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MailTribune.com
  • A losing battle?

    Getting treatment for opiate addiction could be harder than you think
  • As health officials work to reduce the more than 20 million painkillers prescribed in Jackson County each year, patients who have become addicted to opiates — including heroin — and want to find help often must wait weeks or months for treatment.
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  • As health officials work to reduce the more than 20 million painkillers prescribed in Jackson County each year, patients who have become addicted to opiates — including heroin — and want to find help often must wait weeks or months for treatment.
    Patients who need residential treatment can wait from three to eight weeks for a bed to become available in a publicly funded facility, says Rita Sullivan, executive director of OnTrack Inc. addiction recovery programs and services in Medford.
    "It's really tough to put someone on a waiting list who is asking for help," Sullivan says.
    OnTrack offers 16 beds for residential drug treatment, two for youths 18 and younger. Priority is given to pregnant women, intravenous drug users, Department of Human Services-referred cases and Drug Court patients.
    Addictions Recovery Center in Medford offers 28 beds, 14 funded by public money and 14 available on a sliding scale or for insured individuals, according to Christine Mason, ARC executive director.
    Statewide, there are 40 providers of drug treatment programs, six of those publicly funded, offering 500 beds for adults, according to Karen Wheeler, administrator for the Addictions and Mental Health Division of the Oregon Health Authority.
    "There are definitely some needs in terms of increased capacity for treatment for opiate addiction," Wheeler says.
    Those who want — and can afford — private residential treatment programs now must travel to Eugene or Salem after Asante closed its Genesis Recovery Center in 2009. Operating costs had outpaced revenue as the number of patients declined, in part because of poor coverage offered in insurance policies and co-payments that ran to thousands of dollars, officials said at the time.
    More money for Jackson County's publicly funded treatment programs and more involvement from the medical community are needed to curb addiction to opioids and heroin locally, Sullivan says.
    Many addicts progress to heroin when they can no longer get or afford prescription painkillers.
    "We can improve the outcomes if we integrate, like health care transformation is guiding us to do, if we have a medical presence," says Sullivan.
    She envisions doctors on staff at treatment facilities who help counselors manage patients' withdrawal symptoms and ongoing treatment regimens.
    "It's a hard class of drugs to treat," Sullivan says. "It has to be treated on multiple levels. There are great programs, but we need help with the medical elements."
    State Sen. Alan Bates says he is working to increase the amount of funding given to mental health and drug treatment programs by as much as 18.4 percent as this year's legislative session winds down, but as of press time lawmakers had yet to approve a budget.
    "That's more money put into the system, which is a substantial amount," says Bates. "It's part of a package to get people off drugs and save lives. It's the right thing to do."
    Having the ability to treat patients quickly with drug addictions is imperative, Bates says.
    "You have opportunity with patients. You have to strike when the iron's hot. You have to have programs set up where you have capacity," he says.
    Providence Medford Medical Center is putting together care teams for patients that include a behaviorist, case manager, clinical pharmacist and primary care physician, says Dr. Jason Kuhl, clinical medical director.
    "The care team would develop a plan with an intent to taper off the opiate dose with alternative or adjunctive therapy," says Kuhl.
    Doctors at the hospital also are encouraged to use the prescription drug monitoring program, a secure database that tracks controlled substances, to ensure patients aren't shopping doctors and pharmacies for more opiates.
    "Doctors can look and track who and how much is being prescribed," Kuhl says. "It's optional, but we look at this website when we have concerns, or randomly to make sure there is no prescribing habits from multiple prescribers."
    There are two ways opiate addiction is treated — through sobriety-based programs and medication, says Dr. Jim Shames, medical director for Jackson County Health and Human Services.
    Sobriety-based treatment includes counseling, Narcotics Anonymous meetings and/or residential programs in which patients stay on-site while they go through withdrawal.
    Medication-assisted treatment includes counseling and group meetings plus medications, such as methadone or Suboxone, which help reduce withdrawal symptoms.
    "Here's the deal. Opioid withdrawal is terrible," Shames says. "People hate it. It makes you feel like you're going to die. You're not, but it makes you feel like you're going to die."
    Withdrawal from opiates is different than from cocaine, methamphetamine, benzodiazepine (a type of sedative) or alcohol, Shames says.
    "It's just different, and for people going through it, their reaction is often quite different. The truth of the matter is, relapse is very high," he says.
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