heroin epidemic

“When the Lion Kills Your Child” by Louis M. Profeta, MD

In Drug Trends, Healthcare Professional, Heroin, Opioids by admin

The heroin epidemic has spread to the suburbs, and a nightmare is playing out daily in hospital emergency rooms across the U.S.

Two days in a row, I straightened the sheets so they would look perhaps not quite as dead as they were.

My own child about the same age at the time sat in a room on the cancer ward of Sloan Kettering hospital in New York being treated for leukemia. I had been by his side for nearly five months at that point, spending nearly every night in a chair next to his bed. Since he was stable and between the lulls of chemotherapy, I was finally able to get back to Indianapolis in order to work a few shifts in our emergency department. I needed to still make a living.

Two days in a row, my first two days back, I sat in the “quiet room” of our upscale suburban hospital, where we take families in order to tell them the worst news of their life.

Two days in a row, I knelt down, took the hand of a woman my wife’s age, one that was soft and manicured and looked as if it had never held a cigarette or dug a hole in the dirt, and said to her, “Your child has died of a heroin overdose.”

Two days in a row, I stared into the frozen, half-opened eyes of the cold bodies that could just have easily been lounging in the family room of my own house, playing Madden NFL or Monopoly while sipping a tucked away beer and surfing Snapchat. Cold, dead, lying on the cots in front of me, they stared back and I fought with every ounce of my being not to jump into my car or hop a plane and immediately rush back to New York to be with my own son.

You see, heroin is now a middle-class disease, which sadly means one thing: People are finally taking notice.

I hate to tell you, but heroin is now in the Hamptons, in the tree-lined cul-de-sacs of Highland Park, in boarding schools and SAT study groups of the “top-rated high school in all of the Midwest.” It’s in all the places you’ve moved to in order to escape those places you moved from.

Sure, you understand what I am saying. If I ask you to close your eyes and picture a heroin addict, chances are you see a wasting male, staggering in a fog, hair matted with dust, perhaps trying to panhandle a buck then copping a seat on a piece of cardboard behind an alley dumpster while tying a shoelace around his arm.

If I ask you to close your eyes and picture a heroin addict, you might see a burned out prostitute, makeup all askew, lipstick streaks to her chin, leaning into the window of an old sedan.

If I asked you to picture a heroin addict, you might see a couple fringed punk rockers or modern-day Deadhead wannabes lying on some piss-covered mattress in a crack house, rubber bands, lit candles and spoons strewn on the floor.

What you would not see is the face of some real estate agent on a Re/Max or Century 21 sign, searching through your medicine cabinet during an open house hoping to find a bottle of Vicodin or oxycodone all the while ensuring you that your home is in good hands.

What you would not see is a member of the debate team, the Spanish club, the varsity singers, the third violin, or the second baseman popping an oxy left over from grandma’s hip replacement and washing it down with a Blue Ribbon. What you would not see is the Junior League housewife, or the winner of the country club’s men’s division who became dependent on one of a dozen opiate narcotics prescribed for his wisdom teeth, ACL or lumbar fusion.

This is what my partners and I see in the daily flow of patients into our ER. Those dead, the near misses, those that breathe and beat but no longer think or respond to those who love them, the ones that will perhaps go on to give a liver or kidney to someone else now that they are no longer using them. It never used to be like this. We used to see one overdose a month perhaps. Not one a day.

Now, it’s a heartbreaking loop: the cast-down eyes of a mother of three, too embarrassed to look up. She stole a prescription pad, or was found passed out in the bathroom next to the copier machine; I can’t remember which. Pain, anger, humiliation or even ambivalence are common in these cases. Some patients truly want help, while the majority just want out of the ER. Others come swearing, spitting, puking and pissed off that the Narcan antidote administered to them just ruined their $20 high.

“Doc, write my Percocet or I’m buying it on the street and my death will be on your hands.”

“How about I get you some help.”

“I got things to do, give me my f–king papers, let me out of here, I need to get to work and I need a cab voucher.”

Yes, this is what we see daily. It’s pretty much what every ER doc now sees.

I hate to tell you, but heroin is now in the Hamptons, in the tree-lined cul-de-sacs of Highland Park, in boarding schools and SAT study groups of the “top-rated high school in all of the Midwest.” It’s in all the places you’ve moved to in order to escape those places you moved from.

Overnight, heroin went from being a “crime” of the wretched poor, minority class our “enlightened” minds envision to a “disease” of the suburban elite. Funny how things like that happen. Baltimore has about 650,000 residents and nearly 50,000 heroin addicts. They have been fighting this battle for years. They are now looking at the rest of America and frustratingly saying to themselves: “Where in the hell have you been?”

Last year, overdoses on prescription opiates killed more than 15,000 people. Heroin overdoses killed another 13,000. That is one dead every 20 minutes. Last year alone, more than 2 million Americans abused or were dependent on opiate pain medications and every day more than 1,000 people will be treated in ERs for abusing prescription opiates. Nearly three out of four heroin users report abusing prescription pain medications prior to graduating to heroin. How many of us have these in our medicine cabinets? I bet for most of you the answer is: “Yes, but I only have a few leftover from when I had surgery.”

Maybe it’s time then to start treating our pain pills more like firearms…

Dr. Timothy Kelly, a noted addiction expert in our city, told me: “It only takes a few pills to start the addiction. What’s more is how cheap heroin has become, often cheaper than a few cigarettes depending on the purity.” It made me think. Maybe it’s time then to start treating our pain pills more like firearms, keeping them out of reach and disposing of them when no longer needed.

Why are we more worried about gluten than heroin, processed corn syrup than oxycodone, peanuts than hydrocodone? Perhaps it’s because we are afraid to cross that abyss and admit that heroin is now something that children of the middle and upper class should be warned about. Our state of mind in regards to heroin has largely been,“I am as worried about heroin as I am my son or daughter will be eaten by a lion in my front yard.”

“This is the Hamptons, this is Highland Park, this is the best school district in the Midwest with the highest SAT scores.”

As an ER doc, let me be the one to tell you … the lion is in your yard.

Dr. Louis M. Profeta is an emergency physician practicing in Indianapolis. He is the author of the critically acclaimed book, The Patient in Room Nine Says He’s God.