‘I had a hell of a time
finding parents
who wanted to
talk about it.’
— S A M Q U I N O N E S , A U T H O R O F D R EA M L A N D —
T H E T R U E TA L E O F A M E R I C A’ S O P I AT E E P I D E M I C
gene police officers carry narcotics identification kits or
NIKs.
However, Hasselman says first-time offenders cited for
possession have options. “Our first objective is to make
sure they are afforded the opportunity to engage in treat-
ment that would happen through Lane County Drug Court,”
he says. “When people successfully complete drug court
by graduating, the charges are dropped and they never get
probation, have their Oregon driver’s license suspended,
or serve jail time.”
If a person opts out of going through drug court, the
DA’s office follows the typical prosecution track. “Posses-
sion charges can be class B and C felonies. A judge’s au-
thority is limited to felony sentencing guidelines, so simple
possession charges can never go to prison for just posses-
sion, unless there are substantial quantities involved.”
Webb knows several people who have been arrested re-
peatedly for drug use, and she’s still learning the ins and
outs of the drug court system. “I do have the thought that
jail does nothing for addiction because I’m sure, just like
any other jail, drugs are there already,” she says.
R E C O G N I Z I N G A N AT I O N A L
H E A LT H C R I S I S
As people continue sharing their stories — and as more
information about overdose deaths becomes available —
the nationwide conversation about the epidemic is slow-
ly changing. In 2014, the CDC announced that overdose
deaths have surpassed car accidents as the leading cause of
accidental death in the U.S.
On April 4 of this year, Gov. Kate Brown signed House
Bill 4124, which allows pharmacists to dispense the over-
dose reversal drug naloxone and “requires the Oregon
Health Authority to disclose prescription monitoring infor-
mation to practitioner or pharmacist.” In February, Presi-
dent Obama requested $1.1 billion to combat the opioid
addiction problem.
Oregon Sen. Ron Wyden sat down with EW recently
and expressed disappointment in the Comprehensive Ad-
diction Recovery Act of 2016 (CARA), passed by the Sen-
ate earlier this year and the House on July 13, calling it a
half measure. Wyden proposed two amendments to the bill
— taking $75 million set aside for drug manufacturers to
continue making “abuse deterrent” pills and instead help-
ing addicted pregnant women who enrolled in Medicaid,
and more transparency on advisory panels that make pre-
scription practices recommendations to the Food and Drug
Administration. Both were voted down.
The bill passed, but Wyden says, “Congress shouldn’t
be taking a victory lap.” He adds that the efforts were large-
ly driven by the right.
“Who are you going to give this money to?" he asks.
"Women who are enrolled in Medicaid with limited means
are struggling to fight addiction, get their lives back on
track, or are you going to give a windfall to drug compa-
nies?”
Wyden says striking down both of the amendments he
proposed "are to me reflective of how so often powerful
special interests prevail against the public interest.”
He says the next step to addressing this crisis is for citi-
zens to contact their elected officials and make their voic-
es heard. “[T]here have been landmark studies at Johns
Hopkins talking about how 80 percent of the people who
are hooked to heroin and opioids who needed treatment
couldn’t get it, and I said I want everybody to know [that]
under what the Congress just did last week, those treatment
lines are not going to get much shorter.”
The senator says enforcement alone does not eliminate
addiction. “You’ve still got a person in the community
whose addicted, so you have to make the three parts work
in tandem: There is enforcement — important role for it —
but treatment and prevention are equally important, and if
you don’t put the pieces together you’re not going to have
a good strategy.”
Wyden also wrote a letter to the president of the Na-
tional Academy of Medicine regarding two members of
its advisory board who had links to opioid manufacturers.
According to the Associated Press, four members of the
panel were dismissed for having ties to the pharmaceutical
industry because its members are supposed to be properly
“vetted for financial ties that can influence their judgment.”
Wyden says, “They have removed a handful of people from
at least one of the advisory boards and it's largely attributed
to the pressure that we put on them.”
According to CDC spokeswoman Courtney Lenard,
“Prescription opioids can help with some types of pain in
the short term but have serious risks.” She says they are an
important part of treating pain for cancer or hospice care.
“However, studies are not available to indicate whether
opioids control chronic pain well when used long-term.”
Holton says, “For decades, doctors were told that there
is little risk of addiction and much potential benefit for
treatment of chronic pain.”
He continues, “It turns out that is totally wrong — there
is limited potential benefit, and a very significant risk of
long term dependence.”
Dr. Paul Coelho, who works in pain management in
Corvallis, says Holton is absolutely right. “Over the ensu-
ing 25 years we’ve seen opioid overdose deaths, addiction
and now heroin use rise to epidemic levels. It was a colos-
sal mistake and we are paying for it now.”
Coelho says “PHRMA definitely played — and contin-
ues to — play a role in the opioid crisis.” He refers to the
Pharmaceutical Research and Manufacturers of America
and the 2007 New York Times article that covered the $600
million settlement in which Purdue Pharma paid in fines
for “misbranding” OxyContin and pled guilty to “criminal
charges that they misled regulators, doctors and patients
about the drug’s risk of addiction and its potential to be
abused.”
Coelho also refers to a $1.1 million settlement reached
in Oregon in 2015. Insys Therapeutics was accused of “de-
ceptive marketing and improper payments” to sell fentan-
yl, according to The Oregonian.
“Simply put, it is more lucrative for PHRMA to pay off-
label marketing sanctions than to risk designing and per-
forming a randomized trial that could disprove that opioids
have utility for chronic non-cancer pain,” Coelho says.
The new CDC guideline suggests treating patients with
nonpharmacologic therapies like cognitive therapy and
exercise and to incorporate those therapies when opioids
are prescribed. The new prescribing rule, “start low and
go slow,” recommends that doctors begin with the “lowest
effective dose.”
According to the new CDC Guidelines for Primary Care
Providers, “Studies show that high dosages (≥100 MME/
day [morphine milligram equivalents]) are associated with
2 to 9 times the risk of overdose compared to less than 20
MME per day.”
Before Webb became dedicated to decriminalizing
homelessness, she says, she thought people living on the
streets were just lazy. “I lived comfortably above the pov-
erty line until drugs came into the picture,” she says. “I
found it wasn’t so easy for me to get a job once I had a
drug habit.”
She walks through downtown Eugene to get to work
and says she used to joke that the streets were her of-
fice. She says she’s been practicing being a peer-support
specialist before she trained as one. “Often times I walk
around handing out water and granola bars just to get fa-
miliar with new people."
September will mark two significant events for Crystal
Webb — she’ll be celebrating two years in Eugene and two
years of being clean.
“I consider Eugene a healing town — if you want to get
healthy you can do it here; you just have to not be afraid to
ask for help.” ■
eugeneweekly.com • July 21, 2016
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