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Midwest Illicit Drug Crisis: Identifying Signs of Drug Abuse in a Loved One

Midwest Illicit Drug Crisis: Identifying Signs of Drug Abuse in a Loved One

Nearly 200 people died from drug overdoses each day in 2017. A 68% increase from 2016, the more than 70,000 people who died are part of a widespread epidemic in the United States1. The epidemic is a costly problem with $27.5 billion spent annually on treatment services, lost productivity, and criminal justice involvement.Although the issue is widespread, it has made a significant impact in the Midwest. A recent study revealed that Michigan ranks fourth in the nation for overall drug abuse with Ohio ranking second for overdose-related deaths.While the dramatic escalation of illicit drug overdoses has been linked to synthetic narcotics such as fentanyl, the overall issue of drug misuse is a problem for everyone.  For anyone who has concerns about a loved one’s substance use, the following guide provides illicit drug information, describes the emergence of illicit drug abuse, and shows how Michigan and Ohio compare to other regions. Finally, it details the signs a loved one may be misusing drugs and what steps to take.

Illicit Drugs Defined

Illicit drugs can be classified into three categories:
  • Central nervous system stimulants - crack cocaine, cocaine, and amphetamines
  • Central nervous system inhibitors - opiates, heroin and sedative-hypnotics such as benzodiazepines (often found in medication to treat anxiety and insomnia) or barbiturates (often used for pain relief management)
  • Hallucinogens - marijuana, hashish, LSD, and phencyclidine (PCP)
The US Department of Health and Human Services defines opioids as a “chemically related class of drugs that include the illegal drug heroin, synthetic opioids, such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others.”

Understanding the Emergence of Opioids and Fentanyl Abuse

With so much attention on the opioid crisis, it is easy to get confused about the terms and what is actually behind the high rate of drug misuse in the United States. As the drug abuse issue became more prevalent, pressure built for healthcare to re-evaluate how they treat patients with chronic pain and other conditions.States responded by implementing prescription drug monitoring programs (PDMPs) to electronically track the dispensing of controlled prescription drugs to patients. Drugs tracked vary by the PDMP and some PDMPs do not include prescriptions paid with cash. Screening protocols (e.g. Opioid Risk Tool (ORT)) were also put into place to identify patients who may be predisposed to drug abuse or are currently misusing. These screenings also used to help provide patients access to prescriptions for pain management.  When the prescription opioids became less available, those with substance abuse disorders turned first to heroin, then to other illicit opioids and synthetic narcotics, such as fentanyl, which is cheaper to manufacture than heroin.  Starting in 2013, a sharp increase in drug-related deaths was attributed to the influx of illicitly manufactured fentanyl. Currently, deaths from fentanyl overdose are increasing rapidly
Centers for Disease Control and Prevention, National Center for Health Statistics, Multiple Casue of Death 1999-2017 graph of National Drug Overdose Deaths

How Michigan and Ohio Compare to the National Average

A 2018 study examined more than 20 metrics, and ranked states overall and by extent of the drug abuse problem in three key areas: extent of drug use and addiction, the impact on law enforcement, and the availability of treatment services. While several of those metrics relied heavily on opioid usage, it revealed how Michigan and Ohio compare to the rest of the country.While Ohio mid-way in other categories, the state ranked third for drug overdose and addiction. The Ohio Department of Health reports that heroin usage is on the rise. This has created a drug trafficking problem, compounding the negative effects of illicit drug abuse and leading to more violent crimes.Michigan, on the other hand, ranks fourth overall and 10th in drug use. The state has the 18th highest drug overdose mortality rate.  In a May 2018 article, a section commander for the West Michigan Enforcement Team (WEMET) drug task force acknowledged that various areas of the state are facing criminal marijuana usage, crystal meth, and resurging cocaine problems.

Midwest Opioid Overdoses Data

In a report that was updated in February 2018, the National Institute on Drug Abuse reported that for every 100,000 people in Michigan, Wisconsin, and Ohio, over 15 people died from opioid overdoses in 2016. The national average is 13.2 deaths per 100,000.Ohio ranked within the top five states for opioid overdoses resulting in death. In 2016, the overdose rate was more than double the national average at 32.9 deaths per 100,000 people. This is triple the 2010 level of 10 deaths per 100,000 people.Michigan had an average of 18.5 people per 100,000 residents die from an overdose in 2016 with more than half of them related to synthetic opioids.

Recognizing the Signs of Illicit Drug Abuse

While substance abuse does not discriminate, certain factors may make an individual more susceptible. Genetics, psychological makeup, and environment can all play a role, as well as the factors in this list provided by the Mayo Clinic.
  • Regular misuse of a prescribed drug, not taking it the way it was prescribed. This includes taking it for the way it makes a person feel
  • Taking prescriptions "just in case," even when not experiencing symptoms
  • Mood changes, including excessive swings from elation to hostility
  • Changes in sleep patterns
  • Borrowing medication from other people or "losing" medications so that more prescriptions must be written
  • Seeking the same prescription from multiple doctors, in order to have a "backup" supply
  • Poor decision-making, including putting himself or herself and others in danger

What You Can Do to Help

Approaching a loved one with concerns about their drug use is not easy. The Mayo Clinic recommends contacting a physician to discuss your concerns. A doctor can then order appropriate drug testing to determine the best course of action.Encourage your loved one to go through with the testing. Click here for more information about talking to a doctor and getting yourself, or someone you know, tested. Sources:1 Centers for Disease Control and Prevention, Understanding the Epidemic, 12/19/2018