infectious hepatitis drug

>> partial funding for this program have been provided by: the following program may not be suitable for all ages. viewer discretion is advised. ♪ >> my name is molly, and i'm a full-time student at northern kentucky university.

my dad used to read to me before bed every night, and i think that had a big influence on me. and i had written for some 'zines, back in the '90s. i had done some stories, and i really enjoyed it. and right away, i decided to major in journalism.

i have been struggling with heroin addiction for 16, 17 years now. i still feel like it's a big secret that i can't let anybody in on, because it will just mess everything up. like, everybody will look at me differently, and, like, just the

whole stigma, the worthless junkie stigma. i'm already, like, the punk rock girl with all the tattoos. [ laughter ] you know? i don't want to be the junkie punk rock girl with all tattoos. >> all right.

he just texted me and said i've gotta go to milford. so i will drive all way to milford to meet him. he's ready now. yeah, i don't like to think about how much money i have spent on this shit because -- this stuff.

because i could be a billionaire for real. 20, 40 -- i'm going up to, like, the blanchester exit. i think it might be route 28. i'm not for sure. and i will meet this guy there, and get some drugs from him. he told me to come to a certain

spot, and then i will sit there and wait for him. it's usually a gas station or something. and then when he comes in, i will follow him, and then he'll turn around and drive back by and hand me the dope and i will hand him the money out the

window. but, like, this is what i bought. and i guess it's what you would call china white. the stuff is probably like a little bit less than half a gram. i paid for half a gram, but he

always shorts. so -- and then you have to put water on it. and then you have to heat it up. i'm so ashamed. i was expected to, you know, graduate high school, go on to college, and pursue a career and have a family and have children.

and now i have these morals that my parents have instilled on me. and, you know, becoming a heroin addict was not anywhere in the picture. addiction is a very, very, like hopeless feeling. i get kind of an initial rush, which i'm getting right now.

and you can feel the warmth and it's moving through your whole body slowly. ♪ >> our brain is set up to experience reward and remember what was rewarding and repeat that action. so anything you do that you

enjoy, whether it's watching a movie or getting lunch at a certain restaurant, your brain records a memory of that. when use the drug, it does the same thing. use the opioid drug. the problem is it's far more potent than any natural reward

you would get. if you compare lunch at your favorite restaurant and a jolt of morphine or heroin, the heroin experience is so much better, so much more rewarding. so much more euphoria generating that the brain remembers that as the best thing there is.

>> in the 1960s, the typical user was from the inner city, usually male, black and heroin was the first opiate they tried. it's no longer just a problem in indianapolis, cincinnati and louisville, it's spread to the suburbs all over the region. users now are likely to be

white, men and women in their 20s, who get hooked on opiates and then graduate to heroin. >> i mean, this is going to sound bad, but for a lot of the time, i don't think i looked like what somebody would normally picture a heroin addict looked like, for -- until maybe

the last two years. i always looked fairly clean cut. you know, i would wear clothes that were clean. i would shower. i wasn't doing a lot of the things -- at least in public -- that a lot of people associate

with being a drug addict. >> john was a student at butler. he was at a party with his fraternity brothers. he hurt his bark and his doctors prescribed opioid. >> i don't even remember how i did it. really it wasn't that bad of an

injury. i probably could have made do with, like, tylenol or >> in the 1960s and '70s, doctors were trained to give the least amount of medication possible. they feared patients would get addicted.

but then in the late '90s, the doctors added a fifth vital sign. decision to pulse, perspiration, body temperature, the doctors began assessing each patient's pain level. a group of pain management doctors supported by form

suiticcal companies believed -- pharmaceutical companies believed people were suffering from untreated pain. and they used tools like these to rate their pain on a scale of 1 to 10. >> america became a country, where we use 80 to 90% of the

world's painkillers for a country that has a fraction of the world's population. and the amount of use of vicodin, hydrocodone and oxycondone that we use is staggering. >> hospital's accreditation was tied to patient satisfaction

surveys: >> and it got to the point where even the way doctors got paid and hospitals get paid was based on patient satisfaction surveys. and the biggest question on there was, was your pain adequately managed? and that became the driving

force on how doctors are giving out painkillers like candy. they open up anywhere prescription pads and they are giving out painkillers like candy. oxycontin was the most famous because people want to be out of pain all of

the time. if you're in chronic pain, you want 12 or 24 hours of pain relief. one pill, an in terms of marketing of pharmaceuticals, you can sell a lot more drugs and get people more effectively treated the less times you have

to take the pill the better it is. >> and doctors were led to believe that it was not -- addictive. the pharmaceutical company purdue pharma, which has no affiliation with purdue university, distributed

marketing materials praising its new drug oxycontin and saying there was a less than 1% chance patients would get addicted to it. >> when pain treatment is successful, it stays successful, specifically, opioids continue to work over long periods of

time. >> years later an fda investigation found purdue farma.'s claim to be questionable and misleading. >> i remember taking them the first time and thinking, this is this is just what i want to do forever and it would be nice if

i got some other stuff out of life, but this is what really matters. >> think of it as like an amazingly sensitive pleasure button. once it's been pushed, you obsess about getting it pushed again.

it's on a subconscious, biological level. >> in 1996, kayla blevin, he and his girlfriend and one of his best friends decided to enroll in morehead state at that time. >> i was normal at the time. as normal as normal gets. i had a lot of friends on the

golf team and going to class and doing the best thing. one weekend, one of my younger brothers came down to stay the weekend. we do what college kids do, just drinking and having a good time, and somebody had some pain medicine, which, you know, was a

foreign word to me. i didn't know what it was, and suggested we try these pills. and i did. you know, not knowing. and i really didn't get any effect that night but for some reason, i had brought some of the pills home with me.

i will never forget this day. monday morning, we had gone to play golf that morning and i had to go to a class. and i had these four pills, they were red capsules and my friend ron from the golf team, he asked me what they were. and i told him.

he said, you won't take these pills and go to class. okay. so me being the -- you know, oh, yeah, i will. sure i will. the bravado, i said, yeah, i will and i take them and i go to class.

i wouldn't even call it peer pressure. i was just trying to fit in. i go to class, and this feeling, this euphoria came over me. >> caleb had taken the equivalent of a 20-milligram oxycontin, a relatively normal dose that a doctor might

prescribe following a medical procedure, for example. >> we can't all sit around and talk about opiates like they are evil. when you have had surgery, when you need them, they can be amazing! they can be amazing at relieving

pain! so they do have great benefits to them, all right, if used correctly. if used as prescribed. and they are also, though, very addictive. some people do get very addicted to them.

>> i remember two parts of my life, one was before that day and the other was after and they are both very different pictures. and i just remembered thinking that i want to feel this way the rest of my life. i mean, i just remember every

insecurity that i ever had, every feeling of not being good enough, you know, all of the things that i carried my whole life that i didn't tell people about, it went away in that moment. and i resigned to the fact that i was going to chase this stuff

the rest of my life, not knowing where i would get it, but, you know, i knew -- i knew what it entailed and i knew what was in store for me. >> caleb didn't even last another month at college before he dropped out. he moved back home and in with

his parents. the hunt for pills engulfed his life. >> basically what i would do is if i went to your house, i would ask to use your restroom and i would go in your medicine cabinet. if you had something, i would

take it. if you didn't, then i would go on to the next place or visit, you know, emergency rooms, make up a fake ailment. you know, stealing from -- if i knew somebody had an injury, you know, i would show up at your house to pay you a get well

visit, you know, not knowing -- you don't know that i'm going to steal all of your medicine. >> opioid cells within the brain control the amount of pain he feels, which is what opioid drugs aim to do. however, these drugs also activate opioid immune receptors

which release natural feel-good receptors called dopamine to the body. they are designed to motivate you to repeat necessary survival behaviors like eating and drinking, but opioid drugs overstimulate these receptors, causing a much greater release

of dopamine than any other natural behavior does. >> so when dopamine is released, whenever you take these drugs, it keeps you coming back for more, but it also weakens the association between this primitive pleasure center in the brain and the prefrontal cortex,

which is the part of your brain that helps you figure out that maybe you shouldn't do something that feels good right now. >> there are individual differences in vulnerables to all drugs that have complex genetic basis. so you and i both take a drug,

but you may get no euphoria or no euphoria and i get a lot of euphoria. >> people with the certain receptors, if you are lucky enough to have that, when it gets stimulated, it's stimulated to an outlandish degree. >> people thought, oh, okay.

my doctor gave this to me. or these are medications whether my doctor gave them to me or not. these are not street drugs and so they must not be so dangerous, right? and it turns out that was way wrong.

>> caleb advanced like many people who are abusing the opioids do, to crushing up the 12-hour time released capsules and injecting them. that gives you a hefty dose of the opioid all at once. >> this is prescribed by a doctor.

so can't be bad. it has to be safe. i won't get addicted to this. and then, bam, it shows up one day. >> the growing demand helps spawn a new industry, particularly among some small ohio river towns, the pill mill.

these pain clinics prescribed large quantities of painkillers to people would didn't need them medically. people here worked in the coal mines and in factories. they always had a tradition for abusing prescription pain medication to treat chronic pain

conditions. and a psychological pain associated with those dying industries and communities. patients drove in from hundreds of miles away, paying cash for the sole purpose of getting opioid drugs. the staturation of pill mills

along the ohio river blooded the region's black market, causing one health official, calling it a situation of pharmageddon. sales of prescription drugs nearly quadrupled. we were writing enough opioid prescriptions to give every american adult their own bottle.

lawmakers in kentucky and ohio would soon pass legislation to shut down pill mills but with an estimated 2 million americans hooked on opioid, the pump was primed for another drug to take over the mark. -- market. oxycontin's illegal cousin.

>> friends offered me heroin. that's what friends do. i say, no, i will never stick a needle in my arm. and a friend says, you can just snort it. i don't have a problem if i'm not sticking needles in myself. >> according to the d.e.a., four

in five new heroin users start about you misusing prescription painkillers. >> it's to the point where, you know, same as the painkillers, it was all i really cared about, pretty much. >> it's going to break your brain's ability to understand

and feel pleasure. it will change everything about the way you feel pleasure and reward in a bad way. it will be wonderful, there's no question, but then nothing else will seem quite as wonderful ever half. so you are training in normalcy

for one shot of super fun. that's the problem. there's no free lunch. you can't go up and come down and be the same as you were before. think think i can use this drug and it's fun and i will be back to normal.

you never get back to normal. >> heroin is easy to come by. mexican cartels discovered the ripe suburban market. thousands of people hooked on opiates and they could offer something more potent at a cheaper price. cartels established routes in

the u.s., hubs where the drugs could be shipped and a delivery system that fanned out into neighborhoods where they could easily conceal themselves. prescription narcotics sell on the street for about $1 a milligram. so an 80-milligram oxycontin

would be roughly $80. heroin is cheap and the price is falling. it sells for $100 a gram and a gram can be up to 20 doses per high. >> at first, i thought i was being economically. i thought this is a great idea!

i can save money. i can do more of what i want to do but it escalated so fast. i mean, a, because it was cheap; b, because it was always available. i think the only thing keeping me from getting completely out of control on the prescription

pills was that i couldn't get as many as i wanted. but there's nobody regulating the amount of heroin on the street. it's always there, and there's always as much as you could ever possibly buy. >> but john's body was adjusting

to the heroin and he needed more and more to feel any effect. before too long, he was spending at least $100 a day on heroin, just to stave off the withdraw symptoms and be able to function. >> it gets to the point where this is just an awful routine

that you, you know want to do it but you don't feel like you have a choice. and it consumes your whole life. i mean, that's what i would wake up thinking about and it's what i would go to sleep thinking about, and probably 90% of the time in between, i was either

planning or worrying or thinking about it in some way. >> lying, cheating and stealing to get more. >> i think in the month of may 20:03 i was in the brown county jail five times, just in may alone. and it was every week, i was

going to jail, every other week, 30 days here. six months here. you know, ten days here. and that cycle just kept up until finally i hit the big time and they said, we're going to send you to prison now. we are not going to play with

you anymore. i went to lebanon correctional and i remember walking into this block. it was so loud! it was three tiers high, but to me it looked like it was five miles high and five miles long. and it just looked like chaos.

it was loud and fast and busy and it was just like, where did i go wrong, man? somewhere i didn't get something went wrong. something got lost in translation that i'm in prison. i'm not supposed to be here. >> but each time caleb got out,

the addiction would pull him right back. and he would start using again. >> i hit the ground running. i started using immediately. not long after that, i had a fatal overdose, and, you know, i was on life support for a couple of days.

they had to revive me three times, i think. and they had to air carry me. it was just a mess. and, you know, the sad, sick thing about this disease is that, you know, i'm laying in a hospital bed, you know, scratched down to it, and all my

mind could tell me was get somebody here to bring you drugs. get somebody here to bring you and i literally just died, you know, and my parents were there. they actually watched them, you know, performing cpr on me. and it wasn't enough.

that -- to most normal people, that event would make them want to stop doing something, but to me, you know, i just wasn't there yet. and i actually talked somebody into coming to the hospital with they brought me drugs and they thought they were helping me.

i left there and i continued to use. >> one of the things that makes heroin so dangerous is that unlike pills, you don't know what's in it. it's cut with other things that can make it toxic and that change its potency.

some of the materials used to cut heroin include chalk, powdered milk, rat poison and even other drugs. even the people who are selling it on the street don't know what it's mixed with. >> if you overdose on something, i mean it's strong enough to

kill you. so when you are in that mind-set, you tend to want more of that. >> fire and ambulance, what's the address of your emergency. what's going on there? >> i don't know. one of my workers, he just fell

out. i don't know if it's an o.d. he was in the bathroom. he's in here in the kitchen, and he's got a feedle. feedle -- needle. oh, my god. >> so he's passed out. >> yeah, a needle was in his

pocket. >> is he breathing normally? >> is he breathing? no? breathing a little bit. >> okay. is he breathing normally or is he breathing only every once in a while.

>> breathing a little bit or normally? none. give me the address again to make sure i have it correct. >> what the heck? why was he doing this shit? >> give me the address to make sure i have it correct, please.

>> the cycle that we are stuck in with something like that, where we are going to the same house and caring for, well, saving the same person over and over again. >> the reviving them with the heroin antidote narcan or naloxone.

it fills the receptors in the brain so the heroin chemical can't take hold. it's commonly called the lazarus drug because it essentially brings people back from the dead. it's common now for emergency personnel to carry it.

>> the first time i saw somebody come out of a heroin overdose from narcan, it was stunning. i mean it really was. i stood and looked at this young woman and -- i mean, she was dead! i mean, we thought she was dead! the paramedic came in and, you

know, tied her off and gave her a shot of narcan and next thing you know -- he said just wait and give it about 30 seconds and 30 seconds later, she stood up and said, where am i? it was absolutely just stunning that we didn't have to do cpr or anything.

it immediately took her out of unfortunately, the more you see any of you who are police and firefighters, you have to become a little desensitized to it. if you saw it every day, and it upset you every day, it would be hard to go back to work. >> heroin is much more deadly

like other drugs like cocaine or meth, cdc numbers from 2015 show 78 americans die every day from an opioid overdose. in indianapolis, the marion county morgue can see two or three deaths a day. >> so in about 2013, i became alarmed when i started seeing --

we had one week where there were five heroin overdoses in a week. so i started tracking that. i reached out to the local health department, to law enforcement and all of those agencies that i thought would be important to come together to look at what is actually

happening from a social standpoint, with regard to drug overdose deaths. so typically, we would see prior to that, perhaps one every two weeks or so or one even a month. and then when it got to be more than one a week, then it just became a point where i fell like

from a social standpoint and this is within this office a responsibility to identify those social things that may be occurring within the city that other authorities and agencies need to be notified. >> aaron was my middle child and in october of 2016, he overdosed

on heroin. so the story of aaron and his use of heroin is short lived, but i believe that he probably started like we know now most people are starting with prescription pain medicine. not because he was prescribed anything, but because he was

like the majority of young people with his friends, perhaps at a party, or some other social gathering where they all decided, hey, let's try this. let's get into the medicine cabinet and let's see what he can find and let's try it. we were in the process of

getting him some help and he overdosed. and i know that we're never supposed to say, should have, would have, could have, and i know i'm not here as a mother to beat myself up for the things that i miss, but i feel like, especially where the disease of

addiction is concerned, denial is an easy place to stay. and unfortunately, denial causes death from addiction. >> phyllis decided she wanted to tell aaron's story and worked to erase the stigma surrounding addiction. she reached out to the

newspaper. >> the big story, front page, and it was really the start of bringing people out and giving people permission to talk. i heard from so many moms, primarily. you know, this is my story. this is my son.

it's the same story. >> phyllis became a friend to parents struggling with the same law and an advocate. she haunched the nonprofit group -- launched the nonprofit, overdose hotline, and she worked to make naloxone more widely available to first responders

and anyone. you can go into a pharmacy and get naloxone without a prescription. the idea is that the heroin antidote should be more readily available than heroin. [ applause ] >> my name is carl rochelle, i'm

a board member from overdose hotline and i'm here to teach you about narcan and how to use it and make sure you leave with narcan in hand, as well as information on rehabilitative services, detoxification, things along those lines. >> naloxone can reverse the

overdose but it can not stop the in marion county, indiana, for example, about a third of the people who are administered naloxone have previously that's in line with numbers reported across the country. the critics criticize making it more widely available.

they argue that it's enabling addicts to continue to use. >> and a lot of times when it gets the pushback, what i tell people, you are not the one who stands there with the overdose standing and looking at the overdose person and standing next to the family members.

and that's the key. >> you have no compassion for that person that is a human being, that is overdosed, have compassion for the family because that's somebody's son, daughter, mother, father, husband, wife, and they are in grief.

so my thing is if i can spare that family one more day that they can have some hope, or maybe it's that one day that they actually get them into treatment. >> i guess the day that i found out was actually after his first overdose.

and after that first overdose, and he was able to leave the hospital, he said, i have a love affair with heroin, mom. >> casey's story is remarkably similar to aaron. >> when casey died -- i said with casey died an advocate was born and that was me.

i was like a loose cannon shooting off in all directions hoping that i would hit i don't think there's anything more powerful than a mom on a mission. don't mess with moms! because it's moms that get things done.

>> charlotte has been at the forefront against the fight against heroin in northern kentucky. she and her husband couldn't get casey into treatment because he was over 18. they fought to pass casey's law. it gives the family or friends

of an addict the right to lawfully intervene and have court-ordered addiction treatment for their addicted loved one. ohio has a similar law. indiana doesn't have any such law. >> i couldn't think of anything

more appropriate for casey's life than to use it to raise awareness about his disease, and also to get the naloxone medication out there for families. >> the bus travels to all of the eight northern kentucky counties.

charlotte sets up the places that are hot spots for drug deals and she hands out naloxone rescue kits. she also visits events and festivals where she can distribute information about casey's law. >> we have got to break that

cycle, and breaking that cycle, the first step is the naloxone. the next step is treatment. we've got to move them from their addiction into treatment, and that's -- that has to come after that. >> naloxone is the first step in a strategy called harm

reduction, described in the most simple way, harm reduction is about keeping people and society safe until they can get the second is the needle exchange. >> you turn in your used needles and they give you clean ones for however many dirty ones you

turned in. when the pharmacies first started not selling to, you know, people without a prescription, i remember i went into one of the regular pharmacies that i was used to going to. and the pharmacist was like, i

can't sell them to you without a and i stood there for a minute because i was mad, honestly. if you look at a needle or a bag of needles, it will say, "use once and destroy." [ chuckles ] but when you are an addict and you are shooting up several

times a day, you don't use once and destroy, especially when pharmacies aren't selling you more needles. it gets so the numbers are worn off and they are kind of bent up, and it hurts to stick it in. yes, i used needles for so long, that they got weak and by the

scar tissue where i was shooting up, it was so thick that the needle just broke off. and i actually have one stuck in my neck right now and one stuck in my groin. >> so when people come on that actually want access to needles or testing, they will come here

for it first. and they put their dirty needles in here. then we have postcards here that show various techniques of good vein care. >> access to syringes is actually a relatively small part of what the needle exchanges

provide. >> so we have basic toiletries here. we have safer use guides, faqs about the needle exchange, the paperwork that we do for how many in and how many out, tampons and condoms and lube lubrication and individual water

packs and cottons, some sterile safety squares, tourniquets tourniquetscookers and a varietf biohazard containers into needle exchanges have been proven to reduce the spread of blood borne diseases such as hepatitis c which attacks the liver and hiv. >> people ask all the time if i

have an extra needle. i will say, yeah, but, you know, i have hepatitis. and 99 out of 100 times, they are like, so do i. >> still critics are slow to come around, in part they worry that the needle exchanges convey a message that they condone drug

use and maybe even encourage. >> i would say if i put a needle in the middle of this room right now, the three of us would not be any more likely to do i.v. drugs than prior to me putting it it there. i could do that anywhere. >> the 30 years of data shows it

doesn't increase drug use. it doesn't encourage drug use. it doesn't encourage bad behavior. it does serve as a place where you can give treatment information. you can help people. i mean, it's a win/win.

you are not going to lose with the needle exchange program. >> a growing number of cities and states are now considering establishing exchange programs. the latest count shows about 200 across the country. in rural austin, indiana, population 5,000, local

officials struggled unsuccessfully for more than 15 years to get the town's drug problem under control. they were sounding the alarm, but couldn't get anyone to listen, until there was a crisis. >> as you know, since

january 26th, we have been dealing with an unprecedented hiv outbreak, related to injection drug use with now 100 to 70 confirmed cases. >> like hepatitis, i.v. drug use and hiv have always been linked. still, it was a shock when kevin pauley got a letter in the mail,

saying he could be at risk. >> it comes from the clark county health department, stating that someone had tested positive for a communicable disease and turned my name in. pauly went to the health department to have a test swab done.

>> i was devastated. >> the size of the outbreak in scott county was unprecedented, with a confirmed hiv epidemic, the state directed more resources to scott count a and the governor approved -- county and the governor approved a temporary needle exchange.

>> instead of looking at building an infrastructure to prevent the outbreak from happening, we have seen a lack of investment in public health and public health being a broad turn. the infrastructure needed to prevent something like this or

other outbreaks like this from happening again. >> indiana has since developed a system for establishing needle exchanges but the state doesn't provide any funding. so each exchange operates on grants and donations. in the town of austin alone,

between late 2014 and early 2016, 190 new cases of hiv cropped up. the exchanges did help to get the epidemic under control in the county, but not until almost 5% of its population was diagnosed. that's the equivalent of 40,000

cases appearing in one year in cincinnati's home county, or 45,000 around indianapolis. but scott county got the attention of the cdc, prompting an analysis of the factors that made the area susceptible to an hiv outbreak. they considered everything from

overdose deaths to unemployment and availability of treatment programs. the counties that are on the cdc's list, 54 in kentucky, 11 in ohio, 10 in indiana. >> it's here. it's creeping up. it's waiting to explode.

because i have seen a few of them. it just hasn't climbed in the pool yet. it will. it scares the snot out of me because it's coming. it's like floating around. it's like a bee floating around

waiting to sting. it's coming. because i do some work in some of the jails and i see the inmates coming in. and there's a lot of them, a lot of these young people in their 20s, they are addicts. it's there.

i mean, it's in the pool. and once it starts hitting little groups of users and amplifies like it did in scott county, it will blow up. >> indiana has spent close to $2 million on its response to the hiv outbreak, and health experts predict the lifetime

cost of treatment for those impacted by the hiv outbreak could reach $58 million. plus, it's impossible to accurately estimate what drug abuse costs in terms of wasted resources and money each year. a recent guest from the institute on drug abuse puts the

national figure at $143 billion a year. that breaks down to more than $500 a year for everyone in the country, children included, each year. >> but then there's -- you know, if that doesn't compel you, there's collateral damage.

the innocent people that never had the disease of addiction that are going to be hurt by it. >> heroin changes the brain's structure and the ability to the changes are long lasting. so addicts are vulnerable to a relapse long after they quit. quitting cold turkey used to be

the only option, but it worked for a quarter of the people who try it. a better understanding of brain and the addiction has given new forms of treatment. methadone was traditionally used to help people avoid alcohol, but in many cases it's

considered the goal standard for treating people with addiction. four years ago tamara myer was lying and stealing money to feed her drug addiction. she overdosed and a hospital psychologist referred her to a methadone clinic. >> i went and i had a good

experience. i'm still having a good >> along with her vitamins myer takes methadone every day. >> it doesn't, like, alter you in any way. it doesn't, like, inhibit you from doing anything, you know, that another normal person would

do. >> there will be an early assessment to make sure that their symptoms are being managed, that they can still go out and find a job and they can engage in individual therapy and group therapy in that whole thing.

>> methadone stabilizes the brain in the same way that other opiates do. so users don't go through withdraw or have the extreme craving to use. >> because the withdraw, if you said i'm stopping today, the old cold turkey, people are too

miserable to make it. you need a way to make a soft landing and maybe you can get off at some point. in some cases, severe addicts may be on methadone their entire life but they would like to taper that off. it will be slow because

tapering, you have to have another alternative most of the >> you can find clinics in major cities, but in rural areas, it's impossible. and the issue with methadone is you have to take it every single >> there are people having to travel extreme distances just

for treatment. you know, heroin users are early risers. i always explain what this must be like. imagine you miss lunch. it's 5:00. you are starving but you don't have the access to any food.

you will eat whatever you can get if you are starving, right? you are starving! i mean, they need -- they need this substance in order to feel -- not feel cravings for >> this is where other drugs like beufonorphine. it's doubted as a better drug

than methadone because the doctors with prescribe it in the offices, eliminating the need to drive long distances to the clinics. it helps with the craving and the fda approved it for take home use in 2002, but only a limited number of doctors with

prescribe it and there are restrictions on how many patients a doctor can treat with the drug. vivatrol is largely considered the best thing on the mark dollars it's essentially an antidote to the opiate. >> it has no addictive

potential, no abuse potential. there's no withdraw symptoms when you come off of it. >> lacy hamilton works at one of the few clinics in indiana that administers vivatrol. since her office started doing it five years ago, they treated about 35 people.

the chief complaint about vivatrol is the price. insurance will often defer part of the cost, but the out-of-pocket price is between $1,200 and $1,400. but patients only have to go once a month for the injection. >> you just kind of have to be

in the right mind frame, aokay, i'm ready to do this and get clean. they struggle. they are done and sick of being a slave to the drug. and so they just want something to get them off and they don't know even where to start with

that. and their biggest fear is just withdrawing, by far they do not want to be sick. >> federal regulations acknowledge that opioid addiction is a medical disorder, and there's a national movement to treat it as a public health

crisis, rather than strictly as something law enforcement can handle. >> a couple of weeks ago, i suggested that we get a three-man unit to be solely dedicated to stopping these vehicles so primarily what's going on is we have a whole lot

of opiate addicted users, heroin, pain pills, any type of oleate narcotics, lots of addicts that are coming from the suburbs and they are procuring their narcotics in neighborhoods within downtown cincinnati. and then they are traveling back across 471, 275 to return home.

>> so you made an improper lane change. >> and a lot of times they are driving impaired. users needing the drug so urgently to avoid dope sickness that they shoot up as soon as they get the drug. >> so all of a sudden it impairs

you to the extent that people are what we call on the nod. they are actually dozing off, falling asleep while they are driving. and so it just creates a much greater risk than even an alcohol-impaired driver. >> heroin is believed to be a

major factor in the crash. >> tom signen heads a drug task force in cincinnati. >> one of the things that we were missing from overdose tests was we were treating them like an accidental death and not a crime. so we go after people who

supply, people that help inject, people that sell, and ultimately what we are hoping to do is gather enough information and intelligence to go out to the larger dealer whether in the united states or somewhere outside the country, where the d.e.a. would be involved.

>> i'm not sure that we can really get ahead, because from the standpoint, we can't anticipate who will use and what type of drug will be the drug of choice. heroin just didn't assist like this. >> let's say we take out all the

heroin in the world. let's take the task force takes all the heroin, what do we do with the thousands of people who are opiate addicts. every time we think of an answer, there's always another question. and this situation is very

fluid, and that's what makes it so unique. i think heroin we figured out that this is different than anything we have seen. >> you know, it wasn't very long ago that somebody could go out and they weren't ready for help or they couldn't receive people,

and we would say, well, maybe next time. or maybe next week. or maybe next month. but unfortunately, the heroin and the opiates out there next week could be a funeral or an early grave. >> the population most at risk

of overdosing are those recently released from jail or prison. a person is 130 times more likely to die of an overdose in the first two weeks after being released from jail than any other person. jason merrick leads a program at the kenon county jail in

northern kentucky to educate inmates on the various approaches to treatment, community support groups available to addicts, medically assisted options, as well as religious and spiritual approaches. he was in and out of treatment

facilities for ten years before finally getting clean. >> you know, this is a very complex issue, and it was an equally complex solution. so all of those components combined, very well rounded, comprehensive approach. it's not for everybody, but we

are trying to cover as much ground as we can. >> when released from the program is given a shot of vivatrol for free and they are connected with a local outpatient hospital and they are put in touch with like-minded people in the community.

more than a third of all people in prison are low level drug offenders. drug courts are specially courts designed for people found guilty of nonserious crimes related no their addictions to participate in treatment, are aer than serve -- rather than serving out

jail time. there are many variations but end goal is the same, reduce recidivism so the drug user doesn't come back to jail because of repeated criminal behaviors represented to the it consists of counseling, 12-step programs or residential

or outpatient programs. they take the individual over a year to complete. many judges oppose the use of medically assisted treatment drugs and demand that participants be clean of those drugs as well. >> i understand from the medical

community that methadone and naloxone is a medical school used to help with detox and step down. i get that point. i just haven't had a lot of success with it in the criminal justice system. i feel i have a obligation to

balance the public safety with the victims and then you have the defendant and the restorative justice concept and what creates an amount of recidivism to that person. and a lot of times the naloxone and the methadone don't balance out well for the community.

>> participants have to face the judge in court weekly and they are drug tested multiple times throughout the week. if participants fail testing, the judge can impose sanctions such as communicate service or -- community service or jail >> the 2016, state of the

judiciary address, loretta rush called for an expansion of the state's drug court system. >> this past year, my supreme court colleagues and i traveled the state to hear from the trial court judges from all 92 they shared with us what would become a recurring theme, the

drug crisis, particularly heroin and methamphetamine. crippling their communities and flooding their courts. >> some have mental health and substance abuse in the county, and it's justice by geography. >> jonathan was unconscious at an indianapolis jazz station

with a needle in his arm. when police arrested him almost a year ago. >> the police came and the paramedics came and they brought me back, i guess. i don't -- i'm fuzzy on all of and carted me off to jail. >> this time it was pretty

obvious that there were going to be some consequences and there really hadn't before. >> but john avoided going to prison. instead he got into a drug court program. he goes before the judge each week and does the random drug

screen. until recently, he lived here at the fairbanks rehab center in indianapolis. and also held down a job at this little coffee shop. but a couple of months ago, he got clearance and he moved in with his girlfriend.

>> this time, i -- i want to stay clean, which means before i think i lied to myself and told myself i wanted to but in the back of your mind, you are thinking about how you can go get high. so you don't really want to. i'm not always happy, but i can

be happy now. i couldn't before. i didn't feel anything before. now i get to go a real person. >> this is the longest john has been clean in well over half his after five attempts at treatment, caleb is about to celebrate four years clean.

>> i remember i had this moment where, you know, i was trying -- i was trying for the life of me to get clean because i wasn't allowed to be around my son anymore, unless it was supervised. i went to the courts one day and he's staring up into the sky and

i said, god help me. tell me what to do. he told me what to do. he said go to treatment. i never looked back. my son, he's such a blessing and doesn't see me -- he doesn't see me as his dad that was in the crack house when he was six

months old. he doesn't know any of that. he just knows that his dad is there for him and his dad loves him and that's a blessing. >> about a month ago, i was fishing over on the west side of hamilton. and i got a phone call.

one of my -- one of my really good friends, the first -- the first really close friend i had in recovery, they found him dead that morning. he had been clean almost three years and he was struggling for the last few months. he decided to go use and ended

up killing him. and he carried the message of recovery really well. he loved recovery, you know. he was one of the ones that didn't get it. >> celeb works at a recovery center now. >> a common phrase that you hear

in recovery is that, you know, they will take me back out faster than i will pull them in. so if they decide to get here being then i will here and hug other than, that all you can do is just pray for them. >> yeah, as far as immediate plans to get sober, i have kind

of been trying. every weekend, i'm like, i will take naloxone this weekend and i will not use. and then by monday, i will do well enough that i can make it to class and be functional. and every weekend comes around and i have money burning a hole

in my pocket and that craving is overwhelming. i feel like the whole world is closing in on me, and i know that there's just one little thing that can take it all away. and i nut haven't been strong enough. -- and i just haven't been

strong enough. i know in i don't do something soon, i will either end up in jail or dead and to be honest, i mean, i would rather be dead than have to live the rest of my life the way that i have been living. >> i would say, don't do it.

don't use. don't pick it up for the first the first time is -- like, it's never going to end. it doesn't ever stop because the answers that you are living for aren't -- you aren't going to find them in the bottom of this drug.

i have been doing this for almost 17 years and never once found an answer. >> finding the fix. heroin's hold on the heartland is made possible by the radio and tv news endowment, a fund established by listeners and viewers to sustain reporting of

indiana news. more information at indianapublicmedia.org/support.

infectious hepatitis drug 2017-02-13T03:09:00-08:00 Rating: 4.5 Diposkan Oleh: Ramdani Sanghiang Wibawa Tunggal