Before Tom Price resigned as Secretary of Health and Human Services, he gave the press a startling statistic to describe the extent of the nationwide opioid epidemic.
“We lose a Vietnam War veteran”—in which America lost 58,318 soldiers—“every single year to drug overdoses,” he said.
And Georgia is fast becoming one of the most impacted states.
The White House Commission on Combating Drug Addiction, a federal program established in March 2017 to advise the Trump administration on the best methods to combat the epidemic, recently released its final recommendations on Nov. 1.
The report’s recommendations include an expanded system of drug courts, serving as alternatives to the traditional court system, tighter rules on prescribers, requiring them to renew their licenses more frequently, and a media campaign “addressing addiction stigma and the danger of opioids.” There is also a section dedicated to “Supporting Collegiate Recovery and Changing the Culture on College Campuses.”
The Local Problem
According to an 11Alive investigation, there exists a triangular region—dubbed “The Triangle”—in Georgia stretching from South Atlanta to Alpharetta and Dunwoody in the north which has seen a 4000 percent increase in opioid overdose deaths over the last five years. Data from the Online Analytical Statistical Information System (OASIS), a Georgia Department of Public Health database, appears to back up those findings.
Some of the most acutely affected regions in Georgia, according to OASIS data, include Cobb, Fulton, Gwinnett, and DeKalb counties. In 2016, 108 residents in Cobb County died of an opioid or heroin overdose. In Fulton County, that figure was 130. And Gwinnett and DeKalb saw 61 and 54 overdose deaths respectively. Five years ago, all four counties saw substantially smaller incidences of opioid or heroin overdoses (Cobb, 12, DeKalb, 35, Fulton, 60, and Gwinnett, 31).
The Signal spoke with Jeremy Campbell, the lead investigator of “The Triangle” findings, who said most of the victims are young people. “Opioids are killing people in our nation at a rate similar to the rate of lives lost in [9/11] every three months,” he said. But despite the young lives lost, he added this is a nationwide issue for all ages. “The CDC says 44 percent of overdoses are 45 [years old] and older.”
A Taxing Habit
Georgia State University Police Department (GSUPD) Chief Joseph Spillane said the student body has not shown any warning signs, and police haven’t had to take measures to combat overdose cases.
The department recently acquired anti-overdose shots for such cases, but Spillane said they haven’t had to administer any of the agents for heroin or opioids.
“We have not had to administer Narcan [one such anti-overdose agent] to Georgia State students,” he said. Narcan is administered either by injection into the muscle, like an insulin shot, or by spraying into the nose, like some cold or allergy medications.
Additionally, he told The Signal that it would be unlikely that Georgia State students would be affected because opioid addicts would either not be in school, since those drugs absorb their addicts’ lives completely, or, if they were, GSUPD officers would have already administered the anti-overdose agent and reported that information to the public.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of the U.S. Department of Health and Human Services, a whole host of symptoms characterize opioid addiction, including but not limited to a “strong desire for opioids, inability to control or reduce use” and “spending a great deal of time to obtain and use opioids.”
And aside from the mental consequences, an opioid addiction can be financially paralyzing. A study published in the journal Medical Care estimated the total economic burden to be $78.5 billion for 2013, and that more than “one third of this amount is due to increased health care and substance abuse treatment costs ($28.9 billion).”
Individually, some opioid and heroin addicts spend anywhere from $100 to $375 a day to satisfy their cravings, according to VICE magazine.
In 2015, according to a Kaiser Family Foundation analysis of data collected by the CDC surveying opioid overdose deaths by age group, 11 percent in the state of Georgia were 0–24 years old, 29 percent were 25–34, 22 percent were 35–44, 20 percent were 45–54, and 18 percent were 55 or older.
A Snowball-Effect
The Signal reached out to two professors of public health to touch on the possible causes of the opioid epidemic in Georgia.
Dr. Colin K. Smith, a Clinical Assistant Professor of Health and Management Policy at the School of Public Health at Georgia State, said the problem has been growing with time.
To Dr. Smith, the opioid epidemic is “the result of a system of standards of medical practice and care that has grown over the past twenty to twenty-five years.”
“They are the result of the fact that we spent a lot of time from the early nineties on dealing with patients and medical populations in terms of treating the signs and symptoms, not curing the disease,” he said. “We have spent a lot of time in the healthcare system in the past 25 years worrying about pain management.”
The pain management system served as the perfect breeding ground for a growing addiction. Smith explained that now, when patients run out of the ability to obtain those drugs legally, they turn towards illegal methods.
“What happens from there is when it becomes increasingly difficult for them to obtain prescription drugs illegally, they then go to heroin,” he said.
But heroin abuse as seen today is almost unprecedented. According to Smith, the last time the U.S. saw such a crisis was when war veterans were returning from Vietnam.
Dr. Shanta Dube, an Associate Professor of Epidemiology and Biostatistics at the School of Public Health at Georgia State, offered a different perspective. Her work in the Adverse Childhood Experience Study (ACES), a collaboration between the CDC and Kaiser Permanente, has led her to believe that one possible explanation for the opioid epidemic is adverse childhood experiences.
An example she gave was that of two Lawrenceville childhood friends who both died from an opioid overdose on the same day.
One of them—Joseph Abraham—went through an adverse childhood experience, losing two of his close friends in eighth grade, which compounded into him turning to drugs to cope with that loss. The other, Dustin Manning, was battling depression for years, turning to a litany of drugs before ending at heroin.
