Russellville ER doctor recognized for treating opioid patients throughout Arkansas

During the COVID-19 pandemic in 2020, Dr. Kristin Martin saw more struggles and deaths from drug overdoses than from the coronavirus, she said Tuesday at an Arkansas Foundation for Medical Care event honoring her efforts to alleviate the ongoing opioid epidemic throughout the state.

Martin is an emergency department physician and the CEO and medical director of River Valley Medical Wellness, an addiction treatment center in Russellville. She was part of a panel of medical, legal and policy professionals at Tuesday’s event who discussed ways to combat the presence and use of the opioid fentanyl.

“ER docs know exactly what’s happening in our society,” said U.S. Sen. Tom Cotton (R-Arkansas), who presented Martin with an award for her work. “They are uniquely positioned, along with EMTs and other first responders, to know what is happening on our streets. They are the first ones sometimes to sound the alarms about the dangers that may be gathering. For years, that’s exactly what Dr. Martin did.”

Martin told the audience that she had not expected to be honored “for just doing my job.”

Her experiences in the emergency room in 2020 led her to travel throughout the state to provide mental health and substance abuse treatment to patients in crisis. She helped 1,600 people in 52 of Arkansas’ 75 counties in about two and a half years, she said.

“I have met them outside ERs, in coffee shops, wherever they may be,” she said.

Martin once used Narcan, an emergency treatment for overdoses administered through the nose, to save three emergency room patients who each had a different severe reaction to fentanyl they had unknowingly ingested through a vape pen, Cotton said while presenting Martin’s award.

Martin and the rest of the panelists emphasized that fentanyl is not taken on its own but laced with other substances, from drugs like cocaine and heroin to pills that pass as prescription medication, such as Adderall, often used to treat attention deficit hyperactivity disorder, or the painkiller oxycodone.

This means people can be and have been exposed to the drug without their knowledge until experiencing an accidental overdose, Martin said.

Overdose deaths

The state saw 496 fentanyl overdose deaths last year and expects more than 540 by the end of this year, said Col. Bill Bryant, head of the Arkansas State Police. Last year’s deaths were spread throughout the state, though 30% were in Pulaski County and 10% were in Washington County, he said.

Over 90% of law enforcement agencies statewide have their officers carry Narcan, Bryant said.

He and Martin both said their colleagues have had to administer more and more doses of Narcan per person over the past several years.

“When we first started doing this, [we gave] one or two doses, but we’ve given up to eight doses of the nasal spray to keep these people alive,” Bryant said.

Federal law mandates at least 20 years of incarceration for someone convicted of delivering fentanyl to someone who then died of an overdose. A previous conviction would create the option of a life sentence.

The Arkansas Legislature elevated fentanyl trafficking to a Class Y felony earlier this year. Cody Hiland, U.S. Attorney for the Eastern District of Arkansas from 2017 to 2020, said this is “a step in the right direction,” and Bryant advocated for harsher sentencing for those convicted of fentanyl trafficking.

The panelists who have worked in the legal and law enforcement fields agreed that “securing the border” between the United States and Mexico would reduce exposure to and deaths from fentanyl in the U.S. Cotton said tighter border security would not necessarily guarantee that fentanyl would not enter the country from Mexico because the drug is powerful enough to smuggle in small doses.

Arkansas Drug Director Boyce Hamlet said he did not see increasing border security as political, but former U.S. Attorney Bud Cummins said leaving the border “open” is a “totally political move.” Cummins had Hiland’s job from 2001 to 2006.

Arresting and prosecuting people for drug crimes is not enough to create a drug-free society, he said.

“It was good to take them off the street, but the sad truth is, as long as the demand’s there, somebody steps up to replace them the next day,” Cummins said.

Social stigma against drug use and addiction contributes to the problem, said Candace DeMatteis, policy director for the national Rx Abuse Leadership Initiative. The organization runs a prescription drug take-back program.

“We all know people who have dealt with these issues, and it’s hard for these individuals,” DeMatteis said. “They feel like they’re a failure, [but] we can do more to embrace them as a community and help them get help.”

Martin said emergency rooms should make a habit of directing patients to mental health and addiction crisis hotlines if necessary.

“Kris Martin’s phone number should not be the only one that’s available on a Friday night when you’re in crisis,” she said. “I don’t mind answering those calls, but there’s got to be more than just a couple of us around to be able to do that.”