OPIOID EPIDEMIC

CAN ALBUQUERQUE PROVIDE THE NESSESSCARY

TREATMENT OPTIONS TO COMBAT THIS ISSUE?

Danilynn Romero
ENGL 219-011
 University of New Mexico
Table of Contents
 Introduction…………………………………………………………………………………………………2
 Methodology……………………………………………………………………………………………….3
 Results……………………………………………………………………………………………………….4
1. A History of Opioids
2. Legal vs. Illegal Forms
3. Health and Community Effects
4. Treatment Options
 Discussion…………………………………………………………………………………………….………..7
 Recommendations and Conclusion……………………………………………………………….…….7
 References……………………………………………………………………………………………..……8
Introduction
Often, we don’t realize the crisis that our city has encountered, countless people
that are suffering from opiate addiction and the long-term effects that occur from misuse. “We
know the strain that addictions and overdoses put on families and communities
statewide,” said New Mexico Department of Health Cabinet Secretary Kathy
Kunkel. “Our health department is one of many in the state committed to continuing to
support policies and
programs that prevent
drug overdose and help
connect people to
evidence-based
treatment.” (There is
Another Way: Tackling our
Opioid Crisis). This
paper will examine if the
city of Albuquerque can
provide the necessary
treatment options to Fig.1. Opioid-Related Overdose Deaths. 1999-2016. New
combat this crisis. With this Mexico. National Institute on Drug Abuse
research, I can provide
information regarding opiate
use, and the effects on the community, and the possible treatment options for this addiction
locally. More often in the city of Albuquerque, we hear stories of deceased found in our streets
from overdose, or drug-related violence and crimes. “Nearly 3 in 4 overdose deaths statewide
involved opioids of some kind, including prescription pain medication and heroin”, according to
the Human services department website called A dose of reality. (Dose of Reality about
Opioids) New Mexico has in the past been one of the nation’s highest overdose death rates and
opiates is one of the states hardest addiction. Recent information has shown through hard
work New Mexico has dropped in rank for drug related deaths. “Based on a recent report from
the Centers for Disease Control and Prevention (CDC), New Mexico’s national ranking has
improved from the second highest death drug overdose death rate in the United States in 2014
to 17th highest in 2017.” (NMDOH 2018). This opioid epidemic is changing in Albuquerque and
across the nation due to changes in pain management laws, and pharmaceutical practices.
Since the changes have been presented in the community, there is a possibility that this
epidemic may escalate before finding a positive resolution with harm reduction.

Although there are many laws including HIPPA that protect individuals with an
opiate addiction, there are ways of researching the lasting effects of misuse. By having
knowledge in the history of opiates and its origin, we can understand why there are uses for it
today, how it became addictive and what this epidemic has done to our society over time. I will
address how opiates are used in legal and illegal forms because although we see the negative
effects of illegally obtained opiates, the legal forms still pose the same detriment to people
who use them. The criminal statistics for Albuquerque related to drug crimes have shown
fluctuation and through the effort of our community leaders they have seen the rise and fall
when they have offered new programing and assistance for treatment instead of only
incarceration. When researching this social problem, I found that there is assistive programing
that will provide information regarding multiple routes and resources for treatment options in
our local community.

This research will produce informative information regarding an achievable goal

for supporting people in this crisis in Albuquerque. I would promote an awareness that opiates
have many positive medical uses but also carry a greater chance of misuse when used under
unsupervised conditions. With the improvement of access to information it will bring forth
awareness that leaving this crisis unresolved can affect the local community, families, and
individuals. Although, treatment must be voluntary to have a lasting impact the information is
still available for people in the process of helping friends, family, or a loved one seek treatment.
Having a supportive aftercare environment will make the chance of maintaining sobriety that
much better for the person in recovery. Many people are unaware of their treatment options,
resources and opiate replacements. Addiction can be referred to a mental illness and can be
treated and curbed. The goal of this paper is to present the information regarding the
escalated problem of opioid misuse in the Albuquerque metro area and the epidemic of illness
and deaths it is leaving in its wake.

OPIOID EPIDEMIC
METHODOLOGY
When determining if Albuquerque is providing the necessary treatment options
for opioid use, I considered several factors, is information easy to obtain, are there multiple
treatment facilities, and is there support for continued recovery within our community. It is
important to consider the severity of the crisis, and the corruption it brings to ones-self and the
Albuquerque area. Throughout this research, multiple sources will be used to address this issue

1. A History of Opioids: An important aspect of this research is to understand and

recognize the origins of opium and its purpose.
 2. Legal vs. Illegal Forms: A crucial aspect of this research includes recognizing and
educating society on the many forms of opioids in society today. The information
provided will include research that considers a class of opioids and whether the form is
legal or illegal.
3. Health and Community Effects: Often, we don’t realize the effects that occur for
opioid users. This part of the research will address the consequences that are
associated with opioid use and its effects on an individual’s health, family and the
impact it has on Albuquerque community members. Drug overdoses are now
responsible for more deaths in Albuquerque and it is important to develop awareness
about these effects on an individual and the community. This information is important
to recognize, understanding this crisis can provide aid in support and combat to
resolve this crisis.
4. Treatment Options: This section of research will include recommendations for
addressing this issue. With awareness and gained knowledge of opioid users, it is
important to develop a list of resources to support users that need rehabilitation or
opioid replacements.
5.

RESULTS
A History of Opioids
The origin of opioids derived from a poppy plant that was cultivated in Mesopotamia
(Southwest Asia), it is known as Papaver somniferum, the “joy plant”. The plant produces a
narcotic called opium. With the array of colors and its beauty that brought life into gardens, it
is the juice that comes from this plant that created the epidemic we are in today. The narcotic
was originally used to treat pain, help with the common cold and induce anesthesia.

Opium has traveled across the

middle east, flourished amongst
farmers and sold to the highest
bidders. Then in the 18th century made its
way onto the Silk Road. According to
the Drug Enforcement Agency the
trade routes developed between
empires on the Mediterranean coast
and extended to China in the east,
Italy in the west, and Scandinavia in
the north. With the increasing Fig.2. Opium Poppy: History. Drug Enforcement
addiction rate among the Chinese, Administration Museum & Visitors Center.
during the Chinese immigration and
their work in the gold rush and on the U.S railroads. The Chinese introduced America to opium
smoking.
Opium was also a powerful pain reliever used by Greek and Roman physicians. Mainly
used to treat diarrhea, induce sleep or anesthesia. Opium also takes other forms besides
medical use. Opium poppy was also used as a food source, providing a unique taste and a
delicious flavor to bagels and cakes. Poppy also makes colorful additions to any garden.

Legal vs. Illegal Forms

As with any substance there are legal forms that are obtained through a primary care
provider, a pain management specialist, or other health care professionals. When opiates are
prescribed there are ways to manage how much of the substance is distributed to the patient,
the dose is monitored and due to new laws regarding opioid prescriptions there are limits to
how much a provider can give in a set amount of time.

The legal forms of opiates are divided in to three types. The first being naturally
occurring, alkaloids, these are nitrogen-containing base chemical compounds. This compound
occurs in the plant opium poppy. Natural opiates are commonly known as thebaine, morphine,
and codeine. The second type of occurring opiates are buprenorphine, hydrocodone, and
oxycodone this is also commonly known as the prescription drug OxyContin. These opioids are
semi-synthetic, meaning there are created in a lab and have only some natural elements. There
are also fully synthetic forms of opioids they include fentanyl, pethidine, levorphanol,
methadone, tramadol, and dextropropoxyphene. These forms are fully manmade and do not
occur naturally, they must be fully produced in a lab. Each of these types of opioids can be
prescribed by a provider and consumed legally by a patient. The ways these forms of opioids
become illegal is when they are obtained through alternate sources including stealing from
someone who has a prescription or buying them from an illegal source like a drug dealer. Then
the person in possession of these drugs would have what is referred to as contraband. The
lasting effect of this drug is what will drive people to using the illegal form of opioids when they
are unable to obtain them from a medical provider due to new laws, prescription limitations
and complete loss of prescription. This is often when people seek out heroin.

The highly illegal form of opiates is heroin. This is a common street drug and is referred
to by many names. Like many things the names will change with time, culture, and geographic
region. The most common names for heroin are snow, “H”, Black Tar, or Brown sugar. These
names can refer to the texture, color, or combination of mixtures to produce that form of
heroin. In our current society heroin is known as an illegal drug but that was not always the
case, less than 100 years ago heroin was still legal and was considered an alternate for
morphine. Not until the Harrison Narcotics Tax Act of 1914 was heroin usage severely
restricted. It was then outlawed altogether in 1924 and became an illegal drug that people
would still consume due to the addictive qualities of the substance. Heroin can be
administered through several different methods. The first is to snort the powered version.
People will cut lines in the same fashion as cocaine use and the drug will enter the system
through the nasal passages and into the blood stream. The second method is smoking heroin.
This route is different in a sense that you are not actually smoking the substance but inhaling
the vapor created from heating the heroin. The third and most destructive method is injecting
heroin. This is often the last step for most heroin users and provides the quickest high when
injected directly into to a vein. Although after time heroin or any IV drug user will no longer be
able to find good veins they can still inject through IM (intermuscular) or under the first few
layers of the skin (skin popping). ()The detox for heroin is incredibly painful and should only be
done under the supervision of a medical professional or team. The chance of overdose is
peaked after a person has detoxed from opioids and should be educated in the event of relapse
on the use of Narcan. Narcan is a medication that can be administered in the event of an opioid
overdose to stop the opioid receptors and give time to get medical treatment for overdose.
The Albuquerque Police department has trained all their officers on the use of Narcan and it is
kept in at least patrol cars of the department, these are used in the event the officer is called to
an overdose site. Programs like Turquoise Lodge also provide Narcan kits to their patients that
have been identified as risk for opioid dependent and overdose.

Health and Community Effects

One of the biggest advantages to opioids is that it is very effective in controlling
pain. Opioid users are sometimes unaware of the short and long-term effects that are
associated with opioids. Individuals who continue to use or abuse opioids can become
physically dependent and addicted. The body then adapts to the drug and withdrawal will kick
in if the user stops taking the drug or the consumption is reduced. The side effects when going
through withdrawal includes:

SHORT-TERM EFFECTS
 Drowsiness
 Slowed breathing
 Constipation
 Unconsciousness
 Nausea or vomiting
 Coma
 Feelings of euphoria
 Pain relief
 Sedation

LONG-TERM EFFECTS
 Nausea and vomiting
  Abdominal distention and bloating
 Constipation
 Liver damage (when combining opiates with acetaminophen)
 Brain damage due to lack of oxygen that results from respiratory depression
 Development of tolerance
 Dependence

Often, we don’t consider the effects that opioid inject onto the community, here
are some of the issues that occur within the Albuquerque community.

COMMUNITY EFFECTS
 Higher rates of drug related crime
 Higher need for addiction treatment services
 More health needs and costs
 More legislative changes for misuse prevention

Treatment Options
In the state of New Mexico there have been major improvements for treatment
options. Locally Albuquerque has private, county, and state facilities that provide treatment
options for addictions. If a person is seeking treatment for opioid misuse, they would first need
to be voluntarily seeking treatment. One of the common misconceptions is that because it is
court ordered or someone wants to check a family member in for treatment this can be done.
That is not the case, most if not all facilities in the Albuquerque area are on a voluntary basis
and require speaking directly with the person seeking treatment. The major inpatient facilities
in Albuquerque are the county facility known as MATS (Metropolitan Assessment and
Treatment Services), the state facility Turquoise Lodge Hospital, and Haven Behavioral
Hospital of Albuquerque. These are specifically inpatient treatment that will offer the patient
treatment, detox, and possible rehab for their current substance misuse including opiate
addiction. There are other treatment options
through these facilities also, IOP or intensive
outpatient is offered at Turquoise Lodge and
Haven. This type of program is generally
utilized after a patient has been fully detoxed
and is ready to start their long-term sobriety.

The other main form of treatment that

a person might seek when recovering from
opiate dependency is an opioid replacement
treatment. This type of treatment is
sometimes offered inpatient, but the main way is through a clinic that doses the patient either
in their office daily or through scheduled take home prescriptions. In Albuquerque there are
several clinics that do offer this type of treatment option. The ASAP (Addiction and Substance
Abuse Program) through UNM is the largest in Albuquerque and provides prescriptions for
Suboxone, Subutex, and Methadone. There are also other clinics like Duke City toolbox and
Epoch Integrated Health Services. Each of these clinics works with their patients to develop a
treatment plan for opiate replacement therapy along with clinical therapy and follow up to try
and ensure that the patient can be successful in their recovery. Depending on the level of care
there are many different routes to success when a person is seeking treatment. Although it is
not often common knowledge where to look for help, once you find it there are many other
doors that open to continue the journey to recovery.

DISCUSSION
Although the rates of opioid related overdoses and deaths has fallen in the last few years there
is still a need for education a treatment in New Mexico and Albuquerque. New Mexico fell from
being the second highest in overdose deaths in 2014 to the 17 th highest in 2017. This progress is
an amazing step in helping New Mexicans recover from addiction. The previous governor
Susan Martinez stated “It is clear that policy changes we’ve made over the last eight years in
New Mexico have made significant impacts. We’ve been on the cutting edge of this fight and
it’s my hope that New Mexico will continue to play a key role in addressing this national
epidemic in the years to come.” (NMDOH, 2018)

RECOMMENDATIONS and CONCLUSION

The opioid drug overdose death rate in New Mexico remains high, which emphasizes the need
for continued support and work. It goes without saying that the facts do support that the
Albuquerque area does have necessary resources to start combating the opioid crisis in the
city, they do not however have the means to end this crisis currently. Many facilities are limited
in space, there are not enough programs state wide and the metro facilities are over utilized.
This epidemic is getting better in Albuquerque but will have many years and changes before we
can safely say that there are enough resources to end this problem.

Things the individual/community can do to prevent opioid overdose:

 Use caution when using high-risk medications

 People who are concerned about their use of illicit or controlled substances should seek
help with their healthcare provider.
  Individuals with multiple subscriptions should contact their healthcare provider and
gain insight on all medications being taken.

REFERENCES
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