What has caused the opioid epidemic in Pennsylvania in recent years?
That depends on who is asked. This year, the Center for Rural Pennsylvania commissioned a poll asking just that. Thirty-six percent of those responding said individuals making bad personal decisions were responsible for the epidemic, while 31 percent said the over-prescribing of addictive medication was the cause.
Fewer responses were given for the following: a combination of factors, 15 percent; life circumstances beyond one’s control, 10 percent; and insufficient criminal justice and law enforcement, four percent.
Locally, an expert in the field, along with law enforcement and public officials, were mostly of the opinion that a combination of factors were at play.
“I would say there is no ‘one’ factor that has caused the opioid epidemic,” said Angela Eckstrom, executive director of Alcohol & Drug Abuse Services Inc. According to the most recent information she has available, “the majority of folks that have an opioid use disorder report that they first started using opioids because it was prescribed.”
She continued, “I believe that the historic lack of physician education in medical school regarding addictions played a role. A lack of a pharmacy database for years was a factor. The availability of opiates, either legally or illegally, has fueled the crisis. The history of lack of funding for prevention education, treatment and other related substance use services has also played a role.”
Reminding that addiction is a disease, Eckstrom said, “it does not discriminate and can affect anyone regardless of their age, sex, race, religion, decision-making abilities and the like, so I would not cite that as a reason for the opioid crisis.”
State Rep. Marty Causer, R-Turtlepoint, agreed that the crisis is a “complex problem that comes from a combination of factors.”
The Center for Rural Pennsylvania’s study also highlighted that citizens feel the government has an important role in addressing the epidemic. Causer agreed.
“We have already implemented several laws to do so,” he explained. “These laws focus primarily on stopping the over-prescribing of prescription pain medications and require physicians and other dispensers to receive continuing education on pain management and addiction. We have also worked on laws to impose tougher penalties on drug dealers as a tool to help limit the supply of illegal drugs, and continue to direct funding toward treatment programs.”
From the law enforcement perspective, McKean County District Attorney Stephanie Vettenburg-Shaffer said, while she couldn’t identify one cause of the crisis, she agreed with Causer’s belief that “treatment and prevention should be seen as the primary answer.”
The prosecutor’s office comes into contact with many people impacted by the crisis, but Shaffer cautioned that “we cannot prosecute our way out of the crisis.”
“Incarceration and the tools of the criminal justice system will remain, and depending on the drug and the quantity, can include lengthy state prison sentences, and will be sought for dealers — but the problem has to be remedied primarily from the user’s side,” she said. “For dealers looking to come to our area for profit, lengthy sentences for other dealers can act as a deterrence but reducing the number of users will act as the greater deterrence.
“Dealers only profit when there is a market. Treating addicts will eliminate the market for drug dealers,” Shaffer said. “This epidemic has resulted in deaths of people nationwide and in McKean County. Traditional efforts have to be expanded to recognize the heightened impact opioids have had on families.”
Bradford City Police Chief Chris Lucco pointed to over-prescribing of opioid painkillers as causing the crisis, backing it up with his observations from his years on the police force.
“When the medical community began to recognize the prescription opiate abuse issue and began to tighten down on prescribing, it flooded the law enforcement and judicial systems almost immediately,” he recounted. “This problem did not creep up overnight. We have been seeing the abuse of opiates on the rise for several years, but with the previous easy access to very strong prescription drugs it was not getting the (public’s) attention.”
People with prescriptions to the medication got hooked, “but when these addicts were cut off without treatment for the addiction, they began seeking heroin,” Lucco said. “Now add the introduction of the potent butryl fentanyl to the drug market and our people are dying — this is what finally made people realize the seriousness of our addiction problem.”
He agreed with Eckstrom’s assertion that the crisis knows no borders.
“We have seen opiate addiction hit the very young to people in their 60s; men and women, wealthy and poor,” the chief said.
Mayor Tom Riel said he also felt the epidemic was caused by over-prescribing. He outlined a scenario of someone being injured on a weekend and seeing an emergency room doctor, then following up with another doctor after that — and both gave prescriptions. Since opiates are highly addictive, someone might easily get “hooked.”
When the legal supply runs out, and the addiction isn’t treated, “somebody who got hooked would turn to the streets for more pills, which was in most cases a very expensive habit, causing increased associated crimes to follow, like theft and burglary, to support their habit.”
Riel continued, “Law enforcement agencies, in many cases, were caught totally off guard by the epidemic that followed. When drug overdoses increase tenfold, no agency’s resources increase tenfold. I truly believe that law enforcement agencies in the local area did all that they could with the resources available to combat the epidemic, which has subsided for the most part. There are only a fraction of the overdoses locally from opioids than we saw a year or so ago.”
