The Indiana Opioid Epidemic

Coroner offices are running out of room for the overdosed bodies coming in. An incredibly high percentage of Indiana citizens, (let’s call them Hoosiers), abuses prescription opioids. Court systems statewide are in the process of improving response to the epidemic. Indiana has since 2011 had a higher percentage of drug abusers than the national average.

It’s safe to say Indiana is facing its own personal epidemic.

We’re going to discuss the explicit details of the current state of Indiana, and how it came to be. We’re also going to discuss what’s being done to stop the madness, and what possibly lies ahead in the future for the Hoosier state.

Higher than Average

In April of 2017, Indiana University and Purdue University of Indianapolis collaborated on and published an article called Substance Abuse Trends in Indiana: A 10-Year Perspective. To step for a moment outside of the realm of opioids, it’s interesting to note that tobacco use is a serious issue for Hoosiers. The state ranks among the highest for tobacco use, and 15% of expecting Hoosier moms use tobacco as well, an extremely high figure.

Alcohol is, though, the most popular substance of abuse in the state. According to the article, just about half of Indiana residents aged 12 or older had consumed alcohol in the last month, and half of those people had binge-drank.

When it comes to opioids and other drugs that commonly cause fatal overdoses, the bleak picture of Indiana’s drug problem becomes clearer. As shown in the above-linked article, the National Survey on Drug Use and Health (NSDUH) charts the percentages of substance abusers among each state’s population, as well as nationally. Only those aged 12 or over are included.  Now, take a look at the graphic below. (Note: state-level statistics for heroin were not available until 2014.)

Regarding the number of cocaine abusers, Indiana has been below the national average since 2006. But, regarding the number of pain reliever abusers, (the majority of which abuse opioid painkillers), it’s entirely the opposite. Indiana consistently ranks above the national average, usually by one percent or more, which is a much larger chunk of people than you might think.

The population of Indiana is more than, but close to 6.5 million. Let’s say 75% of those people are age 12 or older. That’s a total of 4,875,000 people, and one percent of that is 48,750 people. Rounding up slightly, this all means that on average, every single year, there are fifty-thousand more pain reliever addicts living in Indiana than in any other state in America. (Wow.)

All of these figures are based on the general population. When you apply the same information to only those who received treatment at a facility in Indiana, the Hoosier state is even higher than the national average for percentage of pain reliever abusers. Indiana ranks 17th out of 50 for population level, and also ranks 17th out of 50 for deaths from drug overdoses.

No Room at the Morgues

The following words are not for the faint of heart. As reported last November by the WTHR division of NBC, all across Indiana there are reports of coroner offices running out of room for dead body storage. Why? It’s because of the opioid crisis. “I’ve never seen anything like this. This is a disease that is actually causing people to die at a rate that I have never seen in my 20 years of conducting death investigations,” said Alfie Ballew, chief deputy coroner of Marion County. She continued: “I don’t see that the numbers are decreasing at all. They’re continuously going up. It’s scary.”

In 2016, approximately 280 Marion County residents fatally overdosed on drugs. That’s almost one person per day, just in one county. Since 2007 nearly 5,000 Indiana residents have perished at the hands of substance abuse. Now, Marion County is home to Indianapolis, which is the most populous city in the state by a long shot. This doesn’t excuse the high death count. But it’s safe to say that a morgue running out of room is more likely to happen in Marion County than somewhere like Tippecanoe County, the population of which is literally more than seven times smaller than that of Indianapolis alone.

Think again.

Donna Avolt is a coroner for the Tippecanoe County Coroner’s Office, which recently filled its morgue to the maximum and had to act quickly with all of the fatal overdoses occurring. Donna told WTHR, “We have a steady stream of overdoses. We don’t want to be as busy as we are.” They recently became so busy in fact that they had to purchase a $75,000 refrigeration unit to hold extra dead bodies that would not fit in its morgue.

Donna spoke about the time before the decision to make the purchase: “Our refrigerator unit at that point only held six. It was filled. I also had funeral homes holding bodies for me, and there were bodies at the hospitals. There were so many of them, and it was primarily drug overdoses.” Their newly purchased unit holds twelve bodies, twice their normal capacity.

As mentioned, these are merely two examples of what’s happening to coroner offices all across the Hoosier state. The implications are mindboggling. Drugs are causing people to die at a rate that Indiana as a state was absolutely never prepared for – probably at a rate that most thought could never happen without some type of world war or natural disaster.

One in Twenty

That’s how many Indiana residents admit to abusing opioid prescription pills. As we all know, the numbers in these cases are usually higher than reported, since some people do abuse pills but do not admit it freely. Taking this into account, but still erring to the side of caution, it’s safe to say that one in every sixteen or so Indiana residents abuses opioid pills.

Let’s talk some more numbers, but first it’s very important to know that the vast majority of heroin abusers begin with opioid prescription pills. Now, bearing this in mind, consider the fact that for every one hundred Indiana residents, there are about 84 prescriptions for opioid painkillers written every year, and it’s been this way for a long time.

No wonder there’s a serious opioid epidemic wreaking havoc in Indiana.

Fighting the Good Fight

There are several courses of action being taken by many different Indiana-based organizations and/or branches of government, but first let’s briefly discuss something national that might help in fighting the good fight.

Recently, retail giant Walmart took a major step of its own in combating the opioid crisis. According to the Modern Medicine Network, “In an effort to curb the misuse and abuse of opioid prescriptions, Walmart pharmacies will offer a free Rx Disposal kit to any patients who receive a Class II opioid prescription.” The kit turns leftover opioid medication into a useless gel. This could be good news for Indiana. The state may rank 17th in population, but it ranks 11th in number of Walmart stores.

On a more local front, in the city of Lebanon, some of the high school’s staff is currently undergoing Narcan training. Narcan is an opioid overdose reversal drug which saves countless lives every single day. In fact, Donna Avolt, coroner with Tippecanoe County, said to WTHR, “If we didn’t have Narcan as a front line medication, we would see a lot more deaths that what we’re seeing now.”

Indiana state law says that Narcan can be sold to anyone, over the counter, without the need for a prescription. That’s why the Whitestown Fire Department (WFD) posted an instructional video to their website (and to Youtube, inevitably), on how to properly administer Narcan in a situation of opioid overdose. You can watch the video here.

Clinton Crafton is the WFD Deputy Chief of Operations. He spoke with WTHR about why the video was necessary, and also how it’s not enough: “We know Narcan works. We know that Narcan can make a difference and reverse the effects and give us that fighting chance to get that person to the hospital. Prevention is one of our core beliefs, and in the end, Narcan is not a solution. Long-term addiction recovery is the only cure for this problem.”

More Local Efforts

It’s uplifting that in Indiana there are literally too many efforts being made to fight the opioid crisis to list. We wanted to share with you some of the standouts, in our opinion:

  • The Interfaith Alliance of Carmel, Indiana, is a multi-religion group with a mission to help the city. Earlier this month, the alliance held a forum on answers to the opioid crisis.
  • Last November, the city of Indianapolis filed a lawsuit against several pharmaceutical companies and distributors for their participation in creating the opioid crisis. This month three more municipalities together filed a similar lawsuit: the city of Bloomington and both Lake and Monroe counties.
  • Morgan County Jail is finding high success rates within its Residential Substance Abuse Program, which offers an intensive treatment program for addicted inmates. There is no incentive for less time served – only to get clean – and the program is having a success rate percentage in the 70s.
  • The Community Justice Academy (CJA), launched by the Marion County Prosecutor’s Office in the early 2010s, recently held a session entitled “The Opioid Surge”. The goal was to “offer an in-depth look into how the opioid addiction epidemic is impacting local public health systems and emergency responders,” according to the CJA website.
  • Indiana Supreme Court Chief Justice Loretta Rush delivered a State of the Judiciary address this month to the state’s General Assembly. During the address, Rush said that all across the state, court systems are bolstering efforts to fight the opioid crisis. Such efforts include creating teams in every county to increase treatment efforts, increasing the number of court programs aimed at helping addicts, increased help for the children of addicted parents, and improving overall technology.

In Conclusion

The single most unfortunate aspect of America’s current opioid crisis is that this entire article could have been about ANY state in the country. Alaska is facing its own crisis, as well as Maine, Hawaii, and Florida, which are essentially the four corners of the US. Everywhere in between is also flooded with deadly opioids and other deadly drugs such as cocaine or meth.

Almost all drug addictions start when the affected person is a teenager. Therefore, we are of the opinion that the most crucial weapon in the war against drug overdoses is educating our children. Obviously there is a major amount of work to be done in every regard, from prevention to treatment. However, if we can truly get our youth to recognize addiction as the disease it is, and to try and avoid it, as we do all other diseases, then we have a real shot at stopping the madness that is the opioid crisis of America.

As for Indiana, we at Indiana Center for Recovery are here to help.