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Members of struggling families and addiction experts gathered in Mt. Lebanon Wednesday and sent a nearly unified message to Harrisburg: Skip bills that one legislator called "photo ops" and unleash every available treatment option to curb the opioid epidemic.
"What we need to do is go beyond the photo ops," said state Rep. Dan Miller, D-Mt. Lebanon, to a crowd gathered in St. Paul’s Episcopal Church on Washington Road. "I'm tired of the stories, of, 'I can't get an inpatient bed.'"
Billed as “A Conversation on Combating the Opioid Epidemic across Pennsylvania,” the event organized by Mr. Miller drew an audience of around 100 to the church in Mt. Lebanon.
State and county officials touted their efforts to address an epidemic blamed for driving record overdose deaths of more than 4,600 statewide last year, including 650 in Allegheny County. Mr. Miller, though, saw a clear problem in the lack of parity between insurance plans, and said he will look into legislating the problem.
Others noted the lack of any coordinated system for putting struggling opioid users into available rehabilitation beds, complicated by the fact that public and private insurers have varied coverage rules.
For someone like caseworker Tanya Nix, a drug and alcohol case manager working in Washington, Pa., that can mean hours calling down lists of providers while a person in withdrawal sits watching helplessly. She often calls 12 or 15 rehabilitation providers, waiting on hold to talk with each one, before telling her client where to go -- or that there is nowhere to go.
"We'll have a bed in four weeks," some providers tell her. The user's motivation to get treatment erodes. "By the third [rejection], they're frustrated and want to give up."
A state effort to put together a rehab coordination system didn't work, and Allegheny County officials have started mulling a local effort to match people to rehab beds.
Gateway Rehabilitation, among the region's largest providers, has 152 post-detox beds -- not nearly enough to handle ongoing clients and take in the 50 to 70 people referred weekly by hospitals, said its vice president for operations, Carin Fraioli.
The forum was kicked off by state Attorney General Josh Shapiro, who said he hopes that a 41-state investigation of the pharmaceutical industry will bring swift and meaningful results.
"We're investigating five manufacturers, three distributors for their role in this crisis," he said. "We will not give the pharmaceutical industry a pass in dealing with this crisis," he said, to vigorous applause.
"My view is if there is culpability there, they should be held financially responsible for the damage that they've done here in Pennsylvania, and that really we need to change corporate behavior," he told reporters, while declining to say whether he thought that pharmaceutical executives should go to jail. He said the investigation is "in high gear" and "on a fast track."
Kim Bishop, who travelled to the forum from the North Hills, said that her 29-year-old son got a taste for opioids a decade ago when he was given a prescription for oxycodone after he broke three ribs. Since then, he has transitioned to heroin and has been in 17 rehabilitation programs and overdosed 10 times, she said.
She said she has tried "tough love," but can hardly bear the uncertainty when he is away from home. He has been robbed, has slept under bridges and has been arrested, she said.
"This is certainly not the life that I ever imagined for him," she said. "Every time my phone rings, I'm just waiting for them to tell me they have my son."
Domenic Marks, spokesperson and member of the advisory board for Bridges to Hope Family Support Group, spoke of his family's experience with a daughter who became addicted after using painkillers after having wisdom teeth removed. She is now in recovery after a long ordeal for her and the whole family.
He said he had to realize "she’s not a villain. She is afflicted with a disease. When you can accept that, you can begin to find solutions."
Dr. Dennis Daley, senior clinical director of substance use services at UPMC Health Plan, said that whereas patients with most other diseases are motivated to get medical help, that's not the case for those with addictions. Families or employers are often key in steering them toward treatment, he said.
Mr. Miller assembled panels totaling 14 experts on the effects of addiction on families, the availability of treatment, the impact on children and the delicate balance between enforcing drug laws and encouraging recovery. Once thought of as an urban problem, narcotics addiction is now taking lives all across the county, to the extent that the issue can pack a room in affluent Mt. Lebanon.
As of this week, OverdoseFreePA.org, operated by the Pennsylvania Opioid Overdose Reduction Technical Assistance Center of the University of Pittsburgh’s School of Pharmacy, logged 499 fatal drug overdoses this year in Allegheny County. Because it often takes months for a cause of death to be finalized when it is drug-related, it's likely that the county is on pace to break last year's record.
There would almost certainly be many more fatal overdoses if the state had not improved the availability of naloxone, which reverses overdoses. Mr. Shapiro applauded the lifesaving efforts, but added that naloxone doesn't cure addiction.
He said he supports the concept of compelling people who have overdosed to go into treatment.
One panelist offered the opposite prescription.
"Full legalization of all drugs," said Patrick Nightingale, a criminal defense attorney. "What business is it of the government to incarcerate someone because they don't like the substance they choose to consume? ... Nobody is robbing a bank if their insurance will cover their opioids."
Mr. Shapiro, speaking earlier, dismissed decriminalization.
"I don't see us legalizing the use of carfentanil on the streets as being the answer to this problem," he said, referring to a narcotic originally developed to tranquilize elephants, but now showing up in deadly concentrations on the county's streets. "I truly don't."
Rich Lord: rlord@post-gazette.com or 412-263-1542. Twitter @richelord. Peter Smith contributed.
First Published: November 29, 2017, 7:14 p.m.
