Medical officials: Factors make Appalachians prone to drug abuse

Photo by Brett Dunlap Dr. James Berry, director of Addiction Psychiatry at West Virginia University School of Medicine, talks about medication treatments for drug addiction during a Substance Use Disorder workshop Wednesday in Parkersburg for first responders, community groups and the public.

PARKERSBURG –West Virginia and Appalachia have factors that make people prone to Substance Use Disorder (SUD) as medical officials look at ways to treat it, according to information presented at a workshop in Parkersburg Wednesday.

The workshop was for first responders and the public to discuss the opioid epidemic in the state and what can be done to combat it. Over 50 people attended, including law enforcement, emergency medical personnel and others from throughout the community.

The purpose of this event was to educate on Substance Use Disorder as a disease as this epidemic has touched many lives in West Virginia.

West Virginia leads the nation in opioid addiction with 59 per 100,000 people who died of a drug overdose in West Virginia, said Dr. James Berry, director of addiction psychiatry at West Virginia University School of Medicine. He was quoting figures for 2017 from the national Centers of Disease Control and Prevention. The next state on the list was Ohio, which had 46 deaths per 100,000.

Nationally, 72,000 people died in 2017 of drug overdoses.

Photo by Brett Dunlap Dr. Larry Rhodes, a pediatric cardiologist who grew up in rural West Virginia, talks about the mindset of some people in Appalachia who don’t feel like they have prospects outside of their area. They can be susceptible to drug abuse and addiction, he said, during a Substance Use Disorder workshop Wednesday in Parkersburg.

“That is more people than who died in car accidents and firearms combined,” Berry said. “That has been the case for a number of years now.”

That is more than the U.S. soldiers who died in Vietnam and who died during the height of the HIV/AIDS epidemic, he said.

Dr. Larry Rhodes, a pediatric cardiologist who grew up in rural West Virginia, talked about the mindset of some people in Appalachia who he said believe that everything is preordained and “what will happen will happen” in their choices, including taking drugs and getting pregnant at a young age.

Others feel they became sick because their faith in God was not strong enough, Rhodes said.

Some people in Appalachia don’t have positive adult role models in their lives, he said.

This can lead to drug addiction, he said.

Over the last 20 years or so, the number of overdose deaths due to opioid pain pills has increased significantly over the early days of heroin in the 1970s and cocaine in the 1980s, Rhodes said.

“The pain pills started it,” he said.

However, as legislators tried to restrict access to opioids, people addicted to them have gone to heroin and other drugs they can get because they are “dirt cheap,” Berry said. As a result, death rates continue to rise as some drugs are cut with large amounts of fentanyl, a potent synthetic opioid.

“When someone is using fentanyl it is Russian Roulette, especially if you don’t have much of a tolerance,” Berry said. “That is what we are seeing driving these opioid deaths.”

It is appearing in meth, heroin, cocaine and other drugs.

“This is a disease that transcends the substance,” Berry said.

Some people, including physicians, feel that treating addictions through medication is “trading one drug for another,” Berry said of the stigma around such treatments.

Part of addiction is a “brain problem,” he said of parts of the brain that control dopamines that make people feel good about things.

“However, if you put a drug in your system that is going to release a lot of dopamine in a quick amount of time, that becomes dangerous,” Berry said. “You do that over and over again, the brain starts rewiring itself.”

The need for the drug becomes more important than anything else. Berry said many people he has treated no longer used the drug to get high; they use it to feel normal as being off of it ended up causing feelings of illness, misery and depression.

“That continually drives people to do all of these crazy stupid things that we know is insane,” he said. “They continue because they feel they have to.”

Berry likens addiction to a chronic disease, like diabetes, that people will deal with for their entire lives.

Many people go through detox programs but end up relapsing.

“It usually takes lifelong management and treatment,” Berry said. “It is the one disease that will try to convince you everyday you don’t have it and that you have it under control. What we do is control addiction and try to keep people under control and well.”

He likened it to people on antidepressants. Many people have to remain on those drugs to control their condition, he said.

“Let’s see what we can do to keep people alive, increase their level of functioning and improve their quality of life,” Berry said.

He has had patients who were doing everything they were supposed to be doing when on the prescribed medications, such as Methadone, operating at a higher level, attending therapy and support meetings. They only relapsed when they were taken off those medications completely, Berry said.