The two counselors at a drug treatment halfway house in Chester County, Pennsylvania, were supposed to help others recover from their addictions. But they were overwhelmed by their own drug problems — and on Sunday, they both overdosed and died on a mix of the opioids heroin and fentanyl.
“If anybody is wondering how bad the opioid epidemic has become, this case is a frightening example,” Chester County District Attorney Tom Hogan said in a statement. “The staff members in charge of supervising recovering addicts succumbed to their own addiction and died of opioid overdoses. Opioids are a monster that is slowly consuming our population.”
Residents of the Freedom Ridge Recovery Lodge found the two counselors, whose identities were unreleased, and tried to revive one of them with the opioid overdose antidote naloxone. But it apparently was not enough.
According to the district attorney’s office, the Freedom Ridge Recovery Lodge houses six men in recovery, with two counselors working and living on site. The two counselors who were there on Sunday morning are now dead.
It’s not unusual for counselors to be recovering drug users themselves. Often, their lived experiences can offer some inspiration and guidance to patients. But in this case, their circumstances led to tragedy.
As Hogan suggested, the case is just the latest example of an opioid epidemic that is out of control. In 2015, the opioid epidemic led to more than 33,000 opioid overdose deaths and more than 52,000 total drug overdose deaths nationwide. In Pennsylvania, overdose deaths climbed by 20.1 percent from 2014 to 2015, according to the Centers for Disease Control and Prevention.
Based on local media reports, the crisis in Pennsylvania and neighboring states may now be getting worse — particularly with the introduction of fentanyl into the illicit opioid market. In one Ohio county, a coroner has run out of room for dead bodies two times this year due to the crisis.
Very often, fentanyl is cut into heroin without the user’s or even dealer’s knowledge, making the dose of heroin more potent but also more dangerous. And that’s led to more death in what’s already the deadliest drug overdose epidemic in US history.
The opioid epidemic, explained
In 2015, more Americans died of drug overdoses than any other year on record — more than 52,000 deaths in just one year. That’s higher than the more than 38,000 who died in car crashes, the more than 36,000 who died from gun violence, and the more than 43,000 who died due to HIV/AIDS during that epidemic’s peak in 1995.
This latest drug epidemic, however, is not solely about illegal drugs. It began, in fact, with a legal drug.
Back in the 1990s, doctors were persuaded to treat pain as a serious medical issue. There’s a good reason for that: About one in three Americans suffer from chronic pain, according to a 2011 report from the Institute of Medicine.
Pharmaceutical companies took advantage of this concern. Through a big marketing campaign, they got doctors to prescribe products like OxyContin and Percocet in droves — even though the evidence for opioids treating long-term, chronic pain is very weak (despite their effectiveness for short-term, acute pain), while the evidence that opioids cause harm in the long term is very strong.
So painkillers proliferated, landing in the hands of not just patients but also teens rummaging through their parents’ medicine cabinets, other family members and friends of patients, and the black market.
As a result, opioid overdose deaths trended upward — sometimes involving opioids alone, other times involving drugs like alcohol and benzodiazepines (typically prescribed to relieve anxiety). By 2015, opioid overdose deaths totaled more than 33,000 — close to two-thirds of all drug overdose deaths.
Seeing the rise in opioid misuse and deaths, officials have cracked down on prescriptions painkillers. Law enforcement, for instance, threatened doctors with incarceration and the loss of their medical licenses if they prescribed the drugs unscrupulously.
Ideally, doctors should still be able to get painkillers to patients who truly need them — after, for example, evaluating whether the patient has a history of drug addiction. But doctors, who weren’t conducting even such basic checks, are now being told to give more thought to their prescriptions.
Yet many people who lost access to painkillers are still addicted. So some who could no longer obtain prescribed painkillers turned to cheaper, more potent opioids: heroin and fentanyl, a synthetic opioid that’s often manufactured illegally for nonmedical uses.
Not all painkiller users went this way, and not all opioid users started with painkillers. But statistics suggest many did: A 2014 study in JAMA Psychiatry found many painkiller users were moving on to heroin, and a 2015 analysis by the CDC found that people who are addicted to prescription painkillers are 40 times more likely to be addicted to heroin.
So other types of opioid overdoses, excluding painkillers, also rose.
That doesn’t mean cracking down on painkillers was a mistake. It appeared to slow the rise in painkiller deaths, and it may have prevented doctors from prescribing the drugs to new generations of people with drug use disorders.
But the likely solution is to get opioid users into treatment. According to 2014 federal data, at least 89 percent of people who met the definition for a drug use disorder didn’t get treatment. Patients with drug use disorders also often complain of weeks- or months-long waiting periods for care.
Some states, like Louisiana and Indiana, have taken a "tough on crime" approach that focuses on incarcerating drug traffickers. But the incarceration approach has been around for decades — and it hasn’t stopped massive drug epidemics like the current crisis.