by Steve Reinbrecht
I think I finally understand why the Reading Eagle is having
such a hard time telling its readers about how opiate addicts get treatment in
Berks County.
The rest of the world is using medications to treat opiate
addicts.
But the Berks County establishment, which includes conservative
politicians, the newspaper, the Caron Foundation and the generously
public-funded Council on Chemical Abuse [humorously known as COCA], is stuck on
the 12-Step Alcoholics Anonymous model for ending addiction. That works for
drunks, maybe, but not so much for pill poppers.
That means the Eagle can’t search for the truth on the
matter without stepping on important toes.
Since its newsroom noticed that Big Pharm’s drenching of
America in opiate-based painkillers had led to more overdoses, including of white
people, the Reading Eagle has been struggling to tell a story so far from the
sensibilities of newsroom leaders that the results have been troubling.
The Eagle’s 1,700-word, front-page story Sunday is
another example of faulty understanding at the deepest level. The rest of the
world has awoken to the fact that addiction is a health story, not a crime
story.
But Sunday’s story considers the latest, politician-written
chapter in the War on Drugs -- charging heroin dealers as murderers if a
customer ODs. Harsher penalties might assuage our thirst for revenge, but won’t
solve the problem of helping young people recover from some very bad decisions.
We can’t crime-fight our way out of this.
The solution is education to dampen the stigma and then
making sure everyone who needs it can afford treatment. Consider: some
countries provide clean needles, safe places to inject, and uncontaminated heroin to addicts.
Here’s where the Eagle’s troubles start.
I’ve been wondering when our award-winning newspaper would
get to the crux of the issue: Does Berks County have accessible, affordable and
effective treatment options for people addicted to opiates?
The Eagle has had stories about how treatment often fails, and
that Berks County spends astonishingly more on treatment
than any other county, including Philadelphia.
But it has written little about medication-based treatment
as opposed to faith in a “higher power.”
For example, why do we have only one methadone clinic, the one in West Reading? Does
that one clinic meet the needs?
COCA itself reports in its 2015 annual report that “Berks
County’s methadone out-patient clinic [in West Reading] … is at full capacity
serving 300 individuals. The expansion of this program has been prohibited in
part due to local zoning restrictions.”
The Eagle has trouble seeking the truth on the issue because
the Berks treatment scene is dominated by Caron Foundation, outside Wernersville, which prefers to
use a 12-step, Alcoholics Anonymous style treatment regime. I know that can
work – a good friend of mine who was a drunk turned his life around after 30
days in Chit Chat. But he was addicted to beer, not Oxycodone.
Most doctors these days instead support treatment where
addicts take a small maintenance dose of a drug such as methadone or suboxone that
quiets their cravings so they can go to work or take care of their children
instead of breaking into a car to get money for the next fix.
Buprenorphine, the active ingredient in suboxone, significantly
reduces cravings, mortality, blood-borne disease, and illicit drug use. Researchers say users are likely to stay
in treatment longer than those who use abstinence based treatment.
It doesn’t seem to be catching on in Berks. The Berks COCA website
shows no results if you search for “buprenorphine” or “suboxone." COCA’s
2015 annual report shows that only 16 of its 2,741 “treatment episodes” that
year involved buprenorphine. Only about 20 doctors in Berks can prescribe buprenorphine.
Each is limited to 100 addicted patients.
In February, George J. Vogel Jr., COCA’s executive director,
said in the Eagle “that other than methadone, medication-assisted approaches to
treatment were relatively new and unproven.”
Our top county drug-fighting expert is wrong about that.
In fact, buprenorphine was approved in 2002, and the federal
Substance Abuse and Mental Health Services Administration says that “buprenorphine
represents the latest advance in medication-assisted treatment. … When taken as
prescribed, buprenorphine is safe and effective.”
“In
the first clinical trial of a medication that was used for an extended time to
treat opioid addiction in young adults, participants who received counseling
and Suboxone (buprenorphine-naloxone) for 12 weeks had substantially better
outcomes than those who received the standard treatment of short-term
detoxification and counseling.”
But Vogel thinks it’s unproven, and Caron – the treatment
organization outside of Wernersville -- won’t use suboxone.
It’s website says buprenorphine, the main ingredient in
suboxone, is a “a mood altering opioid receptor partial agonist, which has the
potential for abuse and a risk of overdose upon abrupt cessation and relapse on
heroin or opioid analgesics. If a Caron patient refuses Vivitrol and insists
upon Buprenorphine, we make a prompt referral to an appropriate facility and/or
treatment provider.”
In April 2015, the American Medical Association suggested
how getting better treatment is political as well as medical. [Sorry for the long
quote.]
“The regulatory process for becoming a prescriber and the
patient limits serve as barriers to increase capacity to treat opiate addiction
and the availability of suboxone to opiate-addicted patients, particularly
those patients in jurisdictions that have adopted a law enforcement approach
(as opposed to a public health approach) to combat prescription drug abuse.
The advantages of reducing the regulatory burdens to prescribing suboxone would
not only increase the availability of suboxone treatment for patients with
opiate addiction, but would also increase clinical identification, awareness,
and acceptance of opiate addiction as a disease and reduce the stigma
associated with opiate addiction."
[My emphasis.]
The Eagle has barely touched these issues in its tens of
thousands of words of “coverage.”
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