LOWELL — Last year, 31 people died from opioid overdoses in Lowell, a figure that will likely rise once test results come back on 12 pending cases.
“If 31 people died from a pandemic flu or Eastern equine encephalitis, everyone would have their shorts in a knot,” Lowell Health Department Director Frank Singleton said. “There would be a total panic. But no one talks about drug addiction or overdose.”
“It has always been ‘somebody else’s problem,'” added state Rep. Tom Golden, who has championed bringing awareness and solutions to the problem for more than five years. “People have to realize this is all of our problem. It affects our families, our economy and, most importantly, the quality of life in our communities.”
Opioids, a class of substances made from the opium poppy, range from heroin to strong painkillers folks may have in their medicine cabinet left over from a dental procedure, back injury, or from a family member who had cancer, including such drugs as OxyContin, Vicodin, codeine or Darvon.
A review of 911 calls conducted by the Lowell Health Department revealed that overdoses, both fatal and nonfatal, are not unique to one section of the city. While the numbers are higher in lower-income neighborhoods, such as the Acre and Centralville, in which there were 36 and 28 calls, respectively, to 911 for overdoses last year, there were also 15 calls made from the Highlands and 12 from Belvidere.
A total of 195 calls to 911 reporting overdoses were made citywide last year, with 106 male victims and 89 female victims.
Death-certificate records show that from 2003 to 2011, 192 people have died as the result of opioid overdoses in Lowell, with 20 cases still pending.
Of those who died, 62 percent were between the ages of 35 and 54, 86 percent were white, and 56 percent had completed high school.
Singleton pointed out that the demographics do not support the traditional thinking that those who die from overdoses are homeless or longtime junkies. They are student-athletes hooked on pain pills after an injury; they are housewives who were prescribed Vicodin after a root canal and couldn’t stop; they are carpenters, pipefitters and plumbers who injured their backs on the job.
Cheaper than prescription drugs
What alarms Christine Connolly, the public-health nurse manager for the Lowell Health Department, is the increase in heroin deaths over the last four years, from one in 2008 to nine last year.
“It is because it is cheap and people can snort heroin — they do not have to use a needle,” she said.
Connolly said one OxyContin pill costs $80 on the street while a bag of heroin can be purchased for $5 to $10, leading many people addicted to pills to seek out heroin, especially in a down economy.
According to the National Drug Intelligence Center, a daylong fix costs a heroin addict $130 to $200 versus $400 or more to satisfy a prescription-pill habit.
The good news, Connolly said, is “Lowell has something to be proud of — we are really working on the issue.”
In 2008, the Lowell Police Department received a $125,000 MassCALL2 to Prevent Opioid Overdose grant, and the Health Department wrote a strategic plan and began implementing strategies to prevent opioid overdoses.
In the four years since, the MassCall2 working group, made up of 30 people from law enforcement, health organizations and educational institutions, has met several times a year, hosted community forums and provided educational outreach.
The city recently learned the grant has been renewed for another $125,000.
Since last fall, Lowell has offered Narcan, a nasal spray that temporarily reverses the effects of an opioid overdose, to those who are often in the presence of those who may overdose. The city is one of 16 pilot sites statewide to offer the antidote.
It is also now carried on all basic life-support ambulances.
Fear of police involvement
Connolly said one of the biggest problems with overdose has been the fear of police involvement, which often prevents those calling 911 from being honest about the nature of the emergency.
“They will say their friend isn’t breathing well, when in reality they are not breathing at all, so the dispatcher sends the basic life-support ambulance, and when they got there, they have to call for the paramedics,” she said. “That is another three minutes the person’s brain is without oxygen, and that may be too late.”
Connolly said drugs like heroin or OxyContin latch on to the body’s opioid receptors, located in the brain, spinal column and gut. When too much of the substance covers the receptors, the body gets the message that it no longer has to breathe.
The Narcan spray has a “greater affinity” for the receptors and essentially pushes the opioid off it, prompting the body to start breathing again. The problem is, Narcan only lasts in a person’s system for 30 to 90 minutes, while the drugs may be present for more than 36 hours. If the person who is saved uses again, layering more drugs on top of those already in his or her system, they risk death.
“Unfortunately, it is not unusual for someone to be saved by Narcan, be discharged from the hospital and be dead two hours later,” Connolly said. “But we have had this program since last fall, and people have definitely been saved.”
In Lowell, family members and friends of addicts can obtain Narcan and learn how to use it at Lowell House on Merrimack Street and at the Lowell Community Health Center.
Targeting younger students
Golden and Connolly agree that educating the community is the key to winning the battle against opioid abuse.
Golden said what he has heard while talking to high-school students regarding the subject “boggles my mind.”
They have told him that while the community forums and outreach to student leaders is a positive step, “by the time the kids hit high school, they have already made a lot of decisions,” and that the demographic that needs to be targeted is middle-school students.
Golden said he will work with Assistant Superintendent of Student Support Services Ann Murphy and School Committee member Robert Gignac to increase drug awareness and education at the middle-school level.
Connolly said another move in the right direction has been the establishment of kiosks at the police stations in Lowell, Billerica, Tewksbury, Chelmsford, Tyngsboro and, soon, in Dracut and Westford, where residents can safely dispose of prescription medications.
She said the kiosk at the LPD has been in operation for about six months but has not been used to its potential due to the location. She is hoping to find another secure and convenient location in the city to set up a second kiosk.
Also, Golden hopes the in-patient detox center on the grounds of Tewksbury State Hospital, closed due to financial issues in December 2010, will reopen by the end of the year with 34 beds available for patients.
The next step, he said, is to find a way to fund a 30-day residential placement facility from which addicts can transition into properly run sober houses, “not flophouses, but places where they can really get back on their feet.”
Connolly added that there are also several support groups and many resources available to assist addicts and their families in Greater Lowell.
For more information visit www.lowellma.gov/depts/health and www.learn2cope.org or call the Lowell Health Department at 978-674-4304.
