The Opioid Overdose Epidemic Ep 2 – The Law Enforcement Perspective
By Lauren Brande | Published 11/06/17
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I’m Lollie, and in this series, we’ll be talking about the recent opioid overdose epidemic in the United States. Overdose deaths related to opioids (both prescription painkillers and illicit opioids like heroin) have seen a drastic and tragic increase over the last 5 years alone. Tens of thousands of people are dying every year, and this number is on a consistently rising trend. Why is this happening, and what can we do?
I sat down with three people who interact with the looming opioid crisis on a daily basis: a detective working to protect the people suffering with opioid addiction, a doctor who works to help those who have had their lives devastated by opioid abuse, and a recovering addict that has faced and overcome the throes of opioid addiction.
The Law Enforcement Perspective
In this episode, I’ll be talking with Detective Nicole Lucas of the Delray Beach, Florida police department.
Nicole Lucas: My name is detective Nicole Lucas, and I am a detective for the Delray Beach Police Department in Delray Beach, Florida, and I’ve worked there for about 11 and a half years now. I’m currently assigned to the Sober Homes Task Force.
The Sober Homes Task Force is a task force organized by the Palm Beach state attorney’s office to combat what is called “patient brokering” in the recovery community. Patient brokering refers to the practice of referring people in need of treatment to particular clinics. Doesn’t sound too bad, right? Well, the disturbing side of this is that many of the clinics that pay for these referrals are doing some pretty ugly things.
The addiction treatment industry isn’t very well regulated, though this has been slowly changing over the last few years. Many treatment centers operate as private institutions, meaning there is little, if any, federal oversight. Many lack certification, and some use this relative anonymity to take advantage of vulnerable patients. Insurance fraud is one of the main motivators for patient brokering. Insurance fraud is when a treatment center bills a patent’s insurance for treatment services that were not given. In some cases, the treatment center may even be providing drugs for the patients, just to keep them in the program so that they can collect the insurance money. As if this wasn’t enough, some center owners are even holding patients hostage, selling them as prostitutes, and threatening them if they ever try to leave.
Nicole Lucas: “It’s just so easy for treatment centers to take advantage of people because they’re in their most vulnerable state–the families are at their wits end, people are dying, and they just want help so bad that they don’t necessarily realize what they’re getting into. It’s just a really vulnerable population and once a family sends a loved one away for treatment, a lot of times that person has broken all trust with the family. So now they get to a place that they don’t know and all these unfortunate things are happening to them, like maybe their medication is being withheld, or their cellphone is taken away, or their car keys are taken away, or they’re forced into prostitution, or they’re forced to go to treatment centers where they’re not really getting treatment–many bad things are happening to them, but the treatment center is saying, “No one’s going to believe you.” They’re telling the family one thing, or they’ll threaten the patient, “We’re going to tell your family you’re doing a bad job or you’re doing this or that if you don’t do” whatever it is that they’re telling them to do. And they’re telling them, “law enforcement’s not going to believe you, your family is not going to believe you” and they feel that they have no choice because if they call home and say, “Mom, dad, aunt, uncle, this is a horrible place,” they’re going to say, “I’ve seen the pictures on the internet, that’s a beautiful place!” You know, they just think they’re being manipulated again. So, that’s how the centers have been able to do these things to people.”
This means these illegitimate centers are getting all the money, and legitimate ones that are regulated are struggling financially. That hardly seems fair, right? Enter Detective Lucas and the Sober Homes Task Force.
Nicole Lucas: “For me, my goal is that I want, when someone comes forward and says, “I have a problem and I need help” that then they get help. They don’t get abused and used for their insurance benefits. We need the centers that care about the people, and they’re the ones that are struggling the most. It’s hard for them to stay open because they can’t compete with the big centers that are just giving food cards and gift cards and clothes and shoes and letting people not follow the rules because they don’t care about them, they only care about the insurance benefits, but the centers that are regulated and not giving away free things, they’re struggling financially. So, hopefully with the work that we’re doing (and hopefully other jurisdictions will follow) the bad places will be closed down, so that the good places will be able to continue to run and actually help people.”
As I spoke with Nicole, I could tell that she is extremely passionate about this. I mean, it’s hard not to be when thousands upon thousands of people are needlessly dying every year. As a law enforcement officer, Detective Lucas interacts with the opioid epidemic on a regular basis. Her agency, the Delray Beach Police Department, has taken proactive steps to address the crisis on a daily basis.
Nicole Lucas: “We got Narcan pretty much as soon as we were able to, and there are patrol officers that are administering Narcan, I would say, every day, usually at least twice a day, saving lives. So therefore, our deaths have significantly decreased because we’re very forward. There’s a lot of agencies that won’t carry the Narcan because they say that’s not law enforcement’s responsibility. Maybe it is or maybe it isn’t, but I feel that we’re here to save people, we’re here to help the community, and law enforcement is, I can’t say an exact percentage, but we’re almost always at a scene of any type of incident before the paramedics. That’s why we’re supposed to know first aid, that’s why we’re supposed to know CPR, and why all officers across the entire country should be carrying Narcan–because lives are saved by that.”
On top of this, they have hired a recovery community advocate to help people struggling with substance addiction find legitimate, safe help, and they thoroughly investigate every overdose to catch the “bad guys.” These efforts can, and have, made a huge difference in the overdose crisis, at least in the Delray Beach area. But, how has this epidemic affected the officers themselves?
Nicole Lucas: “We have a lot of young law enforcement officers, and who’s to say what emotional toll that’s taking on them? They’re going to deaths a couple times a week (that number has gone down, like I said), but we responded to a lot of overdose deaths last year, people the same age as our younger officers. So, we don’t know psychologically how all this death and even the administration of the Narcan and what officers and the firefighters have to witness every day, if that will have a toll long-term.
I think that’s also something, as far as people in recovery as well. This is traumatic for our whole entire country. There’s kids, there’s people that are experiencing more death at, you know, 19, 20, 21, 22 years old than most of us will experience in our whole lifetime. You know what I’m saying? It used to be that you maybe knew 1 or 2 people–your grandmother, your grandfather, you know, somebody old passed away–but now all these young people are dying, and we don’t know, I think as a country, what the effect of that is going to be.”
This crisis is not only taking a tragic toll on the lives of those struggling with heroin and painkiller addiction, it is taking a psychological toll on emergency responders and loved ones. The opioid epidemic is a national emergency, even if it hasn’t been officially declared one. Opioid addiction can take hold of anyone, even when the source of the drug is a doctor.
Nicole Lucas: “I mean, police officers, teachers, firefighters, doctors, you know, parents of children, upstanding citizens, and then what do you do now, when all those pills are taken away? So, I think that when people say, “Well, that could never happen to me,” [the truth is] it could happen to anybody. It could happen to any of us. A lot of the people, they just followed the doctor’s orders and they became dependent on these.”
Too often, this addiction starts with a prescription and ends with an overdose. For many who have not experienced what it’s like to struggle with an addiction, understanding why so many people continue to use heroin and opioids despite the huge risks can be difficult. Opioid addiction is so much more than simply wanting a drug. As a person becomes increasingly dependent on heroin or painkillers, whether physically or psychologically, they begin to need the drug in order to feel normal.
The addiction grows and grows, taking over more and more aspects of their lives, including damage to areas of the brain related to planning a way out. This means that even if a person wanted to end their opioid addiction, setting a plan of action and following through with it is significantly more difficult because of the damage that opioid abuse has caused in their brain.
Nicole Lucas: “The people are going through some of the most horrific experiences, and losing literally everything, and they wouldn’t be doing that if this drug didn’t have such a stronghold on them. I mean, I don’t know any mother or father… I guess I don’t understand how any mother could leave her child, and people are just giving up everything for this drug. So, it just has to be stronger than any of us can understand that don’t use it.”
Another aspect that contributes to this tragic overdose epidemic is the presence of other, stronger opioids in street heroin, like fentanyl and carfentanil. To give you some perspective on why adding these drugs to heroin has caused such a problem: Fentanyl is 50-100 times more potent than morphine and 30-50 times more potent than heroin. Carfentanil is almost 10,000 times more potent than morphine.1 Exposure to even a small amount of these drugs can be extremely deadly, and drug dealers are cutting their street heroin with them.
Nicole Lucas: “Historically, drug dealers always cut their product with something, whether it be some type of powder that they get from GNC, or baby aspirin, or some type of material that looks like whatever the drug is that they’re putting it in, so that they can expand the amount so that they can increase the profit. Most likely, they probably thought, “Okay, if I just put a little of this fentanyl in here, I’m going to increase the weight and I’m going to increase the potency so I can increase my profit. I don’t know that any… I think there’s few people in the world that would put something like that in to purposely kill people. But, I think once it started it kind of got out of control and now I don’t know, you know, why it would continue. But, I’m sure initially it just started with trying to make more money.”
The question many people are left with is: why are people still buying street heroin if they know there’s a good chance it could kill them? Is the threat to your life worth the high?
Nicole Lucas: “Okay, from all the interviews that I’ve done it sounds like the heroin with the Fentanyl is not as enjoyable as straight heroin. So, in my understanding, nobody is actually going out there trying to buy fentanyl or heroin with Fentanyl in it. They just have such a strong psychological and physical addiction to heroin that it’s kind of like chasing the dragon–you’re always trying to find that [feeling] like it was the first time. It’ll never be that again. But, they’re just so addicted, they just have to keep trying. They want heroin, but there’s no way to know what you’re getting.
That just shows how strong this addiction is, that you’re putting things in your body that you know could kill you but you can’t help it. There’s some cases where people have started to literally put the needle into their arm, so there’s still blood in the needle, and dead. That’s it. I mean, just that fast. They haven’t even been able to fully inject what was in the needle because it’s so potent. There’s drug dealers saying, ‘Don’t do that whole cap, that’s fire,’ (that’s the street terminology meaning that it’s potent). There’s people where maybe they could have done a whole cap of heroin 6 months ago, now they’re doing like a quarter of a cap. They’re trying–they don’t want to die, but it just has this hold on them. Until they can get to the point where they’re ready for help, they’re just going to try whatever is out there on the street.”
* * *
In the end, it is everyone responsibility to help stop this overdose epidemic. Thanks to efforts from law enforcement officers like Detective Nicole Lucas and the Sober Homes Task Force, many people struggling with opioids have a way to get help and reclaim their life without fear of being taken advantage of or abused because of their addiction. As harm reduction efforts expand, we hope to see the rates of overdose decline, but until then it’s on all of us to help when we know someone in need. If you’re ready to get help for yourself or a loved one, call and we’ll connect you with an established treatment center.
Our next episode will look at the opioid crisis from a doctor’s perspective. What kinds of split-second decisions have to be made when considering whether a person is safe to take opioids? How do doctors assess the risk of addiction, and how has this crisis impacted U.S. healthcare? Make sure to subscribe so you don’t miss out on the next episode of #LetsTalkDrugs!
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- U.S. Department of Justice. (2017). Fentanyl: A Briefing Guide for First Responders. Drug Enforcement Administration.
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