In 2011, Donna Jacobsen was blindsided by painful truths about addiction.
None of the stereotypes about opioid abuse seemed to fit her daughter, who was fresh out of high school and starting college.
“My husband and I celebrated our 45th anniversary,” Jacobsen said. “We have a fabulous home life, and I think we provided that to our children. So what made my daughter go down this path?”
The answer is complicated by shifting trends surrounding opioid use — increasingly potent drugs, worsening youth mental health, dire overdose statistics, and widespread changes in the public perception and response to addiction.
Those changes call for new conversations, which was the goal of Jacobsen, president of the REACH LV Youth Recovery Center, Emmaus, and other experts who spoke recently at an opioid awareness panel discussion hosted by Kutztown Strong, a nonprofit focused on preventing substance abuse.
Inaccurate stereotype
The idea that substance users come from broken homes is an inaccurate myth, according to Dr. Ramona Roberts, clinical psychologist, and senior executive director of regional outpatient services for Caron Treatment Centers.
“When we look at someone who uses, we see that gamut of home environments, sure, some of them are broken homes, but then you have others that come from amazing families with so much love and support, financially stable, well-adjusted socially,” Roberts said.
Jacobsen said she and her husband had no idea what was going on with their daughter at first.
“A friend of mine said to me, ‘Donna, open your eyes because your daughter is a heroin addict and probably worse,’” Jacobsen said.
She said her daughter quickly transitioned from taking pills to becoming an IV user before eventually being approved for treatment.
“We were blessed to be able to get her the treatment she needed,” Jacobsen said. “Our time was very short compared to some families I work with that go through this journey for 10, 15, 20 years…this is a lifelong chronic disease that has to be treated.”
Jacobsen noted that many young users turn to opioids for relief from emotional pain.
“Often, the child is trying to soothe themselves, they’re looking for a way out,” Jacobsen said.
National surveys have shown increases in youth mental health symptoms in recent years, said Kathy Metrick, Kutztown Strong founder and president emeritus.
“From 2009 to 2019, the proportion of high school students reporting persistent feelings of sadness or hopelessness increased by 40%,” Metrick said.
Metrick noted that 44% of young people are challenged every day by five or more substance abuse risk factors including depressive symptoms, low commitment to school and inaccurate information on the harmful effects of substances, according to statewide survey data collected by the Pennsylvania Commission on Crime and Delinquency.
Fentanyl replaces heroin
The risk is amplified by heroin being largely replaced on the streets by far more potent drugs like fentanyl.
“The number of drug overdoses in Pennsylvania in 2022 was almost two and a half times what it was in 2012,” Metrick said. “A hit (of fentanyl) costs less than a six-pack of beer and is 50 times stronger than heroin. But fentanyl isn’t the end game. There are new, more powerful drugs emerging all the time.”
Those drugs can also cause overdoses in people who don’t intend to use opioids, Roberts said.
She said drugs commonly used by those who only experiment with substances — like marijuana and cocaine — can be cut with fentanyl.
“Right now, with the proliferation of fentanyl in all substances, no experimentation is safe,” Roberts said. “Two months ago, I lost a dear friend to a fentanyl overdose. He was not an opiate user. And he was not someone who used substances often.”
Elderly affected
Elderly patients, many of whom initially seek out opiates for pain relief, are also increasingly affected, according to Metrick.
“The rate of overdose deaths quadrupled among adults 55 and older from 2002 to 2021, according to a study by JAMA Psychiatry,” Metrick said.
Marcia Goodman-Hinnershitz, director of planning and resource development with the Council on Chemical Abuse in Reading, said the problem with opiates started with the promotion of drugs like oxycodone as a quick fix for pain.
“They were told that these drugs weren’t addictive,” Goodman-Hinnershitz said. “My mom suffered from spinal stenosis. Her doctor, without understanding the impact, was prescribing her (opiates)…she ended up going through withdrawal when she ran out of her drugs.”
Goodman-Hinnershitz said the landscape for identifying and treating substance abuse disorder has greatly improved since years prior when her mother struggled.
“We have recovery specialists at the Reading Hospital there 24/7 that will meet with an individual and connect them with treatment,” Goodman-Hinnershitz said.
She said part of the solution to addiction involves reframing the public dialogue around substance abuse away from stigmatizing those suffering from it and toward harm reduction.
“I will never use the word addict anymore,” Hinnershitz said. “I look at the fact that these are folks just like someone with diabetes or other chronic diseases. We want to help those folks and give them the tools to minimize their risks.”
When it comes to addressing opiate use in young people, tapping into students’ need for belonging can make them less likely to seek out synthetic salves for trauma and emotional issues, said Caleb Baukman, who works with Berks County middle schools as a site coordinator with Communities in Schools of Eastern Pennsylvania, a social services provider.
He said he’s worked with multiple students who have had loved ones die or have had to call emergency services for parents overdosing.
“They carry that with them every day,” he said. “Our students really, really want to belong. They really want to connect with others. Especially when it comes to substance abuse, (schools) are places where we can give them places to connect with others that have had similar experiences.”
He said schools are a valuable resource in the fight against substance abuse since they provide a unique opportunity for communitywide observation and intervention.
Shifting role of law enforcement
Law enforcement can serve as another intercept point for people to get into treatment, as criminal offenders are four times more likely to be substance abusers, said Kutztown police Sgt. Walt Skavinsky.
“The arrest policies from previous years weren’t working,” he said. “I think it’s important to recognize that we as police officers have a role in helping people recover, not just arresting them.”
District Judge Gail Greth noted that people convicted of certain minor drug-related offenses may have the opportunity to complete a course or undergo other steps to have their records expunged.
“Our young people do make a lot of mistakes, but do we want that to penalize them for their entire life? No we don’t, we want that to be a learning experience,” Greth said.
For individuals arrested for more serious charges, Greth said she has the option of setting drug and alcohol evaluations as a bail condition, or ordering people to work with nonprofits like Berks Connections Pretrial Services to keep them out of the criminal system.
Skavinsky said Berks County has joined the state-sponsored Law Enforcement Treatment Initiative, a program that empowers police to prioritize treatment over criminal punishment.
“If I have a low-level drug offender, and all they did was posses drugs or commit a related crime, I can refer them to that program,” Skavinsky said.
That role is especially essential, considering that in 2022, 136 Berks residents died of drug overdoses, compared to 37 in 2012, Skavinsky said.
Matthew Brett, assistant chief of Allentown emergency medical services, said a fraction of overdose victims are repeat users.
“We’ve had certain people that we’ve ‘Narcaned’ and woken up two, three times a day,” Brett said. “I have an individual that I know his birthday, his Social Security number, because I’ve taken him 52 times for overdoses. The system is not working for that individual, and we’re trying to figure out why.”
Brett said he’s found that a increasing percentage of patients are given Narcan before emergency services arrive.
“That’s bystanders, police officers, firefighters, that’s incredible,” Brett said.
Multiple panelists recommended that people consider carrying Narcan as part of a basic first aid kit.
Goodman-Hinnershitz said a vending machine for Narcan, drug test strips, disposal kits, and other harm reduction products will be piloted at the YMCA in Reading in January, with other machines to be installed elsewhere if the pilot is successful.
Dr. Jennifer Ziegler, emergency medicine physician with the Reading Hospital, noted that suboxone and methadone are also options for helping those recovering from addiction handle withdrawal symptoms.
Recovery possible
Fran Cortez-Funk shared her experience dealing with substance use disorder over decades.
“I started my use in high school,” Cortez Funk said. “I was from a generation where people looked the other way. My mother had no idea.”
She said it was important that people suffering from substance abuse recognize that recovery is possible.
“I am an example of a person of decades that I have lived and loved a life of sobriety,” Cortez-Funk said. “Bad decisions should not preclude you in the life you can live. What we can do is stop the effects, and stop the stigma, and say ‘We’re going to be OK.’”
Cortez Funk noted that the Council on Chemical Abuse provides free Narcan kits to Berks residents.
Those interested in receiving a free kit can submit their mailing address on the Council on Chemical Abuse website.
Source: Berkshire mont
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