Addiction sufferers need accessible treatment

By Brenton Gicker – for The Register-Guard – SEPT. 24, 2017

Brenton Gicker is a registered nurse and emergency medical technician who lives and works in Eugene – and a member of the Mental Health Association of Portland’s Advocacy Council.

Any day of the week, one can find news stories describing the plague of addiction that is ravaging the country.

According to a Sept. 2 story in The New York Times: “Drug overdoses killed roughly 64,000 people in the United States last year… Drug overdoses are expected to remain the leading cause of death for Americans under 50, as synthetic opioids — primarily fentanyl and its analogues — continue to push the death count higher.

“Drug deaths involving fentanyl more than doubled from 2015 to 2016, accompanied by an upturn in deaths involving cocaine and methamphetamine. Together they add up to an epidemic of drug overdoses that is killing people at a faster rate than the HIV epidemic at its peak.”

Much attention is being paid specifically to the opioid epidemic, which kills an estimated 100 Americans daily. Other substances — such as alcohol and methamphetamine — usually destroy bodies and minds over time.

Opioids are arguably more benign than alcohol or methamphetamine — which wreak havoc on people in ways opiates do not — but opioids are extremely addictive and easy to overdose on, which is why they kill so many people.

One might think that, considering the carnage caused by drug abuse that is all around us, and the constant media focus on the horrors of addiction — specifically opioid addiction — there would a concerted effort to enroll addicts in treatment. But that’s not happening.

Narcan — a drug that can potentially reverse an opioid overdose if given early enough — is becoming more readily available to professionals and the public (including addicts and their loved ones), which will potentially reduce the number of opioid overdose deaths.

Primary care providers are being scrutinized for prescribing opioids too liberally — a problem that many blame for the opioid epidemic — and pressured to wean their patients off of them.

Rightly or wrongly, many patients who have relied on opioids for chronic pain management are being tapered off of them.

In some cases, that process is not gradual but abrupt. Given that opioid withdrawal — which typically isn’t a medical emergency though it’s very uncomfortable — is a miserable process.

Patients are often left feeling as if they’re being punished for becoming dependent on drugs prescribers previously encouraged them to take.

But while the media are reporting horror stories and prescribers are changing their practices and medical professionals are educating the public on the use of Narcan, where’s the treatment?

Various local agencies (Emergence, Serenity Lane, White Bird Clinic, Willamette Family Treatment, etc) offer excellent outpatient treatment services.

But for a hardcore addict — you know, the kind of person who is found dead or half-dead in an alley or motel room with a needle in their arm; the kind of person we laugh at when we see their mugshot until we realize we went to high school with them or that they’re a coworker’s child — attending meetings isn’t likely to work.

What they need is inpatient treatment; intensive, holistic treatment — treatment they are highly unlikely to receive without a solid support network and financial resources (which, of course, most addicts don’t have).

Only two local agencies — Serenity Lane and Willamette Family Treatment — offer medical detoxification and residential treatment services.

They are both excellent, essential organizations. But inpatient services offered by Serenity Lane are inaccessible to many because of their insurance and payment requirements. Willamette Family detox and residential programs are more accessible (they accept Oregon Health Plan) but are often full or may have long wait lists and other barriers.

People stay in absolutely miserable situations — the people you see strung-out all over town aren’t having fun — because they don’t know what else to do with themselves.

Maybe they’ve never done anything else. Maybe they’ve never had the opportunity to do anything else. And — considering the barriers that exist to getting help, real help — why even try?

For emotionally and physically battered individuals, it’s just too daunting.

Narcan should be accessible, and doctors should be challenged for turning their patients into junkies. But what is painfully missing are low-barrier, easily accessible treatment facilities — facilities whose message to addicts should be loud and clear: Come to us. We want you to be here. We’ve been waiting for you.