Kirk Seminoff: Combating opioid epidemic takes teamwork

Two recent stories from Ohio – a Cincinnati Enquirer project spending seven days in the world of opioid abuse and a “60 Minutes” report called “Heroin in the Heartland” – put a growing epidemic back in a harsh, harrowing spotlight.

Greg Lakin calls it Monday. Any day, really.

“Come to my clinic for a week,” he said. “You could have a great series.”

Lakin’s Center for Change on North Broadway opens at 5 a.m. daily. Opioid addicts are waiting. They see a counselor and receive treatments.

“Then they can be at their 6 o’clock shifts,” said Lakin, a doctor and state representative in the 91st District representing north-central Sedgwick County. “It truly affects the working class as well as typical drug users.”

Opioid abuse is an epidemic of multiple generations at once, and it’s killing people at alarming rates. The Center for Disease Control says drug overdose deaths have increased more than 2.5 times since 1999. There were more than 50,000 overdose deaths in 2015.

Valley Hope, with five addiction treatment centers in Kansas, has seen consistent numbers of patients abusing alcohol, marijuana, speed, methamphetamines and cocaine. Opioid abusers have gone from 12 percent of admissions to 29 percent since 2009.

Many factors create the epidemic. Cheap and more powerful heroin. Doctors over-prescribing pain medications. Insurance companies moving addicted patients from inpatient to outpatient treatment too quickly.

Opioids don’t play favorites. Race, gender, age, location, economic status and other factors have no part in whether someone can become an abuser.

“That’s what has drawn attention to it now that we haven’t seen before,” said Pat George, president of Valley Hope. “There’s many middle-income and upper-income young people that are dying from this.”

Prescription opioids have been a part of addiction, quadrupling from 1999 to 2010. People getting over injuries or painful dental work receive prescriptions for 30 days of painkillers when the dosage used to be smaller.

“About half of the (addicts) in this town started off on pain pills,” Lakin said.

When the prescription runs out, many addicts turn to heroin coming from Mexico and both coasts. The addiction rate increased as the drug was mixed with synthetic drugs fentanyl and carfentanil, creating a stronger high.

It takes many to combat the disease. Law enforcement separates addicts from bad guys. Pharmacists use a nationwide registry to see if patients are receiving medication elsewhere. Doctors weigh how much pain a patient is feeling before writing a prescription.

There’s more work to be done at the legislative level.

Treatment centers can keep opioid addicts as long as their insurance allows before being moved to outpatient treatment. George said of 53 payers in Kansas, 51 have an average inpatient stay of 19 days. One has 24 and another has nine.

Nebraska’s average stay is 24 days. George jokes addicts are no better or worse in Nebraska than Kansas, but they get more treatment.

George, a former state representative and commerce secretary, is working with legislators on a bill similar to what New Jersey enacted this year. It would mandate minimum coverage requirements for inpatient treatment and restrictions on prescriptions of opioids. Lakin, a Republican, said he would help try to push it through.

“(New Jersey) took the care of the mental-health patient out of the insurance company and put it in the hands of the doctor,” George said. “It costs taxpayers less when you take that long-term approach.”

He hopes to find a receptive legislature, which he thinks is hearing more from constituents.

“Nothing is more convincing that a parent who comes to you and says his son is an addict,” George said.

Lakin, who said he treats more addicts than anyone in the state, sees it from many angles – doctor, lawmaker, former police officer, former prosecuting attorney. He acknowledges the legislature’s role, but it’s only a piece of a complex puzzle trying to catch up to a growing disease.

“We do have to work together,” he said. “We all have a little different agenda and a little different idea.”

This story was originally published September 22, 2017 at 6:18 PM with the headline "Kirk Seminoff: Combating opioid epidemic takes teamwork."