Category Archives: Addiction

How One Town is Attacking the Opioid Epidemic and Succeeding

Dayton, Ohio, is one of the worst hit states by the opioid epidemic, but it’s also a town fighting to save lives with everything it’s got, and it sounds like the town has a plan that other cities and states can learn from. A November article in The New York Times (This City’s Overdose Deaths Have Plunged. Can Others Learn From It?) states that “it may be at the leading edge of a waning phase of an epidemic that has killed hundreds of thousands…in the U.S., including nearly 50,000 last year.” But now, deaths from overdoses are down more than 50% from last year.


This seems to be one of the few hopeful articles about the opioid problem, saying that all opioid deaths are decreasing, according to the CDC. Here’s how this town is doing it.


First
, the governor’s decision to expand Medicaid three years ago means that more people are able to receive free addiction and mental health treatment (and more than 12 treatment centers have opened as a result. Let’s hope they’re good.)


Second
, there is greater support available in the town after treatment, including tons of recovery support groups and the availability of (and training for) peer support personnel. In addition, teams comprised of social workers, police officers, medical personnel, and those in recovery visit people who have recently overdosed to try and persuade them to enter treatment.

Opioid Epidemic


Third
, Dayton has blanketed the city with Naloxone. The police chief is adamant that his staff carry it, unlike some of his peers in other cities who view administering Narcan as enabling. He sees it as a harm reduction tool that will help him achieve his goal of saving as many lives as possible.


Fourth
, Carfentanil (similar to fentanyl, a synthetic opioid 10,000 times more powerful than morphine) is not being found as frequently in overdoses. A DEA agent theorized that perhaps “traffickers realized how much of its base it was killing.”

Fifth, the police and medical workers agree with each other on an approach and are working together. The police often believe in “a punitive, abstinence-only approach to addiction,” while the medical community wants to eliminate deaths by any means possible. In Dayton, the chief supported a syringe exchange program (which was dropped in Santa Ana, ironically), and got a federal grant to distribute fentanyl test strips to check for fentanyl similarities in other medications.


You wonder: Would these steps work in cities the size of Philadelphia or San Francisco? And/or, there are enough smaller towns with a similar problem — couldn’t some of these steps be tried there?

A recent study shows what can happen when medical professionals don’t take every opportunity to help. These professional can be another part of the solution, at least when people start on opioids for pain relief and then become addicted. Researchers at the Washington State University College of Nursing studied a group of ten who fit this profile to answer two questions: How do people with chronic pain move from appropriate use of opioids to addiction? And what prompts them to seek drug addiction treatment?

Part of the reason for the study was that not many people had looked into these questions. It’s
not a large study, but all of those involved fell prey to cravings and then found they were dependent on the pills.

Many of the study participants said their medical professionals could have helped them identify their addiction and get into treatment but instead they felt the providers seem to judge them, didn’t believe them when they complained, or didn’t take their pain complaints seriously. The researchers said the patients’ “most challenging relationships” were with the healthcare workers they dealt with, and what’s needed is more compassionate, nonjudgmental care.

It would be helpful if this study could hit as wide an audience as possible.

If you need additional information about drug rehab in California and any other state, you’re welcome to call Summit Estate professionals at (866) 569-9391.

San Francisco vs. Philadelphia Substance Abuse

There are numerous American cities that stand out for certain characteristics. Madison, Wisconsin as a great place to bike. Cooperstown, N.Y., for the National Baseball Hall of Fame and Museum. Asbury Park, N.J., as the town where Bruce Springsteen got his start. The list goes on and on. Recently, San Francisco and Philadelphia, on opposite coasts, were characterized as standing out for similar reasons: the devasting consequences of addiction. 


In San Francisco, for example, an area of Hyde Street has “an open-air narcotics market by day and at night is occupied by the unsheltered and drug-addled slumped on the sidewalk.” Twitter, the article notes, is only a 15-minute walk from there, and other giants of the technology industry are not far away. (Note that the previous blog post dealt with substance abuse in Silicon Valley, not far from the San Francisco area in this post.)


San Francisco’s “persistent homelessness” is a big problem for such wealth so close to it, and a large part of the homeless are the drug dependent. There are hundreds upon hundreds of heroin needles lying around, along with the people who shoot up. The dealers and users are known as “the street people,” or the street population. One resident said it’s like “the land of the living dead” and accuses the city of allowing a containment zone so that the devastation doesn’t spread. The police say the drug trade is their most significant issue.

Substance Abuse

The problem is so dire that in August, San Francisco health workers walked the streets to find opioid users and offer them Suboxone prescriptions, according to another article. The recipients can get the medication the same day. “At the end of a recent yearlong pilot, about 20 of the 95 participants were still taking buprenorphine under the care of the street medicine team.”


It’s estimated that 22,500 people “actively inject drugs,” and the San Francisco medical director said there’s a strong trend of people using both meth and opioids in the city, which is really difficult to treat. But the goal of going to the streets to find users is to reduce the number of deaths.

 

Almost three thousand miles away, Philadelphia is known far and wide as “the largest open-air narcotics market for heroin on the East Coast” and so it draws people from “all over,” according to an article that appeared in the New York Times magazine last October. In one neighborhood known as Kensington, which actually takes in other areas as well, dealers hand out free samples with impunity and those on drugs are using them in the open or are already passed out. It’s known as the Badlands and supposedly has the purest heroin in a three-state area.

The author rode through the area in 2017 with a special agent with the D.E.A. According to her description, it looks like the apocalypse hit there – “Houses transformed into drug dens, factories into spaces to shoot up, rail yards into homeless encampments.” Sadly, the largest provider of drug treatment programs in the Bay Area is the prison system.


There’s history behind why this neighborhood is the way it is, starting with the fact that it had cheap housing, and once people moved in and a drug haven started springing up around them, they didn’t have the money to leave. That story, and the individual stories, go on and on, and it’s just so sad. Kind of like San Francisco.  Last January the governor signed a statewide disaster declaration—a public health emergency—to take concrete steps to try and address the devastation.


In the comments that appeared after the article, a San Francisco resident wrote in to say, “The article has allowed me to see how intractable our own ‘homeless’ problem in San Francisco will be without first addressing the drug epidemic….[It] shows what a death sentence heroin is, both for the users and for the community that the users (and pushers) inhabit. Why do we as a civilized, supposedly advanced society allow this?”.
 
If you need additional information on this matter or about Summit Rehab  plans, please call us at (866) 569-9391.

Silicon Valley Substance Abuse Redux

Do the West Coast papers cover drug use in Silicon Valley to the extent that other publications do? Because it certainly seems to pop up in other media. Take microdosing, as an example. It’s a valid way to study the effect of a new medication on the body more safely than administering a full dose, but workers in the Valley are microdosing LSD, saying it makes them more productive.

An internet search on “microdosing + Silicon Valley” turns up articles in at least two publications (Forbes was writing about it as early as 2015) and on several websites:  Business InsiderHuffpostMedium, and The Independent and Wired from the U.K…but it took going to the SFgate website and searching to find an article on Silicon Valley and microdosing.

This Summit Estate Recovery Center blog first wrote about drug use in Silicon Valley last winter (2018), and it’s important enough subject to revisit it. At the end of the summer, a contributing writer for The New York Timeswrote an opinion article about a recent visit to the Valley and what she found. There are online and hardcopy headlines: “How and Why Silicon Valley Gets High” and “Turn On, Tune In, Start Up.” The writer had lunch with a couple entrepreneurs there, which were sad upates on the current state of affairs there. One lunchmate told her “that magic mushrooms will help …[her]  become a better reporter … and … that Ecstasy will make …[her] a nicer person.” Seems he also suggested she try ayahuasca, a “brew made from plants that includes the hallucinogen DMT”. Soon afterward she learned that Tesla’s board was worried about company founder Musk’s admission that he has occasionally used drugs.


This was just before the popular Burning Man gathering, and she associated the festival with the use of ketamine. It sounded like that put her over the top:

“I spoke to just over a dozen people who all said consumption was increasing once again. Obviously, there are major problems with addiction to opiates and alcohol here, as elsewhere. But people in Silicon Valley tend to view drugs differently from those in places like, say, Hollywood and Wall Street. The point is less to let off steam or lose your inhibitions than to improve your mind.”
Silicon Valley

She quotes a tech worker as saying “It is all, about the ‘intellectualizing of drug use as a stimulant for the brain’ and refers to Michael Pollan and his book, “How to Change Your Mind,” about the resurgence of psychedelic drugs. He told her that “the exploration of drugs by tech workers remains part of the industry’s ‘hacking ethos’.”


A number of people commented on her article on their own blog. One wrote, “This is what you get when ordinary men aren’t calling the shots: society thinks nothing of pressuring unsexy men to work 200 hours a week, shooting up whatever drugs are needed to make Executive Chad’s arbitrary deadlines, using frickin’ hallucinogens for inspiration and friendship.” I won’t link to the post because he also makes misogynist comments and derogatory comments about one ethnicity.


The article itself had 229 comments on the paper’s website. Here’s one: “Is it any surprise that the gurus of AI and ‘the singularity’ would be taken in by pharmaceutical transcendence? Intelligence without thinking, ‘social media’ instead of culture, spiritual depth in a pill–it’s all about what sells, not what works. It would be funny if the world were laughing instead of throwing money at them.”


And here’s another: “I have always thought (and personally believed) that to expand one’s mind, first the person had to expand their empathy for all others. If you need a drug (natural or synthetic) with your sole purpose … to achieve some type of nirvana that will lead to you pushing yourself above another, then that sort of defeats the purpose, doesn’t it?”


You wonder about the future for these companies and their employees. Will things every change there? What will it take to turn it around? How do you change drug culture embedded in so many tech companies? How do you reach the hard-driving people at the top who are part of the problem if not the whole problem? And what about the individuals who are hurting themselves and their loved ones? What happens to them?

New Opioid and Fentanyl Strips Have Advocates and Critics

Dsuvia

There’s a new opioid in town called Dsuvia. It’s been all over the news lately, and it’s controversial.  An NBC News headline proclaimed “FDA approves powerful new opioid in ‘terrible’ decision.” The FDA was also accused of bypassing its own advisory process to approve the drug.

This drug, which is 1,000 time stronger than morphine, is usually given in IV form. This new formulation is a tablet taken sublingually and is to be used only in health care settings such as hospitals. According to the NBC article, it’s commonly used on the battlefield and similar emergencies “to treat intense, acute pain.”. It was actually the military that requested the pill formulation.

In the middle of the opioid crisis, the obvious question experts are asking is do we really need another opioid? Two criticisms are that there may be more deaths from overdosing with this drug, and health workers in confined health settings may find it easy to steal it. The FDA, however, says it has learned from the opioid crisis and has tightly restricted Dsuvia. It will not be available at pharmacies or for home use, the package is for single-use only, and it should only be used for 72 hours tops.

Side effects, not surprisingly can be horrendous: fatigue, possible breathing problems, and even coma and death. The cost will be $50 to $60 per pill.

Fentanyl

Test strips for Fentanyl

At the same time as a new opioid has been approved, there’s a new “tool” in the fight against opioid overdoses, according to several media outlets — a strip of paper that can test for fentanyl in batches of heroin. In October, The Atlantic reported a recent study found that drug users who employ them as a precaution before ingesting opioids or cocaine can possibly avoid overdosing.

Fentanyl is 50 times stronger than heroin and has been found in at least half of overdoses now. (As indicated, cocaine is often laced with fentanyl as well.) Researchers posit that if more people with substance use disorder had access to the strips, “they’d use less, or possibly not use … at all.” A YouTube video made by the Associated Press shows that when the strip is dipped into a drug, the appearance of two red stripes signifies fentanyl is present, and one stripe means it is not.

As we know, some states, and even cities, are more progressive than others. “… Baltimore; Philadelphia; Columbus, Ohio; and Burlington, Vermont—have started providing the test strips alongside clean needles. The California public-health department pays for the distribution of strips through needle exchanges.” Leave it to California to lead the way. 

However, some health agencies have questioned  the accuracy of the strips and whether or not a person would actually not take drugs they have right in front of them. Also, some experts want to see more research done.

There’s an obstacle as well: Some areas have “paraphernalia laws” that prohibit the use of devices to aid in doing drugs, except clean syringes, so these laws need to be amended to exempt test strips as well. 

The cost may also deter some users. Each strip costs $1.00, and users take drugs on average four times a day, so it’s not a cheap aid for people who don’t have money.

 

Diversion Programs Instead of Jail

The justice system has become a lot more just lately when it comes to people suffering from substance use disorders by offering diversion programs that allow people who abuse drugs and commit crimes to avoid jail time by attending treatment and engaging in long-term monitoring. Certain professionals such as police, doctors, and lawyers have their own way of offering support to those willing to accept help.


Pilots in the throes of addiction are another group that has benefitted immensely from caring colleagues.
Larry Smith, a former commercial pilot for Braniff and United Airlines who was addicted to several substances received incredible support from United Airlines, the FAA Medical Division, and the program for pilots called HIMS (more about that later). Today he is CEO of Get Real Recovery in San Juan Capistrano, CA, an FAA-approved treatment center he co-founded with his wife Lori in 2011.

In 2008, the Office of Aerospace Medicine of the FAA produced a report titled Drug Usage in Pilots Involved in Aviation Accidents Compared With Drug Usage in the General Population: From 1990 to 2005. It mentions a long list of drugs that pilots were using during that time, but what’s also scary is knowing that the report deals only with pilots involved in accidents. You wonder how many other pilots flew under the influence that weren’t involved in accidents.

Larry’s story is mesmerizing. In 1983 he received a DUI, although he was a furloughed pilot at the time. He received a second one that was reduced to a charge of reckless operation without alcohol. Larry now openly admits it should have been a DUI. He thought it was clever how he was able to duck under the radar for so long. Most alcoholics and addicts suffer from extreme denial, he says, and he was no different. Larry teaches that denial is the brain’s defense mechanism to protect the perceived right to use, not a character defect.  Addicted people will use every type of denial possible to avoid being detected. They hide their pain and self-disgust with charm or anger, whatever is necessary. Larry sees himself in others at every intervention, counseling session, and group that he facilitates.

Diversion Programs Instead of Jail

 Larry’s addiction to alcohol started in 1965 at 14 years old. He started using cocaine occasionally in the 1980’s, and by 1998 he advanced to smoking crack. “I recognized I had a serious problem then, but I didn’t know what to do,” he recalls. He was afraid to turn himself in to the EAP or HIMS programs as he mistakenly thought he would be immediately fired if the truth about his chemical dependencies was exposed. 

 On February 3rd, 1999, a vice squad of 12 masked men with shotguns and riot batons used a battering ram to invade his home in Ohio. His arrest quickly made the national news. Smith was released from jail on February 5th and received a call from his chief pilot. He thought he was going to be fired, but instead, his boss offered him treatment. His first treatment center was too lenient with clients, so United’s EAP transferred him to Cornerstone of Southern California.  He admits now, “I wasn’t a model patient; nevertheless, I fell in love with recovery!”

Nine months later Smith flew a 747 from SFO to Kona with 400 passengers on board. He gives all the credit to God and a forward-thinking airline. The FAA, United’s EAP and Management, an Aviation Medical Examiner, a psychiatrist and the Pilot’s Union (ALPA) all closely monitored Captain Smith’s progress for 5 ½ years. During this time, Larry became a licensed counselor and started speaking on addiction and the hi-jacked brain. Immediately after being released from FAA Monitoring, he spent eight years as a volunteer Union Rep to United Airlines EAP. Then and now, he guides and counsel pilots who abuse alcohol and drugs.

 As the HIMS website explains: “The HIMS program was established to provide a system whereby afflicted individuals are treated and successfully returned to the cockpit under the FAA Special Issuance Regulations (14 CFR 67.401).”

It’s rigorous:

“The purpose of the HIMS program is to effectively treat the disease of chemical dependency in pilot populations in order to save lives and careers while enhancing flight safety. The HIMS concept is based on a cooperative and mutually supportive relationship between pilots, their management, and the FAA. Trained managers and peer pilots interact to identify and, in many cases, conduct an intervention to direct the troubled individual to a substance abuse professional for a diagnostic evaluation. If deemed medically necessary, treatment is then initiated. Following successful treatment and comprehensive continuing care, the pilot is eligible to seek FAA medical re-certification.

The FAA requires the pilot to be further evaluated by a specially trained FAA Aviation Medical Examiner (AME) who then acts as the Independent Medical Sponsor (IMS) to coordinate the FAA re-certification process. The medical sponsor provides oversight of the pilot’s continuing care. This care includes a monthly interview by a trained flight manager and by a pilot peer committee member, as well as periodic follow-up observations. Because of the relapse potential of chemical dependency, the monitoring will typically continue for several years after the pilot resumes his duties. The HIMS program is designed to ensure the pilot maintains total abstinence and to protect flight safety.”

Larry explains some of the challenges pilots face this way: “Pilots are great at following directions, like the checklist we give them in recovery, but they’re not so great at processing what’s within. We find that some had trauma in their early life. For example, some were at war, and some grew up with rigid fathers and co-dependent mothers and so forth, and counseling helps them see what may have caused them to drink and help them get out of their own minds.”

In 2010 he wrote The Daily Life Plan Journal, a goal-setting journaling guide for people in recovery to be able to simply draw lines on airplane-like gauges to assess their feelings and emotions. For example, instead of asking them to mark their flight level, they’re asked, What is your motivation level “right at this moment?” It’s an effective way to journal for people who don’t like to write or have difficulty expressing themselves in writing. This journal allows a person to simply put pen to paper and measure their feelings by drawing a line. 

In addition, he wrote a book about overcoming addiction called Flight to Transformation. The book is part memoir and part a strongly spiritual walk through recovery. He’s also expanding his treatment knowledge to include MAT–Medically Assisted Treatment, and the use of Stem Cells in recovery.

Taking Drugs on the Job

With all the evidence available, there’s no denying some employees have used drugs while working, whether they shot up in a restroom, or popped a few pills at their desk, for example. An article in The New York Times holds that  ”As the opioid epidemic continues to rage…, the fallout is increasingly manifesting itself at construction sites, factories, warehouses, offices, and other workplaces.”

An earlier post on addiction in Silicon Valley mentioned that substance abuse in the workplace took place in offices there as well. But this article focuses on a construction worker, an employee in an industry that has been found in the past to have one of the highest rates of addiction of any field. Today it has “the second-highest rate of pain medication and opioid misuse after the entertainment, recreation and food business,”  according to the article, and construction workers also have “twice the addiction rate of all working adults.”

According to an 11-year old survey by the National Safety Council, at the time, 70 percent of employers said that prescription drug abuse had affected their businesses, relating to absenteeism, injuries, accidents, and, of course, overdoses even then. Understandably, there were positive drug tests as well.

Taking Drugs on the Job

The construction worker in the article has overdosed on the job several times, and was revived with Narcan by a coworker at least twice. He never went to rehab, until he was fired and returned to his hometown. He joined the local construction union, which was a lifesaver. He had an outstanding arrest warrant which proved troublesome in getting him into a program, but union officials talked a judge into letting him serve his time in rehab. So far, he has been clean and is working, thanks to his union.

The current statistics are not good: in 2016, 217 workers died from overdosing on alcohol or other drugs at work, which was a 32 percent increase from 2015. Overdose deaths in workplaces have increased every year since 2010. That includes someone at Fiat Chrysler Automobiles, a crawfish fisherman in Louisiana, and a Sam’s Club warehouse worker in Texas. The guy down the street in your neighborhood, the man sitting next to you on the bus, or the father of a boy on your son’s little league team.

The article reports that few businesses are willing to acknowledge the drug use at their company. Yet certain enterprising business people do and are willing to help, like Alan Hart, president of Giovanna Painting in Spencerport, NY.  Maybe it has something to do with the fact that he’s in recovery himself. He tries to help workers enter rehab, although he doesn’t offer employees health insurance. He also fires workers he suspects of abusing drugs while working.

It would be naïve to think drug use doesn’t go on in the workplace, and just like addiction can hit anyone, so drug use can appear in any business.  Perhaps you heard of the teacher who OD’d in a school bathroom and died, although his wife had no idea he was on drugs. The news traveled as far as the United Kingdom.

In the corporate world, perhaps disseminating more information about Employee Assistance Programs would help. (For that matter, a comparison of programs would be a good thing, along with what laws mandate as far as offering employees treatment.) In addition, perhaps there should be guidelines for what employees can do if they suspect a co-worker of taking drugs, not as a punitive measure, but to try and address the problem. And of course, Narcan could be made available in workplaces. At least companies could discuss these approaches and others.

 

ERs Are Stepping Up to Help With Addiction

Addiction Treatment Centers

 

Leave it to California to take the lead when it comes to a group of hospitals trying a new way of helping those addicted to opioids—having ERs administer buprenorphine (aka Suboxone) when someone enters in the throes of withdrawal. (Lest anyone forget, buprenorphine is weaker than other opioids. It activates “the same receptors as other opioids, but doesn’t cause a high if taken as prescribed,” says the article in The New York Times.) A 2015 study by researchers at Yale-New Haven Hospital found that when ERs have done this, the people who get the buprenorphine are more likely (twice as likely, in fact) to be in treatment after a month than people who were only given an informational packet that included phone numbers related to treatment. As a result of the study, an ER specialist who heads the buprenorphine program at Highland Hospital in Oakland convinced the California Health Care Foundation to give his hospital a grant to try the novel method.

 

ER Departments

Out of the box idea? Sure. But it seems to be working. Now ER doctors are calling the lead author of the study every week, she said in August, and ER departments in Camden, NJ, Brunswick, Maine, Philadelphia, New York, Syracuse, and Boston are also offering buprenorphine.The doctors need training to prescribe the medication, as well as a license from the DEA to prescribe it unless someone is in withdrawal, so ER doctors are in a good position to treat those patients. “I think we’re at the stage now where emergency docs are saying, ‘I’ve got to do something,’” the lead author of the study said. “They’re beyond thinking they can just be a revolving door.”

 

Detox Centers in Northern California

 

Treatment in the ER

It’s a rare opportunity to meet people where they need help and get them started on medication for their addiction, the article notes. In some places of the country, it’s not easy to find a doctor who takes insurance AND prescribes buprenorphine. After their ER visit, ideally a person will follow a “wheel and spoke” approach, where they first go to a treatment clinic (the hub), adjust to the medication, and then see a doctor in a primary practice (the spoke). Treatment in the ER involves buprenorphine under the tongue, and usually, a prescription for Suboxone, in the form of strips that will dissolve in the mouth and thus are harder to abuse. Then the person is directed to meet with the head of the addiction program in his clinic, where he’s available one day a week.

 

Detox Centers

 

Even signs posted in the waiting area of Highland ER reaching out to those suffering from opioid use disorder are helping. A woman there for a respiratory infection saw one and told her brother about the signs, and he decided to enter the program. Recently released from prison, he was hoping to stay clean, especially because he had a job offer. Now he had “a stable source of treatment.” California was willing to provide the grants to have this program flourish. Two-thirds of Highland Hospital’s 375 patients in withdrawal accepted the medication and had an initial appointment at its addiction clinic. Not only that, but California has started to require detox centers and residential centers to allow residents to take either buprenorphine or methadone, medication-assisted treatment, which has had a history of controversy. That’s also ground-breaking.

 

For more information or to contact our Detox Centers in the Bay Area call (866) 596-9391.

 

Helping Addicted Inmates

The number of people suffering from substance use disorder who likely think they won’t end up in jail is probably large—especially if they have good jobs. They never think it will happen to them. But it can. As a recent episode of the TV program Dopesick Nation showed, even formerly responsible citizens may find themselves stealing, forging prescriptions, and so forth to support their habit.

 You may have heard we’re not doing nearly enough for substance abusers who end up in jail. But there are a few programs around the country that seek to help these people, often in small towns, that can serve as examples for other towns. Here are a few.

Peer recovery coaches in NJ

 In one NJ town, certified peer recovery specialists are volunteering to work with those suffering from substance use disorder who are incarcerated. In a new program called Next Step, the volunteers are called coaches, and they help to steer prisoners into treatment.

Bail reform in certain areas of the country means that nonviolent offenders are being released earlier, and for addicts, that usually means without treatment or the offer of treatment. (And many [most?] likely got little help in jail.) Although it’s too soon to comment on the program’s success, shortly after the program was instituted at the jail, nearly half of those screened entered treatment.

One of the county prosecutors noted that when people are sent to jail, it’s often their lowest point, a good time to try and convince them that treatment may save their life. Several local organizations have stepped up to provide clinical assistance, including a social services organization helping inmates find jobs, a recovery center, a peer recovery organization and a hospital.

 Having a peer in recovery work with an incarcerated person is another tool in the toolbox to help someone get healthy and return to society.

Helping Addicted Inmates

The Start Strong 3 E’s in Kentucky

There’s a new treatment program in the detention center in Kenton County, KY, in which inmates are expected to be “Employed, Enlisted, or furthering their Education,” 12 weeks after release, according to the program director. The key in this area, which has suffered greatly in the opioid addiction crisis? The jail is partnering with Aetna Better Health and getting help from the Hazelden Betty Ford Foundation.

 The concept involves giving medication not only to quell cravings or ease withdrawal symptoms, but to stabilize patients getting therapeutic care in jail. They will then have the option to stay with medication assistance during and after their incarceration, according to a local TV station. And, luckily for these inmates, there’s an aftercare program with intensive job training.

Vivitrol and Counseling in Central New York State

In Onondaga County, NY, addicted inmates are given the opportunity to have injections of Vivitrol and attend counseling sessions. According to the Vivitrol website, the medication “is a non-addictive, once-monthly treatment proven to prevent relapse in opioid dependent patients when used with counseling following detoxification.”

Chicago’s Thrive program

Inmates suffering from substance abuse in a Cook County jail who are not in the drug court program are being offered naloxone on release and will be monitored “in a modified version of the sheriff’s electronic monitoring program.” (For example, caseworkers who worked with one woman on the inside will continue to work with her once she’s released.)

Other programs, in Indiana, Orange County, Florida, and Cincinnati, Ohio and Kings County, California, to name a few, show that a number of jails realize they can contribute to finding solutions to substance abuse in this country. Whether it’s to offer Suboxone, Naltrexone, Vivitrol, peer coaches, and counseling and job training, or a combination, these programs can serve as a blueprint for other jails.

 

72,000 Deaths

Can the news from the Centers for Disease Control about 2017 drug overdoses BE any bleaker? The years 2016-2017 saw a record number of people dying from overdoses, which was more deaths than from guns, car crashes, or H.I.V.

Someone has done an analysis. Drugs are deadlier now (often due to mixing them with other substances besides the main drug), and more people are using. The good news is that where the deadlier drugs arrived earliest, such as in New England, some states are seeing the number of overdoses drop. Could that be from diligent public health campaigns and offering more addiction treatment, which they were hitting the problem with? 

However, the writer reminds readers that you can’t totally trust the numbers. With an epidemic like the Zika virus, an infectious disease, people sought help, and public health officials moved, quickly. But with addiction, there’s that pesky STIGMA (detailed in an earlier post on this site this month), so that drug users may not have been truthful about their drug use when polled. Also, some drug users don’t have telephones or are hard to reach, and some deaths take longer to be researched and reported than others.

Deaths from Drug Addiction

As mentioned earlier, another reason for the astronomical number of deaths is that the drug supply is changing, as noted by an associate professor at the Brown University of Public Health. Fentanyl is being added to heroin, methamphetamine and cocaine, and even anti-anxiety medicines known as benzos, or benzodiazepines. (Stay tuned for a post on older people mixing benzos with opioids.) That’s especially bad news for “older, urban black Americans; those who used heroin before the recent changes to the drug supply might be unprepared for the strength of the new mixtures,” according to the article.

The East seems to be in a better position than the Midwest relative to this one part of the epidemic, because heroin that makes it way to the West is usually “processed into a form known as black tar that is difficult to mix with synthetic drugs.” The East, however, usually has a white powder that combines well with fentanyl.

Let’s hope that Dayton, Ohio, which has been in the news as a “hot spot” for opioid use, is the way of the future for other states. The county has a new emergency response strategy, is utilizing federal and state grants to combat drug use, and has reduced opioid prescribing and provided addiction treatment to prisoners in jails.

drug addiction treatment centers

Drug Addiction Treatment Centers

There are other hopeful signs: Congress may step in with bills that mandate reductions in prescribing opioids, among other things, and along the same lines, experts are reminding people that we need more funding of public health programs.

There’s yet another action that might help which requires no funding and little effort. A behavioral economist at the University of California and the Chief Medical Examiner-Coroner for Los Angeles County wrote an opinion column to suggest that medical examiners and coroners tell doctors when their patients die of overdoses. They wrote that they believe that more careful prescribing would result if doctors were told, and they even set up a trial in San Diego County in 2015 to test their thesis.

They had a letter sent to half the doctors in the study who had prescribed opioids about that doctor’s patient’s death after each one happened. The letter wasn’t threatening “and gave the clinician a path toward safer prescribing.” The results of the study indicated doctors did reduce their prescribing and started fewer patients on opioids.

Every little bit helps, or at least people are trying.

For more information on our drug addiction treatment centers contact our rehab in California, Summit Estate, by calling (866) 569-9391

Some Good News In Fighting the Opioid Epidemic

A New Medication

 On June 6, CBS TV profiled an early stage biotechnology company called Blue Therapeutics that has developed a non-addictive painkiller. Pharmaceutical companies have been talking about developing less addictive painkillers lately, but their definition refers to pills that would be more difficult to crush and so forth. Blue Therapeutics supposedly has the real thing, which means that people looking for pain relief will not become addicted with this medication as has happened so often with other pain relief. This company’s medication clings to different receptors that are non-addictive and so it “eliminates the narcotic high,” according to a company executive who was interviewed. Unfortunately, the medication won’t be available for about five years. It’s in clinical trials now.

 Acupuncture

 People in recovery from heroin and methamphetamine addiction might suffer from anxiety and fear like Sarah Downs, the woman featured in an article appearing in several newspapers in May. She was at the Pickaway Area Recovery Services (PARS) in Ohio, for acupuncture, which she hoped would ease the symptoms she experienced since getting sober for three months prior. Jimmy Laux, a chiropractor associated with the program, eased needles into her ears in a new program for the center. What’s interesting is that a judge is linked to the program as well. He heard about Laux because he sends defendants to a recovery facility, and Laux educated him about acupuncture for easing addicts’ recovery. This judge has pledged almost $13,000 for treatment for people who don’t have the funds to pay for it themselves. Acupuncture isn’t meant to be used in isolation, the article said. NAR-ANON and AA meetings are also important, as well as therapy. But the executive director of PARS said that his research “shows that people in recovery who undergo acupuncture stay clean at a higher rate than those who don’t.”

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 Brain Stimulation

 It’s surprising that brain stimulation isn’t more well-known than it is when it was publicized as far back as 2015. On a site called Addiction Recovery Guide, run by a psychologist, Magnetic Brain Stimulation and Transcranial Direct Current Stimulation are mentioned as promising research. Magnetic Brain Stimulation stimulates nerve cells in the brain’s prefrontal cortex, which controls impulsive behavior. The article says it’s been used since the 1980 to treat depression, and in a study using it for cocaine addiction, patients were able to reduce their cocaine use and had few cravings after eight sessions. This information was published in the European Neuropsychopharmacology Journal (December 3, 2015). Transcranial Direct Current Stimulation has also been used for depression and anxiety, and was also was found to decrease cravings for drugs, although more study on how many sessions and what length is needed. This information was published in the October 2016 issue of the Annals of Neuroscience.

 Exercise

 The fact that exercise is good for people in recovery is nothing new. Treatment centers often have exercise programs, and clients are advised about the benefits of exercise, But if you thought that was only to return a person to health, you should know that exercise can have actual positive effects on recovery. In June  U.S. News cited a study which found “daily aerobic exercise altered dopamine signaling in the brain in ways that make alcohol and other substances of abuse less appealing or rewarding.” The lead author also said that exercise also increases functioning of the brain’s frontal areas, which help inhibit cravings. For information on drug rehab programs please contact our rehab in California at (866) 569-9391