Treatment options emerge as national crisis spurs teamwork

July 02--CUMBERLAND -- Although combating the opioid epidemic seems hopeless at times, much has been done to develop programs to reduce the scope of the problem.

More eyes than ever before are examining the opioid problem, which began sweeping the nation nearly a decade ago. Community leaders and activists, law enforcement, health professionals, government officials and educators have all stepped up to study and monitor the crisis.

In late 2016, a comprehensive study, "A Joint Report on the Opioid Epidemic: A Prescription for Action," took a look at the problem nationwide. The 52-page report was the product of a joint task force created by the National League of Cities and the National Association of Counties.

Some of the basic ideas, widely agreed upon, included convening community leaders, fostering regional cooperation, advocating at the state and federal level and monitoring progress. Officials also call for an increase in drug abuse prevention education for elementary school-age children through the college level.

Officials agree there is not a simple solution to a multi-faceted problem like the opioid crisis. However, the report highlights several programs that have been developed across the country that are experiencing success in addressing some portion of the problem.

The programs address a wide range of issues from the street-level addict and associated crime to doctor shopping and prescription abuse.

In Erie County, Pennsylvania, the Hidden in Plain Site program includes an "open-bedroom" display, including furniture, which is set up in public places such as malls. Parents and others visiting the display are shown where children can hide drugs and paraphernalia. The program also includes information on the symptoms and behaviors associated with drug abuse.

In High Point, North Carolina, officials are combating overt, open-air drug markets. The program calls for the arrest of dealers and violent offenders. A bank of (suspended) cases for non-violent offenders has also been created.

Law enforcement and health officials involved with the program meet with offenders, families, neighbors and treatment professionals to make it clear that the dealing will stop. The goal of the program is to return the quality of life to the neighborhoods.

In Kings County, Washington, a program known as LEAD (Law Enforcement Assisted Diversion) was created in 2011. The program addresses low-level drug and prostitution crime in targeted areas. A coalition of law enforcement, private and public health officials and community stakeholders was convened. The program's goals are to improve public safety and public order and to reduce the criminal behavior patterns of people who participate in the program.

LEAD is a voluntary pre-booking diversion program that empowers street-level public safety personnel to make decisions about arrests. Rather than moving people with substance abuse problems into the criminal justice system, LEAD participants begin working immediately with case managers and social workers. In addition, LEAD participants have access to trained clinicians who specialize in medication-assisted treatments and have been the key providers in the region for street-level outreach.

Treatment services may include substance abuse treatment, mental health support, housing options and job training. LEAD has been independently evaluated by researchers from the University of Washington. They find that the program reduces recidivism significantly among participants and reduces criminal justice spending. The program has out-performed control groups from non-participants of the LEAD program.

The goal of many of the new programs is to divert non-violent drug offenders from jail to the appropriate treatment program.

Other methods of controlling the problem include making the opioid-reversing agent naloxone more widely available.

In Ocean County, New Jersey, a "Recovery Coach Program" has been introduced for those revived by naloxone. The voluntary program offers a recovery coach to guide addicts through recovery. The coaches are often former addicts. The eight-week program is free or subsidized for the addict.

Many state and institutions are adopting perscription drug monitoring programs. The programs review length of prescriptions and what opiates are prescribed for.

In Colorado, several hospitals have launched a program to reduce the number of opioid prescriptions and the dosage. The programs places comprehensive guidelines for narcotic medications for specific illness and the accompanying prescriptions. The program also allows doctors to put addicts on medications, like buphonriene or methadone, right away. A survey of addicts in Colorado said it was the most effective way to treat the problem.

Officials in Maryland tried to place a seven-day limit on narcotic prescriptions. However, the legislature changed the guideline to the "lowest effective dose."

Florida, which was known as the pill mill capital of the U.S., has developed strict new laws. The state was dotted with pain management clinics. Gov. Rick Scott closed 400 pain clinics virtually overnight. Also passed were laws holding pharmacies legally accountable for ensuring the drugs are used for legitiamate medical purposes.

The policy is designed to add another check in the process of preventing drug abuse and diversion. It places pharmacists in the unwarranted position of policing doctors and discriminating against patients when red flags are noticed such as paying cash for prescriptions.

The net effect of the crackdown in Florida was profound and acute. Prescription drug deaths dropped precipitously within the first year, but heroin deaths rose 39 percent, as patients cut off from legal opioids turned to illegal drugs for relief.

Another effort in parts of the country has been the "Ban the Box" movement. This effort calls for the removal of the box on a job application that must be checked if the applicant has been convicted of a crime. The city of Tallahassee, Florida, adopted an application that removed the box.

The goal is to not prevent potential employers from knowing if the applicant has a record, but to delay that question until later in the application and interview process, giving those with a record a better chance to be hired.

Safe needle drop-off sites or pickups are also gaining popularity. Barriers are also being removed to give drug addicts access to clean syringes.

Officials also want treatment available for addicts that are placed into custody. Access to treatment in jail can give the addict a better chance for success.

Officials are also hoping for an expansion of Medicaid treatment for addicts until they are sentenced.

Follow staff writer Greg Larry on Twitter @GregLarryCTN.

___

(c)2017 the Cumberland Times News (Cumberland, Md.)

Visit the Cumberland Times News (Cumberland, Md.) at times-news.com

Distributed by Tribune Content Agency, LLC.