The Katy area is part of a national trend of increased opioid abuse. Law enforcement officers and medical professionals have seen the number of prescription opioids nearly double in the last two to three years. Last year, the Katy Police Department found 31 instances of illegal opioids—up from 2016 and 2015, which had 17 cases each. Assistant Police Chief Tim Tyler said via email most were found through traffic stops. Harris County Emergency Services District 48 has seen a similar trend in opioid abuse with a spike from 46 patients treated for overdoses in 2016 to 62 patients in 2017. Law enforcement officials in Harris and Fort Bend counties, as well as Matt Feehery, CEO of Memorial Hermann’s Prevention and Recovery Center, concurred. President Donald Trump directed the U.S. Department of Health and Human Services to declare the opioid crisis a public health emergency Oct. 26, following findings that more than 64,000 Americans died of drug overdoses in 2016, according to the Centers for Disease Control and Prevention. Feehery said Houston’s density of overdose and abuse rates is catching up with harder hit metro areas, such as West Virginia and Pennsylvania. “We are seeing an increase in overdose incidents and overdose deaths in all of our counties that surround Houston, especially Montgomery, Brazoria and Fort Bend,” Feehery said.

How it starts

For patients at the Prevention and Recovery Center, or PaRC, Feehery said most patients develop an addiction during treatment for an injury. The two opioids most abused are oxycodone and hydrocodone. “Eighty percent of all first-time heroin users started with prescription pain killers,” Feehery said. The largest user population in the Greater Houston area is between 34 and 54 years old, but law enforcement officials in Fort Bend and Harris counties said children are also affected. “The sky is the limit, but what we have seen here specifically has been a younger population—I’d say the 17-25-years old range,” said Wayne Thompson, constable for Fort Bend County Precinct 3. Capt. Leslie Martinez agreed with Thompson’s assessment. She heads the Harris County Constable Precinct 5 Narcotics Unit, and has in her office a 1-inch-thick stack of photos of young people who died or were treated for opioid overdoses in 2017. Katy ISD officials said via email the district has not seen the problem in schools. Ted Heap, Harris County constable for Precinct 5, described two sides of the issue: people taking drugs to treat pain unnecessarily, and younger users abusing them. “[The opioids] undoubtedly come from a medicine cabinet,” Thompson said. “The younger crowd has either gotten it from their parents, or their friends got it from their parents and sold it to them.” The problem is not isolated by income and can take hold in  wealthier areas, Thompson said. Patients can develop opioid dependency in about one week, Feehery said. Addiction can lead to other drugs, especially if a doctor ends the prescription or other supplies end, Martinez said. “There’s no question that with adults in their twenties, it’s very much a problem,” Feehery said. “But again, it knows no bounds because a lot of people are introduced to it because of a legitimate [medical] reason.”

Treatment and prevention

Thompson described an age gap between those starting to abuse opioids and those seeking treatment. He said it takes time for users to acknowledge their problem. Feehery and Harris County authorities agreed, saying users must often hit rock-bottom to realize the problem. “That’s the nature of how addiction develops,” Feehery said. “It affects your professional life, your personal life, your spiritual life.” Identifying a child’s opioid abuse can be difficult, Martinez and Thompson said. They suggested observing changes in behavior including dropping grades, avoiding contact with parents or joining new social groups. Users find creative ways to hide addiction, such as items bought online or at smoke shops, Martinez said. Feehery said recovery centers focus on “bio-psycho-social aspects” of addiction and give patients tools to regain normalcy, from medically-supervised detoxing and counseling, to 12-step programs. “Treatment isn’t purely an episodic thing,” he said. “It can last as long as a year or longer.”

Moving forward

Government agencies and the health care industry are trying to get a handle on the opioid epidemic in the Greater Houston area. Constables in Harris and Fort Bend counties are trained to identify residents overdosing on opioids and administer Narcan, a nasal spray that counteracts the effects of an opioid overdose. Prosecution of opioid use is changing as well, according to the Harris County District Attorney’s Office. “We prosecute dealers and traffickers aggressively; however, we divert most suffering from addiction to reintegration impact court and other programs emphasizing treatment,” District Attorney Kim Ogg said. The Texas Health and Human Services Commission received a federal $27 million grant in May to fight addiction, which HHSC estimates will affect about 14,000 Texans over two years. The Texas State Board of Pharmacy shortened the time frame for reporting opioid distributions from seven days to one day, effective Sept. 1, 2017, according to its website. “One of the problems we have, one of the issues that Fort Bend Regional Council [on Substance Abuse] in working with our coalition with the community wants to target, we really want to fix, is we don’t have a good reporting system,” said Laura Jenkins, director of program compliance at FBRC. Constables and EMS professionals in Harris and Fort Bend counties agreed, citing a need to analyze case files to determine opioid involvement. Dependable regional data was difficult to find, Feehery and Jenkins said, but medical providers are changing attitudes toward opioids. Organizations, such as the Texas Hospital Association and Texas Medical Board, are encouraging doctors to consider alternative treatments and less addictive medications, Feehery said. Physicians are also moving away from an initiative of eliminating all pain to pain management with over-the-counter medications, physical therapy or issuing smaller, shorter doses. Patients are more aware of the dangers as well, and ask for alternatives to narcotics more often, Feehery said. “What people forget is you’re not supposed to be taking large quantities of really any kind of medication for a long duration,” he said. “But if you’ve got acute pain, you’ve got [over-the-counter medicines, and] that particular medication is effective.” Additional reporting by Rebecca Hennes and Danica Smithwick. Correction Monday, Feb. 26, 2018 at 9:30 p.m. In the originally posted story, Matt Feehery, CEO of Memorial Hermann’s Prevention and Recovery Center was listed as Mike Feehery. We apologize for any confusion or inconvenience this may have caused.