Salt Lake County opioid town hall outlines challenges, successes in battling epidemic

(Francisco Kjolseth | The Salt Lake Tribune) Traffic rolls past a billboard bringing attention to the opioid crisis along U.S. Route 191 in Carbon County where 93 people have died to opioid overdose between 2000 and 2018, according to data from the Utah Department of Health.

A fractured eye socket. A broken nose.

During the seven years she spent with an abusive partner, Destiny Garcia would often go to the emergency room with a host of injuries. She left with pain pills, anxiety medication, sleeping pills, muscle relaxers and, ultimately, an addiction that “overtook everything.”

After ending her relationship, Garcia said it became easier and cheaper to find heroin than opioids. As she risked everything to get her next fix, she and her children soon became homeless on the streets of Salt Lake City.

“My parenting, my home, my family, my self worth, my motivation — it completely took me over, 100% in every aspect of my life,” she recounted at a town hall focused on opioids at the Rose Wagner Performing Arts Center on Wednesday evening.

Today, Garcia has been sober for nearly two years and works as the constituent affairs and volunteer services director at Salt Lake County. She credits the treatment she received after she was swept into jail as part of Operation Rio Grande, an all-out attack on homelessness and crime downtown, with saving her life.

“There is a community out there that is huge,” she said later in the two-hour town hall hosted by the Salt Lake County mayor’s office, Bonneville Media and Use Only As Directed, the state’s opioid public awareness campaign. “There are groups out there, communities out there that are willing to jump out there and help pull you out of that darkness.”

Garcia’s story is one of the positive tales to come out of what’s been labeled an opioid “epidemic,” as more than 76 billion prescription pain pills flooded the country between 2006 and 2012, according to a recent data analysis by The Washington Post based on figures obtained from the Drug Enforcement Administration. Almost 700 million of those pills came into Utah.

That rush of opioids can also be "measured in and seen in terms of loss of life and family members,” Salt Lake County District Attorney Sim Gill said at the event.

From 2001 to 2018, just shy of 6,000 Utahns died from opioid overdoses, according to state data — outpacing deaths from firearms, falls and motor vehicle crashes. In 2017, there were 245 drug overdose deaths in Salt Lake County, according to data provided by the county.

Retired U.S. Navy Adm. James Winnefeld, who co-founded an advocacy group focused on opioid death prevention, told the audience about the devastating loss of his 19-year-old son two years ago to an accidental fatal overdose of fentanyl laced with heroin during his first week of college in Denver, Colo.

“Hope is not a strategy,” he said when asked his advice for those who might be worried about their loved ones’ opioid use. “It really doesn’t work. You have to be willing to step on their toes rather than on their grave, and it’s hard to do.”

Many of the industry’s giants have been blamed for fueling the opioid epidemic that killed almost 400,000 people nationwide between 1999 and 2017, according to the Centers for Disease Control and Prevention. At least 20 Utah counties, including Salt Lake County, and the state have filed claims against opioid manufacturers.

In this Tuesday, July 30, 2019, photo, Salt Lake County District Attorney Sim Gill listens as Salt Lake County Mayor Jenny Wilson, right, talks about the new diversion program for low-level offenders, during a news conference at the Salt Lake County District Attorney's Building, in Salt Lake City. The program intended to prevent individuals from entering the criminal justice system is scheduled to begin Aug. 5 and be phased in over the next 12 to 18 months, said Gill. (Rick Egan/The Salt Lake Tribune via AP)

Gill countered Wednesday that “the opioid epidemic really was about greed and profits," he said, noting that in a six-year period in Salt Lake County, there were 40 pills prescribed per year for every “man, woman and child.”

“And after these big pharma companies made their profits, they left and they left taxpayers and communities with the tragedy that they left behind,” he said. “So we thought that it was not fair for our community to have to sustain that tragedy after they had left, so the litigation was started.”

In defending their sales, the drug companies often point out they were providing legal painkillers and blame overprescribing physicians and unquestioning pharmacies, among other factors.

Dr. David Hasleton, senior medical director at Intermountain Healthcare, acknowledged during the panel discussion that some providers had “not done our due diligence” when prescribing opiates — particularly those who had gone through training some years ago.

“We didn’t know what we know now,” he said. “So now, it’s incumbent upon us as providers to make a difference as much as we can.”

Intermountain Healthcare has been working over the past few years on having “difficult discussions” with physicians, using data that shows patients generally only consume about half of the opioids they’re prescribed, Hasleton said.

“Now we don’t have to have the hard discussions anymore,” he said, noting that physicians there “are self policing” and holding one another accountable for their numbers of opiate prescriptions.

But providers are just one piece of the puzzle in addressing what Salt Lake County Mayor Jenny Wilson called Wednesday “the public health crisis of our time.” The bigger picture, she said, needs to also include taking on “predatory practices” by drug manufacturers, putting more kits with the overdose treatment drug naloxone into the community, raising awareness of the realities of opioid addiction and continuing to expand access to treatment beds.

The county also announced Wednesday that it was one of six communities nationwide that was awarded a $600,000 grant from the U.S. Bureau of Justice Assistance. That money will support a coordinated response to prevent and reduce deaths by helping Salt Lake County “identify public health, behavioral health and public safety responses" County Councilman Steve DeBry, who co-established the county’s opioid task force, said in a news release.

As the county sees an increase in the use of fentanyl and methamphetamines, Salt Lake County Sheriff Rosie Rivera said her office is also working to go after cartels and online drug distributors to address the situation.

While it’s not as concrete, it’s equally important to “let people know there’s hope,” Wilson said, praising Garcia for sharing her personal story. “There is a way to get beyond this. That’s what we’re striving for in this community.”