Caregivers Fight To Loosen Opioids Grip

November 2, 2018

Community members, healthcare organizations and elected officials are struggling together in efforts to contain a national opioid epidemic that’s already claimed thousands of lives.

Caring for those in the grip of addiction and helping them recover are 1199 members. While working every day to prevent the emotional and physical tolls of substance abuse, 1199 members are also spearheading public policy initiatives aimed at reducing addiction rates and the death toll from drug overdoses. David Romeo, Certified Alcohol and Substance Abuse Counselor (CASAC) at St. Martin de Porres substance abuse clinic in East New York, said that the rate of overdosing has gone up exponentially since he began working in Brooklyn 14 years ago.

“Opioids have always been used to subdue pain,” he says. “It is the abuse of these drugs that is the new problem we’re facing.”

People who undergo surgery or suffer from chronic pain are being prescribed opiates in higher doses than ever before, according to the U.S. Centers for Disease Control and Prevention. Linda Dickman, an RN at Orange Regional Medical Center (ORMC) in Middletown, NY, cites overdependence for pain relief as a major factor in the opioid epidemic surge.

“Pain is natural and not unexpected with surgery, but it can be managed successfully,” says Dickman. “As nurses we should be realistically discussing pain management with our patients and reinforcing alternative strategies such as relaxation, heat and cold packs. Alternatives such as meditation and Reiki therapies should be billable [to insurance companies] as alternatives to narcotics.”

“We used to send people home after surgery with a month’s worth of pain medication. Now you only get 10 pills. If the pain continues, you need to get a new prescription. In the past, some people would keep taking the [opioid] pills because they believed they had to finish the prescription and became addicted without realizing,” says Jennifer Ortiz-Patton, an ORMC RN.

Romeo says oxycodone is today’s gateway drug.

“Back in the day, people came back from Vietnam hooked on heroin. Now they start on oxycodone. When they can’t get any more oxycodone from the doctor they switch to heroin, which is cheaper than ever,” he explains.

Lawsuits brought by New York City and State are among the dozens filed by municipalities across the country against manufacturers of OxyContin, Percocet and Fentanyl, alleging the drug makers’ major role in fueling the opioid crisis. To assist in combatting the problem on the ground and addressing the grim reality of addiction, 1199’s Executive Council recently passed a pair of resolutions: one promotes the creation of safer consumption spaces, which are locations where users bring their own drugs and administer them under medical supervision. The second resolution called for the legalization of marijuana; the reclassification and sealing of criminal records for lowlevel possession; and the reduction of sentences for those already incarcerated.

Romeo presented both resolutions, explaining that safe consumption spaces provide a supportive, medically supervised environment, where overdoses are treated or prevented, and users can work to become drug-free at their own pace; the strategy has had some success in Canada and Europe.

“[They] are a controversial solution, which is why we need the backing of the whole union if we are going to make it happen,” said Romeo. “But desperate times, need desperate measures. The use of needle exchanges to prevent the spread of HIV was also controversial back in the late ‘80s. It was effective, though.”

Anibal Garcia is a CASAC at Promesa’s Chemical Dependency Outpatient Program in the Bronx. Garcia has clocked thirty years’ experience in drug treatment and counselling.

“In the past, basically 25 percent of all addicts were in California and New York. Now we see it everywhere. It’s becoming a more rural phenomenon,” he said. “Also, for economic reasons, the heroin epidemic is affecting the Caucasian population. Rather than pay $40 for a pill, they pay $10 for a bag [of heroin].”

RN Therese Mandelbaum, a union delegate of 17 years, works in Same Day Surgery at OMRC. She says the current crisis is proliferating at every stratum of society.

“I think most people in the U.S. are dealing with the opioid crisis one way or the other,” she says. “People in this hospital have lost children. My son and daughter have both lost friends.”

“Recently, I saw a 65-year-old man come in with a heroin addiction.

I never saw that before in my nursing career. He was prescribed OxyContin for pain and the prescription ran out.”

The resolutions passed by the Union’s Executive Council in May also sought to address the phenomenon of moving from prescription drugs to heroin.

“ In the past, basically 25 percent of all addicts were in California and New York. Now we see it everywhere. It’s becoming a more rural phenomenon.”

– Anibal Garcia Certified Alcohol and Substance Abuse Counselor

“Arguments for criminalizing marijuana in the first place were not based on research,” explains Romeo. “They were based on the idea that marijuana was a gateway drug to heroin. Nowadays, Oxy is really more of a gateway drug than marijuana. But people of color are being disproportionately arrested and convicted for marijuana offenses.

It affects their whole lives. People and their families are losing their housing because of it as well as having much worse employment prospects.”

Garcia say it’s crucial for healthcare workers to use their professional expertise and personal investment as community members to influence local and national public policy as well as work with their patients to treat and lower the risk of addiction.

“Twenty-five years ago, we had lots of people addicted to one or two things. Now we have people addicted to drugs that didn’t even exist then,” he says. “And 1199 plays a crucial role in the fight to roll back the opioid epidemic. The union has opened the door to politicians who can really help us with our advocacy. When 1199 talks the world listens.”