72 hours in jail won’t solve opioid epidemic, doctor says

A local doctor says putting those who overdose on opiates in jail for 72 hours is not the best way to tackle the county’s heroin and opioid epidemic.

Horry County Council Chairman Mark Lazarus floated the idea of mandatory jail time for people who are revived with the overdose-reversal drug, Narcan, at a public safety committee meeting Monday. The idea came up as a way to get people, some of whom are overdosing more than once in a 24-hour period, into a holding facility where they can receive help for their addiction.

But the proposal was met with resistance from some in the community.

Myrtle Beach police chief Warren Gall told city council members Tuesday the mandatory jail time wouldn’t work at the city jail, which is a 48-hour hold facility that doesn’t have the medical personnel to treat overdose survivors.

“I think it’s a horrible idea because most people … assume that people are abusing drugs and that’s the problem,” said Dr. David Tonkin at the Elite Pain Management clinic in Little River. “But … two-thirds of the people who overdose on opioids are actually overdosing on legitimate prescriptions from physicians.”

Tonkin travels all over the country talking to groups about the gateway drug — prescription painkillers — that has fueled a heroin epidemic in cities across the country and the prescribing “gatekeepers” that have gone mostly unchecked … until recently.

“It’s the physicians that are causing a majority of the problems,” Tonkin said.

“Physicians hate to hear they’re doing something wrong, but they are. … The doctors are the gatekeepers,” he said.

But in the rush of today’s modern medicine, prescriptions have become commonplace.

“The doctor has six minutes to see the patient. The patient comes in the office, all they worry about is their pain,” Tonkin said. The patients “cannot feel their blood pressure, their diabetes, but the doctor realizes in six minutes he has to address all their problems and all the patient wants to talk about is the pain. So what do they do real quick? They fill out that Percocet prescription. ‘There you go, let’s talk about your diabetes.’

“So over the years, the amount of narcotics these people are on is an outrageous amount of medication. And then there’s a problem,” he said.

And most doctors were never trained about the potential dependency and harmful effects opiates can cause.

“When we were in medical school — and I’m 48 years old — there was like no teaching (on this),” Tonkin said, citing a survey that showed doctors received less than six hours of training on opiates in medical school.

But that is changing.

The Centers for Disease Control released in March a new guideline for prescribing opioids for chronic pain. Last December, 60 medical schools in the United States started offering treatment programs to studying physicians, Tonkin said.

The programs also have shown up in about 191 nursing schools, he added.

And many doctors have put down their pens, fearing the scrutiny of prescribing opiate painkillers.

But that cued up another trend.

As prescribed opiates became harder to get, police say many have turned to cheaper alternatives on the street.

Painkillers morph into heroin

An illicit narcotic officials thought died in the 80s reared its ugly head with the return of heroin and a synthetic opioid known as fentanyl.

The drugs have shown up in 73 police reports in the city of Myrtle Beach and have been linked to at least 40 overdoses since Aug. 1. Horry County also was cited recently as having the most heroin overdoses in the state.

“Every day, 3,900 people start using pain medicine for non-medical reasons,” Tonkin said, citing a CDC statistic. “Every day 500 people start using heroin and out of that 500 people, who start using heroin, four out of five of them started (with) using pain pills.”

Ten years ago, that statistic was one out of five, he said. “We (in the United States) use 80 percent of all of the narcotics in the world. … It’s a huge problem.”

But physicians can still help treat the problem.

Dr. William Earley, at Elite Pain, says they require their patients to tell them if they see another patient selling pills their office has prescribed. And they also have tougher drug screening policies to make sure patients aren’t sneaking in outside urine samples for urinalysis tests. Four patients have been caught doing that in the last year.

“Doctors need to start paying attention to their patients and try to get them fixed. Fix the underlying problem. That’s the key,” Tonkin said.

“But there are some people that need to be on pain pills. It’s just a fact,” he added, citing scenarios where other treatments have not worked.

The Little River clinic helps people not only manage pain, but also beat addictions.

True gratification comes when the doctors see their patients overcome addictions and the change that creates in their lives and the lives of their family, Tonkin said.

For more information, visit www.elitepainmanagement.md or call 843-273-0376.

This story was originally published September 28, 2016 at 11:19 PM.