Brett Jan’s mind was racing. The 33-year-old Toledoan hadn’t slept for days, and his lifelong battle with depression and anxiety had gripped him in a vise of addiction. Struggling with heroin and alcohol, he needed help but still had hope.
An almost compulsive list-maker, Mr. Jan, who played guitar in local alternative rock bands and worked as a property manager, had jotted down things to do and longer-term goals, including finding a good job, getting a cool place to live, meeting the right woman, and buying a Jaguar.
On Thursday, Aug. 7, after waiting two weeks to get an appointment, Mr. Jan walked into Rescue Mental Health Services at 3350 Collingwood Blvd., looking for a lifeline. Instead, he got a referral and more appointments at another agency, Harbor. He was scheduled to see a counselor 12 days later, on Aug. 19; then a nurse on Aug. 22, and finally a prescriber nearly two months after that on Oct. 13.
Mr. Jan never made it. On Friday, Aug. 8, the day after his session with Rescue, he died of an accidental heroin and alcohol-related overdose. He’s one of nearly 150 people in the Toledo area who will have died this year of heroin-related overdoses.
The administration of Gov. John Kasich has done a pretty good job of raising awareness about the state’s heroin and opioid epidemic, educating young people about addiction, and lowering the amount of dangerously high dosages of painkillers prescribed by physicians. Overprescribing opioids such as Vicodin, Percocet, and OxyContin, starting in the late 1990s, got us into this mess.
But the administration has failed to close the state’s enormous treatment gaps, especially in delivering effective medication-assisted treatment. Newer drugs such as Suboxone and Vivitrol that ease the agony of withdrawal and its attendant cravings are widely unavailable.
An estimated 200,000 Ohioans are addicted to heroin and other opioids. The state’s treatment network reaches only a fraction of those who need it — perhaps as few as one in 10. Tens of thousands of people who suffer from opioid addiction cannot get the treatment they need, creating calamity for them and their families and clogging the state’s courts and prisons.
Even many of those who get treatment are forced to wait days, weeks, or even months to see a physician or prescriber. Those delays often mean relapse or even death.
Ask Mr. Jan’s mother, Colleen Jan, a recently retired schoolteacher. She’s left with a wall of photos and memories, and burning questions that will never find answers.
Ms. Jan, 61, of Lambertville, accompanied her son to his appointment with Rescue on Aug. 8. I asked her what she thought the treatment agency should have done.
“You know damn well what they should have done,” she told me. “If he had to wait that long to get help, then give him something to get him through it. Give him Suboxone so he doesn’t have to self-medicate.
“When people can’t get it from a doctor, they buy it on the street. It’s asinine. How my son had any hope at all is beyond me.”
Representatives of Harbor and Rescue Mental Health Services did not return my phone calls seeking comment.
Julie Weinandy, director of nursing at A Renewed Mind in Toledo, said that, largely because of a lack of licensed physicians, clients typically wait two weeks at her agency for an appointment with a prescriber, and maybe a month at many other agencies. A Renewed Mind works hard to recruit physicians to prescribe Suboxone, but it’s not easy.
Some doctors worry about scrutiny by the U.S. Drug Enforcement Administration, or don’t support medication-assisted treatment. Many others simply don’t want to treat addiction because of the stigma.
That’s sad and ironic. Doctors largely caused this problem by overprescribing. Now many of them don’t want to treat the addicts they helped create.
Policy changes would help. Federal law generally limits physicians to 100 Suboxone patients. A bill sponsored by U.S. Sen. Sherrod Brown (D., Ohio) would lift that cap and enable some nurse practitioners and physicians assistants to prescribe the drug.
Allowing some nonlicensed physicians, including those in emergency rooms, to prescribe limited amounts of Suboxone in extreme cases would also make the drug more accessible.
Ohio’s treatment providers also need more compassion and a greater sense of urgency. Addicts like Mr. Jan need help now — not two months later.
“You need nurses who really have a passion for this,” Ms. Weinandy said. “In many cases, it’s our love, and our hope for them, that carries them through.”
Mr. Jan never had the chance. Now his mother struggles to find meaning in her son’s death. She is thinking of starting a nonprofit group to run a meeting place for young people who struggle with addiction — a spot with the ambience of a bar, but without the alcohol.
The former teachers’ union president also shares her story with friends. In doing so, she has learned how widespread Ohio’s heroin and opioid epidemic has become.
“When I came out with my story, I was shocked by how many ‘me, too’s,’ I got from other parents,” she told me. “We don’t talk about it. We need to stop making it something hidden or embarrassing. You think you’re protecting your kid, but what you’re really doing is protecting yourself and your image of yourself as a parent.”
Last year, the number of fatal Toledo-area overdoses more than doubled, to 80. This year, the local death toll is on pace nearly to double again, having reached 123 by the end of October.
Fatal heroin-related overdoses hit record highs during the past two months, Dr. Robert Forney, Lucas County’s chief toxicologist, told me last week. A growing number of them involved Fentanyl, a super-potent painkiller that is sometimes mixed with heroin to provide an extra kick.
To corral this insidious epidemic, we need a treatment network and community that really care about people. Maybe we won’t get there until most of us have a close friend or family member who has descended into the hell of addiction.
At the rate this epidemic is growing, it won’t take long. How many more young people like Brett Jan must die before we get there?
Jeff Gerritt is deputy editorial page editor of The Blade.
Contact Jeff Gerritt at: jgerritt@theblade.com, 419-724-6467, or follow him on Twitter @jeffgerritt.
First Published December 14, 2014, 5:00 a.m.
