turn led to heroin.
“He was a smart kid. I sat in the doctor’s office with him one time and listened to him debate with the doctor,” Charles said. “He knew all the prescriptions out there. He knew what everything about them as far as what the effects were, what they would do for him and what the side effects were.”
Charles said he knows now that at one time, Michael had five different prescriptions he was taking and he had friends forging prescriptions, as well.
“We do have an issue out there with medicine itself,” he said. “I know changes have been made to battle that and that’s good.”
Charles believes that Michael, like other people addicted to opioids, began to have a harder time obtaining the pills he needed, and that’s when he got involved with heroin, which is cheaper and sometimes easier to obtain.
THE CYCLE OF ADDICTION
It’s a story many people in the community are familiar with and it held many commonalities with the theme of the day: The cycle of addiction is a disease that can start innocently enough and quickly spiral out of control to have devastating consequences.
Others who spoke at the event were Dr. John Evans, an addiction specialist who talked about prescribing practices and medical addiction intervention; Kate Long of the Montcalm Care Network, who talked about Naloxone and how it can save lives; Dr. Philip Shumacher, an emergency room physician at Spectrum United Kelsey Hospital; Robert Storrer, a recovering alcoholic and addict; and 8th Judicial Circuit Court Judge Suzanne Hoseth Kreeger.
Evans acted as the keynote speaker and was the first to take the stage. He addressed differences between chemical abuse, dependency and addiction, different medical interventions to help wean addicts off of opioids, how opioids affect the brain and some statistics about addiction.
“(Abuse presents) in one or more of the following over a 12 month period: failure to fulfill obligations, use that is physically hazardous, drug-related legal problems and continued use despite social and interpersonal difficulties,” he said. “Dependence is demonstrated through a tolerance to the substance, withdrawal when you stop using it, drug is used more than intended, inability to control the use of the substance, an effort is put into actually obtaining the substance, important activities are replaced by substance use and substance is continued despite negative consequences.”
Evans, who is the medical director of Victory Clinical Services in Saginaw, said there are two main differences between addiction and dependence. Addiction, he said, is a disease of disordered thought.
“It’s about thinking something’s different,” he said. “Let’s say I go into Mary’s purse, and we’re cousins, and I needed a fix so I go into her purse and I take some money. It’s not stealing because Mary’s family and you can’t steal from family. I’m borrowing it and I’m going to pay her back with my next check. And then my next check comes and I need a fix and so Mary never gets paid back but I didn’t steal it, I just borrowed it, because you can’t steal from family.”
He said that’s an example of the disordered thought process that happens with addiction. He said the other hallmark separating addiction and dependence is that “addiction has cravings and dependence doesn’t.”
“When you’re dealing with opioid addiction, physical dependence always precedes addiction,” he said.
Evans noted that physical dependence can take as little as two weeks to form and it can take up to a year to move a person away from that dependence entirely.
What people become dependent on and eventually addicted to is dopamine. The levels of dopamine in the brain spike when under the influence of opioids, if only for a short time. Eventually, a person addicted to opioids can destroy their brain’s ability to reproduce its own dopamine levels and that can lead to more and more opioid use.
Evans discussed medical treatments available for opioid addiction, including treatment with methadone and Buprenorphine, which both work by bonding to opioid receptors in the brain, blocking opioids from making those bonds.
He said opioid withdrawal can be painful, but no one has ever died from it.
“They’re afraid they’re going to in the first half of it and they want to in the second half of it,” he said.
The worst pain of withdrawal usually lasts about three days he said, but it can take over a year for a person’s brain to return to normal after having to work so hard to maintain homeostasis during periods of addiction, whether that’s to opioids or to alcohol.
Long took the stage to discuss the Montcalm Care Network’s initiative to make Naloxone kits available to the community and to law enforcement. Naloxone is an antidote for opioid overdose that can bring a person out of an overdose by blocking opioid receptors until that person can receive medical attention.
“It’s still important to go to the hospital (after a dose of Naloxone),” Long said. “Opiates still hanging around can re-bond to the receptors (after the Naloxone dissipates).”
A dose of Naloxone can last anywhere from 30 to 90 minutes. Doses contained in the injectable kits given to the community are 0.4 mg dosages and there’s two of them. People interested in obtaining the kits can go to the Montcalm Care Network office at 611 N. State St. in Stanton, where they will receive training on how to use the kit and the kit itself free of charge.
Citizens and law enforcement officers trained on the kits who administer the Naloxone in an overdose situation are protected from an civil or criminal liability from their actions under the assumption that they’re acting in good faith.
An audience member asked Long if she felt that making Naloxone accessible to the community was only adding to the problem.
“When they look at studies for community based Naloxone programs where people who are using are getting trained, they show that people cut down their use as well as decreasing death,” Long said. “So there’s less death, less people using the way they used to use and more people coming in to treatment. Not everyone’s going to fall into that statistical norm and I think the other part of the conversation is where is the follow-up for (those people) in being connected to treatment?”
Which was another thing that was heavily discussed throughout the course of the morning: Resources available locally for people struggling with addiction.
GETTING LOCAL RESOURCES
Unfortunately, as of now, most of the in-patient resources for addicts include some travel as they are nearer to Detroit. Local in-patient resources are generally required to prioritize people who are suicidal in their drug use as there is so much local need for these resources.
There are other resources available locally however, thanks to the partnership from local health organizations and groups such as the Ionia Montcalm Families Against Narcotics (IM FAN), who was founded by Judge Kreeger and a friend of hers.
Organizations such as the IM FAN, and Saturday’s symposium are focused on trying to start a dialogue with people in the community about addiction. Part of that mission is to reduce the stigma that surrounds addiction to make it easier for people who are struggling with it to come forward.
“We need to get away from the idea that addicts choose to do this,” said Storrer. “It’s a brain disease. The brain is high-jacked.”
Kreeger, who was integral in establishing the 8th Circuit Adult Drug Treatment Court in 2015, compounded on that idea by telling the story of a woman she came in contact with who was a teacher who underwent knee surgery. It was after that surgery that the woman began taking prescription painkillers and became dependent and eventually addicted.
“It does hijack the decision making process,” Kreeger said.
While the event didn’t fill up the auditorium at the Greenville Area Community Center, Sara Lincoln, surgical coordinator at Sheridan Community Hospital, member of YOUTHINK Montcalm and one of the event organizers, said the turnout was encouraging.
“We’re trying to target adolescents and (educate) them (about the dangers of opioids) before they get their hands on them,” she said. “We’re not opposed to educating people who’ve already come in contact with substances, but we hope to reach adolescents before they start and so they can educate friends being peer pressured.”
She said events like Saturday’s are great for adults, too, because it lets them know what behaviors to possibly look for in their children and what resources are available for all ages.
“It’s better somebody not knowing there’s these substances going around in this community,” she said.
There were some younger people in the crowd, which Lincoln said she was happy about because those people can now go out into the community and talk to their friends about what they learned. She was also glad that there were some healthcare professionals in the crowd as well.
“I think it’s beneficial for them to see (presenters) talk about the stigma and people being afraid to admit they have a problem in the hospital setting,” she said.