A Nation Addicted Part 1: How We Got Here

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A new study conducted by the Center for Disease Control reveals that our nation’s opiate epidemic grew exponentially worse over the past decade and a half.

Among the most harrowing of the findings are data that indicate Americans are dying from drug overdoses at twice the rate they were in 1999. In 2015, 16.3 out of every 100,000 people in the United States fatally overdosed on drugs — a spike of more than 250% over the last 16 years.

Percentage of total overdose deaths over a 15-year span, categorized by drug. Courtesy of the CDC

During the last seven years, the drugs fueling the elevated number of overdose fatalities nationwide have changed. Natural and semisynthetic opioids like hydrocodone and oxycodone accounted for nearly 30% of fatal drug casualties in 2010; heroin claimed 8% of overdose victims during the same period. Now, heroin is the number one killer, responsible for 1-in-4 drug fatalities. The semisynthetic opioids still represent a large chunk of the overdose deaths at 24%, and their drop in market share of overdose fatalities is most likely due to more people finding the cheaper alternatives in fentanyl or heroin than an actual reduction in opioid abuse. Uppers such as cocaine and a wide range of psychostimulants accounted for roughly one-quarter of the overdose fatalities at 13 and 11% respectively.

Opiate addiction doesn’t discriminate by age. The data from the CDC study shows that from 1999 to 2015, overdose fatality rates increased across each age demographic. Surprisingly, the most substantial jump in overdose deaths was the 55-64-year-old group, which saw an increase of 17.6 fatalities per 100,000 people.

Heroin fatalities have tripled throughout the duration of the study, further cementing the fact that our country is embroiled in a deadly battle against a poison that we won’t win easily. By continuing the War on Drugs for over seven decades and allowing Big Pharma to infiltrate the medical community and drive up prescriptions, we’ve created the perfect storm for overdose deaths.

According to a 2014 report by Express Scripts on global opioid use, Americans consume about 80% of the opioid painkillers on the planet though they account for just 5% of the total population. That means $19.2 billion of the $24 billion global opioid painkiller market’s revenue is generated within the United States. If you look at hydrocodone specifically, Americans consume 99% of the entire world supply.

In 2002, the Hartford Courant ran a series of articles focused on Willimantic, a small Connecticut town that had been overrun with heroin. “Heroin Town,” which spawned a documentary and garnered nationwide news coverage, showed millions of people a scene they may not have realized was playing out in rural America.

Three blond women hurry past a kids’ soccer game to the quaint gazebo in Jillson Square, a traditional New England green framed by a white-steepled church and historic stone house.

Michelle Missino, Jessica Canwell and her sister, Amy-Lee, are itching to shoot up the $10 bags of heroin two of them just bought with cash from a few quick tricks. They escape the late August sun and plunk down cross-legged on the cool wood floor. Missino wraps her arm tightly with a cloth tourniquet to raise a vein, tapping her feet in anticipation.

Almost in unison, the women plunge their needles into the good veins they find between rows of purple-red track marks. They loll in the powerful high of the unusually strong dope, then head for the public water fountain. They pass an old man taking a break from his bicycle ride on a nearby bench, and wash the blood from their syringes as casually as if they were doing dishes.

This is a heroin town. Small, rural, open, friendly — and hooked.

While the heroin epidemic was already well under way, it had just begun to stretch its tentacles to smaller communities not traditionally permeated by the darkest side of the drug trade.

We spoke with Tracy Gordon Fox, the Courant reporter who exposed Willimantic for the ‘heroin town’ it truly was, to gain insight into what the epidemic looked like at that time. Fox is now a Nurse at St. Francis Hospital in Hartford, CT where she sees the effect of the opioid epidemic up close and personal. As a reporter who covered the early stages of the painkiller crisis and a nurse who cares deeply about the well-being of her patients, Fox’s perspective on the matter is a unique one.


Marijuana.com: You saw the opioid epidemic firsthand more than 15 years ago when it was just gaining momentum. Did you ever foresee it getting this much worse?

Tracy Gordon Fox: No, I didn’t see it getting this bad or widespread. But now when I think about it, I can see how easily it would. In other words, when we went out there to look into that story, we were seeing a lot of rural kids addicted to heroin. The story was always the same: they had an injury, were put on opiates, and got addicted. Then, they would gradually move on to heroin.

There was no indication to me that it would get so much more widespread in so many communities. I think what was different from what we’re seeing now is that you can get heroin in every community. Before, there were areas with reputations where you could find heroin; you could go to Hartford, you could go to Willimantic. Now, it is everywhere. That’s why we’re seeing so many overdoses because it has taken off like crazy. There were addicts out there at the time that warned us about this, they said it was going to happen. They told us, “You’re going to see it get worse,” and they were right. To answer your question, I never thought it would get this bad, though. I now live in Colchester, a very rural community of about 17,000 people, and heroin is prevalent. My older kids know a handful of classmates that have overdosed. I think where parents went wrong, and it’s certainly not their fault, was not fully understanding how addictive opiates are. A lot of the time, that aspect isn’t even made clear to them, and then all of a sudden… bam, you have a kid that’s addicted to opiates.

When we went around and interviewed people who were addicted, there was this one girl from Chaplain, this tiny farm town. This girl was a three-sport athlete at the local high school when she suffered a severe knee injury that required surgery. She couldn’t play any sports her Senior year as a result of the injury and became addicted to the opioid painkillers she was prescribed for her knee. When I met her around 5 years later, she was a toothless prostitute selling her body on the street for doses of heroin. That story right there is all you have to say about the opioid epidemic, it’s insane. That frightened me, and I always talk to my kids about that story because it demonstrates just how easy it is to become addicted. I just don’t think enough parents associate legal painkillers with that scenario. For a long time, the pharmaceutical companies tried to downplay the addictive nature of these drugs to doctors, but now we know better. They contain the morphine molecule, so how could the drug not be addictive? Back then, I thought, “Oh, it still has to be a certain type of kid that will get addicted.” Now I know that was shortsighted to think it wouldn’t spread.

Marijuana.com: As a parent, how do you think the legal status of a drug affects how parents discuss it with their children?

Tracy Gordon Fox: Some parents think marijuana is a gateway drug, and it is in the sense that if you go to an illegal dealer, there’s a good chance that dealer isn’t just selling marijuana. I think eventually that dealer is going to say, “hey, try this.” From that standpoint, there is a risk; you don’t know where it came from or what is in it. If marijuana was legalized everywhere, I don’t think it would have that same ‘gateway’ effect any more than alcohol does. When we highlighted that story, we tried to show how a small middle-America town could become inundated by this drug. The problem got worse mainly by being dealt with in an enforcement manner rather than dealing with the crux of the issue, figuring out why kids were getting addicted. The other big message that was lost on parents was if you have these pills in your house, get them the hell out of reach of your kids. Parents leave this stuff around in a medicine cabinet, which is insane. Kids are getting into them and getting addicted. If you look at the process of morphine addiction, once it takes hold it isn’t the user’s fault. It’s very hard to get off of it once you’re on it. Parents have to open their eyes to everything that is around them, including this opioid epidemic. Their kids are at risk, all of our children are at risk. The kids I was seeing who were addicted to heroin were just regular American kids. But some parents are just blind to it because they haven’t seen it. Teenagers don’t tell their parents what is going on, they usually hide things. The only way you stop addiction among the kids is to slow down the pediatric opioid prescriptions.

Marijuana.com: You touched on how this problem was dealt with using enforcement. How instrumental was the ‘War on Drugs’ in perpetuating this heroin problem?

Tracy Gordon Fox: I don’t think illegal marijuana dealers should go away for a long time, that’s stupid. But with heroin, it’s killing people so I do think you should go to jail for giving someone a fatal dose. You are putting the community at risk by selling this potent drug. If we’re going to have a war on drugs, let’s at least have a war on the right drug. I originally became interested in covering the heroin story by talking to a state cop.

Marijuana.com: How were police dealing with users regarding possession back then?

Tracy Gordon Fox: They were just arresting them. The users would go to jail for a little bit, then get out, and create this endless cycle. They weren’t arresting everyone because there was a lot. The hotel we looked at for the story was within a stone’s throw from the Willimantic Police Department and the place was full of heroin, so they didn’t arrest everyone, but the people they did would go in the system. They weren’t treating the heroin problem as a medical issue, they were looking at it as strictly a law enforcement problem. We warned the addicts living in the hotel that once the story broke, the cops were going to come through there with a vengeance because it will make them look stupid — and they did. In fact, we warned the two sisters we followed for 3 months to get out. One of them did, and the other one did not. The sister that stayed was arrested after the story came out. I was so upset with the cops for that because it just felt like they were punishing her for talking to us, whereas I felt like she was brave to tell her story.

Marijuana.com: Who is to blame for the over-prescription of these opioid painkillers?

Tracy Gordon Fox: I read a book that detailed what the medical community was originally told about opiate painkillers, specifically oxycontin and oxycodone. One of the drug companies ended up paying a huge settlement for misleading doctors about the addictive qualities. One of the studies the drug companies cited in the case used only cancer patients. Well, cancer patients are a different animal when it comes to opioids. We put people on morphine drips and high doses of Dilaudid because they are sick with a terminal illness and addiction isn’t your first worry. There’s a huge difference between that patient and a kid with a broken leg. The drug companies are out to make money.

Marijuana.com: Do you think programs like D.A.R.E. could have done a better job of warning youth about the dangers of opioid addiction?

Tracy Gordon Fox: Where I think D.A.R.E. goes wrong is that it starts in the 5th grade, and at that age, kids are still very friendly with the officers that come in. But after that, the cops stop coming in, they lose their connection with the kids. I’d like to see schools have more resource officers that come in and bring addicts to the school to talk to the kids about their struggle with drugs. The kids need to hear these people explain how they got addicted and what it did to their lives. Right now, the education starts, and then it just goes away.

Marijuana.com: Can you go into more detail about how your perception of that world changed after working on that story?

Tracy Gordon Fox: I used to have this image in my head of a drug addict being a criminal, but when I met these people I realized they were victims, not criminals. They don’t know how to get off of the drug, most didn’t have their family’s support. I learned not to judge, and that is hard for a lot of people. They still look at addicts as dirtbags or whatever, but they are just people who have gotten addicted.


So if law enforcement and the rehab community cannot stop the scourge of opiate addiction, is there any hope? Maybe.

Many believe that medical marijuana could provide much-needed assistance in choking out the opioid crisis on multiple fronts.

First, opening up access to legal marijuana offers patients an alternative to far more harmful drugs that they may not have considered previously. Multiple studies have been conducted in recent years that show states with legalized marijuana not only prescribe fewer prescription painkillers but also see less overall opioid use, and subsequently fewer overdose fatalities. Let this sink in for a second: states with legalized medical marijuana experience an almost 25% lower average annual opioid overdose death rate than states without such legislation.

Secondly, marijuana can offer immense relief to those who are already hooked on opiates and are trying to rid themselves of the addiction. Because of the tortuous process an addict faces on the road to recovery, many slip back into the cycle of addiction to escape the intense physical pain of withdrawal. A 2013 study published in the American Journal of Addiction came to the conclusion that addicts who used cannabis to combat their opioid withdrawal experienced less severe symptoms as a result.

In Part 2 of A Nation Addicted, we’ll speak with Dr. James Feeney, the Connecticut trauma surgeon leading a revolutionary research study that could prove medical marijuana’s viability as a replacement for the opioid painkiller.

Cover Image Courtesy of Allie Beckett

About Author

Did the radio thing for a while before writing about music for Genius, Complex, XXL, Elevator, HotNewHipHop, and more. Follow @LongLiveTheDuke on Twitter if you're feeling like you don't want our connection to end right this very moment.

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