Heroin overdoses labeled public health crisis

Robert Brandt, right, stands with his son Nolan Brandt after speaking about his oldest son's death from heroin overdose.
Robert Brandt, right, stands with his son Nolan Brandt after speaking about his oldest son's death from heroin overdose.

The all-day conference at the Cleveland Clinic wasn't the normal medical gathering of white coats and scientific power points.

Instead, the hundreds of attendees included some with tattoos, and others who wore a t-shirts with a loved one's face on it. There were gruff law enforcement officials and passionate pharmacists rubbing shoulders during the coffee breaks, talking about what they all agree is a new health care crisis: heroin addiction.

When Robert Brandt took the stage to tell how his son became hooked on painkillers after his wisdom teeth were removed, many in the audience nodded knowingly.

"Prescription pills were the gateway to my son's addiction and heroin littered the path to his death," Brandt said.

The number of deaths from heroin overdoses skyrocketed 400 percent in Cuyahoga County during the past five years. And, as the year ends, officials expect fatalities to reach 200.

So when the more than 600 law enforcement officials, health professionals, addiction specialists and others gathered at the region's largest health system Thursday, they asked an increasingly urgent question: Why are doctor's prescribing so many painkillers?

Steven Dettelbach, the U.S. Attorney for the Northern District of Ohio, explains....

"There are many sources for the heroin problem and it would be wrong to say that prescriptions are the only source but a lot of people who get into heroin get into heroin because they start getting addicted to opiates that are prescribed or on the street. And changing the culture of doctors prescribing so many pills so often, is part of the solution of this problem," Dettelbach said.

During an morning press conference, the Cleveland Clinic's Dr. Jason Jerry said figuring out how many addicts start with a prescription from a doctor - as opposed to picking up drug use through peers, is difficult. He's a psychiatrist and addiction specialist.

"I don't know that there's any good data out there in the scientific data on that. I would say, from my own practice, I would guess that roughly 70 percent start with a prescription narcotic. … it seems that most of my patients had started with something like an oxycodone and then as they're addiction progressed they realized they could get heroin for cheaper and made that transition," Jerry said.

Cleveland Clinic Chief Executive Dr. Toby Cosgrove took the podium to say the Clinic is taking action.

"We're very conscious of this and we're beginning to monitor our physicians across the organization and the sort of prescriptions that they do and we found some substantial concern and we have eliminated those physicians and reported them," Cosgrove said.

Still, physicians at the conference talked about the challenge of helping their patients deal with pain. Decades ago, doctors only prescribed opiate medicine for those with end-stage cancer pain or post-operation pain.

But since the creation of Oxycontin in the early 1990s, the culture has shifted, says the Clinic's Dr. Jerry. He says there's now an unrealistic expectation that one is to be pain free.

For Robert Brandt, whose son died after an overdose, it's now his mission to educate others about the dangers of prescription painkillers- and to remind people to lives are at stake.

"I don't blame anybody for the loss of my son. Everything's an evolution and we grow and we learn and we adapt. But we need to make changes and we need to make them faster," Brandt said.

After his speech, Brandt received a standing ovation.

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