overdose – Memphis Flyer

I started this year as many do — ready to embark on new goals, embrace new beginnings, welcome a new year with hope. 2020 vision, we all said. What could go wrong?

My birthday is in January. I can’t remember what I did on what must have been an uneventful turn of age in 2020. February, too, is a bit of a blur. What marked the real start of this year — at least where my lasting memory of it will forever be marked — was grief.

A longtime friend overdosed on heroin in early March. She’d struggled with opioid addiction and substance abuse for years. I tried to help her through much of it, offering a place to stay, clothes and food when she’d lost everything (which was every few months), and connecting her to resources that could help with recovery. She had at least two false starts in rehab. After a couple months in the last one, she snuck out and had her final dance with a needle. I remember the moment I read the Facebook message: “I just wanted you to know that Kristin is in ICU in Methodist North from a heroin overdose. Doctor said that she will more than likely not make it.”

Herbert Goetsch | Unsplash

Looking with hope toward 2021

The punch in the pit of my gut, the pang in my heart, the panic. I spent the better part of that week at Methodist visiting my friend, who was in a coma, as doctors ran tests to be sure nothing else could be done, to sort out possible organ donation in the likely case that nothing could. Between my visits, the news was abuzz with the novel coronavirus. Cases had spread in Washington and it was beginning to look as though it was going to be a pretty big deal, even here. Face masks weren’t a thing yet, but every time I walked into the hospital, I wondered if I was at risk for COVID. Was someone infected there? Was this all being blown out of proportion? I stopped at sanitizing stations and rubbed my hands down to be safe.

At the end of an emotionally draining week, my friend was taken off life support. Her memorial service was the last large gathering I attended this year. I carried hand sanitizer, avoided hugs with anyone aside from Kristin’s mother, and winced when someone coughed or sneezed nearby. Had they not heard of coronavirus yet? There are too many people in this room, too close together, I thought.

I grieved for Kristin, of course, but not in the way I would have if it wouldn’t have coincided with the emergence of a worldwide pandemic. I’ve grieved for her throughout this year, but with no hugs, no face-to-face conversations with friends who knew and loved her, too. My sadness over her loss was inadvertently overridden by a new punch in the gut, a different type of panic — one I wasn’t familiar with at all. How many people will die? Will I die? How bad is this virus? How far will it spread?

As the next few months unfolded, we all grieved. We grieved for lost jobs, loved ones who succumbed to COVID. We grieved in the absence of friends and family, for the loss of “normalcy,” whatever that might have been. We pined for gatherings, concerts, theater outings, for any thread of hope that this mess would right itself. We longed for conversations, handshakes, workplace camaraderie, a beer at a damn bar. The world turned upside down, and we were given no clear instructions on how to best proceed. There was no united front.

In some ways, I’m relieved that Kristin’s struggle ended just before the world’s battle with COVID began. She’d likely have been on the streets, risking infections of all types, but perhaps especially the virus. She wouldn’t have had a safe haven like some of us have, nor easy access to soap and showers and sinks. There are many others like her — homeless, struggling with addiction or mental illness, isolated in the truest sense.

With all that’s been lost this year, I’m more grateful than ever for what I do have. A roof over my head, a job (though we’ve been working remotely since March and I miss the shit out of my co-workers), a partner who handles my COVID-fueled existential crises in stride, and so much more.

If you’re reading this now, you have survived this year, too. Perhaps we’ve been through the worst of it. At the very least, we can look at these broken pieces and be thankful for what’s left and how far we’ve come — and to look with hope toward 2021.

Shara Clark is managing editor of the Flyer.

Justin Fox Burks

Drug overdose deaths rose to a record high in Tennessee in 2018, according to new statistics released by the Centers for Disease Controls (CDC), while the numbers were down nationally.

There were 1,837 drug overdose deaths recorded in Tennessee last year, 3 percent more than in 2017. However, such deaths were down 5.1 percent across the country, marking the first decline of overdoses in 25 years.

The figures were discussed recently on an episode of Tennessee Court Talk, a podcast from the Tennessee Supreme Court and the Administrative Office of the Courts. The episode featured Special Agent Tommy Farmer from the Tennessee Bureau of Investigation (TBI) Dangerous Drug Task Force and Dr. Robert Pack, professor of community and behavior health at East Tennessee State University (ETSU).

Farmer, from the TBI, said he wasn’t surprised to see the increase in overdose deaths but hoped the state would “plateau off.” He said the rise is thanks to a transition to illegal drugs from prescription medications.
[pullquote-1] “There’s no doubt it has to do with fentanyl and heroin and the availability of them,” Farmer said.

Pack, the doctor from ETSU, said he didn’t expect a dramatic decrease in the figures here but was pleased to see the shift in the figures nationally. He said headway on reducing overdose deaths in Tennessee won’t be made unless changes are made closer to the source of the problem.

“We have to get upstream as far as we can to stop the cycle of addiction that is occurring in these (communities),” Pack said. “If we can’t stop it, then all we can do is repeat it.”

One way to do that, Pack said, would be to influence kids to be more resistant to drugs.

While much more work needs to be done, Pack and Farmer said gains have been made in Tennessee, particularly addressing the opioid crisis. Pack said more agencies are better reporting overdose deaths now than ever before, which could be one reason for the 2018 spike.

“We’ve said for a long time that the numbers were grossly underreported,” Farmer said. “There’s a lot more out there than we’re actually seeing. I do believe this number indicates that we’re doing a better job of getting good information.”

Overdose deaths are higher in big cities, Farmer said, but that doesn’t always mean the deceased lived in them. Large cities serve as a source of drugs for dealers, so drugs are cheaper there. Also, people want to be closer to the source of their drugs, so they’ll travel to it. When they get the drugs, they don’t wait to take them home, he said, “they’re getting the drugs and overdosing at that location.”

Pack said Tennessee now has better access to care and drugs to help those addicted than ever before.

Fentanyl, a synthetic opioid pain reliever usually prescribed to cancer patience, is on the rise in Tennessee, Farmer said. The drug is powerful, he said. One thing that means is that it’s shipped in smaller units (like the size of two sugar packs), making it harder for law enforcement to detect.

DEA

The opioid fentanyl can be 100 times more potent than morphine.

The drug is being mixed with methamphetamine or heroin. It’s smuggled to Tennessee largely from suppliers in China or Mexico, Farmer said. For users, “it gives them an incredibly powerful high,” Pack said.

What fentanyl gets mixed with largely depends on what is popular in different areas of the state, Farmer said. In Memphis, that’s heroin, where “there’s always been a steady availability” of the drug, he said. Oxycontin is popular in Oak Ridge and Percocet is favored in Nashville.
[pullquote-2] But dealers will blend their drugs with just about anything, Farmer said, if they fear customer complaints. He said TBI agents have found drug operations outfitted with blenders bought from Walmart or Walgreens producing drugs that are not at all what the dealer said they were selling.

“We’ve seen crazy concoctions, made from anything they can get their hands on, from aspirin to ibuprofen to vitamin B12,” Farmer said. “It doesn’t matter as long as it gets them high. The potency of fentanyl is so powerful in microscopic amounts that it doesn’t take much at all.”

Meth returns

Meth is returning to Tennessee “with a vengeance,” Farmer said. The TBI lab is on track to get more submissions of meth than ever before.

“We’ll probably see more than even back in the heyday and at the height of our meth epidemic when the state of Tennessee had the dubious distinction of being No. 1 in the country, the meth capital of the country,” Farmer said.

Laws here have made it harder to get the ingredients to make meth and seizures of meth labs have decreased here by about 86 percent, Farmer said. But what remains is an “insatiable appetite for stimulants in our state” and a steady supply of meth from Mexican drug cartels.

Pack said methadone clinics are seeing a rise in patients screening positive for meth.

“We can’t just deal with this on the treatment side,” Pack said. “We have got to get upstream and deal with whatever it is that is driving people to seek (meth) to fix their pain, their physical or emotional pain with something other than coping or other effective strategies.”