Column: What we can do to improve our heroin treatment system

Posted at 9:01 AM, Dec 16, 2016
and last updated 2017-01-20 14:05:12-05

While covering the heroin epidemic through most of the last year, I met many people who work hard every day to deal with this problem.

Beyond their dedication, they have another trait in common. They’re frustrated.

Frustrated that despite their years of work, this crisis keeps getting worse.

Much worse.

The death toll is enormous. Deaths from heroin and pain pills have surpassed deaths from car crashes, deaths from homicides, deaths from drunk driving, deaths from guns, deaths from suicide. For more than 10 years, the toll has grown steadily.

It’s clear what we’re doing is not working. In this series that I reported, wrote and published this week, I laid out some of the shortcomings of the treatment system. But there’s hope. It won’t be easy, but our community can respond to the crisis and create a better system. Here’s 9 ways that could happen:    

Treat addiction like a disease. It’s widely acknowledged in the medical and treatment professions that addiction is a disease. However, it’s typically not treated like one. Heroin abuse changes brain chemistry. It literally causes brain damage, causing the drug abuser to prioritize seeking drugs over all else. Addicts need medical care, just like anyone with a potentially fatal illness does. Physicians and other medically trained professionals should oversee the addict's recovery. They need follow-up care. They may need a lifetime of care.

Expand treatment. The treatment capacity here is inadequate. Long wait times to get in mean addicts keep using and possibly dying. To ramp up enough treatment to meet the demand will take a lot of money. Congress just passed the CURES Act, which frees up money for treatment. Our local and state health departments need to be aggressive in seeking out this grant money.

READ MORE: The broken, shadow system of treatment

Get our hospitals more involved. We are blessed with excellent, not-for-profit health systems. Their executives could take the lead on coordinating a care system for addiction, creating space for safe detox and follow-up treatment and recruiting more physicians trained in addiction medicine.
More use of medicine. Effective medicines are available to treat addiction, but they could be more widely used. Suboxone, in particular, is restricted by the federal government. It’s a safe and very effective medication that allows the addicted brain to heal and the addict to work and function. State and federal regulators should work to safely expand access to this life-saving drug.

READ MORE: Heroin drug saves lives, but it's hard to get

Create a system of follow-up care. Now, addicts who overdose (if they survive) are revived, then usually released. Those who are arrested may spend a short time in jail, and then be released. Hospitals, paramedics and law enforcement should set up a system where the revived and the arrested receive some follow-up and referrals to treatment. Colerain Township established a program like this, and some other communities are now modeling it.

Stop kicking sick people out of treatment. Recovering addicts are almost routinely kicked out of treatment and sober group homes for any number of slip-ups, some of them minor.  Kicking an addict out to the streets with no transition plan can disrupt their treatment and lead to a full-blown relapse and even death.

READ MORE: 'We can't just throw them out'

Create standards of treatment. Treatment methods vary from place to place and so do results. There’s no agreement on what works best. There’s no standard for measuring results. Medical professionals and treatment providers should develop best practices based on evidence and then work to promote those.

Establish more needle exchanges. Health professionals agree that this region is seeing a spike in hepatitis C cases from needle sharing and they fear a similar spike in HIV cases. Needle exchanges are an effective way to reduce the risk of these diseases. They can also be places where addicts can get some counseling and a referral to treatment. But getting community leaders to agree to needle exchanges can be a slow process. And this is a crisis waiting to happen.

READ MORE: HIV: Our million-dollar time bomb

READ MORE: Editorial: Let's support and pay for needle exchanges

Talk about it. Nearly every parent I interviewed who lost a child said virtually the same thing: They felt alone as they dealt with the chaos of addiction. The fact is, this is a crisis that affects all of us, it’s not isolated to “junkies.” It’s our neighbors, it’s our coworkers; it’s us. The stigma and shame of addiction is preventing people from talking about it, sharing their experiences and taking action.

READ MORE: A long journey from addiction to prison and back