Does politics, not medicine, control addiction treatment in Berks County?

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 2008, according to the National Institutes of Health,

“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.” 

How NOT to cover addiction treatment in Berks County

by Steve Reinbrecht

The Reading Eagle tries so hard to look like a real newspaper when it writes about important topics. But the newsroom leadership has so little journalistic know-how that most of its investigative efforts are gibberish.

 An example is the “gotcha” story on the front page Thursday, with a typically meaningless headline, “The silent treatment,” about a drug-treatment lobbying group.

The web headline tries harder: “On drug abuse policy, one group wields enormous clout but is shrouded in mystery.”

But the 1,600-word story about the Drug And Alcohol Service Providers Organization Of Pennsylvania never explains what the damn problem is.

What sneaky behind-the-scenes shenanigans does the Eagle think it has discovered in its self-described “scrutiny of DASPOP”?

What’s an example of the “enormous clout” the group has had? Why not ask Judy Schwank or Tom Caltagirone. And how has that harmed addicts seeking treatment?

The paper quotes lots of people saying opiate-addiction treatment is ineffective. So how is that the DASPOP’s fault? How has the lobbying group detrimentally affected how addicts get treatment? The story never says.

The big claim is that the Eagle can’t get a list of its members.

The story tries hard to justify its existence:

“The identity of DASPOP's membership has taken on greater relevance as Berks County and Pennsylvania struggle to cope with an epidemic of heroin deaths. Many parents, having spent tens of thousands of dollars on drug treatment on children who subsequently return to drug use, view the system that DASPOP appears to represent with skepticism.

" ‘The rehabs are counting on you relapsing," said Cindy Wanamaker, a Chester County resident who has a 28-year-old son with a history of heroin abuse. "I am sorry; they just are.’ "

But the Eagle never says how identifying DASPOP’s members might relate to the epidemic of deaths, or how the system “that DASPOP appears to represent” is letting them down. What’s the “relevance”?

STORY IDEA: If rehabs want victims to relapse, why not investigate the rehabs?

Not one is contacted or even named in this goofy story.

The Eagle lists the sob stories:

“Wanamaker took out a home equity loan to pay the $30,000 bill for her son's stay at a Berks inpatient facility. It was one of at least six rehab stays.

“Rich Gunter of South Heidelberg Township wiped out a retirement account as he and his wife tried to help their son fight heroin addiction. Between multiple rehab stays followed by relapses, wrecked cars and stolen family items, the struggle has cost the family more than $100,000.

“Julie Umstead of Lower Pottsgrove Township estimated she has spent $34,500 on treatment alone for her 20-year-old daughter, including $19,000 out-of-pocket for a stay in a Berks program.

“Coleen Watchorn of Limerick Township said she and her son's father spent more than $50,000 before their son, Stephen Watchorn, died of a heroin overdose in 2012."

But the reporter never identifies any of these ineffective institutions, much less calls them to ask about the accusations. Is the policy not to embarrass any advertisers or prospective advertisers?

Or maybe he asked, but the families forgot.

“She [Watchorn] said, ‘I can't even remember all of the treatment facilities he went to.’ "

Why not investigate treatment in Berks County?

Here are some basic questions. I’m sure COCA has these answers at its figurative fingertips.

• How many people need treatment for opiate addiction in Berks?
• What exactly happens to addicts when they call a hotline? What steps would they follow to get treated and how does that work in reality?
• What do police do when they make an arrest for opiate related crime? Is treatment offered?
• What happens to an addict suffering withdrawal who appears at one of the hospital emergency rooms? Are they offered treatment?

The Eagle ran a story about a family apparently turned away from “the hospital,” again not identified. Why not look into this?

Thursday's front-page story is a waste of ink and pixels. How about educating us on the mayoral election, or where Reading’s community development money goes, or what happens to the houses on the city’s blighted-house list?

Reading Eagle should follow up on hospital turning away drug addict

by Steve Reinbrecht

The Reading Eagle has pursued prize-winningish reporting on the “scourge” of opiate abuse in Berks County.

But it hasn’t much reported on the treatment options.

It did tell Sunday about the outrage of a Brecknock Township woman who ended up sending her son to California for detox:

“They went to the hospital seeking treatment but were turned away empty-handed to find resources on their own.”

Never concerned with precision, the Reading Eagle doesn’t say if they went to Reading Hospital or St. Joseph’s.

The paper could follow up – what are the treatment options for addicts?

I suspect they are embarrassingly meager in Berks, hence the lack of reporting, because the Eagle would rather avoid embarrassing the Establishment than get at the truth.

There is one methadone center, in West Reading. Others have been proposed, most recently in Caernarvon Township, but opposed by officials swayed by NIMBY complaints.

It’s great to publish sensational horror stories about good children gone bad. 


But now for the real journalistic effort – what’s being done? how is the community helping those who have the disease?

The Eagle could ask the methadone center director: if everyone addicted to opiates in Berks County asked for help, are enough resources available?

That’s what National Public Radio asked Michael Botticelli, director of National Drug Control Policy, in August. 

NPR: “If half the heroin or opioid addicts in the 15 states in this program all wanted treatment, would there be sufficient programs and facilities to handle them?”

Botticelli: “Many of our treatment systems are operating at capacity, have long waiting lists. Many parts of the country don't have a specialty treatment program, but they do have a community health center. So focusing on increasing the capacity within our hospital systems and primary care facilities becomes really important for us.”

So how are Berks County’s health officials planning to focus on increasing the capacity of the hospital systems and two community health centers in Reading?

What do the two hospitals do for emerging addicts?

The paper reports on a Council on Chemical Abuse event:

“The workshop series focused on education about drugs, the disease of addiction, proper intervention strategies and how the community can help not only individuals struggling with addition, but also their families.”

What about practical information on treatment? Recovering takes months of intense support. 
Who offers that in Berks?

What is the process after you call Reading Health System 24 Hour Addiction Hotline -- (484) 628-8186?

Caron, the rehab center near Wernersville, said in February that it was offering $250,000 to $300,000 in scholarship money a month to admit and treat young heroin addicts.

How many are using the money?