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Progress Made In Fight Against Opioid Abuse

The Jones Medical Building will be the home for a long-term addiction treatment facility on the UPMC Chautauqua campus. The renovated housing facilities, which will also provide room for various types of therapy and access to a "wholistic" health care approach, are tentatively planned to open in May. P-J photo by Eric Zavinski

Opioid overdose deaths and all drug-related deaths may have decreased significantly from 2017 to 2018, but opioids, including fentanyl and heroin, are still by far the biggest killers in the county when it comes to substance abuse.

Addiction is the source of the problem. With it comes the negative connotations of those who use continually abusing illegal substances, but the human reality of these situations is far more tragic than it often appears. Defined by the National Institute on Drug Abuse, addiction is the “chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”

Considered a brain disease due to how drugs change brain chemistry on the most basic biological level, addiction affects every aspect of a user’s life, from their usually already troubled socioeconomic lives and mental states of mind. The Centers for Disease Control and Prevention have contributed data to several national studies that suggest people with lower income are more likely to become victims of drug abuse. Accordingly and more so than ever before, agencies and teams of professionals countywide are working on taking on a wholistic approach for treatment of addiction.

From a biological standpoint, naloxone plays a major role in keeping people alive. By numerous health professionals and first responders, the brand name of naloxone, Narcan, has been attributed as one of the biggest factors in decreasing opioid-related deaths by at most 39 percent from 2017 to 2018.

In a separate article for Addicted, Narcan’s impact on saving lives will be explored in-depth. Many health care professionals, county officials and first responders made it clear, however, that if other aspects of a user’s health isn’t addressed, the likelihood of relapsing and perhaps overdosing again is high.

The room shown is an example of the work-in-progress living quarters for the residential facility at UPMC Chautauqua that will be used to treat those who suffer from addiction starting in May. Overall, the unit will have 20 beds spread amongst private and co-op rooms. P-J photo by Eric Zavinski

LONG-TERM TREATMENT AT UPMC

UPMC Chautauqua staff have recognized this, deciding to earn and collect state funding from the Office of Alcoholism and Substance Abuse Services for a long-term addiction treatment residential facility in the Jones Medical Building on the hospital’s campus at 51 Glasgow Ave. A floor is being renovated to host as many as 20 people at a time who need some sort of long-term attention, with their lengths of their stays dependent on their individual living circumstances and extent of their addictions.

Twenty beds are being offered to those who can stay free of charge, so those who want to move on from addiction can restart their lives. As well as physical treatment, various forms of therapy and career services will be offered to residents. The facility will open in May, with more renovations planned in the future to house more individuals if needed.

“Everything we promote is grounded in research,” said Diana Porebski, director of chemical dependency and outpatient behavioral health at UPMC Chautauqua. “Recovery is a continuum.”

Porebski said a comprehensive approach to health care will provide research-oriented, patient-centered care. A focus on positive self-image, mental health and surrounding residents with positive people and elements of adult life are all planned to be keystones of treatment at Jones Medical.

“Outcomes are better … when they have a belief in themselves,” Porebski said. “That’s one of our big focuses: helping people understand themselves.”

She also stated that approximately 80 percent of those who become addicted experienced some kind of childhood trauma, including physical, mental, emotional and sexual abuse. Porebski said the facility and its offerings will be aimed at the root of underlying problems that lead to addiction. Patients will also be able to transition easily from the emergency room to the long-term care facility.

The three phases of recovery are stabilization, in which residents are assisted coping with withdrawal; rehabilitation, in which residents will learn long-term coping skills like how to land a job interview and rebuild familial relationships; and community reintegration, in which residents can still use residential services provided by UPMC but will start to live typical lives through work and time with family again.

Types of therapy offered include traditional counseling, time spent with a service dog, aromatherapy and sound therapy. Residents will be allowed to stay on the medical floor of Jones Medical for up to a year.

“We’re trying to offer a more wholistic approach,” Porebski said.

CARE THROUGH CAER

While a wholistic approach to treatment is one way to battle the already existing drug problems within the community, first responders and Chautauqua County officials are also concerned with shrinking the issues of substance abuse overall.

Since March 2018, the Countywide Alliance for Enforcement and Rehabilitation has brought together county police leaders, medical professionals, school faculty and county officials like County Executive George Borrello and Department of Health and Human Services epidemiology manager Breeanne Agett to the same table.

Borrello said collaboration among the law enforcement, treatment, and prevention and education committees has proven successful already, with more positive results to come in 2019 and beyond.

“For the first time, we’re making a net positive gain,” Borrello said. “It’s really made me feel like we’re getting our arms around this issue.”

The sophomore county executive correlated the drop in drug-related deaths to the more proactive and tool-enabled approach law enforcement professionals and other first responders were able to take in 2018. The expansion of the ODMAP program, a tool that tracks first responders’ reports of incidents of substance abuse and overdoses in real time, and the more prevalent use and availability of Narcan have especially helped in the fight to keep county residents alive.

“We’re getting more complete data than previous years,” Borrello noted, which he said also likely means that positive numbers for 2018 are even better since there may have been more reported incidents than in past years with less favorable statistics. “We’re likely getting more reports.”

Borrello said he thinks 2018 was largely a year of information-gathering and focusing on the enforcement and treatment angles. In 2019, he said more plans for education and prevention will follow suit in order to stem the flow of new users. The county executive also thinks young adults and children are more aware of the complexity of opioid abuse and how “just saying no” to drugs on the street is by no means the only way to avoid potential addiction.

“I think more and more people are aware of the addictive nature of these pain medications (doctors) are all too willing to prescribe,” he said. “The long-term solution has been education.”

He recalled the movements of Students Against Drunk Driving and Mothers Against Drunk Driving. Enforcement of DWI has increased over the decades, and smoking cigarettes is no longer seen as a normal, healthy habit as it was a half-century ago. He suggested that something that carries the same marketing weight of Drug Abuse Resistance Education, otherwise known as DARE, should come back to educate the current generation of youth but with an update for the 21st century.

Through all of the perspectives of combating the issue of addiction, Borrello remarked how crucial solid epidemiology has been and thanked Agett during a February CAER meeting for the continuously updated data surrounding the epidemic.

Tom Tarpley, the coordinator of the CAER task force and a retired police officer from Orange County, Calif., thinks the committees have done an exemplary job of trying to manage best strategies for tackling the issues at hand.

“I think that CAER has played a integral role in proving the coordination and communication among the various entities that are working on the drug problem,” Tarpley said.

He called 2018 a watershed year in which all the players collaborated to address the no. 1 concern: “turn those death numbers around.”

With that accomplished, the idea is to continue implementing what has worked through first responders’ and health professionals’ efforts to treat patients who have overdosed. Tarpley said there have been too many stories of families losing loved ones to addiction.

“Ultimately, we don’t want to see anybody dying,” Tarpley said. “We’re happy to see the numbers are going in the right direction.”

He said CAER has put together a model that will address prevention of the issues moving forward. The Chautauqua Alcohol and Substance Abuse Council was referenced as having implemented important programs for local school districts. CASAC’s role in educational outreach is detailed further in another Addicted story.

“A lot of the stories (of students’ drug use) are frankly quite frightening going on in the schools,” Tarpley said. “Ultimately, we want to break the cycle.”

Not just direct drug use and peer pressure are affecting student bodies; Tarpley mentioned that students, who grow up around drug-infused environments with parents who may use drugs, are also exposed to major stressors.

Tarpley said local police chiefs, Chautauqua County Sheriff Jim Quattrone and New York State Police have all “really embraced the CAER initiative.” Another enforcement goal Tarpley has on his mind is the hiring of a potential full-time investigator from District Attorney Patrick Swanson’s office to help prosecute those who peddle illegal drugs.

“People are getting away with murder,” Tarpley said. “I think we need to send the message to drug dealers … you’re going to spend a number of years (in prison). I think (an investigator position) will pay for itself many times over.”

Follow Eric Zavinski at twitter.com/EZavinski

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