There’s been good news, bad news, a little of both news, and downright sad news on the addiction epidemic front lately.
Go, Maine law enforcement! Now that the addiction epidemic is finally getting the attention it needs from policymakers and in the media, our law enforcement folks are ready to innovate. Departments in Scarborough, Augusta and other communities are developing programs like one in Gloucester, Massachusetts that encourages addicts to seek assistance getting treatment from the police without fear of being charged.
Also, Kennebec County Sheriff Randall Liberty has been named Maine State Prison warden. I’ve interviewed and written about Liberty. He has been innovating to address this epidemic in various ways at the Kennebec County Jail, including an in-house recovery program, and is an ideal choice for the position.
The U.S. Food and Drug Administration approved Oxycontin for use in kids. It’s bad news in my perspective for all the same reasons cited by Dr. Michael Noonan in a Bangor Daily News piece, plus a couple more. As Noonan declared perfectly, “The production, marketing and prescribing of Oxycontin and other similar drugs, called opioids, is one of the biggest healthcare disasters in our lifetime.”
The FDA is basing its decision on information given to it by Purdue Pharma, makers of Oxycontin, who were found to have falsified the research minimizing its potential for addiction. So much for once bitten, twice shy. The decision makers at the FDA cannot possibly come from a region currently being crippled by an addiction epidemic.
A little of both news:
The U.S. Department of Health and Human Services plans to revise prescribing limits for Suboxone, a drug used to treat opiate dependence. This is a tough and complicated one for me. I’ve seen Suboxone used as a critical tool for accessing recovery, but the downside is Suboxone is prone to diversion.
I’m worried about the down side to doctors being able to carry more Suboxone patients. The upside is obvious: More treatment is good. The downside is hard to explain without seeming to demonize addicts, who when ready for treatment, should be able to access whatever treatment they need, including opiate replacement therapy like Suboxone.
The problem is not all people understand that Suboxone is a sought-after street drug. The Suboxone website warns it can be abused like other opioids and can be deadly. It also can be intoxicating to addicts if used more than prescribed. Unlike methadone, it can be prescribed in larger than daily amounts. It can be a lifesaver for an addict committed to recovery, but it can be nothing more than a commodity or part of addiction maintenance for those who still struggle.
I’m all for increased access to treatment for addicts, but Suboxone alone is not treatment. What is treatment? Brent Miller of the Discovery House in Bangor put it well: “It means counseling. … It means diversion control. The behavior monitoring aspect of people who have this disease and helping them change their thinking and their behaviors in the long term, so they have a long-term recovery.”
Some Suboxone users still struggle with their addiction and addiction-related behaviors while legally accessing Suboxone — even while being monitored closely — as was the reported case of Elizabeth Brown. She’s the lady who got in the “road rage incident” in Wiscasset on Tuesday. The Wiscasset Newspaper said she tested positive for amphetamines and Suboxone.
She had a prescription for the Suboxone. A bottle of rum “with rum still in it” was found during a car search. Which means someone on uppers and downers and possibly drinking was allegedly driving erratically on busy Rte. 1. That’s a problem.
Actually, there are many problems, including the fact that the Suboxone website also warns that the combination of Suboxone and alcohol “can lead to loss of consciousness or even death.” I hope the upside of increased access comes with careful consideration of the potentials on the downside, and the funding and comprehensive treatment programming to minimize them.
Downright sad news:
Beautiful 18-year-old Cassidy Patten of Harrison is the latest overdose victim. News reports say she was left outside the emergency room at Central Maine Medical Center but did not stay to make sure she got help. What a devastating thing any way you look at it.
I’d like to say that if I were in that situation, I’d risk getting in trouble rather than letting someone I cared about die. I just don’t know, though, because I have never been addicted to opiates, so I don’t know what it’s like to think with an opiate-addicted mind. I have seen what it looks like to think with an opiate-addicted mind and talked to addicts actively in that state and in various stages of recovery and relapse.
It looks hard. It’s hard to make sense of it because opiates are a drug people take to get high or to feel better, so it looks like they are choosing addiction to enjoy themselves. But the harsh reality is the changes that happen in the brain, in behavior and in judgment make opiates look like anything but fun in the long run. Opiate addiction is a tortured existence, and all opiate abusers, from the first time experimenter to the experienced addict, are potential overdose victims.
After reading about Patten, I started to think for the first time that maybe safe places to use aren’t such a bad idea. Especially in the face of an epidemic that claimed 105 lives in the first six months of this year. Vancouver has a controversial program that provides a safe place for heroin users to shoot up.
Honestly, I’ve never been overly fond of the idea, but besides the issue of overdoses, this epidemic comes with increased likelihood of blood-borne diseases, which this kind of program helps to mitigate. A facility like this would also be an access point to get more Narcan (opiate antidote) in the hands of addicts on the street, possibly saving more lives, like Patten’s.
I know there are a lot of folks who feel totally drained by the demands on their tax dollars, and I totally get that. I, too, could make a long list of things I think our government overspends on. However, I look at Patten’s picture and think of other addicts I know — and I wonder what kind of a price tag people against government-financed treatment would put on their lives.
How much is it worth to our communities at large to have systems in place that could have possibly contributed to saving Patten’s life and more than one hundred other lives?