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'Crazy up and down': As lives lost to opioids, York County leaders scramble for answers

Death tolls rising: York County SC leaders talk opioid crisis

York County and South Carolina medical professionals, elected officials and community leaders discussed the rising problem of opioid misuse during the York County Opioid Summit Thursday.
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York County and South Carolina medical professionals, elected officials and community leaders discussed the rising problem of opioid misuse during the York County Opioid Summit Thursday.

For Eric Bedingfield’s son, one choice led to a battle that would eventually take his life.

York County and South Carolina medical professionals, elected officials and community leaders discussed the rising problem of opioid misuse and abuse during the York County Opioid Summit Thursday at the Magnolia Room in Laurel Creek.

In December, Gov. Henry McMaster declared a statewide public health emergency in an effort to deal with the state’s rising death toll related to opioid abuse.

Bedingfield, a former member of the South Carolina House of Representatives, served on the House Opioid Abuse Prevention Study Committee created by House Speaker Jay Lucas, (R-Darlington). Bedingfield lost his 26-year-old son Joshua in 2016 when Joshua overdosed on a variant of fentanyl, an extremely potent synthetic opioid.

“You never really think these types of things are going to be a part of your family,” Bedingfield said.

Joshua’s addiction stemmed from pain medicines prescribed to him for an injury he sustained while at a “pill party,” when he was a senior in high school. Bedingfield said. At so-called pill parties, people bring prescription pills that are all mixed together in a bowl and passed around, so no one knows what they’re taking. Joshua suffered the injury when he had a seizure after ingesting some unknown pills and fell down stairs, his father explained.

He was prescribed opioid-based pain medication for the injury and later developed an addiction to heroin, a trend experts say is often seen with opioid addiction. A common thread found in addiction stories is people becoming addicted to prescription drugs eventually turning to heroin when they can no longer obtain prescriptions.

Though Joshua got clean numerous times, his addiction was never truly gone, Bedingfield said.

“We learned as a family that unfortunately with this particular drug, users will relapse multiple times,” he said. “I do believe addiction is a disease.”

Someone who has an addiction typically has a craving they cannot control and continues behaviors to fulfill that craving even when there are consequences, said John Emmel, MD, medical director of Charleston County’s Department of Alcohol and Other Drug Abuse Services.

Emmel said opioid addiction disorders the same area of the brain that communicates hunger and thirst and makes a person believe they need the drug to survive just as they need food and water. Most drugs people are addicted to are short-acting, causing their levels to constantly rise and drop, he said.

“That crazy up and down is what wreaks havoc on this part of the brain,” Emmel said. “The part of your brain begins to think ‘I need this to stay alive just as I need food to stay alive.’”

The drugs also disorder the frontal lobe, the part of the brain that controls judgment, setting the stage for a reoccurring cycle of poor decisions, Emmel said.

Bedingfield said he saw that firsthand.

“Once that drug becomes part of your reality, your realities change,” he said.

Once that drug becomes part of your reality, your realities change.

Eric Bedingfield

As death tolls increase, Emmel said medication-assisted treatment, an approach that combines behavioral therapy and medications to treat substance abuse, is important in fighting opioid addiction.

“Medications have been stigmatized for many years, as have people with addiction,” he said.

“While abstinence is a wonderful and laudable goal, if it prevents patients from getting medications that may keep them alive while they get the rest of their treatment, perhaps abstinence should move down the priority list a little bit.”

The Lancaster County Coroner’s Office saw a 400 percent increase in overdose deaths in 2017 compared to 2016, according to a coroner’s office Facebook post.

In York County, the number of overdose deaths, and those specifically related to opioid use, is also increasing, said York County Coroner Sabrina Gast. Many of the overdose deaths involved fentanyl.

Drugs to treat addiction

There are a few medications available to treat opioid use. Methadone, buprenorphine and naltrexone are long-acting drugs that stabilize the brain levels in the disordered area, helping alleviate the craving and allowing the person to focus on the rest of their treatment, Emmel said.

He said the drugs work by blocking the opioid receptors in the brain so that other opiates have no effect. While methadone and buprenorphine are opiates and produce similar effects to opioid drugs but at weaker levels, naltrexone produces no similar effects and requires full detoxification before use, according to the Substance Abuse and Mental Health Services Administration.

Emmel said patients and their physicians should decide which drug is best for them.

Addressing prescriptions, unused drugs

National, state and York County leaders are also working to cut down on the number of opiates prescribed.

McMaster secured commitments from two state agencies to limit the number of highly addictive opioid pills some S.C. patients can be prescribed for short-term pain or after surgery. Under McMaster’s order, patients covered by Medicaid or the state health plan can get a five-day supply of the medication, and must return to a doctor for more.

“This medication is necessary for some people,” Bedingfield said. “What we don’t want to do is create situations where individuals ... have it longer than they need it.”

Through Operation Medicine Drop, supported by York County All on Board and area law enforcement offices, the county has collected more than five million doses of unused drugs, said Bob Norwood, executive director of All on Board. Drop boxes are located at York County police departments and the sheriff’s office.

South Carolina’s prescription monitoring program, known as SCRIPTS, allows medical professionals to see prescriptions for certain controlled substances a patient has filled for a specified time period, according to the S.C. Department of Health and Environmental Control. The goal is to stop people from “doctor shopping” to get prescription drugs a primary physician would not prescribe, said Eddie Black, inspector for the S.C. Bureau of Drug Control with DHEC.

York County is also focused on prevention with programs targeting youth. Keystone Substance Abuse Services is bringing a prevention program to York County sixth graders that emphasizes teaching skills on how to deal with peer pressure and staying away from drugs, said Danielle Center, prevention director.

She said the first contact many people have with drugs in their youth is after wisdom tooth extraction and sports injuries.

Bedingfield said opioid use is a problem that communities must work together to solve.

“We have to attack the issue from prevention, recovery and an ongoing process,” he said. “None of these folks who wind up in this position are morally insufficient people. The drugs do cause them to do things that are against the law... and I get that. But the individual inherently is a good person who just simply needs help.”

None of these folks who wind up in this position are morally insufficient people. The drugs do cause them to do things that are against the law... and I get that. But the individual inherently is a good person who just simply needs help.

Eric Bedingfield

For information on resources, visit keystoneyork.org or call 803-324-1800.

Amanda Harris: 803-329-4082

Opioid use by the numbers

▪ Every 20 minutes, someone dies from an opoid/heroin overdose

▪ In York County, there were 140 accidental deaths in 2015 - 38 of those were overdose deaths, two of which were related to opioid use. For 2017, there were 152 accidental deaths - 51 of those were overdose deaths, 41 of which were related to opioid use. The 2017 number continues to increase as reports come in.

▪ There were 594 opioid-related overdose deaths in South Carolina in 2015, a 16.9 percent increase from 2014

▪ More than 10 million prescriptions for opioids were dispensed in York County for fiscal year 2015

▪ 4 to 6 percent of people who misuse prescription opioids transition to heroin

▪ About 80 percent of people who use heroin first misused prescription opioids

Information compiled from the National Institute on Drug Abuse, the York County Coroner’s Office, York County Heroin and Opioid Prevention and Education and Keystone Substance Abuse Services

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