Frontlines - The opioid addiction crisis that's heading Ireland's way

In January 2017, an ambulance rushed to a house in the Deermount area of Cork city. In bed upstairs, the medics found the body of 16 year-old Michael Cornacchia. A promising young footballer, Michael had died tragically, after taking what he thought was cocaine, but was in fact a synthetic, heroin-mimicking opiate called U-47,700. It was the first serious indication that an opioid epidemic might be on the way in Ireland.

More recently, the increasingly dangerous situation was highlighted on RTÉ’s Crime Call by Detective Superintendent Tony Howard, who warned that heroin and cocaine are now being cut with Fentanyl.

“In recent days, we’ve had reports, from people who inject drugs, that heroin is stronger than before,” said Ana Liffey Drug Project CEO Tony Duffin in a statement. “There is no quality, nor content, control of street heroin. Yet despite this, people who inject heroin generally get into a routine, manage their drug use and attempt to reduce the associated risks.

“An experienced person knows their tolerance and intake of heroin,” the statement added. “Now potency of heroin is increased – there is uncertainty and people are frightened. We are working with people who use heroin, and crack cocaine cut with Fentanyl, to do all we can in the face of an increasingly serious situation, to keep people as safe as possible.”

Ireland is not an isolated case: far from it. Over in the US, the widespread addiction to opiates has already reached crisis proportions. While American drug epidemics don’t always spread this side of the Atlantic – Ireland having to date largely been spared the ravages of crack and crystal meth, for example – there is now enough evidence to suggest that opioid addiction is on its way to becoming a serious problem here.

In America, meanwhile, there are countless harrowing stories, including that of Lisa Spadaro, a native of Trumbull, Connecticut. Spadaro was driving home from work early one evening in 2004 when she noticed two boys carrying a slumped figure. As she slowed the car, she realised to her horror that it was in fact her 14-year-old son, Shane.

She immediately jumped out of the car and pleaded to no avail with her son’s friends to tell her what he’d taken. To her relief he eventually came to, but she remained in the dark as to what happened. It was only years later, during one of the intermittent periods when he was heroin free, that Shane levelled with her.

He’d been at a party in a friend’s house after school. As was customary at these gatherings, attendees had raided their parent’s drug cabinets, and emptied the spoils into a big bowl as a type of pot-luck.

Shane had taken a handful of prescription drugs. He had no idea of what they were and how they might interact in his system. A keen athlete and participant in his school’s ‘gifted’ programme, such out of character behaviour could have been passed off as reckless adolescence. However Lisa started to find needles in the pockets of his clothes as she did the laundry. They were also littered carelessly around his room. By the time Shane reached his twenties, he was battling a crippling addiction to heroin.

Shane would trash the house when she had no money to give him. Over a two-week period in 2016, he was arrested ten times. Then came the call that would nauseate her to the depths of her being. Her son had been arrested for hiding in a car park and robbing an elderly lady. This time he was going to prison.

STOLE FROM FRIENDS

Shane’s story is just one example of how the opioid epidemic is so dramatically derailing the lives of young people right across the United States. According to the American Society of Addiction Medicine, there are 2.6 million people there addicted to opioids. A commission appointed by President Donald Trump to investigate the epidemic recently reported that 142 Americans are losing their lives every day due to opioid overdose. As chair of the commission Chris Christie pointed out, that is a 9/11 scale loss of life every three weeks. Recently in Ohio, the Montgomery County Coroner’s Office was unable to accept more bodies after a surge of opioid-related deaths.

The genesis of the current epidemic can be traced to the 1990s. Manufacturers of opioid-based drugs, such as OxyContin, marketed them heavily as a safe way to treat chronic pain. For many Americans without the insurance to cover alternative treatments, doctors would write prescriptions for 60 days and more, often for having nothing more that a wisdom tooth pulled.

Medicine cabinets around the country, within easy access of curious teenagers, became stocked with supplies of extremely addictive euphoria-inducing drugs.

Former quarter-back Matt DeLuca describes himself as having been a “white collar addict”. He dabbled in heroin but was happy to steal more if it meant he could get his hands on the pills that he wanted. OxyContin was his pill of choice. His mother Donna, a former principal in a Catholic School, describes their family as being upper middle-class. Her husband was a director of information technology at a number of hospitals. “We had an altar boy, we were an intact family. We were having family dinners. We were, for all intents and purposes looking in, a normal family,” she reflects.

The family live in Newtown, Connecticut, a place Donna describes as being affluent and part of the Fairfield County “Gold Coast”, encompassing areas like Greenwich, famous for its polo.

Statistics compiled by the State Medical Examiner for Connecticut illustrate the scale of the problem in that area alone. 917 people died of opioid overdose in 2016. This is compared to 357 in 2012. Within that 917 there was a 155% increase in the number of people who died from using the synthetic opioid, fentanyl – the drug that killed Prince.*

Matt started with smoking marijuana in school. Looking back he believes that it was an attempt to relieve his anxiety. He became what he describes as a highly functioning recreational drug user.

His older brother Christian was already a heroin addict. Having witnessed firsthand the chaos of Christian’s addiction, Matt swore off opioids. Then, when he was 21, for reasons he can’t explain, he took his first OxyContin pill. His lapse in resolve ultimately led to a battle with severe addiction that would consume his twenties.

He describes it as “the worst mental anguish that you’ve ever had.” His mind would play tricks on him and he would believe that it would be just ‘one last time’. It was an illusion. “In that moment when you are sick,” he says, “there are very few things that you wouldn’t do.”

He stole from friends and work. There were countless arrests. He nicked precious, irreplaceable items from his family. When asked what he stole, both he and Donna refuse to revisit what is clearly a painful memory. “It’s a lonely, lonely place to be,” Matt says, “because at that point you don’t even feel like a human being. You kind of feel like an animal.”

Donna is emotional when she recalls Matt weighing under 140lbs and the pain of not being able to reach him.

“When the window of addiction opens,” she says, “especially opioid addiction, it slams shut in a very short amount of time.”

SMUGGLED OPIOID BLOCKERS

This isn’t a crisis that stems from socio-economic reasons. It may be a very ‘white’-centric, middle class point of view, but Attorney General Jeff Sessions has called it “the worst drug crisis in history.” He recently set up a pilot task programme to target doctors and pharmacists who’ve contributed to the problem. In 2007 Purdue Pharma, makers of OxyContin were fined $634.5 million for misleading the public about the risk of addiction. However the prescribing of opioids shows no signs of abating.

According to the Health Strategy Group, 250 million prescriptions were written in the United States in 2015. In fact when you break down the statistics regarding the 2.6 million opioid users in the country in 2015, two million had a substance-use disorder involving prescription pain relievers in comparison to 591,000 that had a disorder with heroin.

Eventually managing to shake the shackles of addiction, Christian DeLuca now owns a rehabilitation facility in Pennsylvania. After numerous unsuccessful attempts, it was only when Matt eventually turned to his older brother for help that his recovery began in earnest.

Matt, now 30, is drug free since 2014. He’s a partner in the C.A.R.E.S. Group, an organisation set-up by Donna, offering support to families in Connecticut dealing with addiction issues.

Lisa’s son Shane is due for release next May. He’s clean in prison, but had his term extended when a fellow inmate’s girlfriend smuggled opioid blockers into the prison to help ease withdrawal symptoms.

“He’s regretful for the thing’s he’s done,” Lisa says. “He doesn’t like to talk about it. Sometimes I do bring it up because I feel like I need to look him in the eye and see that he is really regretful.”

33,000 Americans died of opioid overdose in 2015. That number is expected to rise significantly in coming years with some predicting that 500,000 could die in the next decade.

The Commission On Drugs advised President Trump to declare the epidemic a national emergency. Speaking to one reporter in recent weeks, he declared it as such. It’s a chilling intimation of what could be coming down the line in Ireland very soon.

*Following Prince’s tragic death last year, investigations revealed that the iconic singer had a long-running opioid addiction. The saga that ended with the legend’s untimely passing started in earnest on April 14, when Prince’s private jet – which was flying him home to Minnesota from a performance in Atlanta – made an emergency landing in Moline, Illinois. The singer was then hospitalised and received Narcan, a medication used to block the effects of opioids, especially in overdose. However, he then left against medical advice. One week later, on April 21, California addiction medicine specialist Dr. Howard Kornfield arrived in Minnesota at the request of Prince’s representatives.

The intention was to devise a treatment plan for opiod addiction, but Kornfield’s son called the local authorities that morning stating that Prince had been found unconscious in an elevator. Emergency responders pronounced the singer dead shortly after their arrival. On June 2, the Midwest Medical Examiner’s office stated that Prince had died of an accidental overdose of Fentanyl.

In April of this year, 12 months after his death, unsealed documents revealed that Prince had abused opioid pills, suffered withdrawal symptoms and received at least one opioid prescription under his bodyguard’s name. However, it remains unknown whether Prince obtained the fentanyl by prescription or through an illicit channel. Tracing medication in such cases is notoriously difficult and the issue remains under investigation by several branches of law enforcement.

Unfortunately, Prince’s death once again highlighted the extent of the opioid addiction crisis in the US.