Originally published in Island Ad-Vantages, October 25, 2018
In opiate treatment’s ‘complicated landscape,’ options exist
by Anne Berleant
Treatment of opiate addiction is not one size fits all, and a panel of experts discussed the hows and whys October 18 at the Reach Performing Arts Center, hosted by Opiate-Free Island Partnership.
“It’s a very complicated landscape,” OFIP co-chairman Charlie Osborn said.
Maine is among the top 10 states with the highest rates of opioid-related deaths, according to the National Institute on Drug Abuse. In 2016, there were 301 opioid-related overdose deaths in Maine—a rate of 25.2 deaths per 100,000 persons and nearly double the national rate of 13.3 deaths per 100,000. And, the number of heroin overdose deaths quadrupled between 2012 and 2016, according to the Maine Department of Health and Human Services.
“This is like a major plane crash on a daily basis,” panel facilitator Dr. Dan Johnson, Executive Director of Acadia Family Center in Southwest Harbor, said to the nearly 50 attendees.
“Opiate use disorder” is the medical diagnosis for what Johnson said is a chronic disease, a neurological disorder affecting the brain’s circuitry. “Like other chronic diseases, it needs to be managed,” he said, but unlike cancer or diabetes, opiate use disorder is compounded by stigma and shame.
OFIP now offers a free, confidential consultation with a licensed drug and alcohol counselor for any island resident, “to help figure out the next step,” Osborn announced. To schedule a confidential visit, contact Debra Matteson at 367-5850 or firstname.lastname@example.org.
The local treatment landscape
Dr. Michael Murnik, chief medical officer for Northern Light Blue Hill and Maine Coast hospitals, helped bring the “hub-and-spoke” model to Hancock County. “We try to meet [clients] where they are” he said, with medication-assisted treatment and counseling, a combination that “is the best evidenced based treatment.” A client is stabilized through three to four months of outpatient services through the “hub,” the Downeast Treatment Center in Ellsworth that includes Suboxone, which manages the withdrawal symptoms from opiates. The client then is referred to the “spoke,” a primary care physician. It is not always a one-way path, with clients referred back to the “hub,” if needed.
“This is a chronic, relapsing disease,” Murnik said. “We expect people to fall off the wagon.”
Groups, Inc., located in Ellsworth, offers substance abuse counseling and Suboxone prescriptions with an “empowerment philosophy,” clinic coordinator and counselor Joan Piskura said, working to reconnect a client with family and outside services such as 12-step groups and recovery coaches.
Northern Light Acadia Hospital in Bangor approaches treatment from a “harm reduction standpoint,” narcotics treatment program clinician Courtney Evans said, working first to stop opiate use, and not requiring abstinence from substances like marijuana. Daily methadone and Suboxone treatment is combined with alcohol and drug counselors and mental health practitioners on staff. Evans said a person who has been addicted to opiates for four to six years will spend two to five years in the medication-assisted program, with a 60 to 80 percent success rate.
Open Door Recovery Center in Ellsworth offers an intensive outpatient program of three mornings per week, with medication treatment and individual and group counseling. Its three-month program also requires regular attendance at Alcoholics Anonymous and/or Narcotics Anonymous meetings. Open Door also operates the residential Hill House, where mothers in treatment can stay with their young children.
One panelist credited Open Door and Hill House, in part, with her successful recovery: “The tools and support they offer completely changed my life.”
Nick, a second panelist in recovery, is tapering off Suboxone after four years of medical use. “I’m one of the lucky ones, he said, “[but] I have to be vigilant the rest of my life.”
All of the above medication-based programs require drug testing during treatment, accept insurance and have sliding scales for fees with the low end at zero cost in some instances.
“Treatment is a very short amount of time if you look at the picture of an entire life,” Open Door LDAC Jessica Oakes said.
Irene Laney, an LDAC in Ellsworth involved with Downeast Treatment Center and Ellsworth Police Department’s Project Hope, said she addresses the spiritual side of recovery with her clients, noting that “pathways back to relapse” are largely unconscious.
Our substance of choice was our answer for everything,” she said.
On the island, Debra Matteson, Recovery Coach Coordinator, and Maryann Ogonowski, founder of Friends and Family Group, which meets Tuesdays at the Deer Isle Town Hall, served as local voices on the panel.
“Addiction is a family disease. One person may use but the whole family suffers,” Ogonowski said.
Matteson, who coordinates Healthy Acadia’s Recovery Coach program, discussed how a recovery coach helps people with housing, legal issues, to stabilize day-to-day life issues, and to “realize that living a life without substances can be joyful.” Her position is funded by OFIP.
Since forming in late 2016, OFIP has raised money and awareness to address opiate abuse and addiction on the island. Island Health and Wellness Foundation, the Deer Isle-Stonington School District and the towns of Deer Isle and Stonington have all contributed towards funding education, treatment, and volunteer efforts.
Editors Note: Per a request from event organizers, photographs were not allowed to be taken to maintain the privacy of those panelists in recovery.