Wednesday, January 4, 2017 / The Statement
4B
Wednesday, January 4, 201 / The Statement 
5B

The personal 
and painful 
of the opioid 
epidemic

M

onths ago, when I was assigned 
a story on the opioid epidemic, 
I was confronted with an 

entirely foreign concept: I didn’t even know 
if opioids were injected or ingested. And 
this was an epidemic? I couldn’t begin to 
understand how overdose deaths could be 
happening in my community.

On 
November 
23, 
I 
attended 
a 

community-wide event at St. Joseph Mercy 
Hospital in Ann Arbor that addressed the 
opioid epidemic and how to fight it, hosted 
by the Ypsilanti based addiction non-profit 
Dawn Farm.

From my aisle seat, I watched the 

auditorium fill with Ann Arbor and 
Ypsilanti residents, college students and a 
few families with younger kids. I watched 
intently, ready to scribble notes on trends 
in age groups, gender, appearance, or race. 
To my surprise, none of the categories 
followed a specific trend — there were 
no similarities among the people I saw 
whatsoever.

I was struck. There were people from all 

walks of life who were dealing with an issue 
in my community I hardly knew existed.

What I found was that in 2014, within 

Washtenaw County alone, there were 
65 reported opioid deaths according to 
the Washtenaw Health Initiative Opioid 
Project. Across the US, there are 78 deaths 
from opioid overdoses a day, putting the 
country at an all time high for opioid 
overdose deaths. This wasn’t another story 
which could be shoved aside for a later read, 
but something happening right now.

Opiates are a family of drugs for treating 

pain and affecting emotions. Common types 
include morphine, heroin, hydrocodone, 
and oxycodone, all of which are addictive. 
Opiates are commonly prescribed for 
suppressing pain after surgery, trauma, and 
various injuries.

At the event, I learned of the dramatic 

rise in opioid-related deaths in 2014, which 
spiked nationwide efforts to reduce this 
number, creating with initiatives such as the 
WHI Opioid Project and other public health 
models specific to overdose prevention 
and resuscitation after overdose. In some 
ways, it’s working. In 2015, there was a 25 
percent decrease in opioid overdose deaths 
in Washtenaw County.

The 
numbers 
may 
have 
decreased, 

but forty-nine deaths is still an all too 
significant number.

The forum, and conversations I would 

later have with a number of its speakers, 
informed me of how Washtenaw County 
is currently responding to the problem. 
WHI’s new public health-based model 
has raised local awareness for a national 
crisis, sparking community action among 
the police force, healthcare administrators, 
and overdose subject bystanders, who often 
play a critical role as first responders, 
saving lives. Saving lives is the goal: since 
August of 2015, more than 96 Washtenaw 
County police officers have been trained 
in the administration of naloxone, an 
opioid overdose reversal drug. And there 

have also been community classes on 
naloxone use, and the medication can now 
be co-prescribed to family and friends who 
are concerned of loved ones overdosing, so 
911 isn’t the only way to keep victims alive.

What was most surprising to me as 

a pre-health student was how little I 
knew about this prevalent problem, often 
rooted in the health industry, which was 
not only affecting the country as a whole 
but rampant in the community I lived 
in. Emotionally, the issue is comparably 
devastating to alcohol overdose or suicide. 
A death is a death. But I never encountered 
any information — no pamphlets, no emails 
— about the issue beforehand. For such a 
crisis, I was totally unprepared.

One of the speakers, Ashton Marr, is 

an Ann Arbor resident who has been in 
recovery for 12 years. When she was 19, she 
was prescribed Vicodin after an emergency 
appendectomy and from this introduction, 
her life began to spiral around opiates.

She sat in front of the auditorium with 

her purple Mohawk and matching color 
parka, among a panel of physicians, nurses, 
police officers, and other recoverers. When 
one of the audience members asked if the 
availability of an overdose counteractive 
drug would make opiate users likely to 
overdose just to be resuscitated, creating 
a false sense of security, Ashton shook 
her head. The row of silver hoops on her 
earlobes reflected against the spotlight, 
sending shards of light through the 
auditorium. When she spoke her voice was 
deep, but melodic.

“From my own experience in going 

through addiction, that thought never 
crossed my mind once and that certainly 
wasn’t the goal either. If naloxone knocks 
the opioids off of opioid receptors, then 
you eventually become dope-sick and that 
certainly wasn’t the goal,” she said. Opioid 
and heroin withdrawal symptoms are often 
referred to as “dope sick,” which urges the 
abuser to continue drug administration to 
combat discomfort. The symptoms include 
depression, anxiety, intense cramping, 
bone and muscle pain, involuntary leg 
movements, cold flashes, among others. 
“I was trying to tread the line between 
life and death, I wouldn’t want naloxone 
administered.”

Since her introduction to opiates after 

surgery, Ashton said the intense craving 
for more frequent and larger doses, a bigger 
and better high, began to consume her. As 
she entered community college, she isolated 
herself from her family and friends, mostly 
living from her car, miserable and ashamed: 
“It was like it just took over my life and 
my mind, and I really was up and running 
with opioids. I truly believed I was the only 
heroin addict in Ann Arbor.”

The chase for the ultimate high, the brink 

between the conscious and unconscious 
seems to be a mutual driver for continued 
users, and often the direct reason for 
overdose. And more surprisingly, the 
other common intersection between users 
and overdose survivors is the beginning 

of their addictive trends. The majority of 
opioid addiction start from a sports injury 
or general surgery where opiates are 
prescribed to alleviate immediate pain. 
The patient never gets weaned off the 
medication properly, instead developing a 
dependence on pain suppressors.

Another speaker at the panel, Stephen 

Strobbe, is a practicing nurse and founder 
of the WHI Opioid Project. Throughout 
the talk, he suspected a fundamental issue 
in the prescription system to be a leading 
cause for excess prescription and eventual 
drug misuse. According to Strobbe, there 
are enough written opioid prescriptions 
for each adult in the United States to have 
a bottle for themselves. When I mentioned 
I was a pre-health student at the University 
during our phone interview the morning 
of the panel, Strobbe said he would stay 
after the event to answer all questions – 
going above and beyond from personal 
to research to data-based inquiries – to 
spread awareness on the opioid epidemic. 
During our conversation, he reaffirmed 
the absence of stereotypes in the epidemic. 
There is no “type” for opioid users who 
experience addiction and overdose, besides 
being prescribed a medication, failing to be 
weaned off and then suddenly being in the 
middle a downwards spiral, often with no 
knowledge of who to go to for help.

Marr raised similar concerns on the 

prescribing behavior of physicians. After 
the forum, we sat in two corner seats of 
the empty auditorium. Like Strobbe, she 
offered to give any information to increase 
the public knowledge on the epidemic and 
its severity. “I’ve heard time and time again 
that it’s easier to write the prescription, 
as opposed to getting into conflict with 
somebody or fighting about it,” she said. 
“But the fact of the matter is they have 
the hand in the individual’s death if they 
let the addiction spiral. Doctors are in a 
position where they need to do no harm and 
give care to people, so it’s important that 
they understand how to treat addiction, 
recovery-related resources, how to safely 
prescribe to people, and how to treat pain.”

The physician-patient relationship plays a 

vital role in continuation or discontinuation 
of medication following a painful event, and 
the doctor’s choices can be the rate-limiting 
step to the addiction narrative. A majority, 
if not all, practicing physicians will at some 
point prescribe pain medications to their 
patients. One of the seeds to the epidemic 
could be immediately addressed in the 
hospital, but also the medical schools and 
undergraduate populations who will be the 
next prescribers within five to ten years. 
However, it may also be worth opening a 
discussion how much responsibility the 
doctor has over the patient. It cannot 
entirely be the doctor’s fault if the patient 
decides to misuse their prescribed dose, 
and the doctor cannot always neglect the 
patient of pain medication to alleviate their 
symptoms. These ethical questions do not 
have a simple answer to solve the problem.

So clearly I never pictured a reality where 

opioid addiction and overdose death was 
something real and proximal, something 
that could affect my relatives, family or 
friends.

A 
majority, 
if 
not 
all 
practicing 

physicians will at some point prescribe pain 
medications to their patients. One of the 
roots of the epidemic could be immediately 
addressed in the hospital, certainly, but 
also in the medical schools and even 
undergraduate programs, whose students 
will be the next prescribers within five to 
ten years. But it may also be worth opening 
a discussion of how much responsibility 
the doctor has over the patient. It cannot 
entirely be the doctor’s fault if the patient 
decides to misuse their prescribed dose, 
and the doctor cannot always refuse the 
patient pain medication to alleviate their 
symptoms — in many cases it is necessary. 
These ethical questions do not have a 
simple solutions.

Strobbe 
said 
another 
common 

intersection between users and overdose 
survivors is the beginning of their addiction. 
The majority of opioid addictions start 
from a sports injury or general surgery, 
when opiates are prescribed to alleviate 
immediate pain and the patient never 
gets weaned off the medication properly, 
instead developing a dependence on pain 
suppressors.

In light of all of this, I picture my best 

friend. I picture her brown ringlets of 
effortless curls falling down her shoulders 
and the black-rimmed glasses she wears 
that rest on her cheeks. The studious one 
of all of us, who has (maybe) gotten one B 
in college, organizes all of our volunteer 
events for the fraternity, and laughs five 
times more often than she frowns.

I never realized that she dealt with this 

crisis first hand. Again, an epidemic so 
widespread was lost to me. 

This makes me sift through my entire 

memory since the day I met her, the things 
we talked about, the secrets we shared. It 
never occurred to me that her own sister 
was a victim of this crisis. That she was a 
part of this silenced group, when she was so 
present in my life.

I told my best friend about this article, 

and I asked her about the issue at hand: the 
pain which leads people across the country, 
across the world, to opioid addiction.

“I’ve really never thought about it before. 

I guess it’s different for everyone, like the 
origin of it,” she said. “But it’s the twisting 
torment, that’s builds up in your stomach 
and leaks into your heart and head and eyes 
until it’s all you feel, see and think about. 
It lays dormant until you think it’s gone, or 
at least a little less, and then a tidal wave 
of emotions hit and it’s like, you’re there 
again, at the very first moment you felt it. 
It’s always with you. I think we just learn 
how to control it, regardless of its love or 
loss or whatever else it stems from.”

You can’t tell me Tylenol will take that 

away.

What
Pains
Me:

b yYo s h i k o I w a i

D e p u t y M a g a z i n e E d i t o r

