The extent of Terre Haute’s tragic opioid addiction epidemic has become clear.
In a span of a few days this spring, Vigo County experienced four deaths from overdoses of opioids — a family of prescribed and illicit drugs that also includes morphine, codeine, oxycodone, hydrocodone, fentanyl and other opiate pain relievers. Local law enforcement officials publicly noted the “uncommon” occurrence. The outbreak concerned first responders, who carry the opioid overdose antidotes Narcan and Naloxone, and the broader community.
Terre Haute’s situation is known nationally, too. The city recorded the 14th highest opioid abuse rate in the nation, according to a 2016 study by health care provider Castlight Health. Terre Haute was the only city outside of the South among the top 15. Evansville and nearby Henderson, Ky., ranked 19th. The only other northern cities among the 25 highest abuse rates were Elmira, N.Y., and Jackson, Mich.
Castlight didn’t simply crunch numbers and release the results. Its researchers aim to enlist another sector of affected American communities in the effort to combat opioid abuse and overdoses — large employers with insurance coverage plans for their workers. Along with public officials, health professionals, law enforcement and community groups, employers can play a crucial role, too, by steering an employee away from a potential addiction.
How? The report suggests its findings can enlighten employers and help them, for example, “identify where lower back pain or depression, two conditions closely associated with opioid abuse, are most prevalent in their company.”
Armed with such understanding, employers can then guide employees away from an unnecessary surgery or offer programs with access to opioid abuse treatment. Another goal, said Castlight senior vice president of corporate development Kristin Torres Mowat, “is to shed light that [opioid abuse] happens among the employed population.” That reality defies stereotypes of addicted people. The statistics come from a broad segment — “de-identified” and anonymous pharmacy and medical claims and demographic data of nearly 1 million Americans from 2011 to 2015 with large, self-insured employers. So, the cross-section is large enough to challenge old stereotypes.
It found that baby boomers are four times more likely to abuse opioids than millennials. People diagnosed with behavioral health issues — stress, anxiety and depression — are three times more likely to abuse the drugs. Thirty-two percent of opioid prescriptions are being abused, the report said. And residents of communities with low incomes (where average per-capita incomes are under $40,000) are twice as likely to abuse the medications than those in the highest income areas ($80,000 a year or more).
Terre Haute fits the latter category, with an average per-capita income of $34,396, second lowest of all Indiana metropolitan areas. (Only Muncie is lower.) Yet, addictions and overdoses of opioids aren’t confined to hotbed cities. Two million Americans are abusing the drugs, and 16,000 of them are dying yearly from ODs, the report stated.
“It’s an issue that affects everyone across all 50 states,” Mowat said in a telephone interview from San Francisco.
Because the prevalence of abuse is so high among people with behavioral health problems, community-wide conversations on handling stress, anxiety and depression could provide some resolution to the predicament. “I think we sometimes think, ‘Oh, well, everyone is stressed, everyone gets anxious.’ But at some point, these conditions start to impact our everyday lives.” And they involve everyday people. As Dr. Tim Kelly, a specialist in substance abuse disorders for the Community Health Network in Indianapolis, said in a March interview, “These are the sons and daughters, and brothers and sisters, and spouses and parents of people who are real, living people. And this is absolutely devastating.”
The local lives lost in that short time span this spring affirm his comment.
Emergency response workers remain ready. Terre Haute Fire Department crews administered 107 doses of the Narcan opioid antidote last year, well above the 86 applied in 2015 and 82 the year before, said Robert Eberhardt, the department’s assistant chief of emergency medical services.
The Castlight report highlights the potential benefit of employers’ involvement in the battle. Nearly three-quarters of employees don’t realize their insurance coverage includes treatment for behavioral health, Mowat explained, so only 10 percent utilize those benefits. “There’s a huge opportunity for better mapping of people to these programs,” she said.
“The first step is awareness,” Mowat added, “and the second step is having a dialogue — let’s make sure employees know what resources they have.”
Every success story means a family was spared a heartache.