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Reckoning with Addiction: Shorter lives and other effects

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By John Inscore Essick

Port Royal Baptist Church

The average lifespan for Americans has been going up since the 1960s.

The HIV/AIDS epidemic caused a brief drop in life expectancy in 1993, but the average age began to rise again as we learned how to help those with HIV/AIDS live longer with the virus.

Similarly, public health researchers suggest that the recent spike in opioid overdoses is also lowering life expectancy projections in the United States.

According to the Centers for Disease Control, 2016 marked the second year in a row that life expectancy dropped in the United States.

This means that those born in 2016 are expected to live, on average, 78.6 years (those born in 2015 are expected to live, on average, 78.7 years).

Six out of every 100,000 Americans died of a drug overdose in 2016 (the number was 3.1 per 100,000 in 2015). The numbers for 2017 are not available yet, but public health officials are taking notice of what appears to be an alarming trend.

With more than 140 Americans dying from opioid overdose every day, it should come as no surprise that national, state and local leaders are now acknowledging publicly that we are in the midst of a “public health emergency.” We are still searching for a strategy capable of even containing such an emergency.

Recently I spoke with Roanya Rice, director of the North Central District Health Department, which includes Henry, Shelby, Spencer and Trimble counties, in order to better understand how the health department is addressing substance abuse and drug addiction in Henry County.

Rice described substance abuse and drug addiction as “one of the most pressing problems” in our communities. Henry County’s substance abuse struggles are comparable to neighboring counties, she told me, but she was also quick to point out that Henry County is already actively responding in helpful ways — the August 2017 HOPE for Recovery Walk, for example.

When I asked Rice to describe the health department’s ongoing work among Henry Countians, she said that the health department “brought the Narcan Mobile Unit into every one of our counties, we try to have staff representatives who serve on various community groups working on the issue, and we participate in community forums and walks to bring about awareness.”

Education, community participation and public awareness are important components of a public health response to our addiction crisis, but Rice pointed out that the spread of communicable diseases is a particularly troubling and often overlooked consequence of substance abuse.

Those who are addicted to heroin, for example, are at greater risk to contract and/or spread Hepatitis and HIV/AIDS. At least 20 people in Henry County have been diagnosed with Hepatitis C since 2016, and at least nine of those contracted the disease through intravenous drug use.

Heroin use alone threatens public health, but heroin use coupled with the spread of communicable disease compounds both the depth and breadth of our public health emergency. Reducing the spread of communicable diseases is part of the reason needle exchange programs (NEP) for heroin addicts have been successful in saving lives.

Such “harm reduction” strategies have been employed as a public health tool for the last 20 years, but they remain the object of both misunderstanding and controversy.

There is no immediate plan to begin a syringe exchange in Henry County, and any future plan could not move forward without the authorization of Henry County’s Public Health Board and fiscal court.

Kentucky has around 25 NEPs, and Rice said the Ashland-Boyd Health Department NEP might represent a context similar to ours.

The Ashland-Boyd syringe exchange program began in July 2016. Since then, thousands of syringes have been exchanged and hundreds of addicts have come through the doors.

For many clients the exchange program has been a springboard to getting help for themselves and offering help to others. Maria Hardy, Ashland-Boyd’s public health director, counts at least 50 clients who, after completing an addiction recovery program, have returned to volunteer as peer counselors for other addicts.

These results, Hardy believes, are tangible evidence that syringe exchange programs make a difference. Some will surely resist an NEP. Others will point to places like Ashland-Boyd as proof of NEP’s merits.

Regardless of whether Henry County tries its own needle exchange program, a residential treatment center, or some other program, Rice’s advice is that our public health efforts to reckon with addiction in Henry County be  "multi-pronged. It is going to take a collective effort of the community, health professionals and those who are most impacted working together to find a solution to the issue."

 If we can manage that, the length and quality of lives in Henry County may rise yet again.