Krewe: Addiction and affliction, the opioid crisis in New Orleans

Editors Note:  The following series Beyond the Beignets: An authentic look at New Orleans is a week-long series curated by Rena Repenning as part of the Digital Research Internship Program in partnership with ViaNolaVie. The DRI Program is a Newcomb Institute technology initiative for undergraduate students combining technology skillsets, feminist leadership, and the digital humanities.

Because I live in New Orleans as a Tulane student, I often feel like a visitor instead of a resident because Tulane’s social life is disconnected from the city’s year-round residents. When creating Beyond the Beignets, I compiled 10 articles that articulated an often overlooked part of city life. As the Opioid Crisis sweeps across America, New Orleans has been challenged to provide care with high levels of income inequality and a relatively inadequate health care system. This article was originally published on September 3rd, 2019.

How have opioids affected New Orleans? (Photo: Krewe Magazine)

At his low point, John Randall* hid in a bathroom stall at Ochsner Medical Center to shoot up. He swiped discarded morphine and clean needles from locked storage closets, flashing his nurse identification card to bypass security. His job was physically demanding. From lifting patients out of wheelchairs to pushing heavy equipment around the hospital, John felt the strain of these daily tasks on his lower back. After finishing the prescribed painkiller regimen from his doctor, John needed more.

“I was shooting up whenever I could. My mindset was, ‘I’m not worried about the past or the future. I’m not comfortable in my skin and I need it right here, right now,’” John said. “Within a month I would’ve ended up dead or in jail.”

Stories like John’s are becoming increasingly common in New Orleans. In 2017, there were 219 drug-related deaths in the city, a 138 percent increase from the 92 deaths in 2015. For the past three years, the overdose rate has topped the murder rate in the city due to the prevalence of opioids and synthetic drugs. Former New Orleans Coroner Jeffrey Rouse stated in his 2017 annual report that 87 of those who died from an overdose had fentanyl in their system.

“New Orleans is in the midst of an accelerating public health crisis of drug-related deaths, driven chiefly but not exclusively by the ongoing national opiate epidemic. Medically, expanding access to all levels of addiction treatment is the solution, before persons end up in my office.” Rouse said in his 2016 report.

Treatment centers like Odyssey House are feeling the gravity of the crisis. The federal government has handed almost $6 billion to facilities across the country to accommodate the large influx of opioid addicts. Odyssey House has received $40 million in expansion funds, half of which are going toward a new treatment center located at 2700 S. Broad St. The other $20 million will fund renovations to the current facility on North Tonti St.

“The expansion has been a godsend for this state,” said Odyssey House Chief Operating Officer Arvin Singh. “We had 20 beds when I first started here, and now we’re at 40.”

Singh, who assumed the position in 2018, described the lengthened treatment protocol Odyssey House established since his arrival. Following a week-long “detox” period and 28-day residential period in the facility, patients stay in an intensive outpatient program with provided housing for up to six months.

“The whole point is to feed them into that continuum for their benefit. The longer you’re with us, the better your outcome will be.” Singh said.

While scrolling through emails on his desktop computer, Singh received a remarkable message: Odyssey House had reached capacity. He gasped as he leaned back in his chair, a wide grin covering his face. A full facility, he explained, meant the government would allocate more money to the treatment center.

“We get paid well for each bed that gets filled. Since we’ve never had 40 beds before, this is great for our finances. This is going to pay for new furniture, light fixtures, and equipment for the new building,” Singh explained.

Although this achievement is helpful for treating opioid addicts in the long run, it may create barriers for patients who need help immediately. Mike Perlstein, an investigative reporter at WWL New Orleans, has made it his mission to document both the victims and families impacted by the epidemic. In his four-part series for the station, “The New Face of Heroin,” Perlstein dives into the individual stories of those who have been affected by drug addiction in the past few years.

“I followed around a woman who was desperately trying to get help for her son who was addicted to heroin,” Perlstein described. “She was getting turned away by different facilities that were at capacity and she was worried her son would be dead before he would get help.”

In a crisis without a clear solution, treatment efforts have expanded across multiple sectors. The city has called for exponential development of treatment centers like Odyssey House and other medical services. New Orleans Emergency Medical Service (NOEMS) has worked to train all personnel in the event of an opioid overdose. Ashley Alnwick, a volunteer for NOEMS, describes that even entry-level responders now have the proper training to treat an overdose.

“Dr. Frederick McCall, a paramedic in North Carolina, gave all of us volunteers a talk on the opioid crisis and how vital drug-reversal substances like Narcan are. We’ve had to be constantly retrained because the drugs are changing so rapidly. Synthetic drugs like fentanyl are becoming more popular in the city, which is difficult because we don’t always know what’s in them,” Alnwick said.

John Randall has also noticed this increased potency of heroin in the last few years. Before surrendering his nursing license to attend rehab in 2012, John used only what he described as “pure, pharmaceutical heroin.” He later relapsed after a two-year period of sobriety and turned back to opioids.

“First, I took an Oxycontin. When that wasn’t enough, I used heroin and just one dose knocked me on my ass. It was laced with fentanyl,” John said. “Opioids are becoming more synthetic and powerful because tolerance develops so quickly. You’re always searching to get that feeling of your first time, but as much as you take, you’ll never get there again.”

Thad Tatum, a drug treatment counselor, spends his days providing assistance and comfort to addicts all over New Orleans. He shuffles through the case files that clutter his desk, many containing stories similar to John’s.

“I advocate treatment rather than punishment because drug addiction is a disease. I think society as a whole rushes to judgment, so it’s important for everyone to understand that addicts are not criminals.” Tatum said.

Similarly, John believes his addiction is a product of his mental illness. He describes decades of self-medicating his depression, anxiety, and bipolar disorder with drugs and alcohol.

“It’s the disease that tells you ‘I don’t have a disease.’ Recovery makes you start to feel better and you think that you can use because the next time will be different,” John said.

Arvin Singh hopes that his treatment protocol at Odyssey House is enough to beat this vicious cycle. As one of the only facilities in the country with such an extensive recovery plan, Odyssey House aims to keep its patients clean by providing continuous care even after they’ve left the treatment center.

Singh has created ten Sober Living Houses in the last two months where addicts can live rent-free for three months. After this period, they pay partial rent on the contingency that they have a job and attend group addiction meetings. Two of these houses are now fully operational, but Singh hopes programs like these will expand throughout the country.

“There is a potential to have a solution to this epidemic with more and more organizations coming to the forefront. We have to focus on working collaboratively to impact that continuum and make sure that people don’t get back into that hole,” Singh said.

Another recovery tactic, Singh proposed, is the increased use of Vivitrol, a once-monthly injection that serves as an alternative to Suboxone or Methadone. He believes that these traditional recovery aids are simply alternatives to opioids, while Vivitrol requires less regimented use and completely relieves addicts of cravings. The downside of Vivitrol, however, is that the patient cannot take any other medication for two weeks prior to receiving the injection or they will go into “precipitated withdrawal.”

“Imagine withdrawal times a thousand,” Singh says of this state. “People experiencing precipitated withdrawal are more likely to commit suicide or carry out violent crimes. These people would rather have their arm cut off; the pain is that bad.”

Violence as a result of opioid addiction and withdrawal has plagued New Orleans in recent years. In a city known for criminal activity, officials believe the opioid epidemic is exacerbating the problem.

“These drugs, as this data suggests, are most likely the number one cause of all the violence we are having on our streets which is the number one cause of all of our homicides; thus really showing everyone how much of a major problem drug use is and affecting the lives of our people,” New Orleans Coroner Dwight McKenna said in a June 2018 report.

Thad Tatum understands the agony of both addiction and withdrawal. A former addict himself, Tatum spent 28 years in prison for armed robbery and attempted murder. Since being released, he has obtained a degree in Addictive Behavior Counseling from Southern University in New Orleans in hopes of helping other addicts turn their lives around. Both he and Arvin Singh have dedicated their lives to keeping addicts clean.

“Addiction, just like mental illness, is completely irrational,” John said. “It’s like going the wrong way down a one-way street and thinking no one’s coming the other way.”

Although he hasn’t taken an opioid in over a year, John is still an addict. Now a 51-year-old high school English teacher living in Slidell, he has spent recent years trying to understand his persistent addiction. He believes, like many other addicts, that he was the last person to acknowledge that he had a problem. He now recognizes that opioids are the kryptonite that could cause his ultimate consequence: hurting his three teenage children.

“Sitting down with them before I went to rehab and telling them I have a problem was the most difficult thing I’ve ever had to do. You never want your kids to see you like that.”

Despite suffering through a traumatic childhood, including being sexually abused by a Catholic priest, John refuses to see himself as a victim. This paradox of viewing his addiction both as a disease and something within his control illustrates the fragility of John’s mental state. He shows up drunk to AA meetings. He takes a Xanax every night to fall asleep. He believes his addiction will be a part of him until the day he dies.

“It’s a sea of drowning people with this opioid epidemic, and I’m not sure why some higher power picked me to pull out of the water and save. I’m not sure what the future looks like for me, but I’ve had a lot of gratitude and forgiveness.”

*Name has been changed