The Other Epidemic

From the New York Times

As the number of Idaho Covid deaths slowly climbs past 2200, the other epidemic still rages. Masks won’t help, but social distancing might, if you stay away from the right people. It is estimated that about 280 people in Idaho died from drug overdoses in 2020.

While we rage about mask mandates, our mainly young (but also some older) folks are dropping off. The US saw overdose deaths shoot up 30% last year, the highest increase ever. The nation-wide death total came to over 93,000. I guess when we are comparing that to Covid deaths (613,000) it’s not that big a deal. Are we getting jaded?

Just as we aren’t really sure how to deal with Covid (those of us who are immunized should wear masks inside now?) I don’t see any single answers for the narcotic issue. Doctors in Idaho now prescribe less narcotics. I think that’s a positive. Back in 2010-2012 Idaho doctors wrote 90 narcotic prescriptions per 100 people. Now we write about 50/100 people. Both numbers are well above the national average. But people have pain and narcotics help acute pain.

But with folks getting less narcotics legally prescribed, the fentanyl-cut street narcotics prove more deadly, and our death numbers climb.

At least our Attorney General Lawrence Wasden has an idea what to do. He joined in a suit with 15 other states against Purdue Pharma and they agreed to settle a couple weeks back. Idaho will be getting some $20M over the next 8 years or so. It is supposed to be used to treat narcotic addiction.

But the Sackler family, founders and main shareholders of Purdue Pharma will still have billions. Wasden testified before congress trying to get them to change the bankruptcy laws that allowed the Sacklers to squirrel away fortunes made on the sale of the popular Oxycontin in the 1990’s. Meanwhile, we wear masks, or don’t and watch as our friends, relatives, and neighbors struggle with addiction.

I’ve seen this from so many sides. I’ve had patients in the ER obviously addicted, faking injuries, wanting narcotics. I’ve seen my physician colleagues prescribe irresponsibly. I’ve had a cousin die of an overdose after getting out of a six-month program. I don’t see any easy answers.

Meanwhile, our clinic has been trying to hire a substance abuse counsellor for three months. We run an outpatient program for narcotic abuse. But the structure requires we have a counsellor to evaluate and provide ongoing therapy our enrollees. So, we’ve been three months without being able to enroll anyone new.

It’s not that the pay is low. We provide good pay, benefits, and work support. I have empathy for rural school superintendents in need of new teacher hires. We’ll keep at it.

Not that our program is an answer for everyone struggling out there either. Some folks find other ways to get back on their feet. I support all recovery.

So, what will Idaho do with this money Wasden has bird dogged for us? I’ll bet there will be some new agencies, maybe more people hired by the governor’s Office of Drug Policy. They are up to 6 full time positions now, with a budget of $5M (almost all federal dollars). Will that help lower the addictions, the deaths, the disease that burdens us?

Fundamentally, I think we are going to have to help ourselves, and our neighbors, our friends, and our loved ones. It’s not always easy to know how.

My cousin would call us every couple of months from the program he was in. He always asked me about my motorcycle. He sounded like he was OK, but I knew he was struggling. We couldn’t go see him. When he got out, he overdosed the first week but survived. The second time was fatal. I didn’t know then what I could do. I’m not sure I do now.

About ddxdx

A Family physician, former county coroner and former Idaho State Senator
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