Mon. Jul 4th, 2022

Opioids: ‘End the Stigma of Addiction’

She walked up to the mic to the side of the small stage and modestly remarked that she had no idea why she had been invited to the event.

Someone knew what they were doing because by the time the session ended, Cheri Walter, without a teleprompter or written notes in front of her, had delivered an informative but blunt and moving presentation worthy of any Tony Award-winning performance taking place on a Broadway stage not far from where she spoke.

So, too, Joe Rannazzisi, a former top DEA supervisor turned whistleblower who exposed how the pharmaceutical industry, with the help of Congress and lobbyists, actually worsened the opioid crisis and disrupted the federal agency’s ability to go after “drug dealers in lab coats,” as he once described it.

Walter, who heads Ohio’s Association of County Behavioral Health Authorities, a nonprofit, was among the panelists in the 13thannual two-day conference held by the John Jay College of Criminal Justice’s Center on Media, Crime and Justice.

The event, sponsored by the Harry Frank Guggenheim Foundation, brings together cops, prosecutors, journalists like yours truly, academics, public health professionals and others to discuss crime-related trends. The theme this year? “Justice in the Heartland,” with the opiate crisis as the focus of two panels.

What she and Rannazzisi shared about a substance abuse epidemic that has taken more lives annually in recent years than gun violence, motor vehicle crashes and the HIV crisis at its peak should resonate here and nationally.

Walter knows this issue personally and professionally. She has been in recovery for 36 years. Her mother was a longtime prescription pill addict who died at the age of 86.

Ohio in 2016 recorded the most drug-related overdose deaths of any state, mostly from heroin or opiates — 4,149.

“An addiction is an addiction and we have to address the underlying issues of this disease,” she told the audience. “But the reality is that this addiction is different than most. People become addicted to opiates much quicker than any other drug we have ever seen. Because of fentanyl, a game changer, this drug is deadlier than any we have ever seen….

“The problem we are not talking about is the emotional impact this disease is having on our communities,” she added, “and the emotional impact this disease is having on our first-responders and the emotional impact this disease is having on users who may or may not believe that they can recover.”

In Ohio, as she noted, the process by which first responders revive overdose victims with a naloxone hydrochloride injection has become a verb — a person has been “narcanned.”

But that revival runs hollow if the person is discharged from an emergency room without follow-up, only to be revived again and again. Enter quick-response teams, which arguably first got off the ground a few years ago in a southwest Ohio county reeling from an opiate overdose crisis.

The teams, composed of cops, emergency medical technicians, treatment providers and, as important, certified or credible peers in recovery, visit the overdose victim at their home or other site within 72 hours of their emergency room, clinic or hospital visit.

Cheri Walter

Cheri Walter

“They visit the person who was saved the day before, the next day,” Walter said. “These are the kinds of things we have to do.”

Such efforts are being funded by grants through that state’s attorney general’s office.

“If we don’t keep people alive from the overdose or the addiction, they will never get into recovery,” Walter said. “We have to keep them alive first.”

I don’t know Walter’s politics or lifestyle, or whether she’s into salsa or square dances, or meditates or does yoga. I couldn’t care less. She spoke truth to power for me at the event. She had more to say that struck home.

“We have to talk about the fact that this is a disease,” she said. “If I had diabetes, it would not matter how many times I wound up in the ER because I ate too much sugar. The same has got to be true of addicts …”

She once thought the addiction stigma dissipated as the opiate victims were coming more from the suburban, wealthier communities. She believes that stigma has persisted, if not worsened. She has heard from constituents who wonder what the point of saving the lives of addicts is if some will only come back to rob and steal again.

“There’s meanness in politics right now.” She said. “Ohio is a very conservative state. We actually right now have people talking about, ‘Now, well, the second time people are narcanned, maybe we should make that a crime.’ Really? We are going to criminalize addiction?

“Now, I don’t think that’s going anywhere because calmer heads will prevail,” she said. “But I think when people don’t know what to do, sometimes, on a political level, what they try to do, they try to clamp down on everything, thinking that it will go away, when if anything it will just put it in the shadows and people will not come forward and they won’t get help.”

She also pointed out that cuts to federal Medicaid expansion funds will backfire in the long term.

The expansion “has been the single most important thing for helping individuals with an addiction in Ohio get treatment,” she said. “If Medicaid goes away in Ohio there would be literally billions of dollars dumped into our system just to get all those people who got into treatment back into treatment.”

Rannazzisi followed during an afternoon panel.

Joe Rannazzisi

Joe Rannazzisi

The 29-year DEA veteran, who retired in disgust in 2014, was the centerpiece of a Washington Post/”60 Minutes” exposé that found a “drug distribution industry that shipped, almost unchecked, hundreds of millions of pills to rogue pharmacies and pain clinics providing the rocket fuel for a crisis that, over the last two decades, has claimed 200,000 lives,” as the project described the issue online.

Rannazzisi, then the head of the agency’s Office of Diversion Control, the division that regulates and investigates the pharmaceutical industry, faults the distributors for fueling the opioid epidemic by not doing anything while knowing that pain pills were diverted to illicit use.

“During the height of a drug epidemic driven by the pharmaceutical industry, why is it that Congress would pass a bill to protect the pharmaceutical industry?” he asked the audience. “The pharmaceutical lobby is the strongest lobby in Congress. They are not going to change until we force them to comply.”

He retired in frustration after he went from supervising 600 agents to none.

“I was tired of bureaucrats and I was tired of politicians and tired of talking to parents who lost kids,” he said in a choked voice. “I will be the first to admit it. A lot of people died on my watch … And if you want helplessness, you should have sat in my chair every night talking to doctors and talking to parents, talking to police officers and chiefs saying, ‘Fix this.’

“There’s no type of helplessness like that,” he said.


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