It’s impossible to talk about pain management in 2017, and in Southeastern Pennsylvania, without also exploring the opioid crisis.

The Drug Enforcement Agency’s analysis of drug-related deaths in 2015 shows a continued rise in overdoses statewide, especially from opioids. Published last July, it documents 3,383 drug-related deaths across Pennsylvania that year. Heroin and fentanyl, a synthetic opioid often mixed with heroin, were present in 54.6 and 27 percent, respectively, of all overdose deaths.

That means, according to the Pennsylvania Department of Health, that opioid overdoses are the leading cause of accidental death—not just drug-related fatalities—in the state. Bucks and Montgomery counties, with their mix of densely populated and rural areas, ranked in about the middle of the list, with 117 deaths in Bucks and 136 in Montgomery.

However, that changed in 2016. According to U.S. Representative Brian Fitzpatrick (PA-8), Montgomery County had a “staggering” 240 opioid-related deaths last year. Bucks saw 185. “The fact is, our nation’s opioid crisis transcends politics, and so must our response. Any response to this challenge must treat the whole person, not just the addiction,” says Fitzpatrick.

While the crisis is complex, experts ranging from Thomas Farley, Health Commissioner for Philadelphia, to the National Institute on Drug Abuse trace the roots of the problem back to doctors over-prescribing opioid-based painkillers like Vicodin and Percocet. Many people using these drugs, even as directed, become addicted and seek more to combat withdrawal symptoms. Often, users turn to heroin, which is much less expensive than those pharmaceuticals.

So far, 2017 has seen two big pushes at the state and federal levels. In January, Pennsylvania enacted the Prescription Drug Monitoring Program. Now, by law, all doctors and pharmacies must register prescriptions for controlled substances in a database. The idea is to curb doctor and pharmacy shopping, where people go to multiple doctors for duplicate prescriptions and fill them at different locations to avoid suspicion. The database can also be used by law enforcement to investigate and prevent fraud, abuse and criminal activity surrounding the drugs. At the federal level, the announcement was made in April that Pennsylvania will receive $26 million in federal grants through the 21st Century Cures Act to combat the crisis.

It’s still going to be some time before big programs like these show results. Fortunately, they’re far from the only efforts. In recent years, community members and local leaders have volunteered their time and used their professional resources to launch programs aimed at curbing opioid abuse.

“I wish I had the magic formula,” says Cathy Messina, who knows all too well the dangers of opioid abuse. In 2014, she found her two children overdosing on heroin. Her son, David, didn’t survive. In his memory, Messina formed Drug Addiction oVerdose Education, or D.A.V.E. The nonprofit distributes naloxone (Narcan), a drug that reverses the effects of an opioid overdose long enough for the person to get medical attention.

Thanks to other efforts and funding, naloxone is now in virtually every junior high and high school in Bucks County, and in the hands of police and EMTs across the state. Since 2015, D.A.V.E. has held more than 20 information and distribution sessions, from Levittown and Northeast Philadelphia, to Horsham, Roslyn and even Potts-town. “There’s definitely a need, and definitely a want, sadly,” Messina says.

D.A.V.E. stresses that bringing someone back from an overdose is, at best, only the first step toward recovery. But it’s a hard lesson to impart sometimes, even as widespread as the problem has become. “There’s still a stigma. People are under the impression that the stigma’s dying down, but it’s not,” Messina notes. “People are scared to speak out or scared to ask for help. There are a lot of people out there that have a lot to learn.”

She hopes her own effort, and presence, helps others to break their silence and get the help they need—either for themselves or their loved ones. “I’m proud of my kids. They struggled; they fell into something that’s out of their control,” says Messina. “But we’re allowed to love them. We’re allowed to be proud of them.”

She’s not the only one spreading that message. At the end of April, attorney Robert Whitley launched what he calls the Bucks County Drug Epidemic Blitz. The founder of TruthSpeaks.net, which educates people about drug abuse and addiction, Whitley organized seven informational sessions and town halls over 10 days across the county to help raise awareness. “Almost everybody knows someone who has wrestled with addiction. That being said, sometimes… the issue is so ugly that people don’t want to deal with it, or see it, and they push it off to the side,” says Whitley.

It’s a commonality he’s seen in densely populated places like Bristol or Levittown, and in more rural areas like Perkasie or near Doylestown. “You bring up the problem and people go, ‘Really? But this is beautiful Bucks County.’ They see the pastoral, beautiful surface, but they don’t want to see the cancer underneath.”

In Lower Bucks, turning a blind eye isn’t as easy. At least not for Fred Harran, director of Public Safety for Bensalem. The Bensalem Police Department is essentially on the front lines of Bucks County’s struggle with drug abuse. The township borders Philadelphia, is close to I-95 and the Pennsylvania Turnpike, and boasts a population of nearly 60,000 people—the most in the county. That puts it in the crosshairs of drug traffickers, dealers and users.

Harran goes on record regularly, stressing the need for more treatment options for addicts, noting that the police “can’t arrest their way out” of the problem. However, while he’s advocated for more “beds”, or slots available at rehabilitation centers, that’s only one part of the problem.

“There’s not enough treatment for the amount of addicts there are. What no one is looking at is that we’re not shutting off the supply,” says Harran, stressing the need for police to have more resources to go after dealers and suppliers. “If you have a leaky faucet, the beds are the buckets. We have to get to the main.”

Thanks to support from local government, Bensalem regularly spearheads new programs, like an in-house DNA identification program and database that has spread to the rest of the county. One of its newest initiatives is Bensalem Police Assisting in Recovery, or BPAIR.

Based on a similar program in Massachusetts, BPAIR offers nearly unconditional help to anyone that comes to the police station seeking addiction treatment. Police will check those that come forward for drugs and contraband, but won’t arrest them. Instead, each person is paired with a community volunteer that accompanies the individual to a drug treatment facility, and stays to provide support and encouragement throughout the lengthy evaluation and, if qualified, intake process. Launched last spring, BPAIR boasts 60 volunteers and has helped 38 people.

“It’s a slow start. I thought we’d get a lot more folks,” admits Harran. “I think some people are still a little hesitant because it’s the police department.” Still, the program has worked well enough that Harran and others are working to make this a countywide program by the end of the year. To do so, Bucks has applied for a federal grant for all 39 police departments in the county.

That’s where the 21st Century Cures Act can come in: Some of that $26 million may be allocated to a program like BPAIR. For now, however, it’s a matter of time—something that people like Harran don’t see as on their side.

“[The epidemic] doesn’t take a break,” he says. “I had two more overdoses this morning. In the last 24 hours, three fatal. And that’s just in Bensalem.” Until there’s a major change, he warns, “We’re just putting a Band-Aid on a bleeding artery.”

Jack Firneno is an award-winning writer based in Philadelphia. Connect at DadWriterDrummer.com.

June 2017