Opioid epidemic challenges even the most resilient communities

Small towns faced it all and overcame all kinds of struggles, until the opioid epidemic set in.

I grew up in a wonderful town called St Marys, Pennsylvania. St Marys was founded in 1842 as a German Catholic colony by hardy people who left Germany to escape religious persecution. They came to a new homeland in search of a better life for their families, using whatever they had available to make a living. My grandfather, one of those sturdy Germans, raised 8 children in a 3 bedroom house he bought from Sears, Roebuck and Company. The forge where he sharpened the scissors was made of wood from a nun’s henhouse. He couldn’t afford to buy new nails, so he straightened the nails out of his anvil.

Between the late 1800s and the mid-1970s, St Marys experienced an incredible economic boom. The carbon industry has skyrocketed with all the new cars sitting in the American aisles. Many components of these automobiles were made by members of my family in carbon factories. Then, the late 1970s brought auto imports that devastated the economy. The factories closed and the city was suffering, but not for long.

The entrepreneurial spirit of these hard workers manifested, and townspeople began making powdered metal components for everything from automobiles to NASA rockets. At a recent wedding I attended, I found myself discussing retirement. One of my childhood playmates told me he retired 20 years ago when he sold his business and retired as a millionaire at the age of 40. years.

What surprises me is that all this economic development is taking place in the middle of a very sparsely populated riding. The closest 4-lane highway is Highway 80, which is 30 miles away. But residents don’t need the government to build a highway to spur economic development; they can overcome anything. Or, well, almost anything. The stubbornness and tenacity of this population are equal to the scourge which has decimated so many communities: heroin.

I just finished reading a fascinating book called Ripples: effects of drug addiction. This heart-wrenching book was written (unedited) by 19 different people who had their loved ones abducted due to overdoses, mostly heroin. The book is a collection of stories from real people who will never recover from the devastating effects of opioids on their families. Their children have died from this scourge, leaving unfulfilled promises, empty hearts and the stigma of losing a family member to an overdose.

I dispensed naloxone, using the standing orders from former Pennsylvania Health Secretary Rachel Levine, MD, who wrote these orders in 2015. All of my drug-treated patients (MAT) receive a nasal spray of naloxone (Narcan) when I’m on the bench. I also offer a naloxone nasal spray to anyone who is prescribed more than 50 milligram equivalents of morphine, as recommended by the CDC.

A few weeks ago, one of my patients who is receiving buprenorphine came to tell me that he had used the naloxone I gave him earlier in the week to save a 25 year old heroin addict. Of course, I offered him another dose. Many of my fellow pharmacists are reluctant to dispense naloxone for opioid overdoses or buprenorphine for MAT. My prayer is that they never have to bury a friend or relative who died from the scourge of opioid overdoses.

I had the privilege of speaking with a mother who lost a son to an overdose and who shared her story in Ripples: effects of addiction. Like so many of the deaths described in the book, the common thread that bound patients together was the need for mental health services. Families of patients struggle alongside loved ones who suffer from substance use disorders, and in desperate need of a mental health intervention from our health care system.

My hometown, like so many of yours, has overcome so many economic hurdles. The heroin epidemic appears to be the most insurmountable.

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