Luzerne County Community Health Action Plan: Combatting The Opiate Epidemic

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Running Head: COMBATTING THE OPIATE EPIDEMIC IN LUZERNE COUNTY 1

Luzerne County Community Health Action Plan:

Combatting the Opiate Epidemic

Rebecca L. Beighley

Colorado State University Global Campus

BIO201-2- Public Health and the Environment

Professor Benjamin Wright

July 3, 2019

COMBATTING THE OPIATE EPIDEMIC IN LUZERNE COUNTY 2

Combatting the Opiate Epidemic in Luzerne County

Worldwide there are approximately 27 million people who struggled with opioid use

disorders in the year 2016 (World Health Organization, 2018). There were over 118 thousand

over-dose deaths directly linked to opioid use. While the mass majority of people addicted to

opiates are using heroin, there is the numbers of prescription opiate overdose deaths is steadily

increasing around the world (World Health Organization, 2018). Luzerne County has not been

immune to the current opiate epidemic. Between the years of 2016 and 2017 there were 470

overdose deaths reported – that’s an average of 1 death every 2 days (Pennsylvania Departement

of Human Services, 2018). There comes a time with any community health issue that action

needs to be taken- unfortunately, when people are burying loved ones at an average pace of

every other day- that time has come. In order to save lives, and preserve the lives of the next

generation, Luzerne County and its residents must come together and put into action a plan to

combat the opiate epidemic.

Symptoms

An opiate is defined as a psychoactive substance created form the poppy plant, or

synthetic chemical equivalent. The most widely recognized form of opiate is heroin, but other

examples of substances that fall into this classification are morphine, fentanyl, methadone, and

oxycodone (World Health Organization, 2014). Opiate addiction is characterized as an

uncontrollable urge to take opiates (whether it be orally, inhaled nasally, or injected via iv

needle). This urge is prioritized over responsibilities, familial or work obligations, legality,

negative effects on health, and high risk of death (World Health Organization, 2014). A person

using opiates might exhibit signs such as being in a “euphoric state of mind”, lack of inhibitions,

and incredibly constricted pupils. As the high continues they are feeling progresses they might be

COMBATTING THE OPIATE EPIDEMIC IN LUZERNE COUNTY 3

seen “nodding off” and itching or picking their skin, and sometimes they become nauseous and

vomit (DrugRehab.Org, 2018). With repetitive and extended use of opiates a person’s physical

appearance can be a sign that a person is struggling with addiction- there is often severe weight

loss, bruising and needle marks on arms if they are using it intravenously, changes in personality,

and extreme mood swings. Physical signs are not the only thing that can signify a substance

abuse problem- a person may become secretive, become unreliable, they often have problems

holding onto employment, and many turn to theft in order to obtain the drugs that they feel they

need (DrugRehab.Org, 2018). Often, the biggest give-away that a person has become addicted to

opiates is the withdrawal they face if they run out or do not take another dose after the effects of

the drug wear off. Six to twenty-four hours after use stops, withdrawal starts. Symptoms of

withdrawal include restlessness, extreme irritability, confusion, dilated pupils, muscle spasm,

vomiting and diarrhea, and seizures. The longer a person does not use opiates the more the

physical symptoms of withdrawal subside, but the psychological cravings and feelings of

“needing” the drug to manage can continue for years, and some recovering addicts report that

they never go away (DrugRehab.Org, 2018).

Health Risks of Excessive Opiate Use

Addiction to opiates is a disease that can have far-reaching negative effects on the

individual’s health– ranging from mental disorders to increased chances of exposure to

HIV/AIDS, and Hepatitis B and C. It can cause collapsed veins, abscesses, liver or kidney

disease, weakened immune systems, weakened states of mental health, malnutrition, and

infections in the heart lining/valves, and possibly the most severe consequence: death (National

Institute on Drug Abuse, 2018). An addict’s state of health relies heavily on their current amount

of drug use, and method of use (National Institute on Drug Abuse, 2018).

COMBATTING THE OPIATE EPIDEMIC IN LUZERNE COUNTY 4

When drug usage causes a death, it is referred to as an overdose, and this is by far the

scariest risks associated with opiate use. Opiates effect the part of the brain that signals the

respiratory system to function- breathing. Opioids in high doses halt this area of brain function

and cause respiratory depression leading to death (National Institute on Drug Abuse, 2018).

Negative Effects on Community Health Created by the Opiate Epidemic

Any time a member of the community dies, residents are affected. Children are losing

parents, parents are burying children, and widows are learning to raise their families as a single

parent as a result of the opiate related deaths in Luzerne County. Children raised by parents

abusing drugs are three times more likely to be abused, and four times more likely to be

neglected (Elements Behavioral Health, 2018). These children are the future of our community,

and each day that they are exposed to the harsh realities of opiate addiction, they become more

susceptible to behavior problems, academic problems, and are at a higher risk for developing

mental health issues such as anxiety, depression, or even worse they are more likely to develop

their own substance abuse problems than children that are not exposed to opiate addiction

(Elements Behavioral Health, 2018).

The opiate epidemic also has caused increased crime rates in Luzerne County. According to

police, 51% of prosecuted criminals cite the need to pay for their addiction as the reason behind

their crimes (Bezrutczyk, 2019). In one study done in 2017- 4,069 people addicted to Heroin

were interviewed, the participants were found to have committed over 500,000 crimes over and

11-year period. Crimes committed spanned from burglary, larceny theft, armed robbery, to

prostitution and check fraud (Bezrutczyk, 2019). Crime statistics in Luzerne County support this:

COMBATTING THE OPIATE EPIDEMIC IN LUZERNE COUNTY 5

Crime

Percent Above National

Average

Violent Crime

73.38%

Robbery

41%

Aggravated Assault

25%

Property Crime

296%

Burglary

28%

Larceny Theft

932%

(Crime Statistics, 2019)

The crime rates not only affect a community’s residents physically and emotionally, but

financially as well. The costs associated with arresting, prosecuting, and incarcerating these drug

addicts for their crimes committed to support their addiction are paid from county funds and

taxes. Drug abuse and addiction has been estimated to cost more than $740 billion annually in

lost workplace productivity, healthcare expenses, and crime-related costs (Scot Thomas, 2019).

Diagnosis

The causes of opiate addiction are complicated, and there is no known “single cause” to

the addiction that is fueling the current opiate epidemic. Known “causes” range from genetic

predispositions, co-occurring conditions such as mental health disorders, and environmental

circumstances (Tracy, 2019). Many people who use drugs do not become addicted- one of the

factors that can make someone more prone to becoming addicted after only one or two times

using a substance is their genetics. There are subtle variations in DNA sequencing referred to as

single-nucleotide polymorphism (SNP’s). It has been found by researchers that these SNP’s pass

through familial DNA’s– though more research is being funded and conducted- it has been

COMBATTING THE OPIATE EPIDEMIC IN LUZERNE COUNTY 6

concluded that certain SNP’s show up in the genetics of individuals diagnosed with substance

abuse disorders. Therefore, it can be concluded these SNP’s that are suspected markers for

susceptibility to addiction can be passed through genetics (National Institute on Drug Abuse,

2016).

Substance abuse has also been found to be prevalent in those with co-occurring mental

health conditions. In the year of 2017, 8.5 million American Adults suffered from both a mental

health disorder and a substance abuse disorder (Scot Thomas, 2019). Though mental illness

alone does not cause drug addiction- presence of one condition might make an individual more

prone to the other (Tracy, 2019). Many professionals believe that many drug addicts use drugs-

such as opiates- to “self–medicate” or attempt to manage symptoms caused by their undiagnosed

or untreated mental health condition. Examples would be someone suffering from depression

using drugs repeatedly to elevate their mood or a person suffering from ADHD or anxiety might

use a drug to slow themselves down and feel “normal” or lower their inhibitions, so they feel as

though they can socialize. These conditions did not cause the addiction but were nonetheless a

large contributing factor (Tracy, 2019).

Many drug addicts cite environmental factors contributing/causing their drug addiction.

Growing up in an environment with abuse, neglect, or drug abuse causes increased likelihood

that a child will grow up and develop a substance abuse disorder. Researchers often refer to this

as “next–generation substance abuse”. Links have been consistently found between a parent’s

opiate addiction and their child’s increased risk of developing an opiate addiction (Elements

Behavioral Health, 2018). Other environmental factors that signify an increased likelihood of one

developing a drug addiction are easy access to drugs, being raised in an economically challenged

COMBATTING THE OPIATE EPIDEMIC IN LUZERNE COUNTY 7

area, use of drugs by friends and peers, behavioral problems, and constant attention seeking

behavior (Tracy, 2019).

Another element that has contributed immensely to the current opiate epidemic is the

excessive and unmonitored prescribing of opiate painkillers such as Oxycontin, Vicodin, and

fentanyl, and morphine (Scot Thomas, 2019). Numbers recorded in 2017 showed about 1.7

million people age 12 and older had a pain reliever use disorder (Scot Thomas, 2019). People

who start to abuse opiate painkillers are significantly more likely to start using heroin in the

future.

Other Community Action’s Taken to Combat the Opiate Epidemic

Opiate abuse is not exclusive to Luzerne County, Pennsylvania, nor just the United

States. The Opiate Epidemic is one that countries and communities all over the globe are trying