The experience of negative symptoms due to withdrawal from medication, typically opiates (heroin, morphine, opium). Symptoms may include nausea, headache, insomnia and restlessness. The term is not limited to opiate narcotics.
In June, Alton Banks of Florida began vomiting upon returning home from a day at the local pool. He was later found unconscious by his mother, who immediately called an ambulance. Alton was taken to the local hospital where he was pronounced dead later that evening. The toxicology report found that he had come into contact with the powerful opiates: heroin and fentanyl. Alton, ten years old, had just finished the fifth grade.
This story solidified the severity of our country's growing opioid problem. In 2015, there were almost 13,000 heroin related deaths and more than 15,000 prescription opioid related deaths. The United States Department of Health and Human Services have classified this as an epidemic and it’s getting worse.
To understand the opioid epidemic we must first understand what opiates are. Broadly speaking, opioids are substances that act on opioid receptors in the brain and spinal cord to produce morphine-like effects through a reduction in the amount of pain messages sent to the brain. These substances are synthesized from the opium poppy which is found in Asia and the Middle East. These substances can be anything from weaker opiates, such as codeine and tramadol, to stronger ones like OxyContin and heroin.
When a user takes an opiate the drug enters the brain through the bloodstream and creates a flood of artificial endorphins and dopamine, which are neurotransmitters responsible for feelings of reward, pleasure, and satisfaction. After repeated use, however, the brain will stop creating dopamine and endorphins by itself. This keeps a person from experiencing these feelings unless they’re using opiates. Therefore, opiates are highly addictive. When a person is prescribed opiates to manage their pain, they can become addicted to the effect of the drug.
Opioid abuse is nothing new. Opium, the dried latex obtained from the opium poppy, was introduced to the Chinese by the British Empire. Opium became popular in the United States as early as the 1800s when it was brought over by Chinese immigrants who came to the country to work on the railroads. In 1810, morphine was synthesized from opium and developed as a pain killer. It only took about a decade before the use and abuse of morphine had become widespread in the United States. Then, in 1874, Germany invented and trademarked a new drug called “Heroin,” and marketed it in the United States as a safe and non-addictive alternative to morphine.
By 2014, almost two million Americans had abused, or were dependent on, prescription opioids. As many as 1 in 4 individuals who receive prescription opioids as a long-term medical treatment will become dependant on them. Every day, over 1,000 people are treated in emergency departments across America for misuse of prescription opioids. Ninety-nine percent of primary care doctors routinely prescribe potentially addictive opioid painkillers for longer than the three-day period that is recommended by the Centers for Disease Control and Prevention. This rise in the prescription of highly addictive painkillers is often cited as the reason for rising opioid addiction. Since opioid prescription pills are highly addictive, users often turn to buying the pills illegally or switching to more illicit opiates, such as heroin, after their prescription is discontinued or is no longer eligible for refills.
Heroin has become more dangerous in recent years in part due to the availability of powerful new opiates such as fentanyl and fentanyl analogues. Fentanyl is roughly 100 times more potent than morphine and around 50 times more powerful than traditional heroin. For an adult male, roughly 30 milligrams of heroin is considered a lethal dose, but for fentanyl a lethal dose is only 3 milligrams. Many drug dealers cut their heroin supply with fentanyl to make their product more potent. But with such a small margin for error, many dealers use too much. This can result in overdose or death for the individual unfortunate enough to use the drug. Since users often lack the equipment to test their heroin for fentanyl, they often have no idea how much of the substance is in their dose. This is one of the main reasons for the increase in overdoses and deaths related to illicit opiate use.
This rise in overdoses has resulted in increased widespread use of a drug called Naloxone, more commonly referred to by its trade name: Narcan. Narcan works by blocking the effects of opioids. It also reverses the depression of the central nervous system and respiratory system as a result of an opioid overdose. Naloxone was patented in 1961. It was approved as an immediate and lifesaving treatment for opioid overdose by the Food and Drug Administration in 1971, but Naloxone has only recently gained attention as the first tool in the fight against the rising number of overdoses and deaths around the country. All Emergency Medical Technicians (EMTs), firefighters, police officers and emergency rooms in Galesburg are stocked with the overdose reversing drug. The drug is also often carried by the heroin users themselves and can be purchased over-the-counter at Walgreens.
Small towns across the country have been particularly affected by the growing issue of opioid addiction. Rural areas are prime locations for opioid abuse. Small towns, especially those that have become economically depressed after the 2008 recession, have been hit the hardest by this epidemic. This is because these towns have the perfect mix of both doctors prescribing pain medication and residents self-medicating symptoms of stress that come with living in a town that is losing jobs and population. This makes Galesburg fertile ground for an epidemic.
According to the Knox County Coroner, eight people in Knox County have died of opioid related overdoses in the last two and half years. However, the real concern lies in the amount of non-fatal overdoses that Galesburg sees in a year. According to Galesburg Hospitals’ Ambulance Service, or GHAS, their EMTs have used 148 doses of Narcan in the last year. This number doesn’t include the Narcan that the firefighters, police officers and emergency rooms have used to reverse opioid overdoses. This indicates, roughly, an opioid overdose about every day or two in Galesburg; this trend is on the rise. According to Galesburg Fire Chief, Tom Simkins, the Fire Department is responding to more opioid overdoses and less meth lab fires.
Opioid addiction has become an increasingly prevalent problem in Galesburg. According to Bridgeway, Galesburg’s mental health clinic, 21% of their clients had an opioid dependency. The amount of people in Galesburg who are addicted to opiates is frightening, especially when you consider how dangerous an opioid addiction can be.
I met with a couple of heroin users a month ago to hear their stories. They arrived late to our interview and they were both wearing hospital bracelets. When I asked what had happened one of them explained that they were having abdominal pain and had to go to the emergency room. They showed me an X-Ray of their abdominal area and circled a large, dark mass. They explained that the mass was feces, and that since they began doing opiates they had been constipated.
They both sat down with me to discuss their opiate usage. They both started getting involved with opiates through a research chemical called U-47700. U-47700 is about 7.5 times stronger than traditional morphine and, up until recently, was legal to buy online. They told me that, because the drug had such a short high they would wake up in the middle of the night in order to do more and then go back to sleep. “You get woken up by the withdrawal and you have to do more,” they explained.
After the Drug Enforcement Agency placed the drug into Schedule 1 of the Controlled Substances Act, the users graduated to harder opiates, such as heroin. They spoke about the dangers of heroin usage. Because the chemical makeup of heroin can vary wildly, they never knew exactly what they had been given. “It’s so potent that you can’t eyeball it, you never know what you’re getting,” they explained. They said that much of the heroin around Galesburg is cut with things like fentanyl.
As a result, they had both overdosed on the drug several times. Despite having continued heroin use after they had overdosed, they both maintained that they were not addicted to the drug. They traded stories about the various times that they accidently took too much and had to be revived with Narcan by paramedics. They told me a story about how one of them actually died for several minutes. “I heard you take your last choking breath and watched as your face turned from color to gray and your lips turn blue,” one of them said to the other. “I still believe in God, but I don’t believe in heaven anymore,” the other one said, “It’s just blackness at the end.”
I met up with a woman who was cleaning out her friends’ apartment. Her friend is a heroin addict and had to leave the apartment after the paramedics had come multiple times to revive them, and, as a result, the police were watching the building.
We walked into the room and found a sparsely furnished one bedroom apartment. The main room had one chair and a mattress on the floor. The kitchen was trashed, full of dirty dishes, used needles, and rotting food.
As she cleaned the room she spoke about what it was like to have a friend descend into addiction. She had known this friend for years. She said that they had gotten involved in increasingly bad crowds. As her friend started doing harder and harder drugs, the people they were hanging out with became more dangerous. “The more they did, the more dangerous the groups, then they started getting involved with gangs.” She said that her friend got more deceitful, that everything became how to get drugs. “Almost every interaction became ‘How do I get this from you?’”
As she cleaned the room, she found a cardboard box by the mattress. Looking through the box she found syringes, spoons, lighters, cotton; all things needed for injecting heroin. One of the things in the box was a frayed and worn out leather belt, which was certainly used for restricting blood flow in the arm in order to find a vein. She picked up the belt and looked at it for a while before saying, “This is my belt. They used my belt to do heroin.”
There is hope. Many addicts seek help, around 1 in 5 will receive treatment for their addiction. I talked to two people in recovery. One was dependent on prescription vicodin and the other had been using heroin.
The first person I talked to was prescribed Vicodin by a doctor in Galesburg for chronic pain from an old sports injury. After taking the medication for a while she began to build a tolerance and an addiction. At one point, she had three different doctors all simultaneously prescribing her Vicodin in order to sustain her addiction. She was so drugged up that one day, when her family came home and saw her sitting in her chair, they believed that she had died.
When she decided to get help for her addiction, her counselor had her slowly take less and less Vicodin and, instead, replace the Vicodin with more and more over the counter pain relievers. Eventually she was only taking the pain relievers and she realized that her pain could be managed with just the over the counter drugs. “I didn’t need opiates, that was just the first thing they gave me.”
The next person I talked to was a heroin addict. He began doing hard drugs in his 30s after a series of personal heartaches. When I asked about how prevalent opiate abuse was he stated that it was a “bigger problem than people think and is not getting enough attention.”
He said that heroin is widely available in town: “If you gave a kid $30 he would have an easier time getting heroin in Galesburg than he would getting alcohol.”
He also went on to say that the problem is affecting younger and younger kids. He has been recovering for years now and has been going to Narcotics Anonymous as well as Alcoholics Anonymous and says that while the people in AA are on average older, the people in NA are much younger. He says that the people who attend Narcotics Anonymous are usually between 16 -35 years old, the youngest being 14. “They go to the doctor’s for a sports injury and get painkillers or they steal their parents’ prescription(s) and when that runs out they turn to heroin,” he said.
He also talked about the difficulties with receiving treatment in town. There are currently no inpatient recovery centers, and no places for people to detox. “If someone in town wanted to get help they have to go to Peoria or the Quad Cities,” he said.
But not all addicts get treatment. I spoke with a grandmother whose daughter had died of an overdose of heroin cut with fentanyl. The grandmother has since had to raise her grandkids. She said that her daughter's addiction started when her daughter received painkillers from a Galesburg doctor after complaining about back pain. Eventually she was hopping from emergency room to emergency room, trying to get more painkillers. She eventually resorted to buying off the street and then graduated to heroin.
This grandmother felt guilty that she hadn’t recognized the signs of opioid addiction sooner. “I feel like I enabled her, and that I was blind to the signs of addiction.” She watched as her daughter’s drug problem got worse and was unable to force her to get treatment. “She was a good mom and daughter before the drugs took over.”
Her daughter's death hurt her, but it especially hurt her grandchildren. The oldest child witnessed their mother change as she descended into addiction. The youngest child will grow up not knowing her mother at all. “I always thought that this was the kind of thing that happens elsewhere,” she said. Her hope is that more parents will look closer and be able to see problems before it’s too late.
With all of these deaths, and all of these overdoses, it’s strange that so many people are unaware of the problem. While the opioid epidemic is constantly being discussed in national news, state news, and news in larger cities, it’s not being discussed in Galesburg.
The Register-Mail has discussed heroin, however, seemingly only when when it’s related to crime. When they do talk about heroin, it often contains dangerously inaccurate information. In an article published by the Register-Mail in December of 2015, the paper talked about heroin showing up in area arrests. The article talked mostly about the crime side of the drug problem, but it contains information such as, “two deaths were related to fentanyl, which can be classified as morphine” and “one kratom overdose, which is an herbal heroin available online.” Not only are these statements factually inaccurate, they are actually dangerous. Fentanyl is between 50 and 100 times stronger than morphine. Saying fentanyl is similar to morphine is like saying that you kid’s Little League team is similar to the New York Yankees. The second statement is also incorrect. Kratom is a tropical evergreen tree in the coffee family, native to Southeast Asia. Kratom is plant matter that can yield light opiate-like effects. It contains nowhere near the potency of heroin and it is actually showing promise in helping people get off of heroin.
WGIL has never discussed heroin, and seem to be actively suppressing acknowledgment of heroin usage and opioid addiction overall. According to an ex-employee of WGIL, the description of her brief tenure at the radio station mentions that her supervisor dissuaded her from pursuing serious stories including the heroin problem in Galesburg. She claims that her supervisor told her that her reporting was too negative and put Galesburg in a bad light. This is especially worrying considering this issue needs our media's attention so we have a chance at doing something about the ever present epidemic. It is also concerning considering that the owner of WGIL is the current Mayor of Galesburg. When asked about the accusation, Roger Lundeen, General Manager of WGIL, stated that "We try to choose material that is interesting and relevant to the audience. We are not an investigative journalistic organization."
To fix the opiate epidemic in Galesburg we first must all accept that it is a problem. Before we can even begin to discuss what is the best method to help addicts, prevent deaths and prevent drug use, we must first agree that it is a problem we are willing to fix. All towns are going through similar problems. Drug addiction is an illness and the epidemic is no one's fault. But if we choose to ignore the issue and not do anything about it, then we are responsible for the consequences.
Some names and details have been changed or omitted in order to protect anonymity.