How our communities get addicted to heroin? Author blames opioids

But the nonfiction author was blind to the real reason the drug epidemic had spread so far into the country — even though it loomed over him like a tidal wave.

That reason was what Quinones spent most of his time discussing at Clark Memorial Hospital Friday morning as the keynote speaker for Clark County CARES’ second annual Drug Week. It was also a large part of his bestselling book “Dreamland: The True Tale of America’s Opiate Epidemic.”

He learned of it a few years after he started researching the country's drug problem. 

From 1999 to 2014, the amount of prescription opioids in the United States nearly quadrupled, according to the Centers for Disease Control and Prevention. 

Opioid painkillers, such as OxyContin and Vicodin, are used to treat moderate-to-severe pain, but they’re also addictive. If the pills get too expensive, they’re easily substituted with heroin — a cheaper, but illegal alternative that produces the same high. 

Doctors overlooked these troubling facts for a couple of reasons, Quinones said. 

For one, pharmaceutical marketers claimed that opioids weren’t really dangerous. But even before that, the national attitude toward pain had begun to shift. It became viewed as unacceptable. 

“We have this insensitivity,” Quinones said. “…Nobody can feel the least amount of pain. The smallest little modicum of pain cannot be felt.”

Patients began demanding that their pain be treated, Medicare added pain to their evaluations, doctors acquiesced and drug traffickers profited. 

“This was the first time in the modern history of our country when we had a drug scourge not started by drug peddlers, street dealers, traffickers, gangs and that kind of thing,” Quinones said. “But instead kind of just an acceptance of conventional wisdom within the medical establishment.” 

That’s not to say Quinones thinks opioids should be banned or that pain shouldn’t be treated. There are situations where patients are in crippling pain, and opioids are needed, he said. Quinones just doesn’t want opioids to be the only solution. 

James Murphy, a doctor and owner of the Murphy Pain Center in New Albany, thought Quinones’ assessment of the opioid epidemic was fair. 

He’s sure that there were doctors in the area that fell into the over-prescribing trap. But Murphy, whose practice has been in the area for about 17 years, treats his patients through a multi-disciplinary approach. That means they’re helped through a variety of methods, including physical therapy, non-opioid pain relievers and behavioral therapy. 

Murphy does prescribe opioids, but only in necessary cases and in as low a dose as possible. His patients that take them also have to undergo drug screenings. 

But most of Murphy’s patients come to him already on opioids. 

“My job is to kind of get them off of them,” he said. 

He often starts them on other therapies and sometimes lowers the dosage they're taking. 

An innovative solution

In the many years it took Quinones to research and write "Dreamland", he discovered quite a few things. One of those was that it was more likely for communities like Clark County to have a heroin problem. 

Small towns were among the least prepared for the opioid monster and in places where everybody knows everybody, it can be hard for people to discuss how their son or daughter really died, he said. 

But talking is also what Quinones thinks people need to do to stop the heroin problem. 

He’s done some research on the subject. 

In factories, innovation happens because different groups –  workers,  engineers and  foremen — are all working together in the same space and leveraging their talents. 

“And I don’t understand why communities and towns aren’t the same way,” Quinones said. 

Parent teacher associations, chambers of commerce, pastors, police officers — everyone — should all be working together to solve their community drug problems, he said. 

When one member of Clark County CARES heard Quinones say that, she got excited, said Carolyn King, another member of the organization. 

“She says, ‘you know, it just occurred to me, that’s what Clark County CARES is doing,’” she said. 

The group is bringing people from different sectors of the community together. Quinones’ talk was funded by the local government and held in a community hospital. Another event during Drug Week brought an EMT, an economic development organization leader and two doctors to the same table.

But there are still parties to bring together, King said. 

She’d like to see more educators and people who are addicted to drugs involved in Clark County CARES discussions.