This is the second part of a two-part series on heroin and opioid use in the Kirkland area.
Individuals closely connected with a recent heroin epidemic all seem to paint an eerily-similar picture: unknowing beginnings and a quick downward spiral, often with disastrous endings.
Whether people begin using heroin directly or transition into heroin from other opioids, the result is the same. Opioids flood the body with endorphins — the happy-drug, similar to a runner’s high — and cause the body to produce extra endorphin receptors.
Once the drug has passed, there are more empty receptors than before. Over time, and sometimes not much time at all, things that once brought joy are now joyless. The only thing that brings the high back is a larger dose; a bigger hit.
Enter the transition from oxycodone to heroin, which is stronger and often is cheaper. It’s also more dangerous, and has been the cause of at least four deaths in Kirkland this year.
In a bill passed by both houses in March, US Congress voted to start a process allowing the Attorney General and Secretary of Health and Human Services to award grants as a way to “address the national epidemics of prescription opioid abuse and heroin use,” among other things.
The bill references heroin, prescription drugs and opioid pain relievers as the leading cause of injury-related deaths in the country — higher than car accidents, and higher than firearms.
As the Baby Boomer generation ages, the number of surgeries requiring prescription painkillers has skyrocketed, said Dr. Craig McAllister, an orthopedic surgeon in partnership with EvergreenHealth in Kirkland.
Not all the painkillers are used up post-surgery, leaving a growing stockpile.
“It looks like somewhere between 40-70 percent of teens addicted to opioids started innocently, like a prescription narcotic left in grandma’s medicine cabinet,” McAllister said.
Oxycodone can go for $10 a pill in schools, McAllister said, and because most don’t understand the difference between opioids and other drugs, the more-dangerous drug is disseminated undetected.
A study by the Office of National Drug Control Policy in 2012 found around 70 percent of opioid users got the drugs not from a dealer, but from a friend.
The U.S. Centers for Disease Control and Prevention found opioid use dropping in the 12-17 age group 2011 to 2013, but rising in the 18-25 age group by 109 percent in only two years.
Not everyone reacts the same way. Some get sick or constipated, while others are able to have a few doses without many adverse or long-term effects. A segment of the population appears to be genetically set up to fall for opioids.
Locally, there aren’t many options for concerned teens and parents. Youth-centered detox is difficult to find, and disenfranchised youth rarely come forward for help.
The Behavioral Health Adolescent Program at Fairfax Hospital is one of the few local centers to offer inpatient treatment for abuse of drugs or alcohol.
In the event of an overdose, Washington’s Good Samaritan laws protect anyone — the user or a friend — coming forward for medical care, but that’s as a last resort.
Response in schools
Youth Eastside Services is the face of the opioid response inside Lake Washington School District.
The recent surge in heroin and opioid usage has spurred Youth Eastside Services to put together a new campaign for the school system.
“The first message is, ‘if you haven’t ever used, don’t,'” said Kristie Neklason, the organization’s director of substance abuse treatment programs. “It’s very addictive, and the risk of overdose is extremely high — that means people die, and young people are starting to see that.”
The campaign also lets kids know the dangers of using alone — there’s no one around to report an accidental overdose — and the dangers of mixing other substances like marijuana and alcohol.
Beyond the somewhat limited services YES offers, things like counseling and references, resources for addicted teens are limited in the immediate area.
“There’s a growing need for youth detox,” Neklason said.
If students are caught at school in possession of banned substances, YES specialists take a look at student risk factors with end results ranging from educational diversion to ongoing counseling.
The district keeps stats on how many students are disciplined for drug-related offenses in a school year, but Matt Gillingham, LWSD director of student services, said the district doesn’t really follow up with Youth Eastside Services other than in a broad sense.
“What [Youth Eastside Services] ends up doing with the students is not something we track as a school district,” Gillingham said.
As far as prevention, the district health curriculum is taught once in middle school and again in high school with a biological focus — literally, what the drugs do to the human body.
But information on the YES program is difficult to find — partway down the “For Parents” tab on the LWSD website is a “Community Services” option. Near the bottom of that list is a link for substance abuse, addition and recovery. At the bottom of that list is a contact number and link for YES.
Gillingham said the district was showing opioid use at below the state average, according to a biannual survey of students.
By contrast, Youth Eastside Services has seen opioid use grow dramatically among cases it takes, Neklason said.
In the last several years, opioid-related cases have risen from two percent to 10 percent of Youth Eastside Services’ workload.
Response from the city
It’s not a problem limited to Kirkland and the immediate-surrounding area, but many government agencies have been slow with a proactive response.
Few agencies around the state issue Naloxone or Narcan – a drug that can reverse the effects of an overdose if administered immediately.
Neither the Kirkland police or fire departments carry the anti-drugs, though King County is considering issuing the anti-drug currently carried by county EMTs, which typically arrive on scene at the same time as other first responders.
The agencies which do have the anti-drugs on hand have been successful. The Bellevue Fire Department administers the anti-drug Narcan around 75 times per year, up from 49 occasions in 2010.
Seattle police have successfully used a heroin anti-drug seven times since officers began using Naloxone on overdose calls in mid-March.
