The Cost of An Addiction

(Photo: Jennifer Corbett, The News Journal)

Heroin has a cost, and it’s not always monetary.

For Kim Jones it was her career, her family, her 401(k) and even her class ring. “Nothing was sacred,” the Middletown mother of three recalled. “I thought, ‘This is going to be the way that I die.’ … To me, that sounded like the better option for my family because if I was dead, then they didn’t have to worry about where I was or what I was doing.”

No longer able to hold her job steady, after being employed professionally at AstraZeneca for 10 years, the now 42 year old said she lived from one high to another. “Out of a bottle or out of a needle” searching for answers and self esteem.

Jones recalls standing in her parents driveway, looking her 9-year old son in the eyes as he begged her not to leave him. She had recently divorced and written over custody of her children to parents and was about to move from Delaware to Fort Lauderdale. She had met a man she called her “drug fueled” Prince Charming.

“He said, ‘Mommy, please don’t leave me’ I looked him in the eye and said ‘You’re going to be fine,’” Jones tells, tears welling up in her eyes. “And then I got in the car and drove away. That was my rock bottom, breaking my son’s heart.”

Experts have tried to assess for years the cost of the opioid epidemic, but there are many costs that cannot be accounted for in dollars and cents. Living on the streets, Federal prison time, the never ending destroying and then rebuilding of relationships over the course of an addiction.

Actually determining the value of human life and other costs related to addiction is not an easy task, and the price paid by users and society is monumental, and growing. In a report released from the White house this month, the council of economic advisors have estimated that each person in the US living with a prescription opioid disorder, with heroin use included, costs society roughly $30,000 each year.

The council estimates nationally the cost of the heroin and opioid epidemic to be $504 billion in 2015. This was determined by the factored burdens to the criminal justice system, health care systems, workforce and finally, the thousands who die every year from heroin, fentanyl and opioid related overdoses.

State agencies can’t speak for what the epidemic costs locally and the costs are adding up:

• $508 to respond to each call for service for New Castle County Paramedics, with an average of nine overdoses a day in Delaware’s largest county.

• $49 for each dose of naloxone to save a life, with some overdoses requiring multiple doses of the antidote. In 2016, emergency responders administered naloxone 2,334 times statewide. That comes to nearly $115,000.

• An additional $2 million allocated this year to the state Department of Health and Social Services to cover addiction treatment.

• 308 lives lost in Delaware last year to drug-related overdoses, and another 215 suspected overdoses reported this year. Over the extended Thanksgiving weekend, 11 in Delaware died of overdoses.

“Once you’re addicted, you’re not doing it because it’s fun,” said Dr. Andrew Kolodny, co-director of The Opioid Policy Research Collaborative at the Heller School for Social Policy and Management in Massachusetts. “Once you’re addicted, you’re doing it because you have to.”

Simultaneously more children are being funneled into the foster care system as addict parents struggle to take care of their own blood. Hepatitis-C, HIV and other blood borne illnesses are on the rise. On top of that the criminal justice has been flooded with thousands of drug related cases and the following prison sentences.

Every child born exposed to substances like heroin and opiate – a staggering 431 last year in Delaware alone – and the cost of of a 16 day hospital stay to an addicted newborn is $66,700. Opposed to a $3,500 bill that comes with a health child according to date from a 2015 National Institute on Drug Abuse. Infants born exposed to the opioid family cost the state of Delaware alone $29 million dollars last year.

In 2016, the Department of Services for Children, Youth and their families reported a 22% increase in substance exposed babies, and in turn the state has began to enforce the new policies regarding the education and treatment of women suffering from addiction. But while dealing with their recovery, there are little options for housing where children are able to live with their mother.

But things are changing for some of the lucky women at the home named Connections which is a women and children sober living home. It’s one of the only places in Delware that can mothers can recover with their children. Women relearn how to be parents in an intimate and comfortable setting. It houses 22 women and children currently.

“A lot of women want to get treatment but don’t have anyone to help out with their children,” Said Crystal Abbott, a 35 year old mother of four in active recovery. She works as the house manager at the Connections home. “Many women don’t want to get treatment for fear of letting go of their kids.”

At 18, Crystal Abbott was already a mother of two with no way to support herself. Anxiety medication she was prescribed helped her dealing with the challenges of being an overwhelmed single mother. That’s what started her prescription pill abuse and a battle with addiction.

Abbott is now an example for new mothers, with three years in recovery under her belt. She goes on to say “It is achievable to get back to normal again,” she said, “But we didn’t choose to be this way. It’s not fun. We don’t enjoy it while we’re going through it. We just need someone to help us through”

Kim Jones is one of the lucky ones, statistically. She was inspired by a prison counselor while inside the Dansbury, Connecticut Federal Correction institution. She helped her realize that she would not be fulfilled by cashing stolen checks to support her substance abuse problem.

Delaware prisons Department of Corrections allocates $7.2 million or just 2% of the annual budget for substance abuse treatment. But from the departments annual report from 2016 shows that nearly 50% of inmates indicated an alcohol or drug problem.

Decline rates could be as high as 70% among offenders with substance abuse disorder according to a DEA report on Delaware in early 2017. This is an “Alarming rate given that the Delaware prison system did not have an accredited opioid treatment program, nor did it allow medication assisted treatments except for cases with pregnant female inmates” the report stated.

Medication assisted treatment is a controversial way some doctors have chosen to combat the opioid addicted. Methadone, Suboxone or Buprenorphine help starve off cravings and lower the chances of relapse and is considered the standard care among addiction experts.

Delaware’s state prison system spends more than one million each month on prescription medications in relation to the rise of Hepatitis C infectants. That levels out to be about $20,000 per patient per month according to state records.

“The driver in all of these public health crises is the over-prescription of opioids,” said Kolodny, who will speak at The News Journal’s Imagine Delaware forum Monday. “If we really want to curb the epidemic and stop people from dying, we have to ensure effective treatment is easier to access than pain pills, heroin and fentanyl.”

Although Delaware is trying to make its treatment options more comprehensive and inclusive, many say they don’t know where to go for help. And overdose numbers suggest this is true as well.

Almost 48% of Delawares’ 308 overdose deaths in 2016 were people over the age of 40, 87% of those dead were white and more than two thirds were men.

In New Castle County emergency responders are dispatched once ever 80 mins for an overdosed patient. Sometimes it is an overdose, or it’s a call for someone under cardiac arrest, a symptom that veils the one of the symptoms of an overdose.

Between the beginning of this year and the first week of November 2017, Delaware’s Christiana Fire Company responded to 262 overdose related emergencies. A cost of $75,000 price tag was attached to those calls, firefighters responded to the person in need with basic care, and transportation in one of the departments seven ambulances.

It averages out to $286 per call, but that cost doesn’t account for the additional price of Naloxone, the overdose reversing medication that is used more and more by first responders. Nor does it account for the breathing treatments that may be needed to stabilize an unconscious person. “Though our costs for services have increased and the demand for our services continues to grow, our funding has shrunk,” Chief Rich Perillo of the New Castle Fire Department said. “We continue to do more with less and are apparently expected to do so, as no real options or serious financial assistance have been considered or offered.”

Last year 73 of the 1,595 Naloxone recipients were considered “repeat offenders” having been given one or more doses of Naloxone before, according to the Delaware office of Emergency services. The state Department of Health and Social Services has requested $100,000 to cover the cost of naloxone for first responders statewide in the coming budget year.

ICU Doctor Sandra Gibney argues that Delaware’s 308 overdose deaths would have prevented if the patients had not received “handoff care” or if the patients had followed through with another real person instead of a brochure. The state Health Department has requested $328,500 to fund 20 additional sober living beds – housing that plays a direct role in the success of men, women and children leaving treatment or detox.

The federal Drug Enforcement Administration called heroin the “primary drug threat” to Delaware as federal, state and local law enforcement reported increases in heroin trafficking, heroin seizures, abuse and overdose deaths, according to its 2017 analysis. In Sussex County alone an estimated two thirds of criminal cases are attributed to the rise in heroin and opioid use.

The burden is felt by all law enforcement that now carry Naloxone as another mandatory tool on their belt. New Castle county police have used Naloxone to save 30 lives but the department has recorded 284 suspected heroin overdoses in the 11 months of this year alone.

There isn’t an easy Band-Aid for the public health crisis that many law enforcement agencies see daily – those in need call 911, triggering a response that reaches front-line police officers and paramedics, all the way to state prosecutors and Superior Court judges.

State Attorney General Matt Denn warns that not every person is going to be helped in the same way, and it will require innovative thinking and expanding treatment options. “This is not going to be fixed for free,” he said. “The state is going to have to make some investments”