Pubdate: Tue, 26 Aug 2014
Source: Courier-Journal, The (Louisville, KY)
Copyright: 2014 The Courier-Journal
Author: Georgia Heise
Note: Georgia Heise is the district director of Three Rivers District Health
Department in Kentucky and president of the National Association of
County and City Health Officials.


There is a new normal in our communities. For some children, stumbling
across used, dirty needles at the park is more common than a pick-up
game. Heroin addiction is a big disease with an even bigger negative
impact on everyone.

Kentucky has the third-highest drug overdose ranking in the United
States. Of the 722 drug overdose death fatalities autopsied in 2013,
31.9 percent were attributed to heroin, compared to 19.6 percent in
2012. The estimated cost of substance abuse in Kentucky is over $6

The numbers speak for themselves. Heroin use is everywhere. Our
employers are seeing a rise in the number of applicants that cannot
pass a drug test. Our community members are hearing about heroin
overdose deaths just as commonly as they hear about heart attacks or
cancer. And our families are being destroyed.

But what is driving this huge increase and how do we get a handle on

Unfortunately the causes and solutions to heroin use are complex, and
this problem isn't unique to Kentucky.

As president of the National Association of County and City Health
Officials, I know that communities big and small across the country
are dealing with similar challenges. According to the Drug Enforcement
Administration, heroin overdoses resulting in death increased 45
percent from 2006 to 2010, with 3,038 such deaths reported that year.

This urgent public health crisis has left local health department
leaders -- charged to protect the health and safety of people in their
communities -- with their hands full, and challenged to respond among
many competing priorities. Every day, our nation's nearly 2,800 local
health departments detect and stop disease outbreaks like measles,
tuberculosis and food-borne illnesses. They lead efforts that prevent
and reduce the effects of chronic diseases, like diabetes and cancer.
They are also a critical part of a community's first response to
disasters and acts of terrorism.

Some experts say the dramatic rise in heroin use is due to a rampant
and rapidly growing epidemic of prescription drug abuse.

A recent study by the Substance Abuse and Mental Health Services
Administration shows that four out of five heroin users previously
used prescription pain relievers, called opioids, for non-medical use.
Many people addicted to opioids have found it increasingly harder to
get and have turned to heroin, which costs less and may be obtained
more easily than opioids. Clearly, opioids and heroin are
interdependent problems. If we wish to solve the problem of heroin
abuse, we must also tackle the prescription drug abuse problem.

At Three Rivers District Health Department in Kentucky, where I am the
district director, we are working hard to solve this complex and
widespread problem. In collaboration with the Northern Kentucky
District Health Department, Northern Kentucky Area Development
District, and Impact for Health, a new heroin coordinator manages
prevention, education and policy development. I've seen firsthand how
partnerships and grassroots efforts begin conversations that are
desperately needed to combat this challenging issue.

While we are making progress to improve the public's health in
Kentucky, we can accomplish more here and around the country with help
from our federal policymakers. Yet, ongoing congressional budget cuts
have limited the ability of local health departments to address the
heroin overdose problem.

Congress has drastically cut funding for public health programs over
the last several years, which in combination with local and state
budget cuts means that local health departments like ours are
struggling to do critically important work with fewer staff.
Undoubtedly, these cuts have restricted our ability to serve and
respond to community health needs and public health

What's next?

Kentucky's U.S. senators Mitch McConnell and Rand Paul should use
their leadership to influence public health policies that expand and
strengthen prevention for prescription drug abuse, misuse and
overdose, and provide funding for local health departments or their
system partners to respond to the rising tide of heroin abuse and
overdose. Not only is Kentucky counting on them to do the right thing,
but so is the nation.

We must act now at the local and national level to address this
growing, multifaceted epidemic, because the new normal is
unsustainable and our communities can't afford it.

Georgia Heise is the district director of Three Rivers District Health
Department in Kentucky and president of the National Association of
County and City Health Officials.  
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