Dylan Armstrong remembered feeling like he wanted to die, and the best way he saw out was through a myriad of pills in his father’s makeshift medicine cabinet.
Armstrong’s father stored his medicine in a makeshift medicine cabinet made from a deep freezer and bound by a lock. Armstrong said he cut the lock and stole dozens of OxyContin as well as other painkillers and sleeping pills.
Eventually, Armstrong ended up on a friend’s bathroom floor, an experience he still has a hard time talking about. Armstrong grew up in Pratt, but today lives in a clean-living Oxford House in Salina with other recovering addicts. He’s been sober nearly 13 months.
“There’s drugs everywhere you go, but I don’t know any of the people here,” Armstrong said. “I don’t want to know any of the people. All I know here is recovery.”
Armstrong came to on his own, but many are being taken to the hospital by ambulance. For first responders across Kansas, being called to an opioid overdose is becoming more prevalent, as an epidemic gripping the nation works its way from both coasts to the middle of America.
Kansas had 35 overdose deaths involving an opioid in 2000, according to the Kansas Department of Health and Environment. The death toll climbed to 159 in 2016.
A recent study by the Center for Disease Control and Prevention also shows a rise in the number of morphine milligram equivalent (MME) being prescribed per person. The MME takes into consideration the type of opioid and its strength.
In Kansas, contrary to the national trend, the MME rose between 2010 and 2015 — the latest year available.
The DEA is responsible for regulating opioid prescriptions from pharmaceutical companies on to distributors and doctors.
Scott Collier, a DEA spokesperson based in St. Louis, said the organization began to reduce the number of narcotics that could be prescribed nationwide between 2013 and 2014.
Collier said that’s when pharmaceutical companies and distributors began lobbying Congress.
An amendment to the Controlled Substance Act rid the DEA’s power to issue an “immediate suspension” order to distributors or doctors when it was signed into law in 2016. Collier said the law changed the way his division tries to stop the distribution of opioids but did not slow down the flow of narcotics. Whistleblowers have told news outlets the legislation dramatically reduced the DEA's effectiveness.
Under the Controlled Substance Act, pharmaceutical companies and distributors are required to report suspicious orders. Collier said those companies have lost track of its customers and how many pills go out.
“If you ask them, then they will say: ‘We tried our best,” ’ Collier said. “Maybe, maybe not.”
As for 1.5 million doctors nationwide licensed to prescribe opioids, Collier attributes the lion’s share of overprescribing to a few rogue doctors. Those doctors can do a lot of damage, he said, and usually offer prescriptions for a lump sum of money.
Agents often go undercover to see if the doctor does any kind of assessment that would indicate pain pills are a reasonable prescription.
Among the most notable Kansas’ opioid cases are Stephen and Linda Schneider of Haysville, whose prescription practices led to over 60 patient deaths. Collier said the DEA worked with the Kansas Bureau of Investigation in the case. The Schneiders were given decades-long sentences in 2010.
The DEA also used the Kansas Board of Pharmacy’s drug monitoring system, called K-TRACS, in a case that sent 23 people, including Kansas doctors and a pharmacist, to federal prison.
Doctor prescription data is not available to the public, the National Association of Boards of Pharmacy said.
“Privacy laws prevent the release of this information outside of well-defined and enforced parameters,” Executive Director Carmen Catizone said in an email. “Pharmacies’ opioid dispensing activities are monitored by the individual state boards of pharmacy and the DEA.”
How did we get here
According to the CDC, prescription rates in the U.S. were at 180 MME per person in 1999; and 640 MME per person in 2015 — the latest year available. The U.S. peaked in at 782 MME per person in 2010.
Still, the 2015 figure is triple what it was in 1999. The DEA's Collier believes a few factors led to the rise:
In the late 1990s and early 2000s, doctors were being told to use opioid drugs to treat pain.
The U.S. allows advertising directly to consumers, meaning patients often come in thinking they know what drugs they need to treat their symptoms.
Mass production of opioids has allowed the pills to be available for cheaper.
Preparing for the storm
The Kansas Attorney General’s Office announced in September that it would join 40 other states in a joint investigation into manufacturers and distributors of prescription opioid drugs. Meanwhile, federal dollars continue to trickle down to prepare for the worst.
Also in September, the Kansas Department for Aging and Disability Services announced it was awarded $3.1 million by the U.S. Department of Health and Human Services for the prevention and treatment of opioid abuse in Kansas.
“Opioid addiction and abuse is a growing problem in Kansas, as it is in the rest of the country,” KDADS Secretary Tim Keck said in a press release. “Kansas is the 16th highest opioid prescribing state in the country. We are working to address this critical public health issue before it gets any worse.”
Collier, like many others, said things are only going to get worse. Collier cited studies done by the National Survey on Drug Use and Health. Results from the 2015 study — the latest year available — showed 3.8 million people age 12 or older misused prescription pain pills.
That number, he said, is much higher than it was when the survey was done in the 1970s, before the heroin epidemic that followed.
Collier said narcotic pills on the black market go for roughly $1 a milligram, which means many opioid addicts often turn to a much cheaper drug, heroin.
Today’s death rates involving any opioids are much higher than in the 1970s. Since the start of the century, the number tripled: from roughly 3 per 100,000 people to over 10, according to the CDC.
Armstrong said he doesn't want to be one of those statistics. He is a survivor, he said. The near-death experience still has a profound impact on him. It’s been years, but he still gets an awry feeling when Halloween comes around.
His most vivid memory from that day was seeing his deceased grandma, who told him it was not his time. Then, Armstrong said, he woke up gasping for air.
The 28-year-old knows he has a long road ahead and works harder to make up for the time lost as an addict. He’s moved into a management position at work and started classes to earn his high school diploma. Armstrong said he was 12 hours short of graduating when his addiction started.
Armstrong plans to take a class next month and become certified as a mentor in order to help others with addiction.
“I want to help people,” Armstrong said. “As of right now I see myself as an addiction counselor or something along those lines.”