City holds public discussion on opioids

Kile Brewer
Posted 6/20/18

GREEN COVE SPRINGS – Drug abuse will always be a problem.

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City holds public discussion on opioids

Posted

GREEN COVE SPRINGS – Drug abuse will always be a problem.

Trends change, the drug of choice changes, but there will always be users and dealers ready to buy and sell. In Green Cove Springs, however, recent steps taken by the City Council and Green Cove Police Department look to curb use in their city through community initiatives and a focus on education.

“We have some great practitioners in the area to be able to put some knowledge out there and help us understand the crisis we’re seeing with opioid addiction,” said Police Chief Derek Asdot June 16 when introducing the panel at Green Cove Springs City Hall.

This was the first opioid town hall meeting held by the city, primarily to serve the council and city staff with information that they can use to try and create some positive change in what is commonly referred to as an opioid crisis.

Opioids, the catch-all term for poppy-based opiates such as heroin and opium as well as synthetic alternatives to these opiates like hydrocodone, oxycodone and fentanyl, are the most recent trend in users’ drugs of choice. In the last few years, use in Clay County and Green Cove Springs has been on the rise, but recent crackdowns by area law enforcement and changes in the drug climate have caused a recent downward turn in the trend.

“I can’t address the addiction part of the issue, but what we see as part of it is the consequence of the addiction,” said Lorin Mock, Clay County fire chief.

Mock’s numbers come from the administration of Narcan by his paramedics when responding to medical calls. When a trained first responder issues a dose of Narcan, they are trying to save a patient from a potential opioid overdose.

According to Clay Fire and Rescue numbers, Narcan administration saw the biggest increases countywide, and in the city, from 2015 through the end of last year. In the county, use of Narcan increased from 330 cases in 2015, to 443 in 2016 and peaked at 517 last year. Locally, within the Green Cove Springs city limits, the numbers were 50, 51 and 79 cases. This year, however, Mock said that the county is on pace to see a decrease for the first time since use of Narcan became commonplace.

The drug, a nasal spray, is made up of molecules that push the opioid off the brain's receptors, causing immediate relief from the respiratory failure caused by opioid overdose. In recent years, Narcan has become a mandatory item for all first responders as the drug fentanyl – cheaper and up to 1,000 times more potent than heroin – has crept into the United States. It is then cut with the more expensive heroin powder and sold to unassuming users. The user will never see it coming when they prepare their usual dose, not knowing what they are about to ingest is potentially 1,000 doses at once.

“Fentanyl has really changed the way we do business in law enforcement,” Asdot said, citing that all officers carry Narcan not just to revive a citizen who might have overdosed, but also to protect their fellow officers from casual exposure via inhalation during a routine drug recovery at a traffic stop. “It’s incredibly dangerous.”

In addition to Asdot and Mock, the city invited three medical professionals from Orange Park Medical Center to provide information from their end. This included Emergency Services Medical Director Steve Goodfriend, Pharmacy Director Jodie Graves and Orange Park Medical Center Chief Medical Officer Joseph Parra. The doctors talked about trends in the hospital, and the ER, concerning opioid cases, including their timeline of how the opioid crisis came to be.

“We are somewhat accountable for this,” Goodfriend said. “It was the wild west. It was the wild west for opioids.”

Goodfriend discussed the “pill mills” that started popping up a handful of years ago. Some of the less-ethical doctors were essentially taking in patients and giving them whatever drugs they asked for, without any fear of consequences. Eventually that subsided, with legislation that limited a patient’s maximum supply of opioids to seven days’ worth at a time without needing another handwritten prescription.

Things have changed and doctors are keener on the lies their patients tell them to get prescriptions, and incidental addiction is carefully avoided by limiting opioid use during surgery recovery. However, that only paved the way for more illicit drugs like heroin to make a quick comeback after being on the backburner of the drug trade since the 1990s. Once heroin use increased, dealers started looking for cheaper alternatives, and then fentanyl overdoses began showing up as the potent synthetic opioid started coming to America from China or Mexico.

Council member Van Royal asked the panel of physicians what can be done to curb the problem.

“There is a little bit of good news out there that ERs are down, responses, even in our own communities, are down. But realizing that there’s an underpinning problem, depression and those kinds of things, is there anything we can do as community leaders?” he said. “In this crisis I’d like to think that we may have an opportunity to make that difference as a community. We understand that there’s a problem there and we would like to be a solution as a community.”

The doctors agreed that Green Cove Springs is on the right track, specifically through its increased focus on community outreach and city-sponsored events at Spring Park and Vera Francis Hall Park. They said that in getting people outside, and socializing, is the best thing for those who normally stay inside feeling depressed and using illegal drugs. It’s certainly not an immediate solution to the problem, but showing people they are part of something greater than themselves seemed to be the best suggestion at how a community can tackle these problems.

Education also came up, including getting information on the city website and around town about local organizations that are there to help people going through addiction and mental health issues such as severe anxiety and depression that sometimes lead to drug abuse. Goodfriend discussed programs that take former drug users and assign them as counselors to current users, to let them know that they can stop using and get their life back on track.

“They’re people who can connect with them, they understand, they have empathy for it, they know how it is. I can’t say I can connect as well as someone who’s been in their shoes before,” Goodfriend said. “Before it used to be: criminalize it, and we’ve found out we can’t arrest our way out of this. I think having empathy and understanding how powerful these drugs are combined with someone who doesn’t have as much self-control.”

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