Drug abuse is a serious problem in Brown County. It comes as no shock to anyone at this point that as a society, we have a problem. Brown County leads the state of Ohio in heroin overdose deaths. Weekly in the paper drugs capture the headlines and everyone’s attention, but according to the Direction of Mental Health and Addiction Services for Brown County Deanna Vietze there is light at the end of the tunnel.
Drug addiction comes with a stigma attached to it. “Junkie” has become the phrase attached to someone who suffers from addiction and Vietze said that is part of the problem. She said addiction is much like other diseases people are faced with each and everyday. When comparing drug addiction to someone having type II diabetes there are many similar factors. Type II diabetes is generally caused by lifestyle factors of people predisposed to the condition. An obese person who develops diabetes is no different that a person who develops an addiction, the difference becomes the stigma associated with the disease. However, not everyone who develops type II diabetes is a result of lifestyle choices. But if a person is known to be borderline diabetic, they can make lifestyle changes and not develop the disease. However, if the person quits those changes, they disease will take over the body. It is very similar to someone recovering from drug addiction. If they stop using and change their lifestyle, they can live a full functioning life. If they return to drug use, the results can be catastrophic or even fatal.
According to Vietze, people seeking treatment for drug abuse have intensive outpatient treatment, individual treatment with a counselor, and medicated assisted treatment in Brown County.
The medicated assisted treatment may be the best option for Brown County. The drug is called Vivitrol, and it helps fight opiate addiction by blocking the euphoric effects of heroin. The treatment is a once per month injection that can keep a user off because it does not lead to the ‘high’ feeling according to Vietze.
“It was initially designed for to treat alcohol uptake, but then they realized it could be used to fight opiates,” Vietze said. “Medicated assisted treatment is the ‘gold star’ treatment so to speak. The say without a MATs treatment the likelihood of recovery is very slim. The other MATs treatment is Suboxone, but we don’t have that in the county. However, we can refer to agencies that do.”
Vietze said Suboxone treatment is worrisome to a lot of people because it carries a street value. Why Vivitrol blocks the high, Suboxone works as a replacement for the high and gives the user a high feeling with limited risk. Research suggest Suboxone may be as addicting as heroin when abused for prolonged periods of time, but Vivitrol comes with much less risk.
While Vivitrol is a safer alternative, not everyone is eligible to use the drug for treatment. Vietze said a person has to have a healthy liver in order to be eligible. A person who has uncontrolled Hepatitis C, cirrhosis of the liver, or other damaging disease might not have the option for Vivitrol.
“You can still have Hepatitis C, if it’s under control, and still take the injection,” Vietze said. “You have to do a pretty extensive liver panel and the doctor makes the decision. If it is decided that that’s not an option, then the can be referred somewhere else. I am working with Talbert House to make Suboxone available to those folks who are committed to doing something, but not widespread to anyone.”
While Vivitrol has been available for the last three years, maybe seeking help do not take advantage of the treatment option. The option comes with a major string attached to begin treatment. The person has to be clean when the treatment starts.
“You have to be clean 7-14 days before taking it and I think that freaks a lot of people out,” Vietze said. “They cannot commit to not using or they get right to the cusp of the injection and then they go an use and you can’t have it if you are dirty at the time.”
Vietzes also said that some suggest the lack of use of Vivitrol is because it is a monthly injection and not a daily pill or injection. She said since a lot of users become so used to taking something daily or shooting up daily that mentally, they do not think the treatment is working. Another problem for Vivitrol treatment comes if the user stops treatment of Vivitrol and the opiate high is no longer blocked, a person body is not used to high amounts of heroin and overdoses occur, much the same as a user who has spent time in jail and continues to use upon release.
Treatment options instead of jail time is something Mental Health and Addiction services are working toward at the misdemeanor level of the court. Vietze said they had been working with Municipal Court Judge Joe Worley for a long time to get an option in place for someone to seek treatment rather than jail time. Vietze hopes the treatment option will be successful and move into the felony side at Common Pleas Court. The treatment option would be up to both the criminal and the judge as to who is eligible. According to the Prosecutor’s Office, a majority of low-level crimes in the county can be traced back to drug use and abuse, not every drug user is a criminal.
The biggest concern for anyone facing an addiction may be the cost of the treatment. According to Vietze, Vivitrol is medicaid eligible and for those not on medicaid, Mental Health and Addiction Services picks up the tab for a lot individuals seeking treatment.
“The Board covers indigent folks, those who fall into the category, and honestly a majority of Brown County folks,” Vietze said.”I hesitate to say this, but a lot are covered by Medicaid and Medicaid pays for Vivitrol and treatment stuff. If they fall in the gap of uncovered then State and Federal Funds help pay for that. One of our jobs is to contract for services for those folks through providers, here Talbert House of Brown County Recovery are our agency. They have a sliding fee scale. For example someone works a little bit but does not enough money, we look where they fall and they pay for example 10 percent and we cover indigent totally as well 100 percent for some. Money should not be a factor.”
While Vivitrol seems like the easiest option, it is not a cure all for the disease. A person still has to want to recover. Vietze said all of the treatment in the world would not help someone if they did not want to recover from the disease. She also said ending the stigma attached to mental health and addiction would put everyone on the right road to overcoming this public health crisis. Vietze will continue to work with the Coalition for a Drug Free Brown County to help fight the disease and stigma that is burdensome on an entire system . Addiction put burdens of everything from the court, the jail, prosecutor’s office, the schools, and everything in between. Billions of tax dollars go to fight the disease annually. Vietze said with encouragement and treatment recovery is possible and is hopeful of all the work everyone is putting forth to make it happen. She said it won’t happen overnight, but together, we can change the stigma and make it work.
Vietze said she has a phrase she likes to use when talking about addiction – she said she always says “recovery is beautiful.”