Statistics are the tip of a deadly iceberg in growing opioid epidemic

As Terrebonne Parish explores the potential of joining communities suing big pharmaceutical companies over costs associated with drug overdoses, the march to the graveyard and frantic rides to hospitals continue unabated, with no signs of relief.

What is now termed the nation’s “opioid epidemic” reaches far and wide and the Bayou region is no exception.

“It’s the worst I’ve ever seen it,” said Lt. Jason Kibodeaux of the Terrebonne Parish Sheriff’s Office. “It’s heroin, fentanyl, lacing the heroin with fentanyl to make the effects last longer.”

U.S. Surgeon General Jerome Adams has characterized the problem with stark numbers.

“An estimated 2.1 million people in the U.S. struggle with an opioid use disorder,” Adams said in an official statement. “Rates of opioid overdose deaths are rapidly increasing. Since 2010, the number of opioid overdose deaths has doubled from more than 21,000 to more than 42,000 in 2016, with the sharpest increase occurring among deaths related to illicitly made fentanyl and fentanyl analogs.”

Analogs are derivations of established drugs made in laboratories.

According to the National Institute on Drug Abuse, 115 people die each day in the U.S. due to opioid overdoses. Prescription pain relievers are cited as a big contributor to the crisis. According to information gathered by the Ochsner Health System those pain relievers are not only highly addictive but shown not to be effective for long-term chronic pain management “resulting in decreased quality of life and employment and increased utilization of healthcare.”

REGION FOLLOWS TREND

The numbers are sobering locally, in particular when increases are noted or seemingly expected.

Terrebonne Parish had 53 fatal overdoses in 2017, with more than half of those directly attributable to opioids. In Lafourche Parish there were 15 opioid deaths that year. With this year less than half done, the Lafourche number already stands at ten.

The fatalities, however, are like the visible tip of a much larger iceberg. The true number of people actually using opioids and other drugs cannot be truthfully estimated. Numbers are charted when something goes wrong.

Local hospital statistics show steady increases in the number of people who present with a drug overdose, either in voluntary visit, those instances where they are dropped off by friends or transported in an ambulance. And the numbers are climbing.

At Leonard J. Chabert Medical Center those numbers rose from 89 to 108 from 2016 to 2017, with 61 emergency room presentations during the first four months of 2018. At Ochsner St. Anne in Raceland the number rose from 22 in 2016 to 33 in 2017. For the first four months of 2018, seventeen people ended up in the emergency room.

Terrebonne General Medical Center stats show that from Feb. through Dec. of last year there were 83 presentments of overdose at the emergency department, with 44 between Jan. and April of this year. Thibodaux Regional Medical Center’s numbers rose from 12 to 16 between 2015 and 2016, to 19 in 2017. TRMC was the only local hospital to show a slump this year, with only three emergency room presentments for unintentional overdose so far in 2018.

THE DEVIL TAKES CHARGE

A 360 -degree view of the problem constructed through Interviews with medical experts, users, addicts in recovery, family members and law enforcement personnel reveal a complex and heartbreaking cycle of hope, despair and sometimes death.

The addicted dwell in a demi-monde invisible to most people. Currency, sex and overall freedom are traded for the master, which is the drug of choice. Addiction makes no distinctions of age, race or societal status. The devil claims the bodies of those he can, reducing men and women who might be otherwise productive to zombified shells of who they might have been.

The introduction of fentanyl to the mix has made for deadly intravenous cocktails.

Common opioids are derived from a plant, the opium poppy, and include morphine and codeine, which have specific medical applications, and heroin. Synthetic drugs such as oxycodone and hydrocodone perform the same function.

Special receptors in the brain are designed to receive and bind with the body’s own chemicals that block pain and elevate mood. Opioids perform the same function as those chemicals, but in a much bigger way. They trigger massive release of dopamine and other “feel-good” chemicals, which is why heroin is capable of producing marked euphoria.

Fentanyl is a synthetic opioid similar to morphine, according to the National Institute on Drug Abuse, used by doctors through patches, lozenges or intravenous injection to manage pain after surgery or treat people with severe pain issues. Pharmaceutically it is available in brand names such as Actiq, Duragesic and Sublimaze.

On the street it is mixed with heroin and the cocktail goes by Apache, China Girl, Dance Fever, Tango and Cash and TNT, to name just a few. It can be shot, snorted, or orally injected.

Current litigation is centered on allegedly aggressive and careless marketing by pharmaceutical companies of pain pills and patches prescribed by doctors for legitimate purposes. People remained addicted and turned to street drugs like the heroin mixtures for maintenance, although the story is not the same for everyone.

Fentanyl can be 30 to 50 percent more powerful than heroin. A heroin user who is unaware that they are also taking fentanyl can easily overdose.

ECSTASY AND AGONY

Sarah Beth Pellegrin knew the struggle well. The single mother of three was full of life, had eclectic musical tastes, and was always ready with a laugh. But the laughs grew less frequent as she sank into a well of addiction, leaving loved ones to puzzle over how best to help.

“We had struggled with this for years and years,” said her mother, Renee Dryden Bertinot.

Jailed on an assault charge, Sarah was discharged into Terrebonne Parish’s drug court program. State District Judge Johnny Walker gave her a rehab option, and Sarah became an inpatient at Phase II in Pineville, where she remained there for over six months.

Renee had custody of the children, and there was hope.

“I was very hopeful,” Renee said. “When she came home she had a very good outlook. She was in a place where she hoped to get her children back.”

There were journal entries where the young woman wrote of plans for the future. Sarah attended meetings of various recovery groups. When she received coins or chips she would proudly show them to Renee. Each one was a building block toward the future that both worked to build together.

But the devil lurked, biding his time.

“The best we can figure is that she began associated with old acquaintances again and she relapsed,” said Renee.

Still under the supervision of the drug court, Sarah failed a drug screen and was jailed for a weekend.

DOWNWARD SPIRAL

Sarah was jailed for a weekend for violating drug court requirements. A relapse group was added to the menu of support services, but Sarah told Renee that there was too much of an emphasis during those meetings on talk of the actual drugs. Sarah struggled with one foot in the world of recovery and the other in the world of people from her past.

“You can’t associate with users who are actively using and stay sober,” her mother said.

Things were looking up by the time April of 2018 rolled around.

From what Renee could see, progress was being made, and Renee saw more of the daughter she once knew.

“Things were looking good again,” Renee said.

On March 29 Renee and Sarah had made a visit to the Social Security office in Houma. Sarah was to pick up one of her children from daycare, and Renee also told her about a job opening she could check out.

Later in the afternoon Renee got a call from the day care. Her granddaughter was still there past her 1:30 p.m. dismissal time. Renee called her sister, Monique Duplantis, who went to their mother’s house on Keith Street in Houma, where Sarah was living.

The door was locked and the lights were on. Sarah’s car was in the driveway.

Monique was still on the phone when she got inside the house. When she entered the bathroom all Renee heard was a loud scream.

“I’ll never forget it,” Renee said.

Houma police officers responded but there was nothing that could be done. Sarah had lived on this earth for 31 years.

“A lot of it comes down to the individual, the recovering person saying I have to cut off all ties to anybody I knew,” Renee said. “When Sarah came out of rehab I was fearful of her coming back to Houma. She had mentioned moving, she said ‘I know exactly where it is. She might have moved but she had to finish drug court. I do know she did not intend on dying that day.”

FRIENDS AND RELATIVES

Problems were just beginning for the woman she had texted with earlier in the day. Examination of her cell phone and information from witnesses led officers to the Roussell Street door of 24-year-old Alexis Trahan, of 1140 B Rousell St. She is currently charged with heroin distribution, but prosecutors are still mulling a homicide charge.

Forensics examination indicated that Sarah died instantly after injecting herself. The substance she used was 100 percent fentanyl, toxicology tests disclosed.

Law enforcement officials find themselves increasingly tasked with choosing whether to charge friends and loved ones with murder or manslaughter in connection with overdose deaths. The shady-looking drug dealer with the luxury automobile, users confirm, is usually not the culprit in many opioid sales, although the substances find their way into the U.S. from shipments originating in China, Mexico and other countries.

A recent case where “friendly” distributors were implicated involved a 2015 drug death involved that of 35-year-old Christy Lynn Hurst, a mother of two, who was found at the Economy Inn on Hollywood Road.

Charles Lindy Hammonds III, then 18-years-old, was charged with 2nd degree murder, as was 27-year-old Shantelle White. Louisiana’s 2nd degree murder statute includes unlawful distribution or dispensing of drugs that are the direct cause of a person’s death. Both pleaded guilty to negligent homicide.

Police agencies are working day and night to take drug dealers off the streets but acknowledge that it often degenerates into a game of whack-a-mole. An arrest is made, large amounts of narcotics can be seized, and new people pop up in their place.

Some comfort is taken in the knowledge that taking quantities of drugs out of circulation, and thwarting those who profit off of misery and death. But they say the laws they enforce in many cases do not carry penalties that act as enough of a deterrent.

“It used to be that you got life in prison for dealing heroin,” said Sheriff Jerry Larpenter. “When that changed things got a lot worse and you have what you have now.”

Lt. Kibodeaux agrees

“Since the legislation changed the heroin statute and lessened the time, from that time on heroin and opiates skyrocketed off the chart,” Kibodeaux said.

SAVING LIVES

The introduction of fentanyl has increased the stakes for law enforcement in other ways. The drug is so powerful that inadvertent contact — such as might occur with officers making arrests or even assisting with an overdose case — can cause illness or even death.

It was initially for the protection of law enforcement officers that a powerful antidote to fentanyl and other opioids came into their hands. But its use has also benefitted the public at large. Sold under brands such as Evzio and Narcan, the drug Naloxone works as a temporary antidote for overdose, blocking or reversing the opioid effects.

Local officers now routinely carry the drug, which is benign and creates no effects if an opioid is not present, provided by the Louisiana Department of Health and Hospitals and Louisiana Attorney General Jeff Landry. Early in May Lafourche Parish Sheriff Craig Webre reported that on two separate occasions that month his deputies saved two lives, the third and fourth instances of deputies using naloxone to reverse the effects of opiate use.

At around 9 a.m. on May 5, deputies found a man convulsing on a shoulder of La. 1 in Larose. They found him to be unresponsive with shallow breathing and saw puncture wounds indicating drug use.

They administered the naloxone with an auto-injector, which works like an Epi-pen.

“A short time later, the man began to take deeper breaths and become more aware of his surroundings. He was transported to a local hospital for further treatment,” Webre said.

The next day a deputy answering a medical emergency call in Gray at a truck plaza, where they found a man on the ground and also learned he had taken heroin before slurring his speech and collapsing.

The next day at about 4:40 p.m., deputies responded to a truck plaza in Gray in reference to a medical emergency. Upon arrival, the deputy found a man lying on the ground near the diesel pumps. During the encounter, deputies learned the man had taken heroin. Deputies learned the man had been talking to a friend when he began slurring his speech and collapsed.

Deputies observed the man to have a very light pulse, shallow breaths, and constricted pupils. The deputy used a naloxone auto-injector. Within minutes, the man became alert and oriented, and he was transported to the hospital for further evaluation.

“There have now been four instances in as many months wherein deputies have used naloxone to save an individual suffering an apparent opioid overdose,” Webre said. “The previous incidents occurred in February and March 2018.”

DOUBLE-EDGED SWORD

A Terrebonne Parish deputy, Julio Escobar, was on patrol recently when he was called to a medical emergency near Mobile Estates in Gray.

“The guy was in the grass and he wasn’t responding,” Escobar said. “I gave him a sternum rub and saw that he was fading out, white as can be with a low pulse.”

Escobar asked a woman who was with the man what happened and she acknowledged that had hit some heroin. He also learned that first responders were five minutes out.

The man, he surmised, did not have much time.

“I ran back to my truck where my pen was and followed the instructions,” Escobar said, describing how he administered an injection to the man’s leg. “He ended up coming back.”

Sheriff Larpenter is pleased that his deputy was able to put the pen to good use. But he sees Naloxone as a mixed blessing.

“We are saving these people but not getting them off the heroin,” Larpenter said. “They are not rehabbing. They are getting out of the hospital and going back to the same environment and so it is a double-edged sword. If you don’t stop it they’ll do it again and again and there will be nobody left to save.”

Saving lives is what families want to do when confronted with the tragedy of an addict in their midst. But they say resources for themselves and the loved one who is addicted are hard to come by.

Kimberly Chauvin has learned through heart-breaking experience with loved ones how difficult coping with addiction can be, and that close relatives play a crucial role in heading off disaster.

“There is no silver bullet,” she said. “Family is needed to be part of the support team. You really need to research the person’s drug of choice, to understand it. Understand what it would take for them to detox and how it affects the brain.”

Most importantly, she said, is to realize that addiction can indeed affect someone in your family, and that there is no absolute immunity.

“People assume that most drug addicts come from horrible homes or horrible families,” she said. “And yes there are some that come from horrible families and there are some that come from families that are not horrible.”

FAMILIES HELPING FAMILIES

Last week about 20 people gathered in a library meeting room, all touched by the addiction of a family member, and trying to determine what they could do to help themselves scope with the tragic aftermath and help others before it reaches that point.

Renee Dryden Bertinot had invited them, through Facebook messages in groups where struggling families meet online, and word of mouth.

“There were people like me who have lost their own children, a couple of moms, and we talked,” Renee said. “We feel lost because there is such a stigma and you don’t want to talk about it, but I am not ashamed of who my daughter was. We tried. I tried to find affordable rehab programs. She got into the state program at Pineville and thank God that she was able to get into that, a few months of her not in the depths of her addiction. We need more funding for quality, affordable rehab.”

Family members hope that by sharing their individual experiences they can be more effective as a group marshaling local resources and getting help that matters, or just helping others cope.

The families ar going to gather again, and Renee is in the process of setting up a locally oriented Facebook page for parents, focusing on the Bayou Region.

Despite the pall that addiction has laid over so many local families, there are success stories.

Starla Pitre has spent the last three of her 38 years keeping her demons at bay. Alcohol, methamphetamine, heroin and pills are all part of her story.

“I lived every day to get loaded,: she said. “I didn’t care about nobody, I just cared about getting high … I was so lost, I was out of my mind … “God kept me in jail as long as I needed to be so that I could learn who I am.”

Today she works at a Mr. PoBoy restaurant, where she was given an opportunity for which she will be forever grateful. Divine intervention, she said, was part of what led her to help and keeps her in check. She successfully completed Terrebonne Parish’s drug court program. She also completed something else — a two-year program at Terrebonne Parish Education.

“Once people start seeing you are doing good they start helping, and they believe in you again,” she said.

Asked if there was one key factor to her success thus far, Starla said keeping away from people and places related to her addiction.

“It is about people separating their self,” she said.

The biggest impediment to meaningful recovery, Starla and others interviewed for this article maintain, is keeping away from the people in an individual’s drug world.

But that can be difficult in a community so small.

That’s what Starla has continued to do, however, that and focus on her new relationship with God, she said.

“I try to keep everything positive, keep the drugs out of it, the alcohol out of it,” Starla said. I just keep it on the positive.”

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