‘The least of light’

By Alex Ashley
Four of four parts 

There is a certain comfort to the inside of a police cruiser at night: the deep, resonant bellow of the engine; the whir of the air conditioning; the hiss and chatter of the CB radio.

Knowing what lies outside, it’s nice to feel safe and secure.

The world of drugs, especially, is such a strange place – a world different from the world most live in.

It’s a world where deaths by opioid overdose, at least in Washington state, are a bigger number than deaths due to motor vehicle accidents.

It’s a world where family and friends become targets.

It’s cold, grayscale and blurry.

Most of all, it’s dark.

Yet, the darker it gets, even the least of light seems to shine brighter.

While it is true that drug addiction – heroin and opioids in particular – have become a big problem county and nationwide, it is equally as true that there are those fighting for a solution.

Divergence

Treatment is tricky business.

Grant Taylor, MD, a doctor at the Everett Clinic at Stanwood, said there is a reason heroin addiction so easily becomes a problem.

“It’s very real,” Taylor said, noting that oxycodone and heroin are “biologically similar.”

“It does the same exact thing to the brain.”

Anecdotally, Taylor said – he can’t share any information as to whether cases discussed were in their clinic – he has heard of patients who have been on high doses of opioids, “and when the doctor starts to wean them off, they make the switch over to heroin.”

Oxycodone has a street value of about $1 per milligram, with the highest dosage being 60 milligrams.  Heroin, some say, is about $5 for a hit – a much better value than a $60 pill.  An easy choice.

“We are very aware of divergence,” Taylor said. “That’s when a patient gets a prescription and then sells the pills on the street.”

Dr. Taylor, 38, graduated medical school in 2004, and arrived in Stanwood in 2008.  In that time, he has become familiar with the early stages of addiction in patients.

They get hooked, and then for some, there’s no turning back.

“There’s always so much embarrassment and shame for those with addiction,” Taylor said.  “But we aren’t trying to get people in trouble, we are trying to help them, even if that includes an addiction they need help with.”
Taylor said they would never fire a patient on the basis of an opioid addiction, although they would never enable the addiction.

“The state of Washington created a database for all controlled substances,” Dr. Taylor said, “and every prescription filled goes into that database.”

The purpose, he said, is to make sure a patient is not “double dipping,” as it were, bouncing from hospital to hospital trying to collect opioid prescriptions.

Hospitals also do urinalysis drug screening at random.  Often, he said, if a person is selling their prescription on the street, their test will show up negative, because it’s not in their system.  They don’t ask why, but they do take appropriate actions when they see early signs of a problem.  A problem that, if left unchecked, can become the early groundwork of a more serious problem.

“We’re not looking to punish,” Taylor said.  “We’re looking to help.”

‘Good Samaritan’

Hospitals’ response to opioid addiction is just one piece in a framework of provisions aimed at helping addicts to get help.

In 2010, Washington passed the 911 Good Samaritan Drug Overdose Law.

The law provides immunity from prosecution for drug possession charges to overdose victims and bystanders who seek aid in an overdose event.

It took five years to pass, and even five years after that, a lot of people don’t even realize it’s a law.

“A person acting in good faith who seeks medical assistance for someone experiencing a drug-related overdose shall not be charged or prosecuted for possession of a controlled substance…” says the law, “or penalized…if the evidence for the charge of possession of a controlled substance was obtained as a result of the person seeking medical assistance.”

A footnote in Washington State Legislature reads: “The legislature intends to save lives by increasing timely medical attention to drug overdose victims through the establishment of limited immunity from prosecution for people who seek medical assistance in a drug overdose situation. Drug overdose is the leading cause of unintentional injury death in Washington state, ahead of motor vehicle-related deaths. Washington state is one of sixteen states in which drug overdoses cause more deaths than traffic accidents.”

Fear of arrest or police involvement, researchers say, is the most significant barrier to the ideal first response during an overdose.

So people die.

Pat Slack, commander of the Snohomish Regional Drug and Gang Task Force, is thankful for the passing of the “Good Samaritan Law.”

“It took us so long to get that passed,” he said, “but it’s a powerful tool to fight these deaths that keep occurring.”

A very specific part of the legislature says that “a person acting in good faith may receive a naloxone prescription, possess naloxone, and administer naloxone to an individual suffering from an apparent opiate-related overdose.”

Naloxone, marketed as Narcan, is a prescription opioid antagonist that reverses the depression of the central nervous system, respiratory system and hypotension.  And while it may cause symptoms of withdrawal in a user, it will save their life.

It is on the World Health Organization’s “List of Essential Medicines,” the most important medications needed in a basic health care system.

Slack, along with police officers in several agencies around Snohomish County, have been receiving training on how to use Naloxone over the past month.

It buys first-responders, either law enforcement officials, or even friends or family who can get a prescription at a local pharmacy, time to get an overdose victim to an emergency room.

Hope Soldiers

“You can’t treat death,” said Slack.  “Once someone is gone, there’s no magic formula to bring them back.”

Slack believes in laying the important groundwork to help someone long before naloxone is necessary.

Lindsey Greinke, 26, a former addict, works with Slack in what he calls “the rubber bullet side of police work,” the social aspect of law enforcement.

Greinke founded Hope Soldiers, a non-profit organization that reaches out to those struggling with addiction, or self harm, helping them to find the resources they need to make changes in their lives.

On certain days, Slack and Greinke dress in street clothes and take Slack’s personal vehicle to visit addicts who they think they may be able to reach.

“You have to be bold when it comes to addiction,” Greinke said.  “It’s not small.”

Slack will ask the person to come out onto public property so they are all on neutral territory, and if the person agrees, something happens they may not expect.

They just talk.

“He isn’t there just as a cop,” Greinke said of Slack.  “He’s there as an average person who has an genuine interest in helping someone potentially save their life.”

He’s quick to admit a lot of his fellow officers are not so focused on the social aspect of police work, yet it’s equally as important as law enforcement.

In April, Greinke held an event at Everett’s Mariner High School, where both she and Slack spoke to an audience of over 900.

“I carry a badge and a gun,” Slack said, clad in his uniform, his badge shining in the light of the school gymnasium, “and that’s not the way to solve the problem.   From now on, you’re going to see officers roll up onto a scene, and they won’t pull out a gun, they won’t pull out a baton.  They’ll pull out some naloxone and say hi.”