Painkillers. They’re necessary in some cases, for without them, people who suffer from chronic or acute pain couldn’t function day to day.
But for those who’ve become addicted, they’re a dangerous, sometimes deadly, fix.
Consider the deaths of music star Prince and actor Heath Ledger. Prince died in April of what a medical examiner called a “self-administered” overdose of the painkiller fentanyl, one of the most powerful of all opioids. Ledger’s life ended in 2008 from accidental overdose of prescription medications, including painkillers oxycodone and hydrocodone.
But it doesn’t just happen in Hollywood or Paisley Park. The devastating consequences are wrenching small-town Minnesota.
Casey Jo Schulte, a 26-year-old college student from Montevideo, less than half the size of Litchfield, was found dead in a Fargo apartment garage in August 2015.
Her mother, Shelly Elkington, says opioid exposure is responsible.
Elkington spoke at a forum about the opioid crisis last month in Litchfield. A nurse, she has turned her pain to purpose by sharing Schulte’s story, advocating for measures to curb opioid use and meeting with state lawmakers.
“We need to make people aware, not only in our community, but our neighbors and also our state, and our nation and the world,” Mayor Keith Johnson said before Elkington was introduced.
‘ONE DAY TOO LATE’
Schulte, a 2007 graduate of Montevideo High School, about 65 miles from Litchfield, was studying biology with plans to become a nurse.
Shortly after starting college, Schulte was diagnosed with Chron’s disease, a painful condition that inflames the digestive tract. She began taking prescription opioids, and the painkillers provided relief from her significant pain.
Complications from “some really bad surgeries” resulted in more opioids, Elkington said.
“Five prescriptions she walked out of her physician’s office with — every 30 days,” Elkington said, despite having an “extremely well-intended physician.” The process, she explained, proved to be draining for both patient and doctor.
Three years later, in 2015, “things went terribly wrong,” Elkington said.
Just months before her death, Schulte began using street heroin, an opiate that’s most commonly used as a recreational drug for its euphoric effects.
Heroin, which is made from morphine, has been used medically in some countries to relieve pain or in opioid replacement therapy. On the streets, it’s injected, sniffed, snorted or smoked. Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping and breathing.
Prescription opioid pain medicines such as OxyContin and Vicodin have effects similar to heroin, according to information from the National Institute on Drug Abuse. Research suggests that misuse of these drugs may open the door to heroin use. Nearly 80 percent of Americans using heroin (including those in treatment) reported misusing prescription opioids first, the institute reported.
As time went on, Schulte became increasingly dependent on opioids. Her crumbling emotional state only worsened her dependency and pain levels.
“I watched my daughter lay in a bathtub for two days. I watched her sweat through sheets and clothes four times a day. I watched her be the most miserable human being on this planet,” Elkington said of the severe withdrawal symptoms Schulte experienced.
Schulte agreed to seek opioid dependency treatment beginning Aug. 20, 2015. Sadly, she was found dead Aug. 19, “one day too late,” Elkington said.
Elkington stressed that these tragedies can happen in Meeker County and that opioid abuse is present here. “I work closely with our police chief in Montevideo, and he will tell you that this is a problem in your community,” she said. “We didn’t think it was, either,” she said of the stigma she works to shatter through her advocacy.
“My daughter’s ‘drug dealer’ started off as a prescribed medication from her doctor. She didn’t think she should take it because you trust that relationship,” Elkington said. “We just have to advocate for ourselves and for our family members as prescription drugs become the start.”
Elkington understands that the answer to this growing epidemic is not to stop prescribing opioids altogether but feels strongly that more guidelines should be in place. In late 2015, Elkington submitted comments to the Centers for Disease Control as part of the public comment record for its proposed regulations.
“Please fight for those who not only die from this mass epidemic, but for those who are currently living it,” Elkington wrote. “Casey Jo never feared dying from her medications, she feared not having them. Reform will come too late for Casey Jo. Which makes me so very sad, but please help others with these guidelines. Please.”
