Navigating the heroin minefield

By on June 2, 2016
(Left to right) Craig Stedman, Lancaster County District Attorney, and emergency room doctors Michael Reihart, of LGH/Penn Medicine, and Dr. Christopher Echterling of Wellspan, discuss the drug addiction epidemic during a forum, at Ephrata High School. Photo by Patrick Burns

(Left to right) Craig Stedman, Lancaster County District Attorney, and emergency room doctors Michael Reihart, of LGH/Penn Medicine, and Dr. Christopher Echterling of Wellspan, discuss the drug addiction epidemic during a forum, at Ephrata High School. Photo by Patrick Burns

Everybody knows heroin is a highly addictive opioid narcotic that first robs ambition, then dignity, and, all too often these days, one’s freedom and/or life.

The destructive heroin epidemic is widely documented as news stories abound of grieving parents, an overwhelmed legal system, besieged medical professionals, and swamped recovery centers.

A group of professionals from those aforementioned fields met last week in Ephrata, along with a trio of ex-drug users, in a “conversation” about how to prevent a miserable and terrifying future for our local youth.

But some of the 175 people who attended the forum organized by the county’s Anti-Heroin Task Force at Ephrata High School on May 26, came away with something perhaps unexpected: Hope.

Joel Jakubowski of Teen Challenge Training Center said society is getting better about responding to addiction “but we’re not quite there yet.

“Can you imagine if we lit every house on fire in this nation that’s experiencing addiction,” he asked. “Oh wait a minute, they are on fire. “That is what’s happening; our homes are on fire. Our neighborhoods are on fire. Fires kill people and so does addiction.”

The response to the drug epidemic — it is the leading cause of death among people aged 24 to 44 — is to educate, said Jakubowski.

“We need to send people out into the world as advocates for truth, getting away from the myths” about addiction, which all members on the nine-member panel described as a disease, he said.

Jakubowski credited Lancaster County Judge David Ashworth who was in the audience listening to the panel which included Craig Stedman, Lancaster County District Attorney; front-line emergency room Drs. Michael Reihart, of LGH/Penn Medicine, and Christopher Echterling, Wellspan.

Ashworth presides over a unique Drug Court program — “one that’s the model used around the state” — that helps offenders eliminate their dependency on drugs, Jakubowski said. The result is a dramatic decrease in repeat in offenders and lives that get transformed.

Other advances include alleviating the threat of being prosecuted for reporting the overdose of others through the Good Samaritan law and the introduction of lifesaving Naloxone which revives overdose victims.

Still, funding for addiction treatment has been cut 22 percent since the 2008-09 fiscal year, according to a report titled, “Heroin: Combating this Growing Epidemic in Pennsylvania.” The report also said only one in 10 people who need addiction treatment are able to access it.

Ephrata Mayor Ralph Mowen, who chaired the event, prefaced the meeting stating that heroin is not a local problem but a national one that “crosses all economic conditions, geography, race, gender, and age.”

Stedman echoed Mowen’s views stating “the United States has 5 percent of the population and 80 percent of the drug overdoses (deaths).”

EMTs in Lancaster County responded to 1,000 calls for overdoses in 2015, Stedman said.

“That’s 5 percent of all the calls they respond to,” he said. “Think about that. That’s 5 percent of time when they can’t respond to somebody who is a law abiding citizen who has health problems.”

Much of the conversation, especially from drug counselors and former users, Dave Highfill, residential coordinator at The RASE Project; and Jack Pacewicz, of Empowering for Life; discussed the causes of addiction and how to avoid it.

Echterling discussed the lingering problem of people becoming addicted to opiate meds prescribed for pain. He advocated that those prescribed such meds as oxycodone and oxycontin to develop an “exit plan” with their doctor to switch off to different treatment and even doctors scrutinizing patients’ drug use doing “pill counts.”

“We’ve started that out at many of our practices at Wellspan and have gotten a negative reactions from many people who say ‘You’re treating me like a drug addict’,” he said.

Echterling said the risk-benefit profile of opioids for pain management is “not what we thought it was five or 10 years ago.”

He equated it to prescribing a patient Coumadin for a blood clot and not checking the patient’s blood for two years to see if the medicine is the right dose.

“My colleagues would consider me practicing malpractice,” he said.

Reihart, LGH emergency medical director, also noted that addicts are often mixing heroin with even more lethal drugs such as fentanyl, a powerful painkiller that can be 80- to 100-times stronger than morphine or heroin alone.

He said it’s vital to discuss the dangers of drugs and poor decision making with young children

“People don’t just one day say I want to become a drug addict,” Reihart said. “There’s deviations over a lifetime, you can take that wrong turn one percent of the time over 30 years and end up being a 90-degree angle from where you want to be.”

Amy Sechrist, of Compass Mark, said addiction can be avoided through preventative action and noticing the warning signs early in young people. She said alcohol can also create a path for some addicts who may be genetically predisposed to addiction.

“Not everyone who ends up addicted to heroin starts with pain killers,” Sechrist said. “They start out like how we all start out, they try alcohol.”

Pacewicz, who grew up in Western Pennsylvania, talked about coming back from from poor decision that led him to addiction and 17 years in jail for numerous crimes that fed his habit.

In recovery for 36 years, Pacewicz often introduces himself as “an addict” at meetings.

“But I’m not going to say that today because addiction is not an identity it’s a disease,” he said to the loudest applause of the evening.

While the panel agreed that drug addiction is a disease — addicts crave a shortcut to the brain’s reward system by flooding the nucleus accumbens with dopamine — Stedman noted the heroin epidemic was fueled by societal influences.

“One of the reasons it’s become a big problem is because of the breakdown of the family,” which Stedman called the “No. 1 defense” against crime and addiction.

Stedman also blamed a dismissive attitude about the dangers of highly potent marijuana, which is the drug panelist said often begins the journey to heroin addiction that typically begins around the age of 14.

“We’ve got a cultural decline, let’s tell it the way it is,” he said. “(Marijuana) is in songs, it’s in popular culture, we have a president who said ‘what’s the big deal,’ essentially about smoking a little marijuana.”

Stedman cited a recent study of heroin addicts by the Center for Rural Pennsylvania.

“Every single one of those heroin addicts they encountered had used marijuana before they abused heroin,” he said.

Patrick Burns is social media editor and a staff writer for The Ephrata Review. He welcomes your questions and comments and can be reached at or at 721-4455.


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