Fentanyl use rising fast in Delaware

Stigmas, treatment options discussed at symposium
October 4, 2017

Drug overdose deaths are climbing nationwide, and Delaware rates are among the steepest – with an increase in fentanyl use driving that trend.

Roughly 64,000 people died in the United States from overdoses in 2016, a more than 22 percent increase from the previous year. Deaths involving fentanyl more than doubled since 2015, and have increased by 540 percent in the last three years, new data from the Centers for Disease Control and Prevention show.

“Fentanyls are changing the equation of this epidemic,” said Renata Henry, executive director of the nonprofit training organization The Danya Institute, who presented the new data at a recent Science Over Stigma symposium in Bridgeville.

The data also show the steepest rises in deaths among 21 states with the highest quality of reporting data were Delaware, Florida and Maryland – in that order. Delaware saw a 71 percent increase in drug-related deaths in that 12-month period, CDC data show.

“All evidence suggests the problem will continue to worsen in 2017,” Henry said.

The fallout from a rise in deadly drug use also includes an increase in viral infections such as HIV and hepatitis, more babies born drug-dependent and an increase in children placed in foster care, she said.

“The economic burden to this country is pegged now at about $78.5 billion,” she said. “I expect that to change and rise.”

Those statistics are startling, Henry said.

“You've got to think prevention, intervention, treatment and recovery,” she said. “You have to think laws, policies, practice and programs all together.”

Science also is key in finding the appropriate treatment and recovery options for substance disorders – as well as a slew of co-occurring disorders such as anxiety, depression and other mental health issues, Henry said.

“Substance-use disorders are a chronic brain disease that can be treated,” she said.

Keynote speaker Dr. Yngvild Olsen, medical director of the Institutes for Behavior Resources Inc./REACH Health Services in Baltimore, explored the science behind addiction, driving home the point that addiction is a chronic brain disease, not a moral choice.

“We really need hope in this epidemic, and there is hope,” she said. Unfortunately, she said, medical experts are still identifying risk factors associated with substance-use disorders.

“We don't have good genetic tests or blood tests or urine testing or anything else that can really predict what kind of risk factors are going to come together in any particular individual to have them develop an addiction,” she said.

Research has found, however, that 40 percent to 60 percent of the risk is genetic. Scientists are still trying to pinpoint how genetic differences drive that risk, though, Olsen said.

Trauma also plays a key role as a major environmental risk factor, she said.

“I think we really underestimate the impact and the prevalence of trauma in people who have substance-use disorders, particularly in people who have opioid disorders,” she said. “We really, really, really need to be screening for and paying attention to trauma as one of the risk factors for people who are coming in to treatment, as well as those who aren't.”

Access to treatment is another major barrier to fighting the epidemic, Henry said. Nationwide, about 80 percent of people who need treatment aren't getting it.

Chronic use of opioids changes how the brain functions, leading to medication-assisted treatment and lifelong management recommendations, Olsen said.

A long journey to recovery

That's what worked for Seaford resident Kandice Seymour.

When Seymour started abusing substances, heroin wasn't her first drug of choice.

“I started at a young age, after a traumatic experience when I was 12,” she said, citing her first experiences with alcohol. “At the time I didn't think I had a problem. I just thought I was a normal teenager, doing normal teenage things.”

In retrospect, she said, it's not normal for a teenager to get arrested and be in and out of juvenile detention centers. At one point, while she was on juvenile probation and skipping school, she was flown to a detention center in South Dakota. She returned to Delaware about age 17, got married at 18 and had her first child.

She was clean for a few years, Seymour said. Then she was introduced to Percocet.

“When I took that it was like I had no worries in the world,” she said. “One thing led to another. I started having friends that used Percocets and I began to spiral out of control.”

Seymour said she lost her car, her job and custody of her daughter. Over the years, she tried detox and rehabs more than 20 times until she finally found Connections and started a medication-assisted treatment program with methadone.

“I continue to just try to be better than I was yesterday,” said Seymour, who has been clean since August 2014. “My thinking pattern is totally different, and I owe a lot of that to methadone.”

Medications play a key role

Methadone, buprenorphine and naltrexone are the three Federal Drug Administration-approved medications that address opioid addiction. For many like Seymour, they are vital to overcoming opioid use, Olsen said.

“Everybody's recovery is going to look different, because everybody's an individual and unique,” Olsen said. “Right now, really the standard of care … indicates that all patients with an opioid use disorder should be offered medication as a component of treatment.”

Regardless, she said, overcoming opioid addiction is all about long-term recovery and management, which could include treatment for other mental health disorders, group therapy and counseling.

“There really are many paths to recovery, one of which can be any of these medications,” Olsen said. “They can save lives and improve lives, and that's really, ultimately, what we all care about.”

If you or someone you know is struggling with a substance-use disorder, go to