Eugene weekly., July 21, 2016, Page 14, Image 14

ago, Webb was living in Gulf Port, Mississippi, working as
a market-training manager for Taco Bell and was in a long-
term relationship with her then-partner. Hurricane Katrina
ripped the roof off of her Mississippi home — and leveled
the Taco Bell — so she relocated to her mother’s home in
Mobile, Alabama.
Webb’s decade-long relationship ended abruptly, and
she began taking prescribed pain medications for a back
injury. Vicodin and Percocet helped Webb’s pain, and she
says Xanax and Soma, a muscle relaxer, were later pre-
scribed.
A few years later she met and began dating a new part-
ner who “had a very similar past as mine. We both had trau-
matic childhoods and we clicked, and it was a recipe for
disaster because neither of us knew how to support each
other. We triggered each other.”
Webb says nearly everyone in her Alabama social circle
had access to prescription opioids, used them or sold them.
Opioids saturate Oregon. With a population of 3.9 mil-
lion, 25 pills are available every year for every man, wom-
an and child, according to the Oregon Prescription Drug
Monitoring Program, a program run by the Oregon Health
Authority. That’s 100 million pain killers prescribed annu-
ally, and from 2012 to 2013, Oregon was number two on
the list of non-medical use of opioids, according to the Na-
tional Survey on Drug Use.
In Oregon, 43 percent of overdose deaths are caused
by prescription opiates, according to an Oregon Health
Authority statement. The statement acknowledges the in-
crease in prescription pain medication since the ’90s.
In February, the Oregon Coalition for Responsible
Use of Meds hosted the Lane County Summit to Manage
Chronic Pain and Reduce Prescription Drug Abuse. Lines
For Life Executive Director Dwight Holton says there was
an audible gasp in the room when he presented a specific
slide. Lines for Life is a nonprofit dedicated to preventing
substance abuse and suicide.
The slide showed numbers from study published in 2014
by Express Scripts, a pharmacy benefit management com-
pany: “47 percent of those on opioids over 30 days are still
on them three years later and 60 percent of those on opioids
longer than 90 days are still on them five years later.”
Holton served briefly as Oregon’s U.S. attorney and left
that office to run for state attorney general in 2012. While
in the U.S. Attorney’s Office, he worked on policy changes
with Lines for Life. He says in 2010, when working as a
federal prosecutor, he thought that it was heroin that was
responsible for more than 400 overdose deaths in 2009 as
reported by State Medical Examiner Karen Gunson. “The
medical examiner told me to guess again,” Holton says.
Prescription opioids were responsible — not heroin.
Sam Quinones tells EW, “This has been a quiet epidem-
ic.” Quinones is the author of Dreamland: The True Tale
of America’s Opiate Epidemic, a nonfiction narrative that
chronicles the history of the medical advertising industry,
the use of opiates prescribed to treat pain and the evolution
of opiate addiction that made room for the easy delivery of
Mexican heroin throughout the U.S.
In Dreamland, Quinones details a series of meetings
where doctors met in Milan to discuss treating terminally
ill patients with opiates. The World Health Organization
called morphine “an essential drug” for treating cancer pain
and also “claimed freedom from pain as a universal hu-
man right.” According to Quinones’ research, this changed
medical and public opinion; therefore, if someone sought
medical attention for pain, that person should be believed
by doctors who should then “prescribe accordingly.”
The opiate problem has evolved over the past several
decades. “It used to be that half of the country was supplied
by Turkey and Burma and it was very expensive, very weak
and hard to get,” Quinones says. Then a “total paradigm
shift takes this pill epidemic to awaken the trafficking that
has made them readjust their production.”
Quinones says that huge amounts of heroin are now
coming from Mexico. “It doesn’t get cut, it’s really cheap,
really prevalent, really potent, and Oregon has become a
big hub.” Another problem is black tar heroin; Quinones
found that “when people get out of jail or rehab they go
back to this stuff [because] it’s much cheaper.”
According to the CDC, prescription opioid deaths have
quadrupled since 1999 with 165,000 people dying between
12
July 21, 2016 • eugeneweekly.com
1999 and 2014 — 14,000 deaths in 2014 alone. The Or-
egon Health Authority says, “In Oregon in 2013, more drug
overdose deaths involved prescription opioids than any
other type of drug, including methamphetamines, heroin,
cocaine and alcohol.”
Holton says, “People have been dying from opiate ad-
diction for a long time now.” Holton has seen the epidemic
shift, too. “For the longest time we did not use opiates for
pain treatments precisely because of a concern for addic-
tiveness — we’ve known about the addictiveness of opi-
ates for hundreds of years,” he says.
Despite that knowledge, another pivotal moment in opi-
oid prescription practices that was discussed at the Lane
County Prescription Summit was Dr. Hershel Jick’s 1980
study, “Addiction Rare in Patients Treated With Narcot-
ics,” in the New England Journal of Medicine. Holton says
aggressive marketing and perpetuation of the myth that
opioids can be non-addictive are some of the reasons be-
hind the current epidemic.
So as opiates spread uncontrollably across the country
and here in Lane County — paving the way for heroin be-
cause of its cheap cost and interchangeable high — why
has it taken decades for people to talk about it?
“Stigma,” Holton says. “For many years people did
not understand the breadth of this problem because of the
stigma.”
Quinones says, “There’s no public violence. Doctors
prescribing opiates thought it was a good idea and parents
of overdoses were ashamed.”
He adds, “I had a hell of a time finding parents who
wanted to talk about it.”
KICKING THE HABIT
As Webb struggled with addiction in Alabama, she was
hit with another blow. “Losing my insurance plan was how
I moved from opiates to meth,” she says.
The drug abuse worsened for her girlfriend, too. “A year
later, I almost died. A year and a half later, my girlfriend
died.” Webb says her partner died of a combination of meth
and Roxycodone, an immediate-release version of oxyco-
done.
The day before her girlfriend overdosed, Webb brought
her a chicken sandwich, a soda and clean needles. “I’m
glad that the last time we were together it wasn’t a fight,”
she says. The day after the funeral, Webb was on a one-way
flight to Eugene with the goal of getting clean. But she got
high by injecting crystal meth before takeoff.
In his research, author Sam Quinones discovered that a
drug trafficking operation out of Xalisco, Mexico, known
as the Xalisco Boys, developed delivery operations that
made it easy for addicts to get their hands on dope. An in-
formant in Dreamland noted that the new heroin cells op-
erate “like a pizza delivery service.” The drivers navigate
around cities to deliver the black tar heroin, which is stored
in balloons the drivers carry in their mouths.
Quinones tells EW that part of the business model in-
cludes hanging out near methadone clinics. “These guys just
made an art of it — going to a town, getting an addict to go
to a town and an addict will take them to places,” he says. In
his book, Quinones writes that the Xalisco Boys saw meth-
adone clinics as “game preserves,” where they’d lurk and
catch people at clinics to provide them with “free samples.”
Methadone treatment is also highly stigmatized, ac-
cording to Linda Hill, a spokesperson at the Lane County
Methadone Treatment Program. “An important role for
clinic staff is to provide advocacy and support to patients.”
Hill says, “Methadone is a synthetic opioid that sup-
presses withdrawal by acting on the opioid receptor sites
in the brain. It is an important, lifesaving “medication as-
sisted treatment” option for those struggling with opioid
addiction.”
Methadone treatment breaks down like this: Most new
patients are required to show up daily to receive their dose
of methadone; one-to-one counseling and other treatment
services are provided. With demonstrated stability patients
can eventually earn “take-out” privileges and come to their
clinic less often, according to Hill. She says that most
methadone clinics embrace the dual focus of harm reduc-
tion and abstinence.
Holly Peters kicked her addiction because what she
“learned was that opiate addiction is a mental, emotion and
physical experience, learned that my recovery needed to be
an experience, too.” After she completed a recovery pro-
gram, she earned her bachelors degree in psychology and
her master’s in social work.
“My recovery needed to replace all of those things,” she
says. “That’s what we are trying to do at our program by
taking a holistic approach so people can get that without
having to reach our to an illicit substance.”
And users always face the risk of getting caught. More
than 800 meth and heroin cases were filed in a seven-month
period in Lane County, according to Chief Deputy Attorney
Erik Hasselman. But he says those numbers don’t necessar-
ily indicate a spike.
D W I G H T H O LT O N S P E A K S AT A
SUMMIT TO END DRUG ABUSE
Holly Peters is the intensive services director at South
Lane Mental Health. She watched her father suffer after a
back injury and the death of her mother. He was prescribed
opiates for his injury, and she says that when it came time
for him to taper off, he didn’t have the support and resourc-
es that were necessary. Peters began drinking and taking
opiates and heroin at the age of 14 and eventually watched
her father lose his struggle with addiction.
“We’ve been working with very limited number of law-
yers,” Hasselman says. The voter-passed 2013 Lane Coun-
ty jail levy “also had some money for the DA’s office built
into it — we were able to prosecute with that money. We
had not been prosecuting the overwhelming majority of the
drug charges for a few years.”
And if a person is carrying a pipe or a baggie with trace
amounts detectable, they can be cited for possession. Eu-