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Help available for opioid addiction

News Staff Writer

Note: This article is the second in a two-part series on the opioid crisis and its effect locally. This article deals with the options available for those addicted to opium-based pain medications.

The term “opioids was initially used only in reference to synthetic opiates — drugs created to mirror opium, but chemically different. Now the term is used for the entire family of opiates, including natural, synthetic and semi-synthetic.
Due to a nationwide crisis built on over-prescribing of opium-based pain killers and the addictive powers of the drugs, those who have found themselves in the grip of opioid addiction, as well as chronic pain sufferers who take the drugs as prescribed, are finding it harder and harder to get the medicines they need.
But help in several forms is available for those who are serious about removing the hook opioids has in them.
“People can get help simply by asking, if they truly want to get help,” Escambia County Drug Court Director Denise Carlee said. “They can call the courthouse and speak with me. I am glad to give them phone numbers to different treatment facilities. There are detox centers around to help them come down from their use and then be placed in an in-house facility for long-term treatment for drug dependency. They can also go to the local mental health facility and seek help there.”
Another treatment for opioid addiction comes in the form of Suboxone, itself an opioid that contains two active ingredients, buprenorphine and naloxone. Dr. Sheldon Harigel of Atmore, who established a Suboxone clinic in June, said the drug is highly effective in combating addiction to opioids, though the danger of Suboxone addiction exists.
“Suboxone is an opioid antagonist,” Harigel explained. “It allows the narcotic portion to bind where it’s supposed to in the body while leaving a ‘blocker’ in the system so if people try to abuse other pain medications it essentially has no effect. Suboxone is an opioid narcotic, but completely different from run-of-the-mill pills. It is very effective for pain relief and the cravings that addicts have.
“Suboxone is easier to come off than methadone. It doesn’t give a person that high, the euphoria they are looking for. It’s been very effective in treating opioid addiction, but like anything, it can be abused.”
He said the clinic grew from the death of another local doctor who had been treating addicted individuals.
“To prescribe Suboxone, you have to have a certificate and you have to go through training from the American Board of Addiction Medicine,” Harigel explained. “There are not a lot of people around who are certified to prescribe it. I actually got certified three or four years ago. Dr. [James] Dixon was doing it, and he had a very good patient base. After Dr. Dixon passed, a lot of his patients were either (1) looking for a new doctor, or (2) going back to the streets to get what they could now that Suboxone was not available.”
The local family physician operates the clinic each Saturday, from 8 a.m. until noon at his 402 Medical Park Drive office, just across from Atmore Community Hospital. He said the number of addicts who have sought help has grown exponentially since the clinic opened.
“We started out in June with six to ten patients; now we’re up to forty-five,” he said. “Like with any addiction, if you want to get better, Suboxone is a great medicine. We have a growing clientele, and as far as I can tell, it keeps [addicts] off the streets and keeps them from abusing pain pills. It saves money; it saves marriages.”
Anyone who is struggling with opioid addiction can find out more about the local clinic by calling 368-7974. Harigel added that Atmore Community Hospital also has a detox program.
“Just call the office and ask to speak to someone about the Suboxone clinic,” he said. “I have several nurses who work with that, and any one of them can put you on the right path. Also, there’s a program called New Visions at the hospital that’s an in-patient detoxification program to help people get off opioids, heroin, crack cocaine, alcohol or whatever. It’s been fairly successful.”
To inquire about New Visions, call 368-2500 and ask to speak to someone about the detoxification program.
Methadone and buprenorphine are considered the “gold standard” for treating opioid dependence, but many critics argue that such treatment is not effective enough.
U.S. Secretary of Health and Human Services Tom Price has been a vocal proponent of another drug, Vivitrol, an injectable, extended-release form of Naltrexone, a pure opioid blocker in contrast to buprenorphine, which is a partial opioid, and methadone, classified as a mild opioid.
Perhaps one of the most significant advantages of treatment with Vivitrol is that it removes the risk of developing a secondary addiction to the medications being used to wean people from drugs like heroin or hydrocodone.
But that benefit comes with a high price tag.
According to oceanbreezerecovery.org, an injection of Vivitrol costs $500 for those with Affordable Care Act coverage and more than $1,000 for those covered by private insurance. In comparison, Suboxone costs a little more than $50 for a month’s worth of tablets, and a month’s supply of methadone pills retails for less than $15.
The opioid addiction crisis has forced doctors to employ stricter guidelines when prescribing opium-based pain medicine. That protocol, while limiting the availability of opioids to those who might abuse them, has also made it harder for chronic pain sufferers to get the medications they need.
The husband of one such individual said his wife, who has been taking prescription pain killers for some time, is now treated more like a criminal suspect than a patient when she visits her doctor.
“When she goes in to get her pain meds refilled, it’s like she’s reporting to her probation officer or to drug court,” the man said, who asked not to be identified. “They count her pills to make sure she hasn’t taken more than she’s supposed to, and she has to take a urinalysis or blood test from time to time. Because of the so-called opioid crisis, it’s like pulling teeth for her to get new prescriptions each month. You hear a lot about the opioid crisis but you never hear anything about that.”