Opioid Summit attendees learn solution to addiction is prevention

POPLAR BLUFF, Mo. -- "This has been very eye-opening," Robin Sides of Pyramid Tri-County Hospice said while attending the Missouri Opioid Summit at Mount Calvary Powerhouse Church in Poplar Bluff.

"I knew the issue with fentanyl patches, but I didn't know some of the uses and how pure some of the forms could be."

Sides was one of many representatives from the community, including prevention and treatment workers, social-services agencies, school and medical professionals, law-enforcement officers and faith-based groups, who came together to address the opioid epidemic in the area and statewide.

The summit was hosted by the Missouri Department of Health and Senior Services in partnership with the Butler County Health Department.

According to Whitney Preslar of the Butler County Health Center Emergency Response Center, about 250 people attended the summit.

Fentanyl, an opioid medication used to help relieve severe pain that is prescribed to many cancer patients, has become a growing problem in the area, especially when it is mixed with heroin.

Butler County Sheriff Mark Dobbs said the issue hit close to home recently.

Dobbs recounted an incident where a young woman died from a drug overdose in her home. During the investigation, drug paraphernalia was found. It was discovered the young woman died from an overdose of heroin mixed with fentanyl.

"It (fentanyl) is so dangerous to come in contact with and can remain airborne," Dobbs said.

The officer, who packaged the substance from the scene to be tested, began to show symptoms of coming in contact with fentanyl and was taken to the hospital.

"He probably would not be with us if we had not gotten it addressed as soon as symptoms began to show," Dobbs said.

Theodore Cicero, vice chairman for research from the Department of Psychiatry at Washington University, said the situation probably is worse than they have heard.

Many patients Cicero has come in contact with said their mind-set for taking opioids was they were legal, "at least it was not heroin," and they know the dosage they are taking.

"The drug they avoided before, heroin, they are now switching to because it is purer," Cicero said. "They feel they have no choice because it has been made harder to get the pill they took before."

Cicero said he has heard many other reasons why opioid abusers are turning to heroin, including a way of "escaping," to chase a high feeling, self-esteem or other underlying issues.

Cicero said heroin has an uncertain purity and ingredients added to that make the approximate dose amount hard to determine. In return, overdose deaths have increased.

Once tolerance levels build, Cicero said, many begin to snort or inject the drug to get it to the brain quicker.

"The bottom line is the opioid problem is not going away until it is addressed," he said. "Treatment or better yet, prevention is the first step."

Larry J. Reavis, assistant special agent in charge with the Drug Enforcement Administration, said he wanted the crowd to take away a message of hope from the summit.

"There is power in prevention," Reavis said. "We can't arrest our way out of this problem."

Howard Weissman, National Council on Alcoholism and Drug Abuse executive director, said when it comes to the disease of addiction, prevention methods have not been applied as with other diseases.

"When we are talking about prevention, we are not talking about wagging a finger at someone saying don't do drugs," Weissman said. "We are talking about ways to deal with self-esteem and depression issues."

Funding issues came up during discussion of a prevention curriculum being incorporated into schools.

"I'm asked, 'How can we afford it?' And, that is not the right question," Weissman said. "How can we afford not to?"

Missouri House Speaker Todd Richardson said during the summit he was glad to see so many people working together on a problem in Missouri and the country.

A statewide drug-monitoring program has been a focus of Richardson since the first day he took office, he said.

Gov. Eric Greitens recently signed an executive order establishing a prescription drug-monitoring program statewide, no longer leaving Missouri as the only state in the country without such a program.

Richardson said he is hopeful Missouri will become a leader on how to combat the opioid epidemic.

The Opioid Summit concluded with a panel of local experts giving their take on the problem and needs they see in the community.

Poplar Bluff Chief of Police Danny Whiteley was among one of the 10 panel members.

"Somewhere around 2003 to 2005, we initiated a 'prescription pill case' locally," Whiteley said. "We identified a huge problem then with opioids, and we still have that problem today."

It was during the investigation, Whiteley said, Poplar Bluff was discovered to lead Troop E by a large margin in prescriptions written for hydrocodone, oxycodone, oxycontin, fentanyl, Xanax and soma.

"With the opioid-prescription abuse, it has opened the door for heroin to become a major problem for all of Southeast Missouri," he said.

The area also was one of the leading in meth manufacturing, but the requirement of a prescription for Sudafed has reduced the number of meth labs drastically, Whiteley said.

"Legislation in these areas absolutely works," Whiteley said. "It is tried and proven."

With the assistance of the Sudafed prescription requirement and drug monitoring program, Whiteley said, law enforcement can concentrate on other criminal activity.