Giving to Receive
June 1, 2018
IN THE DANCE ONCE MORE
June 1, 2018
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 some-
thing 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 demimonde 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.
In national media, it’s painted as the “opioid epidemic,” and its impacts have not spared the area with several local authorities saying the area has been bit hard in recent months.
At Terrebonne General Medical Center, the number of drugs overdoses steadily gone up in recent months. There was an average of just 2.6 per month from Feb. – June in 2017, but in 2018, that average has climbed to 11 per month.
