The Impact Opioids Have Had in Georgia

Opioid abuse has reached an epidemic level in the state of Georgia.

While heroin and other opioids are a growing problem nationwide, Georgia, in particular, is reeling from an increase in overdose deaths caused by these drugs. In this post, we’ll go over the impact opioids are having in Georgia, including the overdose statistics locally versus the national average, as well as the economic impact the state is seeing from the crisis.

First, let’s go over what opioids are and why they are being abused.

What Are Opioids?

Opioids are classified as drugs that act on the body’s opioid receptors. They come in natural, semisynthetic and synthetic forms.Natural opioids include drugs like morphine, which comes from the resin of the opium poppy. Semi-synthetic opioids include prescription drugs like hydrocodone and oxycodone, and also heroin, which is created from morphine. And synthetic opioids include fentanyl and methadone.

These drugs are used medically as pain relievers. Some, like fentanyl and methadone, can actually be used to treat opioid abuse disorder. Others may be used as cough suppressants or to treat diarrhea. While these drugs are indeed very effective at treating pain, especially severe pain associated with accident-related injuries, cancer, or post-surgery, they are also easy to develop physical dependence toward, which can lead to abuse and addiction.

Because they block pain, reduce anxiety and produce a sense of euphoria, opioids have a high potential for misuse. As a user builds a tolerance to the drug, they will need more, or a higher dose, to achieve their desired feeling. When a high wears off, the person’s body may not have a natural opioid response any longer. They will then crave another dose.

This sometimes leads a person to turn toward cheaper street options of opioids, coming from so-called “pill mills,” or even lead to the use of a drug like heroin. People report that addiction to opioids can become all-consuming and lead them to do anything to obtain more, or something similar. This can lead to lying, stealing, and other dangerous behaviors.

While the nature of these drugs often is the cause of abuse and addictive behavior, however, it is not the sole reason for overdose. A person can experience overdose from opioids from a single use. No two people tolerate the drug equally, and batches of the “street” forms of these drugs can often be mixed with unknown substances, which can lead to fatal doses.

Overdose From Opioids Nationwide vs. in Georgia

Recently (April 2016), the Georgia Prevention Project started a program called the Substance Abuse Research Alliance (SARA), with the aim of assisting the Georgia State Senate Study Committee on Opioids and Heroin. This collaboration of more than 60 participants, which includes researchers and practitioners with years of experience in substance abuse, has conducted research on the current crisis and how the problem has emerged in recent years. They released their findings in a whitepaper called Prescription Opioids and Heroin Epidemic in Georgia.

In this whitepaper, SARA says that opioid overdoses, which includes prescription opioids and heroin, kill 78 people daily nationwide. This is a figure that has quadrupled since 1999. Overdose deaths from opioids reached an all-time high in 2015 when 33,091 people died across the nation. Since 2000, more than 300,000 people have died from opioid overdoses. More than half of all overdose deaths nationwide had some involvement of opioids.

Worse, is that according to SARA, deaths related to opioid overdose are on the rise in Georgia, closely mirroring that of national trends, and in some areas actually far exceeding national averages. Using information acquired from the Georgia Department of Public Health, SARA found that overdose deaths in Georgia are nearly equal to deaths caused by motor vehicle crashes.

In Georgia, opioids–particularly prescription pain relievers and heroin–are the primary cause of drug overdose deaths. In 2015, out of the 1,307 drug overdose deaths in Georgia, 900 of them were caused by opioids and heroin. This represents 68 percent of the total overdoses for the year and places Georgia among the top 11 states in the nation for prescription opioid overdose deaths. The Center for Disease Control (CDC) studied the rate of heroin-related overdose deaths specifically and found that 222 people in Georgia died from heroin overdose in 2015, up from 153 deaths the previous year.

Other recent data shows the local impact. Of Georgia’s 159 countries, 55 had higher drug overdose rates than the national average in 2014. Eleven years ago, just 26 Georgia counties were above the U.S. average, showing a significant increase and also displaying how the problem has branched well beyond Atlanta’s cities and into rural communities. Sixty percent of those 55 counties that had drug overdose rates higher than the national average are located in rural areas. These areas have limited access to substance use disorder treatment as well as medication-assisted treatment, which may be part of the problem.

Another alarming stat shows that overdose deaths in the state of Georgia rose significantly between 2013 and 2014, and have tripled between 1999 and 2013. Specifically, prescription opioid overdose deaths increased by tenfold in Georgia between 1999 and 2014, rising up to 549 deaths.

During the time between 1999 and 2014, overdose deaths per 100,000 people nationwide rose from 1.4 to 5.5. During this same time period, the rate of opioid deaths alone in the state of Georgia increased from 0.6 to 5.5 per 100,000 people–a rate this is much higher than the rate of opioid deaths in other states.

Part of the problem is that in recent years, opioids have become more readily available. Prescriptions for opioid analgesics continue to rise, with the sale of opioids having quadrupled in the United States between 1999 and 2014, despite the fact that the rate of people reporting pain has not risen. Having a drug be more accessible also means it is cheap, which leads more users to turn to the drug.

With Mexican cartels changing their business strategies and moving more opium into America than ever, heroin is becoming much more available as well. Couple that with the cheap price and it’s easy to see how the misuse of opioids can often grow into heroin use. The SARA study shows that 12.5 million Americans said they abused pain relievers in 2014. Two million of those reported having a pain reliever drug use disorder. And during that same year, around 914,000 Americans said they had used heroin, 519,000 of whom met the criteria for a heroin use disorder.

Economic Impact of Opioids

Naturally, the opioid epidemic is costing the country and state of Georgia a lot of money. For the year 2013 alone, the cost of prescription opioid misuse, dependence, and overdose was estimated at $78.5 billion. More than one-third of this amount ($28.9 billion) came from increased health care and substance abuse treatment costs.

According to a study led by Curtis Florence at the CDC’s National Center for Injury Prevention and Control, in the state of Georgia, the health care costs associated with opioid misuse alone were estimated at $447 million for the year 2007, with the estimated per-capita costs at $44. When taking into account the rise in overdose deaths and abuse of opioids in Georgia since that time, experts estimate that health care costs have risen at least 80 percent since that time. Many of those same experts say that the state must monitor the escalating costs.

In 2002, 302,000 people were hospitalized in Georgia for reasons related to opioid use and dependence.  By 2012, the number had risen to 520,000. During the same time period, the cost of opioid-related inpatient cares more than doubled, reaching $15 billion in 2012. The same study found that health care accounted for around 30 percent of the costs associated with opioid abuse in 2013, with the total spending for health care and substance abuse reaching beyond $28 billion.

Health insurance covered most of the costs, but nearly 25 percent was paid for by public sources, including Medicaid, Medicare and other public insurance, plus government-funded treatment programs.

Since there are often legal ramifications to these drugs, the study found that state and local governments paid for most of the $7.7 billion that was spent on criminal justice related costs. Tax revenue was also lost because productivity slipped. According to the study, nearly 2 million Americans had abused or were dependent on prescription opioids alone in 2013.

The 16,000 opioid-related overdoses in the year 2013 are estimated to have cost the economy $21.5 billion.

The opioid epidemic may also be partly to blame for workforce shortages, particularly in rural Georgia. In a recent meeting of the state’s new House Rural Development Council, local businesses reported having trouble filling entry-level positions because of failed drug tests. Opioids are diluting the local employment pool. However, there currently is no data to support these claims.

Where In Georgia Is The Opioid Epidemic Occurring?

While opioid overdoses have occurred all across the state, most people typically associate the drugs with cities like Atlanta, Augusta, and Savannah. And while the area of Atlanta does indeed continue to contain the highest concentrations of heroin use, the use of heroin and other opioids is growing rapidly in other areas of the state.

There is a growing area of risk that is now collectively known as the heroin triangle. The area sits above Atlanta and extends to Marietta, Sandy Springs, Alpharetta and Johns Creek.

These are suburban, middle to upper-class communities that have been shocked by the rise in opioid-related overdose deaths of their residents. 306 people died of an opioid overdose in Cobb County, which includes Marietta,  in 2016. Fulton County, which includes Sandy Springs, Alpharetta, and Johns Creek, saw 359 people die of an overdose during the same year. These towns have the highest overdose death rates recorded in county health records.

Where Are The Opioids Coming From?

For those wondering where the drugs are coming from, reports suggest that most of Georgia’s opioids come from Mexico and South America. It is trafficked through the border to the east coast. The drugs typically come through Atlanta before they make their way into the suburbs and into the hands of high school and college-aged students. This mainly relates to heroin, as it has become far cheaper than regulated opioids, and much easier to access.

Meanwhile, the devastating impact opioids can have on families is something that cannot be measured. If you or someone you know is abusing or addicted to opioids, get help before it is too late. The state of Georgia has many recovery facilities available to assist those dealing with opioid dependency. If you encounter someone suffering from an overdose, dial 911 immediately and follow these steps provided by the Georgia Department of Public Health.

Sources:

Hart, Ariel. “Opioid Crisis Drives Up Georgia’s Overdose Deaths.” AJC. 25 July 2018. 15 Mar. 2019. https://www.ajc.com/news/state–regional-govt–politics/opioid-crisis-drives-georgia-overdose-deaths-outpace-nation/UNJnBSHzgN3rwfs36Em5XO/

Langford, Jim. “Prescription Opioids and Heroin Epidemic in Georgia.” SARA. Dec. 2017. 15 Mar. 2019. https://www.acponline.org/system/files/documents/about_acp/chapters/ga/substanceabuseresearchalliancegeorgia_preventionproject2017.pdf

Georgia Opioid Summary. NIDA. 14 Mar. 2019. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/georgia-opioid-summary