Painkiller addiction is an ugly trend that public health officials finally are getting their arms around. But they need to widen their embrace quickly, to incorporate a quiet demographic desperately in need of support and resources.
It’s hard to imagine anything more alarming than a 984 percent increase in opiate and heroin abuse among all groups from 1998 to 2011, but here it is:
A 3,695 percent increase for abuse of opiates and heroin among American Indians.
“These are startling statistics, which the Centers for Disease Control and Prevention (CDC) would well note,” said an understated Richard Wright, chairman of the Minnesota American Indian Advisory Council. The council represents 11 Minnesota Indian reservations.
On June 7, Wright brought together more than 30 chemical addition counselors and public health officials for a lunch-hour discussion on how to “optimize care for opiate-addicted clients,” and figure out how to care for the caregivers, too.
Wright, who’s been in the chemical-addiction field for 30 years, knows their work is tough, partly due to insufficient funding and few culturally sensitive programs for the American Indian community, where addiction is complicated and often multigenerational.
Wright began to document a rise in abuse of painkillers such as Vicodin, Percocet and oxycodone about five years ago as he assessed clients for potential treatment programs. Soon, many were gravitating for the first time to cheap and easily accessible heroin, “becoming daily users immediately.”
Of particular concern is opiate abuse among females. Gavin Bart, a Hennepin County Medical Center physician, has seen a growing number of American Indian women seeking treatment at HCMC’s addiction medicine clinics.
“They’re getting younger and they’re often pregnant,” Bart said.
In addition, Bart found that 23 percent of American Indian high school girls in the metro area answer yes when asked whether they used prescription pain pills not prescribed to them in the past 12 months. That’s compared to 18 percent of American Indian boys who answer yes.
This far exceeds the number of white teens who answer yes to using prescription pain pills not prescribed to them: 7 percent of boys and 6 percent of girls.
What’s going on with American Indian girls?
“Females tend to be more emotionally out there than boys, and to explore their environment in an emotional way,” said Wright, who conducts evaluations of adolescents as part of his work. “A lot can go wrong to impact how they feel about themselves.”
Turning to pain pills for relief is as easy as opening a parent’s medicine cabinet, he said, or attending “Skittles parties,” where kids bring multicolored pills from home, crush them up and put them into drinks.
Suzanne Koepplinger, executive director of the Minnesota Indian Women’s Resource Center, agrees. “Peer pressure is huge,” said Koepplinger, who said that, while alcohol addiction is still a monster problem in the American Indian community, painkiller addiction is growing.
Self-medicating, she said, often is a response to sexual violence. “They’re trying to cope with deep pain,” Koepplinger said. “Until we begin to unpack that deep trauma,” she said, “we can’t find solutions.”
The issue of prescription drug and heroin abuse, brewing for more than a decade, is suddenly everywhere. Earlier this month, Twin Cities Public Television, in collaboration with the Minnesota Department of Human Services, aired “Heroin at Home,” a two-part documentary on opiate addiction and heroin’s resurgence.
My colleagues, Maura Lerner and Mike Kaszuba, recently reported on a wrongful-death lawsuit filed by the family of Minnesota Wild hockey player Derek Boogaard against the National Hockey League. The suit blames the league for brain damage and Boogaard’s addiction to prescription painkillers, which kill an estimated 15,000 people annually.
In February, I featured Judy and Bill Rummler, whose son, Steve, died in 2011 of an accidental drug overdose. They started a foundation (www.steverummlerhopefoundation.org) and have testified in front of the FDA to demand tighter regulations of prescription opioids.
The good news is that thoughtful efforts are beginning. Dave Hartford, DHS assistant commissioner of chemical and mental health, said that many groups have been addressing opiate addiction since September, with a unique push in the American Indian community.
Strategies are focusing on prevention and early intervention, as well as stepping up law enforcement efforts.
Equally important, though, is establishing treatment programs on reservations, as well as tapping into sacred medicines, traditional values and the wisdom of American Indian elders.
“No one should suffer like this,” Koepplinger said. “None of us can be well if most of us are not well.”