ARBOR VITAE — A consortium of health-care providers in the region stands ready to help those struggling with opioid use disorder (OUD) developed through abuse of prescription opioids or from illegal street sales.

“It’s especially bad in this area,” Dr. Michael Larson informed the two dozen people attending last Thursday’s Arbor Vitae town hall meeting on the opioid epidemic sweeping across America, including here in the North Woods. The Vilas County Public Health Department sponsored the meeting.

Larson, a clinical psychologist at Marshfield Clinic’s Minocqua Center pain management department, urged greater compassion on the part of family, friends and coworkers for those with OUD by understanding that opioid abuse causes intense craving in the brain function.



Impact of opioids


Picture a softball, Larson explained, as he outlined the impact of opioids on the brain. That’s the craving size for a person deprived of water for five days. Then picture a basketball. That’s the craving size of someone who’s gone without food for seven days.

But the craving is much worse for someone dependent on opioids and not able to get relief, the doctor said.

“A person who has had a well-developed opioid use disorder, and they go without that substance for a day . . . the volume of their craving was about the size of a municipal baseball field,” he said, referencing medical research on opioid addiction.

Over time, the user might need to take more of the drug just to feel “normal” or to get the same “high.”

“So when we talk to people about moral failing or (say) ‘you just have to suck it up and be tough,’ we’re missing the boat,” Larson said. “We don’t understand what they are dealing with.

“It also explains why people do crime; do a lot of other bad things; put themselves in dangerous situations; don’t necessarily care for their kids as well as they would like. Maybe don’t have a job; can’t handle finances. Whatever else is going on in their lives, it’s pretty much meaningless when you have that type of craving going on in your brain.”

Drug addiction is a serious illness that affects people from all walks of life and most age groups, including teens. But even young children are traumatized when a parent or older sibling abuses opioids or methamphetamine (meth).

Both illegal and prescription drug deaths factor in this epidemic. Prescription opioids for pain relief include brand names such as Vicodin, Oxycontin, Dilaudid and Demerol.

According to the National Institute on Drug Abuse, there were 865 opioid-related overdose deaths in Wisconsin last year. Many got the drug from their own doctor or raided medicine cabinets of family and friends. From 2000 to 2016, the number of deaths in Wisconsin due to prescription opioids increased 600 percent, from 81 to 568.



Combating the problem

While the crisis remains real, there was some good news recently. Prescriptions for opioids in Wisconsin have gone down by 32% over three years, according to the Wisconsin Controlled Substances Board.

Part of the reason for the drop was the state’s implementation of the Wisconsin Enhanced Prescription Drug Monitoring Program a few years ago. Every prescription of a controlled substance, including opioids, is tracked from the doctor’s office to the pharmacy. No longer can a patient “doctor shop” for additional opioids.

At Marshfield Clinic, there is greater awareness of the opioid impact on society, Larson said. Alternative drugs and pain management programs are being used instead of opioids when a patient suffers injury or chronic pain from a disease.



Better understanding

While the turnout for last Thursday’s town meeting was small, it’s a start to better understanding of the crisis and the solutions, the doctor noted afterwards.

“We have to get more awareness out there of people getting engaged in the problem,” he said. “I think this is a good start because this group can spread out and hopefully educate other people about some of the things going on. We need to get more awareness and more urgency for people to treat this.”

The doctor said prevention “is really the key” in reducing the opioid epidemic. He said that means discouraging recreational use of harmful drugs to convincing patients that other forms of pain control therapy are better than relying on sustained prescription opioid use.

“We can’t prescribe our way out of this problem,” Larson added. “We do not need a substance for every problem, whether it’s sleep aids or meds for anxiety and depression.”

But resources are trailing the need that’s out there, he added. 

“We don’t have enough (alcohol and drug recovery) counselors. We can’t get people in quick enough (for treatment). We need treatment providers and we need recovery-oriented people that are really willing to help those people in recovery get through it,” said Larson.

He urged people to consider a career in recovery counseling, pointing out that Nicolet College in Rhinelander has “a great program” for that training.



The HOPE Consortium

Those dealing personally with opioid use disorder or meth use disorder – either as a user or a family member or friend — can find help through the HOPE Consortium. The 24/7 hotline number is 844-305-4673.

HOPE serves as an umbrella resource center for northcentral Wisconsin, providing guidance and information about the various drugs, including heroin, as well as treatment options.

Services are available from agencies in Vilas, Oneida, Iron, Forest and Price counties, and from the Lac du Flambeau Chippewa, Forest County Potawatomi, and Sokaogon Chippewa tribal nations. A priority is given to women of childbearing age.

Among the services offered is a recovery coach who can assist in navigating community resources, sober companionship, a plan for wellness and much more.