addiction

Kim Malcolm speaks with Vancouver Sun columnist Vaughn Palmer about Fentanyl, an opiate claiming lives in British Columbia. Overdoses from this drug are on the rise and health officials are trying to educate the public. 

Scientists and doctors say the case is clear: The best way to tackle the country's opioid epidemic is to get more people on medications that have been proven in studies to reduce relapses and, ultimately, overdoses.

Yet, only a fraction of the more than 4 million people believed to abuse prescription painkillers or heroin in the U.S. are being given what's called medication-assisted treatment.

During the 1930s, as Adolf Hitler was rising to power in Germany, the man who would turn out to be his most implacable foe was drowning — in debt and champagne.

In 1936, Winston Churchill owed his wine merchant the equivalent of $75,000 in today's money. He was also in hock to his shirt-maker, watchmaker and printer — but his sybaritic lifestyle, of a cigar-smoking, horse-owning country aristocrat, continued apace.

This story is part of NPR's podcast Embedded, which digs deep into the stories behind the news.

In the spring of 2015, something was unfolding in Austin, Ind.

This story is first in our four-part series Treating the Tiniest Opioid Patients, a collaboration produced by NPR's National & Science Desks, local member stations and Kaiser Health News.

The new movie Krisha is a family drama about addiction and chaos. In it, a recovering addict named Krisha comes home for Thanksgiving after being away from her family for years.

If the family in the film seems tighter than most acting ensembles, it's because they have history: The director and writer, Trey Edward Shults, cast his aunt as the main character, his mother as the family matriarch and himself in the role of Krisha's estranged son.

For many people struggling with opioid use, a key to success in recovery is having support. Some are getting that support from an unlikely place: their health insurer.

Amanda Jean Andrade, who lives west of Boston in a halfway house for addiction recovery, has been drug- and alcohol-free since October. It's the longest she's been off such substances in a decade. She gives a lot of the credit for that to her case manager, Will — who works for her insurance company.

Three decades ago, the treatment Michele Zumwalt received for severe headaches involved a shot of the opioid Demerol. Very quickly, Zumwalt says, she would get headaches if she didn't get her shot. Then she began having seizures, and her doctor considered stopping the medication.

"I didn't know I was addicted, but I just knew that it was like you were going to ask me to live in a world without oxygen," she says. "It was that scary."

When Jack O'Connor was 19, he was so desperate to beat his addictions to alcohol and opioids that he took a really rash step. He joined the Marines.

"This will fix me," O'Connor thought as he went to boot camp. "It better fix me or I'm screwed."

After 13 weeks of sobriety and exercise and discipline, O'Connor completed basic training, but he started using again immediately.

"Same thing," he says. "Percocet, like, off the street. Pills."

About 120 people a day are dying from unintentional drug overdoses, according the Federal Drug Enforcement Administration.

An increase in prescriptions for painkillers, like Oxycontin, is one reason. Another is that when opioids aren’t available, people often turn to heroin because it is cheaper, stronger any easier to obtain these days.

The problem appears worse in some communities, but it’s not often clear why.

Ten years ago, Chris Young was crushed by a car he was working under. “He was crushed accordion style,” says his wife Lesley.

The accident left Young, 45, almost completely paralyzed and in a wheelchair. He does have some sensation in his legs, but that is also where he experiences acute pain.

“It feels like electric shocks, like lightening bolts going down my legs and when it gets down to the bottom it feels like someone is driving a big metal spike up my legs,” says Young.

Dawn Brown in a trailer for the documentary 'A New High.'
YouTube

Jeannie Yandel talks with Dawn Brown, a participant in Seattle Union Gospel Mission's program that takes a team of homeless people who are also struggling with addiction up Mount Rainier. Brown's experience is chronicled in a new documentary, "A New High."

In a community center just south of Los Angeles, upwards of 50 people pack into a room to offer each other words of comfort. Most of them are moms, and they've been through a lot.

At Solace, a support group for family members of those suffering from addiction, many of the attendees have watched a child under 30 die of a fatal drug overdose — heroin, or opioids like Oxycontin or Vicodin that are considered gateway drugs to heroin.

Drug-caused deaths in King County from 1997 to 2014.
University of Washington's Alcohol and Drug Abuse Institute

Ross Reynolds talks with Dennis Donovan, director of the University of Washington's Alcohol and Drug Abuse Institute, about the loss of detox beds in King County and what that means for people struggling with drug and alcohol addiction. 

Kimberley Enyart was never interested in doing recreational drugs. But then she was in a car accident — and her doctor prescribed a powerful opiate for the pain.

"It just would put me off in la-la land, and make me feel better," she says. "I loved it. I loved that high."

When Enyart's prescription ran out, she did whatever she could to convince other doctors that she needed more. Eventually, she moved on to dentists.

"I even had two back teeth pulled over it," she says.

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