Opioids in Campbell County: A hopeful future

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By Crystal Huskey

There are a host of questions left following this series on opioids and their effects on Campbell County: are local doctors over-prescribing? Are any local businesses offering addiction recovery programs? Are there alternative, out-of-the-box treatment plans that have not been tried yet? Is the current overdose fatality count accurate? With every article, new questions pop up.

Despite that, a number of things have taken place over the past week that should have a powerful effect on ending the opioid epidemic locally. On Sept. 29, District Attorney General for the Eighth Judicial District (which includes Campbell County) Jared Effler, along with a number of other DAs and the guardians of two babies, filed a lawsuit against five pharmaceutical companies, a pain clinic, the owner of the pain clinic and two drug dealers.

“We’ve been working on this for quite some time,” said Effler. “We’re optimistic about our chances of winning. What we hope to gain by this is to recover monetary damages to cover expenses the government has incurred, like increased law enforcement and increased incarceration rates.”

The lawsuit states that “for decades to come, the police departments, schools, district attorney’s offices, hospitals, doctors, insurance companies, TennCare, and the taxpayers of the State of Tennessee and the Opioid Epidemic Affected Counties, will bear the financial burden of the Defendants’ campaign to addict America to opioids.”

There are a few differences in this lawsuit versus the one that was filed in Sullivan County earlier this year. For one, the U.S. Department of Justice has identified the I-75 corridor as one of the main drug trafficking corridors, according to Effler. All the DAs in this lawsuit are geographically connected to the I-75 corridor and represent 15 counties.

“That’s the common denominator,” he said.

The text in the lawsuit concerning the corridor says: “Interstate 75 has long been known as a drug corridor, and represents one major path of transportation for the illegal opioid market. In 2006, the United States Justice Department identified Interstate 75 as one of ‘eight principal corridors through which most illicit drugs and drug proceeds are transported to and from market areas’.”

A few answers

One of the statistics released by the CDC concerning the number of opioid prescriptions per person in Campbell County was perplexing. How can we have 1,900 prescriptions per 1,000 people?

“That’s evidence of the opioid epidemic and that we’re at the center of that,” said Effler. “When we look at opioids per capita, two of the counties in the 8th district rank in the top ten; Campbell ranks as the third highest in the nation and Claiborne ranks as 6th. We think it gets back to the practices of the defendants, the manufacturers, and we believe there needs to be some accountability. This is the biggest public safety issue that I’ve encountered since I became DA (2014).”

Represented in the lawsuit are two infants, both from Campbell County. Baby Doe #1, as the baby is referred to in the lawsuit, was born to a mother who was addicted to opioids.

“Baby Doe #1 is a victim of the opioid crisis,” reads the lawsuit. “He was born addicted to opioids, diagnosed with Neonatal Abstinence Syndrome (NAS), and forced to endure a painful start to his life: crying excessively, arching his back, refusing to feed, and shaking. His mother, Mary Doe, did not start out as an addict. As a result of [pharmaceutical company’s] fraudulent schemes, Mary Doe’s community in the Appalachian region of Tennessee was awash in opioids, fueling a dramatic increase in those exposed to and addicted to oxycodone, hydrocodone, Percocet, OxyContin, Roxicodone, Opana, and other opioids.”

Mary’s addiction, according to the lawsuit, started when her mother gave her Roxicodone to help with joint pain. By the time she was 18 years old, she was fully addicted. When she discovered she was pregnant a few years later, it was too late to prevent her baby’s addiction. The baby is represented by his court appointed guardian Ad Litem, Robert Asbury.

Baby Doe #2 was born in Campbell County at home, addicted to drugs. Asbury also represents him. On the day of the baby’s birth, the mother injected herself with Opana, and then almost immediately went into labor. His aunt and uncle delivered him, three weeks before his due date. He was then taken to Indian Mountain Hospital in Jellico, where he was diagnosed with NAS. He continues to suffer from numerous health and behavioral issues to this day, according to the lawsuit, and his guardians “worry that he will have lasting learning disabilities as a result of his drug dependency en utero.”

The suit alleges that these two babies “are two of thousands of innocent infants victimized by the Manufacturer Defendants’ campaign.” In 2016, 26.2 out of every 1,000 babies born in East Tennessee were diagnosed with NAS.

According to the Tennessee Department of Mental Health and Substance Abuse Services, the number of Tennessee babies born with NAS increased tenfold between 2000 and 2010.

How are the pharmaceutical companies to blame?

According to the lawsuit, which is supported by dozens of anecdotes, news stories and reports, prescription opioids like hydrocodone, Percocet, OxyContin “have never been proven appropriate for the treatment of chronic pain and other non-acute medical problems.” Despite the widespread use of these medications, there is no significant evidence to support their use, according to the National Safety Council. No evidence exists to support long-term use – anything over four months – to treat chronic pain.

And, they are highly addictive. The pharmaceutical companies claimed they weren’t. The lawsuit alleges that “Tennessee’s opioid crisis is not an accident: it is the result of a conspiracy of the [pharmaceutical companies] to fraudulently convince physicians that opioids carried a low risk of addiction and were therefore appropriate for non-acute problems like chronic pain.”

There was an aggressive, concerted effort, according to the lawsuit, to promote the drug to doctors. They used fraudulent claims like claiming that OxyContin provided 12-hour relief. Purdue Pharmaceuticals later even admitted that claim was false. Because it did not prevent pain for 12 hours, patients had to take more pills, increasing the risk of addiction.

The lawsuit is over 100 pages, providing huge amounts of evidence to back up their claim that the companies had a knowing, active hand in the current opioid epidemic.

State representatives take action

On Sept. 26, Tennessee State Representatives released a report with recommendations aimed at curtailing the epidemic. State Rep. Dennis Powers, who represents Campbell County, was one of the representatives on the task force. A number of proposals were presented, including: providing money to establish more prescription pill drop-off locations; exploring legislation to give patients an option for a partial fill of their medication or putting an expiration date for the partial fill option; limiting emergency rooms to prescribing 10 days worth of pills; limiting the number of days an opioid pain reliever can be prescribed to 10 days at the lowest effective dosage; prohibit pain clinics from treating walk-ins. It also recommended greater access to recovery services and creating Recovery Schools in each grand division of the state.

“A lot of people, once they get to that 30 or 60 day period of taking pain pills, that’s when they get addicted,” said Powers, explaining the limits on pills prescribed. “A lot of people keep the leftovers laying around in their medicine cabinets, and that’s how a lot of young people get started.”

The task force began work on the proposals in March, and consulted the Department of Mental Health and Substance Abuse Services, the Tennessee Bureau of Investigation, doctors, patients and addicts. Establishing alternative pain management plans was also deemed important.

“We’re going to take these recommendations to the governor, the Department of Health, and the Department of Mental Health and Substance Abuse,” he said. “We want to start recommending these guidelines for these particular drugs.”

He acknowledges that there are people who genuinely are in pain and need strong painkillers. He personally has had seven back operations and said he understands people who are in chronic pain.

“I get emails and comments from people often with those concerns,” he said. “There are substitutes though, that are not addictive.”

He felt confident in their recommendations, noting that the restrictions that were put on over the counter medications like Sudafed and others that were used to produce meth have been effective in reducing the number of meth labs and people addicted to it.

“We’ve got to make people aware of the problem,” he said. “We have to change some ways we’re providing pain management, too. There’s a fine line there of helping people address their pain and then getting to a point where they’re addicted. I’ve seen it happen in my family, my church, where people take it for the right reason and then end up addicted.”

There are some good faith based initiatives locally, according to Powers, like the Shepherd’s Home, Springs of Life in Jellico, and Celebrate Recovery. He would like to see government money diverted to programs like that that are already making a difference in the community.

“I’m honored to get to carry these bills,” he said. “I know how important it is to our area to address this issue.”