Christy Smith, Unicoi County Prevention Coalition director, left, directs questions towards a panel of experts during an informational opioid forum held on April 26. (Erwin Record Staff Photo by Kendal Groner)

By Kendal Groner

A Community Opioid Forum held on Thursday, April 26, at Calvary Baptist Church gave attendees an opportunity to learn facts about the opioid epidemic and what local resources are available, in addition to hearing from a panel of experts.

The event was hosted by the Unicoi County Prevention Coalition, the Tennessee Department of Mental Health and Substance Abuse, and the Washington, Unicoi and Johnson (WUJ) County Medical Alliance.

The panel of experts consisted of: Dr. David Kirschke, Northeast Regional Health officer for the Tennessee Department of Health; Regan Tilson, Town of Erwin police chief; Mike Hensley, Unicoi County sheriff, Angie Hagaman, Diversity Promoting Institutions Drug Abuse Research Project (DIDARP) director; Dr. Paul Jett, physician with Ballad Health; and Angela Murray, director of Corporate and Community development for Watauga Recovery Centers.

“It is our hope that these meetings will continue to educate the public about the opioid epidemic and direct individuals to recovery resources in their area,” said Terry Geraci, president-elect of the WUJ Medical Alliance.

The forum began with an informational video by the American Medical Alliance (AMA) that provided statistics and background information on the growing epidemic.

With an average of 44 people dying each day in the United States from an opioid overdose, many addicts switch to heroin after their supply of pills runs out, according to the AMA. This troubling public health crisis impacts individuals from all classes and walks of life.

Following the video presentation, Christy Smith, director for the Unicoi County Prevention Coalition, began directing questions to the panel of experts and first asked them to differentiate between dependence and addiction.

“When we think about addiction we typically think about people misusing the medication in ways other than intended,” said Dr. Jett.

Jett said that dependence is actually a natural cycle for any opioid use, even as directed by a doctor, and stopping use abruptly will likely lead to at least some withdrawal symptoms. Addiction is characterized by compulsive behavior, continued abuse of drugs, and persistent changes in brain structure.

“If untreated, addiction can last a lifetime,” said Smith. “According to the National Institute on Drug Abuse, there are three factors that contribute to opioid addiction: genetics, environment, and opportunity.”

After being in recovery for 11 years for opioid addiction, Murray said that all three factors played a role in her addiction.

“I do have addiction in my family, for sure,” she said. “Because I was always a business owner and worked for myself, I had a perfect opportunity to use without people knowing.”

Murray said she grew up with chronic migraines and after being treated with several medications that failed to alleviate her pain, she was told her only option for pain relief was hydrocodone.

“The more I used, the better I felt and the more I used, the more I needed,” said Murray. “I became dependent and then full-blown addicted.”

According to statistics shared by the Unicoi County Prevention Coalition, there is a 40 percent increased risk that an individual will become addicted to opioids if a first-degree relative also suffers from opioid addiction.

Environmental factors that contribute to opioid addiction include: availability of opioids; perceived risk of opioids (the coalition found that 75 percent of high school students perceive heroin as dangerous, but only 40 percent perceive prescription opioids as dangerous); psychological stressors; learned coping mechanisms; and traumatic life experiences.

“Substance Abuse and Misuse Statistics from the Tennessee Department of Health show that for every 100,000 deaths in Unicoi County, 28 are caused by drug poisoning and this is higher than both the Tennessee and national average,” said Smith.

In 2016, there were six overdose deaths in Unicoi County, five of which were from opioids. That same year, a total of 32,610 opioid prescriptions were written in the county, or approximately 1,840 prescriptions per 1,000 people.

Around 127 pills are prescribed every year for each person in Unicoi County, according to research by the coalition.

“Most people that fatally overdose in our area are between the ages of 25 and 54,” said Dr. Kirschke. “In our region, we’ve had one or two child or teenage deaths, although non-fatal overdoses in teens are increasing.”

Smith said the coalition conducted a survey on drug use and attitudes towards drug use among sixth, eighth, tenth, and twelfth graders in Unicoi County schools.

“We found in Unicoi County, the average age of the first use of a prescription drug not prescribed to them is 13,” Smith said.

According to the survey, 51 percent of those who used prescription drugs not prescribed to them in the last 30 days obtained them from a relative, friend or someone they knew for free; 17 percent got it from a relative, friend or someone they knew without asking; and 18 percent purchased them from the internet.

Town of Erwin Police Chief Regan Tilson said the number of DUIs have almost doubled in the last few years and the majority are not from alcohol, but abused substances.

“Years ago it was alcohol, but this day and time it’s prescription drugs,” said Mike Hensley, Unicoi County sheriff. “It presents a problem for us when we pull someone over and they’re on something, but they have a prescription for it.”

Tilson said officers go through extensive training to determine if someone is under the influence of an illicit substance and added that each DUI arrest can take two or more hours of an officer’s time.

Kirschke also talked about Neonatal Abstinence Syndrome, or when a child is birthed from a mother who is addicted to opioids.

“Basically, it’s become somewhat of an epidemic, especially in East Tennessee,” he said. “It seems like many of the child fatalities, especially infant deaths, a lot of them are from neonatal abstinence syndrome.”

Dr. Jett also said that the East Tennessee region has a rate of Neonatal Abstinence Syndrome that is 10 times higher compared to the rest of the nation.

“We are leading the way with a lot of bad things,” he said.

• • •

The panel discussed what spurred the opioid epidemic, and pointed to events back in the 1980s and 1990s that acted as a catalyst for increased use of pain medications. Oxycontin was first introduced by Purdue Pharmaceuticals in 1996.

“We started to judge hospitals by how satisfied people were with their pain levels,” said Kirschke. “There was a time period during which physicians were basically graded with how well they treated pain … doctors’ hands were almost tied.”

Hagaman and Murray spoke on the varied treatments available for opioid addiction that include abstinence-based outpatient treatment, more intensive outpatient treatment, inpatient treatment which typically lasts 30 days and medication-assisted therapy.

“There are all sorts of different types of treatments out there and it’s going to be different for each person,” said Murray.

Smith said, unfortunately, many of the treatment programs don’t last long enough and can lead to relapse. She said goals of recovery include: reduced mortality, improved social function, decreased or discontinued drug use and improved quality of life.

Kirschner also mentioned Naloxone, the antidote to opioid overdose that is available in nasal sprays and injectable forms.

“It reverses the effects of the opioid,” he said. “You can get it from most pharmacies without a prescription and many clinics offer it for free.”

Unused medications can be disposed of at the Unicoi County Sheriff’s Department or the Erwin Police Department.

In Unicoi County, CHIPs offers “Living Free” – a faith-based recovery meeting on Thursdays at 9 a.m. For more information, call 743-0022.

Family support meetings are offered in Johnson City at Covenant Presbyterian Church on Mondays at 7 p.m., Tuesdays at 7 p.m, and Thursdays at noon. Harrison Christian Church offers a meeting on Tuesdays at 10 a.m. and Watauga Avenue Presbyterian Church on Saturdays at 7:30 p.m.

First Christian Church in Erwin offers an AA meeting on Thursdays at 6 p.m.

To connect to more resources in the region or to learn more about the Unicoi County Prevention Coalition, contact Christy Smith at 735-8407.