It could be anyone – your next door neighbor, your doctor or nurse or a co-worker.
“I’ve seen doctors and nurses addicted (to opiates),” said Certified Nurse Practitioner Sue Berger. “It can be anybody from all walks of life.”
Substance abuse is a nationwide problem, officials say, but new treatment options in the area aim to help individuals addicted to drugs or alcohol combat the problem.
“(Heroin) is a public health crisis,” said Champaign County Common Pleas Court Judge Nick Selvaggio. “It covers all levels of individuals, from different socio-economic backgrounds. We’ve had individuals with no criminal backgrounds addicted to heroin, individuals who had full-time jobs who lost employment because of heroin, and individuals who own their own homes, who lost them because of heroin.”
Unintentional drug overdoses caused 2,110 Ohio resident deaths in 2013, the latest data available, according to the Ohio Department of Health. Records show there were 196 more deaths in 2013 compared to 2012. Opiates, which include prescription painkillers, were involved in more than 70 percent of overdose deaths. And heroin-related deaths increased in 2013, surpassing prescription opiates among unintentional overdose deaths.
The state of Ohio deemed it had an opium epidemic in 2010, Community Mercy REACH Manager Sheri Haines said. Mercy REACH is an outpatient drug, alcohol and tobacco treatment program offered through Community Mercy Health Partners in Champaign and Clark counties.
Patients became addicted to opiates because they needed pain medication, and when doctors stopped prescribing them, they found heroin cheap and available.
Community Mercy REACH has seen an increase in the number of patients treated for addiction of some type. Haines said in 2008, 14 percent were opiate-related diagnoses. In 2014, that number had increased to 24 percent. That data includes both Champaign and Clark counties.
According to the Logan County Coalition on Opiate Release Efforts (CORE) website, 15 percent of Logan County deaths in 2013 were caused by drug overdoses.
In 2010, doctors were reducing the number of opiates they were prescribing, pill mills began to be looked at, and people began gravitating to heroin usage as their prescription drug supply dried up, Haines said. Mercy REACH began to see more and more clients referred by physicians because the doctors thought their patients were drug-seeking, or they were kicked out of the doctor’s practice.
Mental Health, Drug and Alcohol Services (MHDAS) Board of Logan and Champaign Counties Director of Services Tammy Nicholl said Logan County has a high rate of prescribing opiates to citizens. That rate is higher than the state average.
“We are getting to the place where, between the two counties, almost every week we are losing a person,” she said. “We acknowledge fully that there are not enough resources for what we need to do with the heroin issue. This is one of those issues that’s going to take a whole community to make a difference.”
Addiction: the disease
Berger, the certified nurse practitioner at the Chronic Care Clinic at Mercy Memorial Hospital, said genetics plays a role in whether a person will become addicted.
“Genetics loads the gun, but the environment pulls the trigger,” she said. “If you take two people, one with and one without genetic predisposition to addiction and expose both to the substances, one will become addicted and the other won’t. Once you throw in the environmental triggers, the addiction becomes manifest.”
Berger said she has seen addiction in all types of people during her career. Often, it starts with being prescribed an opiate to manage pain.
“After about four months of being on narcotics, you do not get an improved quality of life,” she said. “You are your own normal. You don’t realize you are over-sedated. Human nature is ‘just give me a pill, I want a quick fix. Who wants to go to physical therapy?’”
Once the addiction sets in, the person’s only thought is not wanting to endure withdrawal symptoms, so they keep taking the drug.
“You are not craving heroin specifically,” Berger said. “It’s that they are scared they will have horrendous withdrawal symptoms.”
Setting up a system
Frequent drug overdose deaths prompted action in Champaign and Logan counties. Representatives from Consolidated Care and the Mental Health, Drug and Alcohol Services Board (MHDAS) of Logan and Champaign Counties met with Champaign County Common Pleas Court Judge Nick Selvaggio earlier this year, looking to develop a multi-agency approach to the problem.
Logan County agencies banded together in September 2014 to form the Logan County Coalition on Opiate Release Efforts (CORE), MHDAS board Director of Services Tammy Nicholl said. The group involves a mix of counseling, medical and law enforcement personnel, who work to help individuals kick their addiction. Nicholl said the hope was to develop something similar in Champaign County.
Not long after talking with Nicholl and Consolidated Care, Selvaggio met with a representative from Alkermes, who talked about the company’s drug, Vivitrol. Vivitrol is a prescription, injectable medication that blocks the pleasure centers of the brain from responding to opiates or alcohol. The drug is being used as part of addiction counseling and treatment programs in other areas of the state.
After that meeting, Selvaggio investigated a medication-assisted treatment program in Marion County. He then brought representatives from agencies around Champaign County together to introduce them to Vivitrol. In that meeting were representatives from local government, schools, businesses, health care providers, faith-based groups and other public service agencies. Selvaggio introduced attendees to a Vivitrol representative who described how its use might help address the opiate addiction and overdose problems in the county. Agencies began to talk about how they might integrate its use in their programs.
Ways to get treatment
Champaign County residents now have a few options to obtain medication-assisted drug and alcohol treatment. They can be prescribed it through Consolidated Care’s psychiatrist, they can get it through Community Mercy REACH, or they can get it by working with Addiction Angels of America, which is located in Columbus.
Selvaggio is now ordering medication-assisted treatment through sentencing in his court, if an offender seeks it. Then the county probation office gets the ball rolling in connecting that individual with a treatment program.
Individuals can also seek out each agency on their own; they do not have to go through the courts or a public agency like the Department of Job and Family Services.
In Logan County, Consolidated Care has a psychiatrist who can prescribe Vivitrol for treatment, but there is a long wait list to get in to see that psychiatrist, Nicholl said. Logan County CORE is working with Mary Rutan Hospital to provide other avenues for use of the drug in treatment, she added.
Berger said she’s looking forward to offering another tool in the fight against addiction by having Vivitrol available.
“I’ve seen the power of it helping people get their lives back,” she said. “I’ve seen the fallout, the tragedy of addiction. To see that there’s some type of viable option to give people their lives back, it’s exciting.”