In a rough 48 hours last June, Macon emergency rooms admitted more than a dozen people who had swallowed street pills disguised as the painkiller Percocet.
The craving for a strong analgesic drove each patient to buy little yellow pills from people who didn’t care what they were selling.
One hospital medical director said he’d never seen so many overdoses in such a short stretch. Law enforcement officers, including the GBI, tracked what a sheriff called “poison.” Most people survived, but investigators suspected the pills in four deaths.
That’s just one example of what Georgia is wrestling with — and the cost to the public purse of what’s called the “opioid epidemic.”
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“It’s not just an Atlanta problem — it’s a problem in Middle Georgia,” said state Sen. Larry Walker III, R-Perry. “It’s ruining lives and killing people and probably driving up our crime.”
Sometimes folks get into opioids with a legitimate painkiller prescription after a surgery, for example. But that family of chemicals, which includes heroin, is addictive.
Opioid addiction drives folks to get drugs where they can. Sometimes that's by asking several doctors in a row, called “doctor shopping.” Or maybe going to the black market, where things that are stronger than heroin are for sale.
Hospitals come in when there’s an overdose, a tainted batch, a baby born addicted. Emergency rooms fill up. Cops run after the pushers. And then there are the Georgians who battle addictive disease.
Renee Unterman has met lots of people with stories of addiction. Earlier this month, as she presented Senate Bill 352, she looked up to the second floor of the Senate chamber, where guests sit.
“I dedicate this bill to two mothers,” she said, gazing toward Kathi Abraham and Lisa Manning, mothers whose sons, Joseph and Dustin, died of suspected opioid overdoses on the same day last year. The families lived in the same subdivision, just four streets apart.
“We have people peddling lethal substances,” said Unterman, R-Buford.
Her Senate Bill 352, approved unanimously, does a couple of things.
It would create the office of a sort of drug czar, an executive director of substance abuse, addiction and related disorders, who would oversee a state Commission on Substance Abuse and Recovery. The office will work to unify efforts among state and local agencies — law enforcement, public health officials and others — who confront the addiction and substance abuse crisis.
It also explicitly bans a scam that has kept prosecutors in places such as Delray Beach, Florida, busy: so-called “patient brokering.” That’s when owners of spurious halfway houses accept kickbacks for sending well-insured patients to equally spurious outpatient treatment programs, which bilk insurers. No one gets real treatment.
“This is a long, long journey,” Unterman said near the end of her speech. She said she intends to be back next year to keep working on the latest opioid front.
The state is trying to keep from going the way of places like Kentucky and Ohio, states where opioid addiction rates are among the highest.
Several states and hundreds of counties have sued opioid manufacturers, accusing them of deceptive marketing and downplaying opioid risk. Plaintiffs such as Fulton County say it costs taxpayers plenty, everything from police time to morgue space. Athens-Clarke and Oconee counties initiated such lawsuits earlier this month.
10 years behind
Neil Campbell said it means something to see “recovery” in Unterman’s bill, that people who are in long-term recovery are at the table. She’s executive director of the Georgia Council on Substance Abuse.
“The messages that you get around addiction are just so grim, and that’s not true. People can get better,” she said.
But she also said Georgia — and the country — are at least 10 years behind, that overdoses really started increasing in the early 2000s.
“Not only are we playing catch-up, our heads are in the sand about what we can do about it,” she said.
The council offers some direct services, including peer support, working with people whose lives are moving much faster than the stately pace of government, education or much of anything else.
“We hear, every day, people struggle. (They say) ‘I can’t get my kid into care. I have to get my kid arrested in order to get services because the only thing here is a drug court,’” Campbell said. “If someone has diabetes, they can get help. If they have an addiction, where can they go?”
One place that offers such services — among many other services — is the Phoenix Health Center in Warner Robins. It’s part of a network of such centers statewide that get public funding and take clients regardless of their ability to pay.
About 14 percent of all people enrolled in substance abuse services there have an opioid-related addiction, said the center's interim director, Beth Ragan.
She said opioids are a high priority for the state department that works with centers like hers. They’re making sure the centers are trained and ready to help.
“As the statistics show increases, even though we’re not feeling it at the significant rate that other areas are feeling it, it doesn’t mean that we won’t, and so we have to be prepared if and when that happens,” Ragan said.
No matter what the substance, though, addiction recovery involves “wraparound” services: follow-up care, therapy, helping people develop skills, helping them overcome whatever drives the behavior, she and her staff say.
Back at the state Legislature, meanwhile, Walker is carrying another incremental bill, another brick in the wall Georgia is trying to put up between opioids and addiction.
Georgia health care providers are supposed to log opioid prescriptions in a database so that they can see if patients are getting a lot of prescriptions. His bill would allow law enforcement agencies from other states look in the database — if they have a search warrant. It's meant to remove state borders in the investigation of possible criminal cases.
Walker, like others, says there's plenty more to be done.
“I think you could throw as much money as you wanted to at this problem and it would still be a problem,” he said.
Unterman also said more needs to be done. She’s got plans to try and get new money for fighting the epidemic in the budget for the year that begins in July.
Time is getting short this year, though. The annual legislative session ends in late March.