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Will opioid crisis get worse before it gets better? People on front lines discuss challenges

By Dan Miller


Posted 2/21/18

There are signs of progress in combating the opioid epidemic, but the crisis will likely get a lot worse before it gets better.

That was one of the major takeaways from a panel discussion on the …

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Will opioid crisis get worse before it gets better? People on front lines discuss challenges


There are signs of progress in combating the opioid epidemic, but the crisis will likely get a lot worse before it gets better.

That was one of the major takeaways from a panel discussion on the opioid crisis that was held at Penn State Harrisburg on Thursday, Feb. 15.

The panel included health care professionals on the front line of the crisis everyday, as well as just ordinary folks whose lives have been turned upside down by the epidemic.

“People ask me, ‘Do you think it’s slowing down?’ No. We haven’t even seen the tip of the iceberg yet. There’s no doubt in my mind,” said Jim Lingg, a paramedic shift supervisor with Life Lion. “It will peak and it will slow down, but, man, the damage that is left as a result of this — it’s crazy.”

Lingg talked of responding to opioid overdoses all over this area on a daily basis. There are days when he and other first responders give Narcan to revive someone who has overdosed, only to be called back to revive the same person a second and even a third time during the same 12-hour shift.

It’s overwhelming, so much that Lingg left a position he had had as a deputy coroner for Lancaster County in May because he couldn’t take it anymore.

“It sucked the life out of me,” he said of the job with Lancaster County. He remains with Life Lion.

As for progress, doctors are not prescribing opioids to relieve pain as routinely and automatically as they used to, said Dr. Lawrence Kass, an emergency room physician at the Penn State Milton S. Hershey Medical Center.

Education on the risks of prescribing opioids is becoming part of the requirements for a doctor to be licensed, he said.

Organizations that accredit the colleges and universities that produce doctors are looking to change curriculum requirements to add more substance abuse education, said another panelist, Eric Doerfler, a nurse practitioner.

But as Doerfler noted, it will take awhile for the changes now being put in place to have an impact.

Meanwhile, Kass said he feels like a character in a story about a man who is rescuing someone drowning in a river.  As he revives one person, the rescuer hears another call for help, and then another, and another.

Who is it upstream who is throwing all these people into the water, the rescuer wonders, Kass relates. But the rescuer is too busy trying to save the life of the person in front of him to be able to find out.

While he sees signs of fewer overdoses from legal prescription drugs, overdoses from illicit drugs like heroin keep going up.

Overall, “we have not made a dent in the fatalities due to opioids,” Kass said. “It’s very difficult from my position to get at the guy upstream. … I’m hoping with this kind of a community awareness that we can get to that root. It’s not going to be solved by the docs or the medics or by somebody on Capitol Hill. It’s down here.”

If public education is key to overcoming the crisis, as the panelists all agreed, it would appear there is still a lot of work to be done in that regard as well.

Fewer than 35 people attended the panel discussion, although it had been publicized ahead of time in the Press & Journal and by Penn State Harrisburg through its website and Facebook page.

A daughter’s story

Before Wendy Loranzo’s daughter Elizabeth died from an overdose on March 19, 2017, in Londonderry Township, Loranzo said she didn’t really know anything about heroin.

She certainly knew nothing about fentanyl, the substance that was responsible for Elizabeth’s death, according to the woman with the Dauphin County coroner’s office who called Loranzo four days after her daughter died.

“I said, ‘I don’t even know what fentanyl is. Can you spell that?’” Loranzo said during the panel discussion.

Loranzo, who lives in Middletown, knew from the start that she would stand up at her daughter’s funeral and tell everyone there that Elizabeth had died of a heroin overdose.

Afterward, Loranzo decided she had to do much more. She created the Elizabeth Loranzo iCare Foundation, a nonprofit organization people can contact if they or someone they know are dealing with heroin addiction and need help.

“We work very closely with the (Dauphin County) drug and alcohol offices,” Loranzo said. “We get people immediate response time, we get them into rehab, we provide them resources, we speak at public meetings, we have funds (to provide) Narcan to families free” and to help people get into rehab if they don’t have the money.

Her own experience illustrates the challenge of changing the mindset of people when it comes to the opioid epidemic.

“When my daughter went into rehab two years before” she died, “I didn’t want to know about it. I was mad, I was angry, I was embarrassed. I just kept thinking, ‘Why can’t she just stop?’” Loranzo said.

Had she known then what she knows now, Loranzo said she would have taken a leave of absence from her full-time job to stay with Elizabeth and to get her help, and to take care of her grandson, Elizabeth’s son.

Her grandson is now being raised by Elizabeth’s fiancee, whose ongoing recovery from his own drug addiction provides Wendy Loranzo with a glimmer of hope.

And despite all that she has learned about heroin and addiction since her daughter died, Loranzo said that the learning never stops.

No matter how many town halls and community forums like this that she goes to, Loranzo always learns something new at each one.

“I take away so much information. I meet people (who) I’m able to call afterwards,” Loranzo said. “Someone said to me a few months ago, ‘God didn’t take our children, He received them.’”

“I’ve been able to look at death a little differently, and my daughter is in a better place. I still want her here, but she died for a reason. She died for me to help other people.”

Loranzo always has a big picture of Elizabeth sitting next to her when Wendy gives these kinds of public presentations.

A daughter survives

Elyse Rhode also brings her daughter, only her daughter is alive. In this case the roles are reversed.

Rhode was addicted to heroin for three years. Come March she will have 12 years clean.

Rhode said she brings her daughter to these forums because she wants her daughter to know what Rhode didn’t know, when she started using drugs in high school.

“This is what drugs do — I’m not going to hide it from you,” Rhode said of her conversations with her daughter. “I’m going to give you support at home. If you want to talk about something, I’m going to answer.”

Rhode credits her recovery to getting arrested and being put in jail, which got her into the Lancaster County drug court.

“They became the group of friends that I was looking for. They cared about what I did in my spare time. They made me feel like I was worth more than what I thought I was worth,” said Rhode, who today is a volunteer with the drug court system.

While in recovery Rhode met and married her current husband, a police officer. She gives him a perspective on drug addiction that he didn’t have before — that of the user, and what leads them to do the things they do.

The panelists also briefly discussed the impact of Gov. Tom Wolf on Jan. 10 declaring the heroin and opioid epidemic to be a statewide disaster.

Among many provisions, the declaration enables emergency medical service responders to leave Narcan behind with family members, in case they need to use it later. That raises issues for the paramedic and EMT community, Lingg said.

For example, how much Narcan are EMTs now supposed to carry, if they are to leave some behind? How much time is an EMT to devote to training a family member in how to use Narcan?

If the family member uses Narcan in the wrong way and something bad happens, is the EMT responsible?

None of the answers to these questions are apparent, at least not right now, Lingg said.

Police having Narcan is making “a huge difference” in saving lives, because police usually get to the scene first, Lingg said. But he has yet to see any data or information to shed light on the impact of leaving Narcan behind.

But doing so is still worth it, even if the unknowns outweigh the knowns, Kass said.

“If somebody is dead I have lost the opportunity to get them into rehab. If they have got Narcan in the house maybe it’ll help and it gives me that one more chance to talk to them about rehab. Even if there are 100 doses out there and one life can be saved, that’s worth it,” he said. “I’m optimistic even though there is no data to say that it has helped yet.”

Rhode said her own husband, the cop, is sometimes “iffy” about the wisdom of police using Narcan.

“‘We see these people every week,’” she said he tells her. She tells him, “Look at where I am today. I didn’t overdose, but what if I was that girl that overdosed? Look where I am today, spreading the word, having two beautiful daughters. You never know who you are helping.”