For years, it was thought that opioid epidemics were a thing of the past. But after hundreds died of heroin overdoses in Connecticut last year, the narcotic pain medications are back in the spotlight.
The numbers are stunning. In the decade from 1997 to 2007, roughly 2,200 people died of opioid overdoses in Connecticut. In 2015, that figure totaled over 700. Projections for 2016 indicate that it will be even higher — tentatively, around 850. In New Haven, the opioid crisis came to stark public light on June 23, when 17 people overdosed on a single night, causing three deaths. The epidemic has swept through nearly all of Connecticut’s cities and towns, leaving few places unaffected.
The main fight in the struggle against the opioid epidemic, activists and legislators said at an Aug. 31 press conference in Hartford, is with the stigmatization that surrounds opioid use. This forces users to retreat into the shadows of society instead of feeling comfortable seeking help for their disease out in the open, they said.
“The great enemy is stigma and shame,” said Sen. Richard Blumenthal LAW ’73, who is a leading advocate for the fight against the opioid epidemic at the federal level. “All that’s needed for the triumph of stigma and shame is for good people to do nothing, and we cannot be inert.”
The great tool against the lethal effects of overdoses is a drug called naloxone, commonly known as Narcan, which, if administered soon enough after the overdose, can prevent death.
Much of recent legislative action on the opioid epidemic concerns the distribution of Narcan. One bill, intended to make Narcan more readily available, allows pharmacists to issue prescriptions for the drug; other legislative efforts seek to require first responders — police and fire departments — to carry supplies of the drug to be administered when they arrive on the scene.
Opioid overdoses in Connecticut are concentrated in the state’s urban areas — notably Bridgeport, Waterbury, Hartford and New Haven. These are also the cities whose already-busy police departments are being called upon to help save lives in their cities.
Equipping police departments with Narcan can seem like a quick and obvious fix, but the reality is more complicated than it looks. At a July roundtable in New Haven, just after the night of the 17 overdoses, Deputy Director of Emergency Management Rick Fontana noted the high cost — at least $40,000 — of Narcan-equipping programs, plus the difficulties of training police officers in additional medical techniques.
For U.S. Rep. Elizabeth Esty, a Democrat who represents northwestern Connecticut in Congress, the high price of Narcan kits threatens to stop lives from being saved. Mirroring well-publicized hikes in the price of the anti-allergy drug EpiPen, the price of Narcan has drastically increased in recent years, a development that might push the crucial drug beyond the financial means of cash-starved municipal police departments.
“It is price gouging and literally people [are] dying because they can’t afford it,” Esty said at the press conference. “And that’s just wrong. And whether it’s the Federal Trade Commission or the FDA, [they need to] step in and say ‘This is wrong, there’s no justification.’”
Supplying first responders with Narcan is one thing; raising awareness of the drug among the public is another, equally important issue, according to Jonathan Harris, commissioner of the Department of Consumer Protection. To that end, he said, the state has developed an interactive map showing the locations of all pharmacies in the state stocked with Narcan. Harris has experienced the effects of drug abuse in his own family life: His brother-in-law died of an overdose, and a cousin has also struggled with addiction.
But the problem is getting worse, not better, as the purity of opioid supplies sold on the street is becoming increasingly dubious. The 17 people who overdosed in New Haven in June, for instance, believed they were buying cocaine. In fact, the white powder they purchased was pure fentanyl, an opiate some 80 times more powerful than morphine that is increasingly being intermixed with supplies of other drugs.
Nor is fentanyl the only culprit. In Florida, Blumenthal noted at the press conference, a spate of recent overdoses involved heroin cut with horse tranquilizer.
The speakers at the press conference, held to mark Overdose Awareness Day, all emphasized one point: that heroin addiction, and drug addiction more generally, should be treated as a disease or illness, not a crime nor a source of shame.
“We are never going to win the war against every overdose, said Rep. Sean Scanlon, D-Guilford, describing addiction as a “public health emergency.” “But we can win the war against stigma, and we can win the war when it comes to making sure that people have access to the help that they deserve, and they need.”