Opioid replacement drugs out of reach for many in upstate

Link to original: http://wrvo.org/post/opioid-replacement-drugs-out-reach-many-upstate#stream/0

  APR 25, 2016

When Melissa Ives was recovering from a brutal motorcycle accident, the opioid medication she was prescribed helped mask the pain. But eventually, those pills ran out so she turned to a cheaper alternative – heroin.

“I was addicted for five years,” Ives said. “I could do up to 40 bags a day of heroin and it’s just a miracle I’m not dead. I am grateful to be walking and talking.”

Ives, who lives in Fulton, attributes her recovery to the treatment she received in  Syracuse, where many drug abusers in central New York turn because there are few clinics in the area with comparable services.

One of those detoxification clinics is at Crouse Hospital, where they offer an opioid replacement called methadone. It’s administered daily under the supervision of health professionals. The hospital’s chemical dependency treatment director Monika Taylor said people from 17 counties in central New York travel to Crouse to get the daily dosage.

“Right now, we have a wait list of about 380 patients for this particular treatment,” Taylor said. “So, for the methadone program there is probably at this point a 9-12 month wait before somebody can get admitted.”

Taylor said this is not your typical wait list.

“There are definitely people that are continuing to use while they are out there waiting to get into the program and we have heard of people dying that are on the wait list.”

Conifer Park in Liverpool started sharing some of that load this month with their new methadone program, which will help alleviate the crushing demand. Conifer Park’s director of regional services Mike Kettle said Crouse and others were supportive of their efforts.

“This is something we saw a great need for, we got support from the state and the community and I truly do believe today we are going to be saving lives,” Kettle said.

Even with the two methadone clinics in Onondaga County, only 10 of the state’s 95 methadone clinics are located in upstate. That can mean long commutes for people in the 42 counties that don’t have a methadone clinic.

Federal officials are trying to expand access to another opioid replacement drug called Suboxone, which can be taken at home. But eligible doctors are currently allowed to prescribe Suboxone for only 100 patients a year. Mark Stevens, whose son was once an addict, said that’s not enough in rural areas like Oswego County where only three doctors can prescribe the drug.

“If each doctor only gives a hundred, that’s 300 people in this huge community – Oswego County,” Stevens said. “300 people, that’s all they can take care of? There’s more than 300 addicts out there.”

The U.S. Department of Health is currently in the process of raising the limit of suboxone prescriptions to 200 per year. And, central New York Congressman John Katko (R-Camillus) and Sen. Kirsten Gillibrand (D-NY) have proposed a bill that would allow eligible doctors to prescribe an unlimited amount. Still, Stevens said Suboxone is only part of the answer.

“Some of these doctors that give the Suboxone keep them on it for so many years,” Stevens. “If you find a facility that will wean them off it, then they get the proper health and then educate them and keep them going.”

Those ancillary services like therapy and counseling, which are part of a holistic recovery, are also struggling to keep up with the spike in drug abuse.

Editor’s note:

Susan Craig with the New York Office of Alcoholism and Substance Abuse services (OASAS) said the state is working to treat the abuse epidemic by expanding access to buprenorphine, opioid drug replacements, and other treatment services.

“The New York State Office of Alcoholism and Substance Abuse Services (OASAS) has been actively engaged in adding more than 2,000 opioid treatment slots to its system of care, mostly in upstate NY,” Craig said in an email. “In addition, OASAS has made it possible for current opioid treatment providers to request an increase in their treatment capacity limits. Additionally, prescribers of buprenorphine in OASAS-certified opioid treatment programs are allowed to treat an unlimited number of patients, so OASAS is encouraging New Yorkers interested in buprenorphine treatment to ask their opioid treatment provider about this treatment option.”

Craig said people can find inpatient treatment services available in real time at its bed availability dashboard.