Opioid abuse is not yet a crisis in Kansas. But Olathe psychiatrist David Willey says it’s heading in that direction.
“What I’m seeing today is scary,” Willey said Thursday. “The truth of the matter is it’s not getting better. It’s getting worse in many ways.”
Willey works at Cottonwood Springs, a new 72-bed hospital that offers inpatient treatment for mental health and substance abuse problems. He spoke Thursday at a panel discussion on opioid abuse hosted by the Johnson County Mental Health Center at the Ball Conference Center. The panel included physicians, law enforcement officials and emergency medical technicians.
“After about four months we’ve been full and we’re busy,” Willey said of the hospital.
Willey said nationwide deaths from prescription opioids are leveling off, suggesting physicians are tightening their prescribing practices. But at the same time deaths from illegal opiates are on the rise, suggesting people who are addicted are moving to cheap street drugs as an alternative.
He also said some users, especially young people, are gong online and buying synthetic opioids that are like nothing he has ever seen before.
“These patients, these people, are having blackouts and convulsions and they end up at my hospital,” Willey said.
But Willey said Kansas only ranks 41st in annual opioid deaths, so there’s time to stem the tide.
Ryan Jacobsen, the medical director for Johnson County Emergency Medical Services, said the county doesn’t have an opioid crisis right now but “it’s certainly on the rise.”
Jacobsen said a search of dispatch records revealed that his staff responded to 86 calls last year that included the words “opiate” or “heroin.” But he said that’s a low figure that doesn’t capture all overdoses.
He also explained how Kansans will soon be able to access naloxone, an emergency medication that can stop an opioid overdose. The Kansas legislature passed a law this year allowing pharmacists to give it out under a standing order from Rep. Greg Lakin, a Wichita Republican who is also a physician.
Starting July 1, any Kansan will be able to walk in and buy it after receiving training from the pharmacist, at places that stock it.
“If people start asking for it, they will start stocking it,” Jacobsen said.
CVS Health has already started stocking the medication in other states with similar laws.
The price of naloxone has been climbing as demand had grown, but generic versions can still be purchased for as little as $40.
The new Kansas law means police officers will also be able to carry naloxone to use when they respond to overdose calls or to use on themselves if they’re exposed to powerful illegal opioids that can be fatal if accidentally inhaled.
“Some law enforcement agencies have hinted they’re going to be interested in carrying it and some have hinted they will not,” Jacobsen said, adding that it largely depends on agency budgets and how prevalent opioid abuse is in their jurisdictions.
Jacobsen said expanding access to naloxone is an important step, but it’s not the solution for fighting opioid abuse.
“It’s just a Band-Aid,” Jacobsen said. “You’re near death if you’re using that drug. We’ve already failed.”
Kim Templeton, an orthopedic surgeon in the University of Kansas Health System, said the medical community needs to rethink how it deals with patient pain. Fewer opiates should be prescribed, she said, and more comprehensive approaches should be employed that focus on helping people function rather than numbing them.
“We’ll never be pain-free,” Templeton said.
Willey said Missouri should end its holdout as the last state without a prescription drug monitoring program that allows doctors to spot patients who are pill-shopping. But he also said physicians in other states need to be far more diligent about using their tracking systems.
He said there also needs easier insurance reimbursement for treating opioid addiction with inpatient therapy and the assistance of alternative medications like suboxone and methadone. He said that’s often the only way to break the grip of the drugs.
Willey knows from experience. He’s a recovering opioid addict who went into psychiatry to help others find the path out.
“I’m not a model of addiction,” Willey said. “I’m just an example of how you can recover from opioid addiction with the right therapy, the right treatment.”