Police Psychology | Opioids and Opiates
by Gary S. Aumiller, Ph.D. ABPP
I live on Long Island, NY. Last year 493 people died on Long Island from opioid and opiate overdose with Fentanyl being the worse drug for deaths. That’s more than were killed in car accidents in one of the most heavily trafficked areas of the country. More than gang related deaths, more than murders in general (although one could argue that a person selling opioids to another is actually committing murder). Yes, 493 people died last year and the trend so far this year suggests we may actually be ready to beat that number. So, I called Geisinger-Marworth Treatment Center, an awesome facility in the woods of Pennsylvania, that I refer almost any police officers from anywhere. I asked them what is the deal with the opioid problem on Long Island and do I have anything to worry about with the nation’s cops. Some of what I found out is a little disturbing.
Let get the vocabulary right first. “Opiate” is a word that covers naturally occurring derivatives from the opium plant like Heroin, Morphine and Codeine. They are the original addictive drugs and really what it was all about when the guys came back from Vietnam addicted to Heroin and Opium. Opioids are synthetic versions of the opiates like Oxycontin, Oxycodone, Dilaudid, Percocet, Vicodin, Percodan, and Fentanyl. Both sets are addictive, but the synthetic drugs have become a bigger problem recently and it’s not just what is being sold on the streets.
Geisinger-Marworth set me up with a social psychologist named Dr. Joseph Boscarino who who does research in opioids for Geisinger-Marworth. Dr. Boscarino looked through over 2000 electronic record of people who had come into their hospital system for a variety of reasons and have overdosed on opioids. The reason for the opioid use in the first place ranged from recreational use, to open heart surgery, to injuries and pain management. Oxycontin and Percocet caused most of the overdoses. For most of the people in the study the drugs were prescribed! It has hit both sexes almost equally and women were represented more in his study. And get this, the average age in the study was 52 years old. Now that breaks stereotype of the young drug addict that we all have.
A year after the overdose, 9.4 percent didn’t have to worry about anything anymore because they had died. In fact, since the recidivism rate is so strong, meaning more were likely to overdose again, death is a pretty frequent outcome of overdose on opioids, especially multiple overdoses. Evidence in Prince and Michael Jackson cases suggested multiple overdoses on opioid drugs before their final deaths. They were right in the average age range found by Dr. Boscarino, and although Michael Jackson ended his life on Propofol, there was a lot of evidence suggesting opioids were also involved in his final dose. And now it is reaching epidemic proportions. Pretty bleak picture!
What does this have to do with police? Police officers must deal with this in a couple of ways. The obvious is when on a call or on the street. They need to be aware that it is no longer Heroin that is the major problem, but a whole lot of prescription medication. The source is not necessarily what we used to call a “pusher” but it could be a parent’s medicine cabinet. People like to keep drugs like pain killers around in case they need them. I was given 60 Oxycodone when I had open heart surgery of which I took one. You’d be surprised the number of people and the quality of people wanting to take it off my hands when I was saying I had to go to the precinct to dispose of them. In the education programs officers do in school and in the community, emphasize the need to get rid of drugs, especially pain killers. Have a deposit area in the local precincts and advertise it.
The second way officers need to be aware is simpler. Police officers, in fact all first responders, tend to be more prone to injury. It is an active job, and as you age, you are less and less able to respond physically and the cumulative effect on your muscles and connective tissue can cause you a pain problem. Your doctor tries to help, and wham you end up addicted. Dr. Boscarino stated some get addicted while others do not and he is looking for a way to test for that. I have had quite a few first responders from my job and many more from around the world that have problems with painkillers they were taking as part of a treatment or pain management. Letters to this blog are astounding with people asking for help. After 9-11, the numbers in this area were also staggering. Awareness doesn’t fix the problem, but it may have some preventative effect. Awareness may get you to sign into a rehab like Geisinger-Marworth before you do some major damage from a prescription medication, and that is always a good thing.
Dr. Boscarino suggest that prescribing some dosage of Naloxone with opioid treatment is part of the solution to the problem. Naloxone is an opioid antagonist that helps prevent the misuse of opioids. He also suggests coming up with predictive model so people can know if they have a propensity. It is clear that Gesinger-Marwaorth and Dr. Boscarino have some definite ideas for a problem that is affecting our life right now. It is clear that officers have to become a resource to their friends, their community and themselves when it comes to opioid and opiate use.
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***Geisinger-Marworth accepts patients from across the country into their rehabilitation programs. They have a wonderful program for first responders. Click on the symbol below or in the sidebar to go to their website.