SUMMARY: The opioid epidemic sweeping the nation once more took center stage after law enforcement officials revealed that music icon Prince's death in April was due to an accidental overdose of fentanyl, a synthetic opioid far stronger than morphine. Hari Sreenivasan talks to Sharon Stancliff of the Harm Reduction Coalition for more on how we can reduce opioid fatalities with better addiction treatment.
HARI SREENIVASAN (NewsHour): The opioid epidemic and the problems of treatment.
Law enforcement officials told the Associated Press and The Minneapolis Star-Tribune today that music legend Prince died from an accidental opioid overdose in April. The superstar, according to reports, self-administered fentanyl, a synthetic opioid painkiller much stronger than morphine.
It's also been reported that Prince had an earlier overdose, and was then revived with a dose of a drug called Narcan. That treatment, and Prince's later attempt to get help from an addiction specialist, have cast a spotlight on the question of treatment for addiction.
Here to discuss this with us is Dr. Sharon Stancliff, medical director of the Harm Reduction Coalition, a national organization focusing on advocacy and the health care of those struggling with drug use.
Doctor, when you hear fentanyl, a fairly strong drug in all the classes of drugs, what does that make you think of what Prince was going through?
DR. SHARON STANCLIFF, Medical Director, Harm Reduction Coalition: Well, I understand Prince had a chronic pain problem, and fentanyl is often prescribed either as a patch or preparations that dissolve in the mouth for chronic pain.
We don't know if he had a prescription for that, but that's extremely likely. We also are hearing a lot about fentanyl in the news because there is illicitly manufactured fentanyl found in many parts of the country either mixed into heroin or sold as heroin.
So, we're hearing about a lot of fentanyl overdoses. They could be from pain management or they could be from illicit preparations.
HARI SREENIVASAN: When you see these stories and hear about these stories across the country, we're seeing, we're hearing more about people who get addicted while they're being treated for chronic pain.
DR. SHARON STANCLIFF: Right.
Well, anyone who takes an opioid on a repeated basis daily will become dependent upon the opioid. Many people will be able to, when the pain stops, taper off of the opioid and go on as though nothing had happened.
Others find that it's really hard to taper off, and once tapered off, they continue to have craving for that — an opioid for weeks, months, even years, and so that's why we have a variety of medications to treat opioid addiction or opioid use disorders.
SUMMARY: Former Los Angeles Times reporter Sam Quinones examines the dramatic surge of heroin use in the U.S. in his new book, "Dreamland: The True Tale of America's Opiate Epidemic." Quinones paints a graphic portrait of the national problem in a conversation with Jeffrey Brown.
GWEN IFILL (NewsHour): Now the latest addition to the NewsHour Bookshelf.
According to the Centers for Disease Control, heroin usage in the U.S. has doubled among young adults in the last decade and deaths have quadrupled.
Former Los Angeles Times reporter Sam Quinones looks at what’s driving that surge in his new book, “Dreamland: The True Tale of America’s Opiate Epidemic.”
He recently talked with Jeffrey Brown and painted a graphic portrait of a national problem.
SAM QUINONES, Author, “Dreamland: The True Tale of America’s Opiate Epidemic”: This is the quietest epidemic, drug epidemic or drug scourge, we have ever had in this country, certainly in the last 50, 60 years.
No public violence is associated, not like crack, where the people were battling for street corners and this kind of thing. People are dying alone in their bedrooms, in a McDonald’s bathroom. And there’s no publicity. Families are stigmatized, horribly mortified that their kids are addicted and then that their kids die of this stuff.
JEFFREY BROWN: So, this came from reporting on the drug trade in Mexico and the U.S. What grabbed your attention?
SAM QUINONES: Well, I discovered in the course of my reporting the story of one small town in Mexico on the Pacific Coast, where everybody in that town had migrated to the United States, had developed a system for selling heroin.
They were master heroin retailers in the United States, selling heroin like pizza, like delivery model. And they had used this system to, first of all, employ hundreds of people in the town and spread across the country, so they were in like half the country.
What I also came to understand, though, was that they had this enormous market for heroin. This one small town became one of the major suppliers of heroin to the United States. That market was due entirely to a whole new supply of addicts who got addicted to prescription painkillers.
SUMMARY: The deadly Ebola virus normally spreads among animals but occasionally spills over to humans, to dire effect. To understand how such diseases make that jump, scientists must find the animal host. But the hunt for live samples of Ebola in animals has never turned up a smoking gun. Science correspondent Miles O’Brien follows epidemiologists in Sierra Leone on their hunt for deadly diseases.
LINA MOSES, Tulane University: Kenema became the epicenter of the outbreak in July.
MILES O’BRIEN (NewsHour): Lina Moses is back at it, on the trail of a killer virus near Kenema, Sierra Leone. She is still haunted by memories of the worst days of the Ebola epidemic last year.
LINA MOSES:We didn’t go searching for Ebola. Ebola came to us. It came with a vengeance.
MILES O’BRIEN: She took us to the remote villages of Kpalu.
LINA MOSES: This is the first time we have trapped for a while since the Ebola outbreak started.
MILES O’BRIEN: An epidemiologist and disease ecologist with Tulane University’s Viral Hemorrhagic Fever Program, Lina leads a team focused primarily on a virus with Ebola-like symptoms, Lassa fever. Lassa and Ebola are so-called zoonotic diseases caused by viruses, parasites or bacteria that are normally spread among animals, but occasionally spill over to humans, often causing severe disease.
Understanding how these viruses make the jump into humans is at the core of her research.
LINA MOSES: Any time you’re looking at zoonotic disease, you have to start looking at the animal that carries it, the animal that maintains it in nature, and that’s the only way you can start to control it.
SUMMARY: In Sierra Leone, health care workers use infrared thermometers to monitor those who may have come in contact with Ebola. It takes 21 days before they can be deemed virus-free. That’s why researchers are trying to create more precise infection detection. In the second in the series, science correspondent Miles O’Brien looks at the efforts to create faster, more reliable testing for the virus.
SUMMARY: A rural region of Indiana has become the center of the state's worst-ever HIV epidemic. For the first time, that state's legislature passed a bill this week allowing drug users in high-risk areas to trade used needles for clean ones. In collaboration with Kaiser Health News, special correspondent Sarah Varney reports on how health officials, lawmakers and residents are grappling with the crisis.
JUDY WOODRUFF (NewsHour):In a first for Indiana, the state’s legislature this week passed a bill permitting drug users in areas with health outbreaks to trade used needles for clean ones. It’s in response to an HIV outbreak of historic proportions.
Sarah Varney has our report from Austin, Indiana, near the Kentucky border.
This story was produced in collaboration with our partner, Kaiser Health News.
WOMAN: Jesus loves you, you know.
SARAH VARNEY, Kaiser Health News: Local churches in Austin, Indiana, have taken to the streets to reclaim their neighborhoods from a drug-fueled HIV epidemic that has decimated this all-American town.
Over the last month, this prayer walk has grown from a handful to hundreds. Austin is a largely white town of some 4,000 people, proud of its country roots and manufacturing plants that have held on despite hard times and growing poverty. It’s a place where everyone knows everyone else, but few families have escaped drug addiction.
HIV cases had been few and far between in this rural patch of southern Indiana. But, in January, the number of confirmed cases jumped to 11, then to 40, and now more than 140 people are infected. It’s the largest HIV outbreak in Indiana’s history and the largest seen in rural America in many years.
Dr. William Cooke is Austin’s only physician. He says the conditions for an outbreak have been ripe for a decade.
DR. WILLIAM COOKE, Foundations Family Medicine: We had a high incidence of drug use. That started off as just painkillers, people sharing their prescriptions with each other, buying prescriptions, that sort of thing. And then somewhere around 2010, 2011, that took a turn towards I.V. drug use.
SARAH VARNEY: A prescription painkiller called Opana had been reformulated, and addicts found they now needed to inject it to reach a euphoric high.
DR. WILLIAM COOKE: In the county, it wasn’t surprising that HIV came in next.
JEFFREY BROWN (NewsHour): I spoke to John Moore, a photographer with Getty Images, a short time ago. He witnessed the attack on the quarantine center and has been documenting the outbreak in Monrovia.
John Moore, thanks for joining us.
First, tell us more about the event. Who was involved and why did they seem to be doing it?
JOHN MOORE, Getty Images: Well, it was an angry crowd who had just driven away a burial team who had come to claim several bodies that were suspected of — people suspected of dying of Ebola.
And the crowd drove away the burial teams and the police and then marched on the isolation ward, the holding center for Ebola patients. They pushed through the doors and told people that they really didn’t have Ebola after all, that they were sick of other causes, and that it was safe to come out.
There’s a lot of people who deny the existence of Ebola here. They think that it’s a scheme, a hoax, a plot by the government to bring in international money. And they pulled these people out of the ward. And then I left the scene because it was getting difficult.
And afterwards this crowd looted the facility, taking soiled mattresses and contaminated medical equipment, and I assume spreading the disease much more in their community.
JUDY WOODRUFF (NewsHour): Now a spreading health crisis in Africa.
International and regional officials met in Ghana yesterday to coordinate a strategy to contain an outbreak of Ebola and keep it from spilling over new borders.
Jeff is back with our report.
JEFFREY BROWN (NewsHour):With more than 750 cases of infection identified and at least 467 individuals killed, the latest Ebola outbreak in West Africa is the now the largest and deadliest ever of the disease.
Since February, Ebola cases have been reported in both rural and urban areas of Guinea, Liberia, and Sierra Leone, leaving health workers in a race against time to halt the deadly virus from spreading.
Ebola is highly lethal, killing 90 percent of those who become infected, and is transmitted by direct contact with the bodily fluids of infected animals or people. Despite precautions, health workers can still be at risk.
This nurse contracted the virus after interacting with an Ebola patient who later died.
WOMAN: How are you feeling? Do you feel sick?
WOMAN: I feel weak.
JEFFREY BROWN: And there are further dangers for health workers. In April, a Doctors Without Borders facility in Guinea was attacked amid accusations that the staff brought the disease into the country. And this week, the Red Cross temporarily suspended operations in the southeastern part of the country after armed men surrounded and threatened workers.
BERNICE DAHN, Deputy Health Minister, Liberia: Our biggest challenge is denial, fear and panic. Our people are very much afraid of the disease.
JEFFREY BROWN: Ending their meeting in Ghana yesterday, health officials spoke of meeting that and other challenges. World Health Organization Assistant Director-General Keiji Fukuda:
KEIJI FUKUDA, Assistant Director-General for World Health Security, World Health Organization: That combination of having multiple mini-outbreaks going on within the larger outbreak, having them take place in different countries, with difficult communities, different cultures, makes it very complex.
JEFFREY BROWN: Among the summit’s resolutions, stepped-up surveillance to better detect virus cases, enhanced cross-border collaboration, and increased engagement with local communities and global health partners.
SUMMARY:The latest Ebola outbreak in West Africa is now the largest and deadliest outbreak ever. And unlike outbreaks of the past, it is affecting both rural and urban areas. Jeffrey Brown talks to Laurie Garrett of the Council on Foreign Relations about a recent summit on the outbreak, distrust building against health workers in infected areas and how porous borders make this outbreak so hard to contain.
JUDY WOODRUFF (NewsHour): Several countries in West Africa are now coping with the worst outbreak of the Ebola virus in years. The World Health Organization describes it as one of the most challenging episodes of the disease it’s ever faced. More than 100 people have died so far.
Ebola, which is spread by a virus initially transmitted from wild animals, has a high fatality rate.
Jeffrey Brown has more on the struggle to contain it.
JEFFREY BROWN (NewsHour):One of the concerns is that Ebola has crossed borders. Guinea is where the outbreak began and was first made public in March. More than 100 deaths and 150 cases have been reported there.
Another troubling aspect: The disease has turned up in a wide area, from tropical forests to the capital of Conakry to the Liberian border. In Liberia, investigators believe there are at least 10 deaths. Health officials are now investigating possible cases in both in Mali and Ghana.
And more than 60 percent of infected people so far have died.
Laurie Garrett of the Council on Foreign Relations has tracked outbreaks in the past as a journalist and author of several books on global health and disease. She joins us now.
SUMMARY: After Haiti suffered a 7.0 magnitude earthquake, experts believe aid workers accidentally brought cholera to that nation, spreading due to unsanitary conditions. The epidemic has made 600,000 Haitians ill and 7,500 dead. Fred de Sam Lazaro reports on the challenges to treat a disease not seen in Haiti for more than 100 years.
FRED DE SAM LAZARO (Newshour): The 2010 earthquake that devastated Haiti may still loom large in Americans' memory, but, in Haiti itself, that was at least three disasters ago, before Hurricanes Tomas last year, Isaac in August, and recently Sandy.
Each storm brought a grim reminder of yet one more ever-present disaster: the deadly cholera epidemic that started 10 months after the quake.
At the cholera ward of Saint Luc's Hospital just outside the capital, Port-au-Prince, Dr. Jackinson Davilmar says since Hurricane Sandy admissions have doubled from 20 to 40 patients each day.
I am Retired U.S. Navy (22yrs) and a Vietnam Veteran. After my Navy retirement I was in the computer related industry, now retired. In 2000 I was a registered Republican and voted for George W. Bush. Six months of having Bush in the Whitehouse forced me to re-evaluate my political stance. I had always thought of myself as a Moderate Republican, but was a Republican by "default" NOT because of close examination of the GOP. Due to what has happened in America since 2000, I now consider myself a progressive, and registered as a Non-Affiliated voter.
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