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LMS President’s Message – September 2019

LMS President’s Message, September 2019
LMS Opioid Symposium
By Charles L. Papp, MD

Recently, we have all been saddened by the tragedies in El Paso and Dayton. The issues involved have been part of much discussion and press. Unhappily there is another tragedy that is involving our community, and it reaches further and affects more people. There were more deaths in Kentucky due to opioid overdose during 2017 alone than there have been mass shooting deaths in the entire United States since 1963. Most of us don’t want to deal with addicts. They have a stigma, they are manipulative, and they make us uncomfortable or even angry. Very few of us want to use our precious time and energy to deal with a person who we believe will not change. Because of this, we can slip into a sense of complacency, believing we really don’t have to deal with the issue. That would be a mistake. Addiction has grown to the point where it penetrates all walks of life, all occupations, and is found in every neighborhood.

Several months ago, I overheard one of my employees sharing about a scheduler’s niece who had just died from an overdose. I asked a few questions and to my surprise, I was bombarded with stories of children, relatives and neighbors who had lost their lives to drug overdose. If you think this is an anomaly, I challenge you to bring this up with your own office staff, your neighbors or even your teenage kids. You will likely be just as surprised as I was.

A dear woman who works in my office introduced me to her daughter, a former addict. Melissa has now been clean for three years. I met with Melissa over coffee to hear her story. In high school, like many teenagers, she played around with alcohol and marijuana. She married young, had a child, and moved to Oklahoma with her husband. She matured and grew out of her teenage habits. Unfortunately, her marriage didn’t work out and she returned to Lexington when she was thirty. Out of convenience, she reassociated with her old high school friends. By this time, several of them had become addicts. Eventually, they introduced her to a dealer.

Continuing with a string of bad choices, she moved in with him and received her first hit of heroin. Within a week she was addicted, although for over six months she refused to believe it. To convince herself and others that she was not hooked, she began to overcompensate. She made sure her house was spotless, worked hard at her job, and was very involved with her child. The addiction continued to prey on her until it became difficult to hide. People were beginning to suspect. Her feelings of guilt and desperation increased as her inhibitions lowered. She found herself doing things she never thought she would do. She began lying to her friends, stealing from her mother, even shoplifting. To keep her pride she told herself at least she wouldn’t sell her body to get a hit, until she did. And each time she did something she hated, it became easier to do the next time. Her life continued to spiral downhill. She lost her child, then she lost her home. She was living in her car, and was close to losing it as well. Homelessness was the next step down when it finally happened. She overdosed in the car and woke up after four or five hours. In her terror she sensed an overwhelming message that if she got high one more time she would die. When she tried to drive away, she was pulled over for DUI. The police found a small amount of heroin in the car, and she spent thirty days in prison. She realized all her friends were addicts, and she had nowhere to live when she was released. Fortunately, the drug court placed her in Chrysalis House. This was the beginning of her climb out of desperation. She stayed there for six months and was then given an apartment and a job. She continued with three more months of outpatient therapy.

Melissa has now been clean for three years and is continuing with AA. She has committed herself to befriending and helping other women caught in addiction. Frequently, she will stop by the Chrysalis House to listen, counsel, and give advice. She follows up with calls and texts to encourage those going through rehab. The endings are not always happy. Every week or two she hears of someone she knew or tried to help who has died of an overdose. Last year, she befriended a 22-year-old woman she met at the Chrysalis House. She is encouraged that this woman is now in an apartment, has regained custody of her two-year-old, and has been clean for six months. Melissa calls and texts her frequently to encourage and check on her.

Stories like these reveal that the opioid crisis is closer to us than we think. It is real, it is prevalent, and it is stealing lives and hurting families and children, neighbors and colleagues. To help physicians get a better understanding of the issues and gain insight into the community resources available, the LMS has prepared a symposium on Wednesday, October 16, at 6:00 pm at the Signature Club. This will qualify for 2.5 hours of AMA PRA Category 1 CME. We are working obtaining the mandatory HB 1 accreditation as well.

Speakers include:
Mayor Linda Gorton – Perspective from city government.
Dr. Tuyen Tran, LMS Board Chair – Overview
Fire Department Battalion Chief Chad Taylor – First responder’s view Lou Anna Red Corn, First Assistant, Fayette Commonwealth Attorney
Dr. Michelle Lowfall, Associate Professor of Psychiatry – Discussing the recent federal grant to address opioid addiction and the HEAL Initiative
Andrea James, Special Projects Coordinator for the Mayor – Best Practices
Dr. Mark Jorrisch, Immediate Past President Kentucky Society of Addiction Medicine – Addiction medicine resources
Genia McKee, Coordinator, Kentucky Safe Communities –

At the end of the presentations, there will be a panel for questions and answers. In addition, there will also be tables set up in the back by representatives from community resources and organizations with literature and contact information.

Our goal is not to make everyone an addiction specialist. Instead, we want everyone to leave the symposium with a bag of tools that can be used to help direct, refer, and counsel those we meet in any setting who are struggling with addiction. Our medical training gives us insights and our patient-physician relationships allow us to ask questions that may not be addressed anywhere else. Like it or not, we are on the front lines of this battle.

Not long ago Melissa tried texting her friend. The responses became less frequent and then stopped. She tried calling, but got no response. When the first responders arrived, they found her dead of an overdose in her bathroom. She was only twenty-two years old. When they found her she was covered with toilet paper. Her two-year-old was by her side and told the EMT that her mommy was cold.

We can and must make a difference. Make time to attend the symposium. Learn about the resources that are available. If you recognize and direct even one person into rehab or prevent one overdose, the godsend is measureless. Imagine what kind of blow we could deal this plague if our entire community of physicians got involved?

Charles L. Papp, MD