By Karen Cornelius
The College Club of Vermilion sponsored an informative evening with guest speaker Dr. Stephen Evans, Lorain County coronoer, who appeared at the United Church of Christ, Congregational on Wednesday night, November 8. His impressive presentation, “Are We Winning The War On Drugs?” drew a large audience to hear what this expert on the front lines of overdoses and death had to say on the opioid crisis.
Dr. Evans has worked for the Lorain County Coroner’s Office as a deputy coroner for 19 years and in July, 2011, was appointed Lorain County coroner. He was re-elected coroner in the most recent election. He is a lifelong resident of Lorain County and raised in Lorain, Ohio. He went to Ohio State and received a bachelor of science degree in 1972, a master’s degree in 1974, and a Ph.D degree in 1976. He graduated from Wright State University School of Medicine and received an M.D. degree in 1980. He is board certified in Emergency Medicine and Family Medicine and has served at several hospitals in the area.
The guest speaker started off with a history of drug overdoses through the decades stating there were 10-20 per year then in 2010-11 they were bumped up to 20 with overdoses tripling in 2012 to 60. “What happened, were they bad drugs?” he wondered. No, the demographics had changed from inner-city to white, middle class, suburban, to employed, with 60 percent male, but now men and women are almost at 50/50. “We were in the middle of an epidemic,” said Evans. “Lorain County was just late to the party.”
Over 160 people are dying every day in the United States, and by 2016, there were more overdoses from drugs than the entire Vietnam War in the U.S. “The statistics just keep going up and up. Ohio is going up faster than any state in the United States. Ohio is #1 of all the states,” said the coroner. Also in the top five, are Pennsylvania, West Virginia, and Kentucky. “We are in the epi-center of this drug problem, and people are getting younger and younger.” Evans said his youngest overdose was a two-year old, and his oldest, was 75-years-old so far. This was a grandfather who shared heroin with his grandson.
It was noted the drug problem is multi-factorial with lots of reasons and guilt. He pointed the finger at drug companies coming up with stronger and stronger pills for pain. He said drug companies paid for a study to show these various pills, such as percocet and oxycodone, were safe and non-addictive. The federal government pushed doctors and hospitals to relieve people’s pain or not get paid for treatment. It was a bogus study, said Evans, and then the government pushed the other way closing clinics. “But, they let the genie out of the bottle and people were addicted.” Where did they go, to the streets for heroin because it was cheaper.
The doctor said no one learned from history which started thousands of years before Christ with the “Joy Plant” which was opium. Morphine came along in the Civil War billed as safe but a huge population became addicted. Then to get off morphine, a new drug, a heroic drug was promoted as safe, that was heroin. Now heroin is being mixed with other drugs like cocaine and finally the most powerful of them all, fentanyl, a synthetic opioid. Fentanyl is 100 more times potent than morphine. In 2016, fentanyl led the way in Lorain County for overdose deaths, 74. Next there were 51 with heroin, and 35 with cocaine. Right now there are one out of six in Lorain County using drugs inappropriately. “We are going to run out of people.”
The doctor said a lot of heroin comes in from Mexico and can be injected, but it destroys the veins and long term damages every organ in the body. He stated he has seen injections even in the tops of heads and the toes, and track marks all over arms. It changes a person’s appearance and creates a rough life. He showed the audience a photo of two grandparents overdosed in the front of a car with a five-year-old grandson alone in the back seat. “This photo haunts me. How do we save our children?”
Dr. Evans was so frustrated he wanted to save people which led him to Project Dawn and spearheading the drive to provide Naloxone or Narcan, to people overdosing. He said 80 percent of the people who overdose are with someone. However, it could take a rescue squad ten minutes or more to respond. This person would stop breathing in five minutes and then he or she would be gone. He thought perhaps the police departments were the answer because they respond faster. However it was illegal for the police to dispense medicine. Evans went to state senator Gayle Manning and got legislation passed to allow Lorain County to start a pilot project with Narcan, a synthetic narcotic in a nasal spray that blocks the effect of opiates like heroin on the nervous system.
The coroner personally went to every police department. He said at first some were resistant with some thinking, just as the public, that the overdoses were just thinning the herd. Yet, other officers said wait, my brother, sister, uncle has a problem. After saving one person, police officers were convinced to help save lives. During the one-year pilot, 60 people were saved by law enforcement. “Over 300 now have been saved in Lorain County and are alive because the police carry Narcan,” said Dr. Evans. “It was not the cops versus the criminals, it was cops versus the victims.” The coroner warned that people who think thinning the herd is acceptable, it could be their own family’s herd they are not saving. “The chances are everyone knows someone with a drug problem. I would give Narcan a million times over.”
With Project Dawn working, Evans started receiving calls from all over the country and the world, invitations to speak as far as Italy. Then, every county in Ohio joined the program. Thousands were saved and more in the United States. Evans said when they were starting to feel good about themselves, something happened in 2016, it was fentanyl, something you can make in your kitchen sink. The cartels found this new drug, had Chinese scientists come over and man-make it. It’s so available that China can ship it to the U.S. and it can be ordered on the Internet. In 2016, overdoses doubled again.
“We’ve lost the war. We are doing something wrong. We can’t arrest out way out of the situation,” said Evans. He said you can arrest dealers, but there is always someone to take their places. We have spent billions per year in this fight to no avail. What, he asked, is the solution. To him, it’s education. “Education is the most powerful weapon which you can use to change the world.” Teach children at an early age the risks. High school is too late, there are already drugs there. It’s stopping people from starting. “The way out is prevention. It’s cleaning up the community, the schools, and the neighborhoods.”
Adults can start by cleaning out their medicine cabinets. He stated people say shoot the drug dealers, but parents are often their kids first drug dealers keeping pills they should not keep. Dr. Evans advised not to start taking any pain medication. Often teenagers have wisdom teeth pulled and receive pain pills which can be a start to addiction. Children also bow to peer pressure and think they are immortal. He encouraged everyone to use Tylenol or Motrin instead. Short-term pain pills may bring relief, but a lifetime of addiction, said Evans.
He added people also have to be further educated about addiction as a disease and treatment. He said it takes at least 35 weeks to get off, and people have to understand relapsing is normal. Falling off the wagon after recovery is normal. He gave an example of a woman who was addicted and her husband moved them out of state to keep away from her previous friends. She was clean for five years and came back to Lorain County when her mother died for one day. She took a trip to the drugstore, met an old acquaintance and died of an overdose the next day. The thinking was one hit would not hurt. “It’s a complex problem. Detox is five days, but she was five years clean.” The coroner also stated that car wrecks are related to drugs and alcohol and marijuana. There are three leading causes of fatal crashes, drugs and alcohol, drugs and alcohol, and drugs and alcohol.
Dr. Evans ended his talk with a visual perspective of a Lorain County cemetery filled with tombstones. “We are going to need a bigger cemetery.”