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Saturday, 15 April 2017 12:30

THE RISE OF AN EPIDEMIC: As death toll mounts, employers can stand as a line of defense in battling opioid addiction

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Brandon Hool, director of the Clean Works program at The Grand Rapids Red Project, holds a vial of naloxone, a drug used to reverse the effects of opioid overdose. Naloxone can be administered through an injection or intra-nasally. Brandon Hool, director of the Clean Works program at The Grand Rapids Red Project, holds a vial of naloxone, a drug used to reverse the effects of opioid overdose. Naloxone can be administered through an injection or intra-nasally. Photo by Katy Batdorff

Last year, Larry Zeiser answered a phone call that would forever change the way he perceived drug abuse in West Michigan.

From the call, Zeiser learned one of his employees, a young lady who had just started with his East Grand Rapids restaurant, Derby Station, had passed away from a heroin overdose. He was caught off guard. He had last seen her on a Saturday when she was working a double shift. She seemed happy, he said. Two days later, she was dead. 

Shockingly for Zeiser, the situation repeated itself six months later. This time, the call was regarding an employee at Graydon’s Crossing. As in the case prior, the female employee’s death was the result of a heroin overdose.  

“You would have never known, she was like the girl next door,” Zeiser said. 

He found out she had been dabbling with the drug as a way to manage depression. Other workers knew about her heroin use, but she hadn’t discussed it openly. 

Zeiser’s situation underscores what many business executives believe is a little talked about, yet deadly epidemic in West Michigan. Overdoses and death from opioid use have increased substantially over the last two decades as prescription drug abuse has given way to harder street drugs such as heroin. 

Long considered a public health and societal issue, the ongoing opioid abuse crisis has started to hit home for employers in the region. It affects their workers, robs the talent pool and takes the lives of their customers. 

“It’s bigger than anyone is talking about,” Zeiser said. “Talking to my staff at Logan’s (Alley), they had relatives that passed away, like younger people. Recently, there was another restaurant owner who lost a 24-year-old kid all to the same thing.

“It pops up in the news every once in awhile, but at that point I thought, ‘My staff needs to be trained on what to look for and make it OK to talk to people.’”  

SHEDDING LIGHT ON AN EPIDEMIC 

To begin addressing the problem at his businesses, Zeiser brought in Grand Rapids-based Arbor Circle to offer mental health services to his employees. He also called The Grand Rapids Red Project, a nonprofit public health organization, to train his employees on opioid abuse. 

The Red Project offers employers free training to educate workers on the signs to look for in a person who may be abusing opioids or who could be suffering from an overdose. The organization also teaches people how to respond to overdoses and issues free doses of naloxone, a medication that can reverse the effects of overdose. 

“A lot of people are dying right now — dying really young and people aren’t ready to address it,” said Brandon Hool, director of Clean Works, an overdose prevention and response program at The Red Project. “It’s always been, ‘It’s us, in Grand Rapids. It’s the people downtown that are dying. That’s really sad, but that’s your problem.’ No, it’s like everyone, everywhere.” 

The perception of addicts as strung-out ne’er-do-wells shooting up opiates in some dark alley doesn’t hold true, according to Hool, a former user who has been sober for seven years after a decade of injecting drugs.

Opioid addicts represent a broad swath of society, including people of all ethnicities and professional backgrounds, from doctors and lawyers to those on the manufacturing plant floor.  

“A lot of our clients drive, our clients work, they have houses, they are consumers,” Hool said. “As far as employers go, it’s their customers who are at risk, it’s their employees.”

In 2016, 62 people died from opioid-related deaths in Kent County alone, according to data from the Kent County Health Department. Opioid-related deaths in Kent County have increased steadily since 2003, peaking at just shy of 90 deaths in 2015. This year, five people have already succumbed to opioid overdoses through the months of January and February. 

In Ottawa County, 32 people died from drug overdoses in 2016, with the majority of the deaths  linked to opioids, according to health department data. Meanwhile, Berrien County had 16 overdose deaths directly attributed to an opioid and another 16 deaths where a combination of drugs were at play, said Dr. Frederick Johansen, medical director at the Berrien County Health Department and the county’s medical examiner. 

These days, far more people survive an overdose than die from it, in part because of the proliferation of rescue kits including naloxone. 

In Kent County last year, 684 people overdosed on drugs including opioids, according to health department data. 

Statistics like those led Tami VandenBerg, owner of the Pyramid Scheme and the Meanwhile and executive director of Well House, to bring in The Red Project to train her staff on the opioid epidemic and the use of naloxone, which she now carries at both of her bars. 

“Just in the last six months to a year, we’ve lost two musicians that were very close to a lot of my staff members at the Pyramid Scheme and the Meanwhile to overdose,” she said. “I also lost a friend from college in the last few weeks who was part of the restaurant industry for many years. I was just seeing tremendous grieving and I was seeing a big desire from people I hadn’t necessarily seen it from in the past to take action.”

VandenBerg served on the board of The Red Project for four years, chairing it for three of those years. 

BRUSHING THE PROBLEM ASIDE? 

For those struggling with addiction, seeking help can be challenging, especially if they are employed. 

To receive the treatment they need, workers will likely need time off the job to seek medical detoxification and mental health services. However, informing their employers about their addiction could result in them losing their jobs, as many employers lack treatment programs. 

Nancy King, program manager for Families Against Narcotics’ Southwest Michigan chapter, sees the problem as an extension of the societal stigma leveled at drug users.

King, who lost her 21-year-old daughter to a heroin overdose in 2012, believes employers, law enforcement and society at large should view addiction as an illness, rather than a criminal offense. 

“If (employers) had someone who suffered from cancer or diabetes, they would be concerned about their health issues,” King said. “When it comes to addiction, basically what the community looks at is criminal — this is a choice, these are bad people.”

For her part, VandenBerg has made it known to her employees that they can come to her for support if they are struggling with addiction.

“I don’t judge anybody for using,” she said. “We don’t know what people are going through. I’m not going to judge people. I just want to keep people safe.” 

Law enforcement organizations have also begun incorporating treatment programs in conjunction with their drug enforcement efforts in recent years.

The Michigan State Police (MSP) plans to roll out its Angel Program statewide this year. The program, modeled after a similar initiative in Massachusetts, allows people struggling with opioid addiction to present themselves at a MSP post where officers will help connect them with partnered organizations offering treatment, without the fear of prosecution. If the individual appears with a user-amount of drugs, those drugs will be confiscated, but the person will not face arrest. 

“The big thing is that law enforcement has been saying for the last year-and-a-half that we’re not going to arrest our way out of this problem,” said Andy Fias, section commander of the West Michigan Drug Enforcement Team at MSP.

TRACING THE RISE 

Experts trace the current opioid epidemic to the mid 1990s, when doctors began treating patients for pain. Because the drugs were presented as a non-habit-forming treatment for pain management, doctors began prescribing strong narcotics such as oxycodone to help their patients. 

However, it soon became apparent the prescription drugs were addictive and the influx of those drugs spilled over into the black market. 

If physicians expect abuse, many will abruptly cut patients off from further prescriptions, forcing users to the street where they can purchase prescription opioids at a significant markup, Hool said. 

While prices vary, a single pill of oxycodone can fetch $30 on the street, Fias said. It’s not uncommon for heavy opioid users to consume six or more pills a day. At street prices, it doesn’t take long before the costs of maintaining an opioid addiction become unsustainable, leading people to harder, but cheaper drugs like heroin. 

Compared to prescription drugs, a 200 milligram package of heroin — typically packaged in a folded lottery ticket — costs roughly $20. Injection size varies widely among users: Some inject that amount a couple of times per week, while heavy users could use 500 milligrams at a time, once or twice a day, according to Hool. 

As the opioid epidemic has grown in recent years, street drugs like heroin also have become more potent, Fias said. In 1981, the average purity level of heroin was 10 percent, but it increased to 40 percent in the late 1990s. Now, it’s not uncommon to find heroin at 80 percent purity, if not higher grades. 

Coupled with the higher potency, dealers started to cut the drug with even more powerful synthetic opioids such as fentanyl and carfentanil. On its own, heroin is roughly three times stronger than morphine, the drug from which it is derived. By comparison, fentanyl and carfentanil can reach 10,000 times the potency of morphine, according to reports. 

For an unexpecting or inexperienced drug user, the introduction of these two substances can prove extremely deadly. Many of the recent overdose deaths can be attributed to the presence of fentanyl or carfentanil, sources said.

“Heroin is not being produced by a pharmaceutical company. You get adulterants, you get things like fentanyl, which increases the potency exponentially,” Hool said. “Now (people) become a huge risk for overdose and it all started with something pretty benign. I had a surgery, broke a bone, got hurt somehow, got in a car accident — that’s what’s happening.”

THE PATH FORWARD 

Overall, most sources interviewed for this report noted that employers — and society as a whole — are failing to do enough to curb the outbreak of opioid-related deaths. While opioid addiction is often seen as a deeply personal issue, employers are not immune to its effects on their workforce.

Instead of ignoring the problem, Hool and others hope other companies train their employees on overdose prevention and care, as well as stock rescue kits with naloxone on site. 

Ideally, Hool would like to see employers set aside funding and resources to support employees through medical detoxification and other recovery programs.

“They’re going to end up with a great employee who is extremely loyal,” Hool said. “People who are using tend to be above average kind of people.”

Restaurateur Zeiser plans to mandate opioid training through The Red Project for all of his managers going forward. 

“When it comes to human life, I don’t think I’m a good human if I’m sweeping something under (the rug) because I think I’m going to get in trouble,” he said. “I think it’s a duty of all of us, whether you’re an owner, an employee or just a friend. You have to take ownership of this because it affects us all.” 

Read 4388 times Last modified on Sunday, 16 April 2017 20:59
John Wiegand

Staff writer

jwiegand@mibiz.com

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