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Dr. Heather Roe has a front-row seat in watching a generation of parents bury their kids.
She’s an addiction medicine specialist running Harmony Medical Clinic, a facility that specializes in medical treatments for people addicted to opioids, alcohol and other substances.
Drug addiction has been a national concern for years, but she’s seeing a dramatic shift — the drugs are getting more lethal.
“Three years ago, I started to see people come in reporting using Perc 30s — that was the drug used off the street,” she said. “Now, almost 100% of the people I meet are using an opiate in pill form: fentanyl.”
Fentanyl has garnered national attention for its fatal potency. The U.S. Centers for Disease Control and Prevention credited illicit fentanyl for a sharp increase in overdose deaths involving synthetic opioids — killing more than 36,000 people in 2019, a figure 12 times higher than 2013’s total.
Greg Anderson, resident agent in charge for the Wichita office of the federal Drug Enforcement Administration, said the statistics don’t reflect the magnitude of the opioid public health crisis.
“I don’t think we have a true grasp of how much [deaths] have increased,” he said. “Emergency services are not having to respond to every overdose. Not every overdose is going to the hospital to be counted.”
What is harm reduction?
Roe, desperate to save lives, began considering a new strategy prior to treatment: harm reduction.
Harm reduction is a holistic and nonjudgmental approach to providing services to reduce the effects of illicit drug use.
Roe said harm reduction techniques are compelling for putting people who use drugs at the center of treatment and resources.
“You hand out fentanyl testing strips, Narcan kits, issuing safe supply and safe consumption … and you engage with the individual so when they feel ready for treatment, they know who to talk to,” Roe said. “That’s amazing.”
However, Roe said no true harm reduction program exists in Wichita that can provide services to people not interested in help or those not ready to change their behavior.
“I am very hopeful that in the near future, there will be policy changes to allow a much more diverse and meaningful harm reduction program in our community,” she said.
Kansas has some of the highest opioid dispensing rates in the country, according to CDC data.
The state had a 59.8% dispensing rate per 100 people — the seventh highest rate in 2020, meaning doctors wrote enough prescriptions for 64.3% of residents to have one.
How severe is the crisis in Kansas? According to the National Center for Drug Abuse Statistics:
- 156 people died from opioid overdose in one year.
- Opioids are a factor in 45.2% of all overdose deaths.
- 5.6 out of every 100,000 residents die from an opioid overdose. That’s 61.6% below or less than half the national death rate.
Localizing the opioid crisis
In 2017, the U.S. Department of Health and Human Services declared the opioid crisis a public health emergency. That same year, more than 140 people died per day from a drug overdose, according to the agency.
Anderson referred to the issue as a public health epidemic.
“Kansas lags behind the national trend of opioid addiction, however, we’re catching up rapidly,” Anderson said.
In Sedgwick County, opioids played a role in 181 deaths between 2012 and 2017. County commissioners declared the opioid crisis a “public nuisance.”
“We’re seeing a lot of counterfeit drugs here,” Anderson said. “We have a substantial opioid issue in Sedgwick County.”
Drug-associated deaths in Sedgwick County increased by 38% from 2015 to 2019, according to the Drug Misuse Data Dashboard operated by the county’s health department. Opioids, cocaine and stimulants were associated with 83% of the deaths in 2019.
There has been an increase in fentanyl-laced drugs in Kansas, according to data collected by Sedgwick County and the DEA.
“DEA studies show that about 42% of these little blue pills, the fake oxys, contain a lethal dose of fentanyl,” Anderson said.
Fentanyl testing strips, a “drug check” test, is currently considered drug paraphernalia in state law.
Earlier this year, the Kansas House Committee on Corrections and Juvenile Justice sponsored a bill to remove the current classification in an effort to make the testing strips accessible. The amendment passed the state House in February but stalled in the state Senate Judiciary Committee.
The medication to reverse an overdose
Lisa Vayda, a Wichita pharmacist, has advocated for statewide harm reduction related legislation. She played a role in passing a state law giving first responders permission to administer naloxone, a medication that can counter the effects of an opioid overdose sold under the brand name Narcan.
“People who use substances are entitled to basic human rights and services to reduce the harmful effects of substance use,” Vayda said.
“I am a licensed healthcare provider,” she said. “I can give naloxone to someone if I have a prescription for it, but I can’t distribute naloxone in a community event setting.”
Kansas pharmacists can dispense naloxone to patients, family members and bystanders, but only 1 in 4 has signed the statewide protocol that provides guidelines for dispensing it, according to the Kansas Board of Pharmacy.
The state allows pharmacists to provide naloxone to patients, family members, bystanders, law enforcement, EMS agencies and school nurses.
Along with the low number of pharmacists certified as naloxone dispensers, the medication could be expensive for some.
A call to a Wichita CVS found that a single Narcan nasal spray costs $89.99 — with an automatic manufacturer coupon. The pharmacist said they could not see the spray’s cost prior to the discount.
Sedgwick County Emergency Medical Services are experiencing a significant uptick in patients receiving a dose of naloxone. Between January and September this year, emergency responders injected 671 people with naloxone. In 2017, only 291 patients received the medication.
“The overdoses that EMS responds to only represent one portion of overdoses that occur,” Paul Misasi, deputy director of operations for Sedgwick County EMS, wrote in an email. “Some patients are driven to the hospital via private vehicle.“
Misasi said EMS frequently responds to emergency calls in which a person is unresponsive for unknown reasons. In such cases, naloxone may be administered to rule out an overdose.
“If there is no positive response to the medication, one still cannot rule opioid overdose out completely, since response can be dose dependent,” he said.
‘A lot of people are afraid to call’
Vayda also advocated to reform the state’s good Samaritan Law to include nonmedical personnel who intervene in a medical emergency. Currently, the law only protects people with at least some verifiable medical knowledge.
She said people should be able to call 911 for help with a drug overdose without fear of prosecution.
“A lot of people are afraid to call,” she said.
Roe said there is a huge emotional weight on harm reduction providers like herself and those struggling with drug misuse.
Harm reduction strategies can keep people safe until they decide to turn to treatment, Roe added.
Anderson said the opioid crisis is a problem that impacts people — regardless of income or class.
“Everybody in all walks of life in the United States is subject to the effects of this epidemic. We really need to come together to look for creative ways and solutions to help solve it,” he said.
If you or a loved one has an addiction disorder, treatment is available. Call Comcare’s 24 hour crisis hotline at 316-660-7500.
Nationally, you can call 1-800-662-HELP to connect with a helpline for referral and information services. Click here for a map listing substance abuse and mental health centers in the United States.