Code heroin: St. Elizabeth treats heroin addiction as a lifelong health problem

Heroin can result in more health issues than death

FORT THOMAS, Ky. – Nearly 100 people came into St. Elizabeth Medical Centers with a heroin addiction in June, including 63 overdoses admitted to the emergency room.

“There’s not any day that we’re not faced with a patient with a heroin-related issue,” Ashel Kruetzkamp, St. Elizabeth emergency room manager, said.

Heroin doesn’t just cause death, but could result in lifelong medical problems, she said.

With staggering overdose statistics statewide, St. Elizabeth is taking on the battle for those in Northern Kentucky one addict at a time, armed with tools like a pilot study for a new clinic aimed at using stabilizing medications; giving more resources to addicts and their families; and tracking addicts along their way to recovery.

It’s a battle, Kruetzkamp said, that begins with compassion and being well informed.

Fighting With Care

“With heroin, you’re playing Russian roulette,” said Kruetzkamp, a 20-veteran at the hospital who oversees the day-to-day operations at the emergency room at St. Elizabeth in Fort Thomas, Ky.

“It’s definitely been very eye-opening. We’ve never seen anything like this, this sustainable, this long and causing this many health issues.”

“When you start to see the population coming into the ER, you’re like, ‘Wow.’ We’re becoming more caring and compassionate to [the] addiction disease than before.”

A lot of this comes down to education and compassion, she said, since most times the hospital ER staff is the first contact that the addict has.

“They’ve already lost a lot: family, friends… if we turn our backs on them, they lose more hope,” Kruetzkamp said.

“Not until there’s a crisis do we realize that we need to do more education,” she said. “That’s what we had to step up and do.”

St. Elizabeth has implemented heftier resource binders for all nurses on staff, as well as resource packets for both the patient and their families with information on community-based treatment and detox. The hospital has also started educating addicts’ families on how to to petition the court using Casey’s Law to permit involuntary treatment for their loved ones.

Kruetzkamp has started tracking heroin patients in order to provide treatment for them at the hospital and beyond, she said.

And that’s more than two addicts every day coming in for an overdose.

Campbell, Boone and Kenton counties were in the top five counties in Kentucky for heroin overdose deaths, according to the 2013 Kentucky Medical Examiner report.

READ FULL REPORT.

  • Campbell County- 16
  • Kenton County- 34
  • Boone County- 22

St. Elizabeth has already seen a spike in numbers for heroin overdoses this year with 336 as of June, nearly 100 more than 2011’s total overdoses.

“[We’re] trying to understand what’s happening in our community and being more responsive to the patients’ needs,” Kruetzkamp said.

Kruetzkamp has started to manually run reports on opiate overdoses and calculating known heroin overdoses at all five St. Elizabeth medical centers.

Her next step is to begin tracking all heroin patients, not just overdoses; because heroin addicts for a variety of reasons, including withdrawal symptoms, infections to the heart and skin abscesses from injections, pneumonia from snorting, liver disease and hepatitis C from sharing needles.

In June 2014, 30 patients were treated for withdrawal symptoms, and eight were treated for skin abscesses related to IV drug use. 

However, those numbers are only for ‘known’ heroin patients.

“If a patient denies use and we did not obtain a drug screen they are not included in our data,” Kruetzkamp said.

Kruetzkamp plans to focus on follow-ups with patients, posing the question, ‘Did the resources help?’

“We need to hear from them, the patients. You have that golden window, opportunity when they come in with withdrawal or an overdose to help them.”

Stabilizing The Addiction

Every person in Northern Kentucky is one or two phone calls away from someone affected by heroin, or someone who could end up in jail or dead, said Dr. Jeremy Engel, a physician with St. Elizabeth.

“It’s ripping apart the fabric of this community,” he said.

Engel believes that every heroin addict should be stabilized on some form of medication, but not just methadone. Methadone works well for some patients, he said, however, insurance is currently not covering the NKY Methadone Clinic and you have to go daily for treatment.

“Essentially, we don’t have treatment in Northern Kentucky, [it’s] 25-percent adequate at best,” Engel said of the thousands of patients in Kentucky not getting the treatment that they need.

“We have the antidote, but we’re not using it. The first step takes treatment,” Engel said.

“The longer it takes to wrangle the issue, the more will die,” said Engel. He's participating in a pilot study at St. Elizabeth for a new center for treatment using addiction medicine to stabilize opiate-addicted patients with Naltrexone, Vivitrol and Suboxone.

Suboxone is being used by some physicians, he said, however, they are limited to the number of patients they can treat. Four doctors are providing the medication within Northern Kentucky, limiting the amount of addicts who can benefit from Suboxone treatment.

“With heroin addiction, every day we wait, people are dying. It’s like suicide,” Engel said. "Suicide is emotional isolation. [Person] feels ineffective and has the means and the willingness to self-harm and if you add heroin, it adds pleasure and relief from pain. Basically, we have suicide through heroin.”

The new treatment clinic at St. Elizabeth is currently open with two patients, Chuck Washburn, director of the System Behavioral Health department, said. They hope to be able to include more patients in the future. however, at this point, it's too early, he said, to tell the impact.

READ MORE: Heroin in the Tri-State

Northern Kentucky Voice: Your Voice, Your Story is a periodic and ongoing series on WCPO.com about the people of Northern Kentucky making a difference in their community. If you would like to tell your story, or know someone who should, email Jessica Noll at Jessica.Noll@wcpo.com.

For more stories and photos by Jessica Noll on issues impacting Northern Kentucky, visit http://www.wcpo.com/noll or follow her on Twitter @JessicaWCPO.

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