Connect with us

News

‘It was just kind of normal.’ A Vicksburg family struggles with opioid addiction

Published

on

Graphic by Drew Landon Harris for the Vicksburg Daily News. All rights reserved.

Tommy Collins* was 4 years old the first time doctors prescribed opioids for an ailment.

“I was a good mother,” Vicksburg resident Jane Collins said with just a hint of defensiveness in her voice. “When he was little, they would put him on opioid cough medicines.”

Throughout his life, Jane saw doctors prescribe narcotics to her son multiple times. As he was growing up, Tommy played sports at school, and he received opioid prescriptions for his injuries, even for a concussion. Once, he developed an MRSA infection, and doctors gave him powerful pain medication for that, too.

MRSA, up close.

MRSA, or Methicillin-resistant Staphylococcus aureus, is a drug-resistant staph infection that generally starts as painful red bumps on the skin, but can spread to bones, joints, the bloodstream and vital organs including the heart and lungs. It can be life threatening.

“Month after month, year after year, the doctors wrote prescriptions,” Jane said.

This was decades before the problems of prescription opioids became nationwide news. Tommy was a 1980s baby, and the prescriptions didn’t worry her—at first.

“It was just kind of normal,” she said.

Jane now knows that Tommy became addicted to those prescription pain pills. “When the prescriptions ran out, he started buying them off the street,” she said. “I didn’t know this at the time, of course.”

 

The crisis gets nationwide attention

In October 2017, President Donald Trump declared the crisis a public health emergency, a designation that allowed for research in federal agencies, but didn’t provide access to emergency federal funding to the states.

“As Americans, we cannot allow this to continue,” Trump said at the time. “It is time to liberate our communities from the scourge. We can be the generation that ends the opioid epidemic.”

Critics say the president hasn’t done nearly enough. Many states don’t have the resources to take on the nationwide problem. At the time, the federal public emergency fund only held about $57,000, leaving many wondering where the money would come from to tackle a problem that could cost the nation tens of billions of dollars. Last year, Congress approved $3 billion a year to help states fight the scourge.

Opioid prescribing rate per 100 persons, U.S. and Mississippi, 2006 to 2017. Source: National Institute on Drug Abuse, CDC and IQVIA Xponent 2006–2017.

Mississippi ranks fifth in the nation for per capita opioid prescriptions, with more than 183 million dosage units dispensed in 2017, according to Stand Up Mississippi, an organization working to fight the crisis in the state. (A dosage unit is the number of pills prescribed per use. If a doctor says to take two pills three times a day, the dosage unit is two pills.)

That amounts to enough pills to provide roughly 50 dosage units to every man, woman, and child in the state.

The Centers for Disease Control says that in 2017, Mississippi providers wrote 92.9 opioid prescriptions for every 100 persons, compared to the average U.S. rate of 58.7 prescriptions.

 

Pharmaceutical companies on the hook

Beginning in the 1990s, pharmaceutical companies began aggressively marketing a new type of medication to doctors as being an effective, non-addictive solution for pain. Today, it’s widely known that the drugs—opioids—are extremely addictive. But it took hundreds of thousands of deaths and 2 million addicted patients to get the public’s attention. Today, there are some 2,000 lawsuits filed against companies such as Purdue Pharma, which manufactures OxyContin.

Earlier this year, California Attorney General Xavier Becerra accused Purdue and its former president, Richard Sackler, of helping to fuel a nationwide crisis by marketing OxyContin as safe despite knowing it is one of the most abused opioids in the country.

“Purdue Pharma and Dr. Sackler started the fire and then poured gasoline on the opioid crisis with practices that were irresponsible, unconscionable and unlawful,” Becerra said in a statement.

Doctors, always looking for ways to help patients in severe pain, heavily prescribed the drugs, unaware they were setting many patients up for a lifetime of addiction.

“If they say, ‘This is OK,’ you think the doctor is aware,” Jane said. “They were being lied to by the pharma companies. They did not have accurate information.”

Unlike some addicts, Tommy Collins never graduated from pills to other illicit forms of the drugs. “He never, ever used heroin,” Jane said. The reality is that it didn’t matter, because street drugs of any kind can be lethal.

When he was about 20, Tommy moved away from Vicksburg, eventually ending up in Iowa. Jane knows that her son unsuccessfully attempted to break his habit several times. “He tried to stop and kept trying to stop,” she said, but each time he would find a new supplier and the cycle repeated.

In early 2015, an Iowa coroner examined Tommy’s lifeless body and told Jane and her husband, Max, that the cause of his death wasn’t clear.

“At the time of death, they said, ‘We don’t see anything wrong,’” Jane said. It would be another five or six months before they learned the truth.

“He had 10 times the lethal dose of fentanyl,” in his system, she said. Whoever sold him that last batch of pills had spiked them. Or maybe Tommy thought he could handle the new synthetic opioid that is 50 times stronger than pure heroin.

Jane immediately did what she could to help find the people responsible for Tommy’s death.

“I downloaded all the texts from his phone,” she said. “Grabbed them all and sent them to Iowa after we got the autopsy.” It was a futile attempt. The numbers Tommy had called weren’t in service or had been changed.

 

Do opioids really help?

Tommy’s case is officially cold, now, but the Collins family’s opioid trials are far from over.

About 10 years ago, Tommy’s dad, Max, cut his leg while on the job. Like his son, Max developed a MRSA infection, and doctors prescribed opioids for the pain. As the infection worsened, so did Max’s pain. It spread, eventually requiring surgery—and even more opioids.

Doctors prescribed Lorcet and later Norco, both versions of the same drug combination: hydrocodone, the opioid, and acetaminophen, a non-opiate pain reliever commonly known as Tylenol.

Max also tried to get off the pills, Jane said, but the pain would get even worse. “debilitating,” she called it. Max would become agitated and angry as the opioids wore off and the pain increased. Sometimes he was suicidal. Eventually, doctors would put him back on the pills.

Photo from the National Institutes of Health

Research shows that using opioids, whether prescription pills or street heroin, changes the way the brain works. Opioids feed the brain’s pleasure centers, giving users a feeling of relief or euphoria. As users take more and more of the drugs, the brain’s natural ability to feel pleasure is dampened, eventually making it impossible for an addict to find pleasure in anything but more drugs.

Many clinicians also believe opioids can hurt more than they help when it comes to treating pain.

In a 2016 study published in the Proceedings of the National Academy of Science, Dr. Peter Grace of the University of Colorado at Boulder found that chronic pain worsened for rats treated with morphine (another form of opioid) after just five days of treatment. The effect persisted for several months.

“We are showing for the first time that even brief exposure to opioids can have long-term negative effects on pain,” Grace wrote. “We found the treatment was contributing to the problem.”

The phenomena Grace described is called opioid induced hyperalgesia, or OIH, described as a heightened sensitivity to pain because of opioid use. It’s a paradox first noticed in 1870: Morphine tended to “encourage the very pain it pretends to relieve.”

Researchers are still attempting to distinguish the phenomenon from the brain’s increasing tolerance for opioids, reducing their effectiveness the longer they’re used. As the drugs become less effective in relieving pain, doctors increase dosages. That works for a short time, then the dosage has to be increased again. It’s a never-ending spiral with no end in sight. If, however, increased pain is due to OIH, higher doses only serve to worsen the pain.

“Max ended up on disability,” Jane said, adding, “He still has pain, but it’s not as severe as when he was off them.”

Jane worries for her husband, though. “You get tolerant of the dose level,” she said, and right now, there aren’t any effective substitutes. “At this point, we know of no other options.”

She’s seen changes in Max’s demeanor, but it’s hard to pinpoint what caused them. “The problem is that he’s also in constant pain. … Just that is going to change your personality,” she said. “He’s much more unpleasant to be around. He’s short-tempered, doesn’t think as clearly, gets angry more easily, is more forgetful.”

Max is bound to reach a point where the pills no longer help. “I know that this dosage will not be adequate,” Jane said. “Then what is he going to do?”

Jane takes cold comfort in the fact that pharmaceutical companies are finally being held to account for the role they’ve played in addicting and killing millions of Americans.

“It doesn’t bring back Tommy,” she said. “It doesn’t cure Max.”

 

Say no

Jane Collins has become something of an expert on opioid addiction, now referred to as Opioid Use Disorder, or OUD by the medical community. In addition to her husband and her son, she’s seen close friends struggle. One is afflicted with rheumatoid arthritis; another suffered the results of a botched surgery. “It’s a tragedy,” she said.

At the height of the prescription drug crises, hospital rooms often had charts in them with cartoon faces representing a spectrum of pain, from a smiley face for no pain at all to a weeping face depicting excruciating pain. Nurses would mark which face represented their patient’s pain that day.

“The goal was to have nothing but the smiley face. That’s not reasonable,” Jane said. “That’s not sensible.” Doctors can’t stop every pain, she indicated, nor should they. Pain is a sign, and not all pain is physical.

Law enforcement, the courts and lawmakers all have a role to play as well. Drug users aren’t criminals, Jane said. To the contrary, OUD is an illness, and the addiction crises should be recognized and dealt with as a national public health emergency.

“Our drug courts need to understand that they can’t just tell someone addicted, ‘Stop.’ They need medical attention and care,” she said.

Legislators looking at allocating funds toward ending the crisis must keep in mind that prevention is just as important as treatment.

Each of us has a part in the drama, too. “Be aware of what’s being prescribed to the people you love,” Jane said. “Say ‘no’ to doctors” prescribing opioids. “That’s a starting point.”


This story is the first of an ongoing series about the opioid drug crises in Mississippi, focusing on the people of Vicksburg and Warren County.

*At their request, we have changed the names and some personal details to protect the privacy of the family featured in this story.

News

Multiple vehicle wreck at Mission 66 and Indiana Avenue

Published

on

First responders were on the scene of a multiple vehicle accident at Mission 66 and Indiana Avenue in Vicksburg Saturday evening.

Police and rescue vehicles were called to the scene around 7 p.m.

First reports say there are multiple injuries in this accident.

The Vicksburg Daily News will provide additional details as they become available. Please avoid the area if you can.

Continue Reading

COVID-19

Mississippi sets new one-day COVID-19 case record Saturday with 1,972 reported

Published

on

Mississippi zoomed past the previous one-day record of new COVID-19 cases Saturday, with the Mississippi State Department of Health reporting 1,972. The previous record of 1,775 new cases was reported July 30.

Three weeks into November, the number of new cases reported is more than all the cases reported in October.

The state’s seven-day average of new COVID-19 cases continues to climb toward the numbers seen in this summer’s surge. Saturday, the average neared 1,300 per day. A steep rise in hospitalizations is accompanying the rise in new cases, threatening once again to overwhelm the state’s health care system.

Across the U.S., the surge is gathering speed. Friday, at least 198,500 new cases were reported, another record, and the seven-day average of new cases is quickly approaching 200,000 per day. Cases are rising in 47 states. Hospitalizations are soaring as well, with more than 82,000 patients.

Friday, pharmaceutical giant Pfizer announced it has submitted its application for emergency use of its vaccine to the Federal Food and Drug Administration. Approval is expected to take about three weeks. If approved, the vaccine could be available to high-risk groups such as health-care workers and the elderly before the end of the year.

In Warren County, MSDH reported 16 new COVID-19 cases Saturday and no new deaths. The cumulative number of cases in Warren County to date is 1,707, and the county’s death toll is 56. Although the county has been spared the huge increases seen elsewhere, the 14-day average has risen from about five cases per day to nearly 7 cases in the past few weeks. No deaths have been reported in the county in November.

Statewide, MSDH reported 1,972 new COVID-19 cases Saturday, the highest one-day increase since the crisis began, bringing the total cumulative confirmed cases in Mississippi to 142,401. The seven-day average of new cases is 1,294 per day, about 536 cases and nearly 60% higher than the seven-day average a month ago. The average is on par with numbers seen in July.

At the beginning of the crises, the age group with the most COVID-19 cases were those over 65. Now, most new cases are seen in younger people who are more likely to survive the virus than those 65 and older. In September, the age group reporting the most cases in Mississippi were 18 to 24 years old. That has shifted to a slightly older group. In November, the age group reporting the most cases in Mississippi are from 25 to 39 years old followed by those 50 to 64 years old.

MSDH reported Saturday that 15 more Mississippians died of COVID-19 statewide. The cumulative number of deaths in the state is 3,657. The state’s rate of deaths to confirmed cases is about 2.6%. This rate has dropped slightly as the number of cases are going up faster than the number of deaths at this time.

Deaths are a lagging indicator. While July saw the highest number of new cases since the crisis began, August saw the highest number of deaths. The highest number of deaths in any one day in Mississippi was 67 reported Aug. 25.

The deaths MSDH reported Saturday occurred between Nov. 13 and Nov. 20 in the following counties:

County Deaths reported Saturday
Holmes 1
Jackson 3
Jefferson Davis 1
Lafayette 1
Lee 1
Madison 1
Pearl River 1
Perry 1
Rankin 1
Tate 1
Walthall 1
Yazoo 1

Another six COVID-19 related deaths occurred between Oct. 31 and Nov. 13 and were identified from death certificate reports.

County Deaths identified from death certificate reports
DeSoto 2
Harrison 1
Marshall 2
Sharkey 1

New cases and deaths were reported to MSDH as of 6 p.m. Friday, Nov. 20. MSDH usually reports statistics on the COVID-19 coronavirus each day based on the previous day’s testing and death reports.

The primary metric concerning state health officials are the numbers of people hospitalized, and that number rose steadily with the rise of new cases in July and August. On June 6, the number of Mississippians hospitalized with confirmed cases of COVID-19 was at 358. Hospitalizations tripled by late July.

Hospitalizations then steadily dropped through Oct. 3 when they began rising again along with increased cases. The last week in October, hospitalizations were levelling off; however, since Nov. 4 hospitals have seen a steady rise in COVID-19 patients once again.

The number of Mississippians hospitalized for the virus as of 6 p.m. Thursday, Nov. 19, was 965, about 80% of the late July peak of about 1,200. The number includes 863 with confirmed cases of COVID-19 and 102 people with suspected but unconfirmed cases. Of those with confirmed infections, 225 were critically ill and in intensive care units and 99 were on ventilators.

Source: MSDH

MSDH has estimated the number of people who can be presumed recovered from COVID-19 in Mississippi. That number is 116,683 through Sunday, Nov. 15. It represents about 81.9% of the cumulative 142,401 cases reported as of Saturday, Nov. 21.

The number of cases in Warren County three weeks ago, Saturday, Oct. 31, was 1,576, therefore the estimated number of people presumed recovered in the county is 1,520, or about 89% of the 1,707 cumulative cases reported as of Saturday, Nov. 21. The county has an estimated 131 active cases.

These estimates are based on MSDH’s guidelines for calculating estimated recoveries when hospitalizations are not known, using the number of cases 21 days ago, less known outcomes (deaths).

The total number of Mississippians tested for COVID-19 (PCR and antigen tests identifying current infections) as of Saturday, Nov. 14, is 1,165,593 or about 39.2% of the state’s 2.976 million residents. MSDH reports statewide test results once a week. Without daily updated numbers of tests, it is impossible to accurately calculate Mississippi’s positivity rate (positive results to tests, seven-day average); however, the rate was 19.7% Friday, according to Johns Hopkins University. The national rate is 10%, and 5% or lower indicates adequate testing.

The total number of outbreaks in long-term care facilities was 173 Saturday, an increase of three since Friday. About 38.3%, or 1,400, of the state’s total deaths were people in long-term care facilities. The cumulative number of COVID-19 cases in LTC facilities is 7,384, about 5.2% of the state’s total cases.

A total of 26 deaths in Warren County were residents of LTC facilities.

MSDH is no longer reporting outbreaks in individual long-term care facilities in Mississippi and has replaced it with access to a database from the Centers for Medicare and Medicaid. You can access and search the data by provider here. The latest data available is for the week ending Nov. 6.

For additional information, visit the MSDH website.

Continue Reading

COVID-19

CDC recommends people not travel for Thanksgiving

Published

on

The Centers for Disease Control and Prevention has recommended people not travel to Thanksgiving celebrations this year.

As COVID-19 cases continue to increase rapidly across the United States, the safest way to celebrate Thanksgiving is to celebrate at home with the people you live with, the agency writes on its website.

Travel may increase your chance of getting and spreading COVID-19. Postponing travel and staying home is the best way to protect yourself and others this year.

Gatherings with family and friends who do not live with you can increase the chances of getting or spreading COVID-19 or the flu.

“The safest way to celebrate Thanksgiving this year is at home with the people in your household,” said the CDC’s Dr. Erin Sauber-Schatz.

More than 1 million COVID-19 cases were reported in the United States over the last seven days.

The CDC offers guidance having a safe Thanksgiving, including wearing a mask and practicing social distancing in addition to hygiene recommendations such as frequent hand-washing. Also recommended are alternatives to big gatherings such as sharing meals virtually and playing games at home with the family.

For more information, visit the CDC website.

Continue Reading

Vicksburg
52°
Partly Cloudy
6:39am4:59pm CST
Feels like: 52°F
Wind: 0mph N
Humidity: 93%
Pressure: 30.2"Hg
UV index: 0
MonTueWed
66/45°F
73/64°F
73/45°F

Categories

Categories

Trending

Do NOT follow this link or you will be banned from the site!