Valley General Hospital in Monroe is increasing their addiction-related medical services in hopes of enabling more patients to achieve long-term sobriety.
In addition to increasing capacity in their acute medical detoxification program, as of August 1, they reinstated their state-funded treatment program for pregnant women. The Chemically Using Pregnant program, also known as CUP, is a 26-day inpatient treatment program that is available to women who do not have health insurance.
Recovery Center Program Manager David Anderson shared that the detox facility has been ramping up ever since it opened in August of 2013, and now will be able to accommodate more patients.
“We started off with four beds and we got a license for eight,” said Anderson. “So now we’re looking to expand because the demand has been high.”
The detoxification facility has contracted with most insurance companies, but is unable to accept Medicaid coverage like Washington Apple Health. The CUP program, however, is available to provide treatment to uninsured pregnant women provided they are eligible for Title XIX medical coupons.
The detoxification program provides medically-supervised detoxification services to patients undergoing acute symptoms from either opiate or alcohol withdrawal. Benzodiazepine withdrawal is also treated, which includes withdrawal from medications like Valium, Xanax and Klonopin.
A medically-supervised detoxification program is often necessary for patients with substance abuse issues prior to them being able to function and participate in a residential treatment program. Some residential treatment programs will not take patients who have not been through a medical detox.
During the detoxification process, medications are used to stabilize the patient and to help them manage the withdrawal symptoms more effectively. Certain types of withdrawal, particularly from alcohol or benzodiazepines, can be extremely serious, even life-threatening.
Opiate withdrawal, while intensely uncomfortable for the patient, is generally not life-threatening.
Medical Director Dr. John Patz is an addiction specialist who has been treating substance abuse disorder patients since 2003. In addition to advocating for 12-step recovery programs, Patz also supports the use of abstinence-promoting medications like Suboxone and Naltrexone, particularly when treating patients who are addicted to opiates.
“Our approach to opioids is not just detoxification,” said Patz. “We consult regarding abstinence medications and if it makes sense to put someone on Suboxone, we will.”
Patz confirmed that the subject of medically-assisted recovery is controversial. Some treatment facilities and chemical dependency specialists are opposed to utilizing substances like Suboxone to help patients stay sober, particularly on a long-term basis. On one side of the issue is the fact that many substance abuse patients can lead productive lives while taking medications like Suboxone. On the other hand, some professionals take issue with the fact that, regardless of their productivity, the patient is still dependent on a particular substance which needs to be ingested on a daily basis.
Patz shared that the statistics regarding substance abuse are grim.
“If we look at abstinence rates from alcoholism, best I can tell it’s about 40 percent. If we look at abstinence rates from opiate dependency, best I can tell it’s about 20 percent,” said Patz. “Medically the question that occurs to me is; what’s the difference? Why are the numbers so much poorer for opiate dependence than for alcoholism?”
Patz also explained that in addition to a bleak 20 percent remission rate, opiate dependency drastically reduces life-expectancy by about a third.
“From a public health standpoint, that’s a rather nasty disease,” said Patz. “The question becomes; is there medication that we can use to improve that sort of sobriety rate?”
The medication Suboxone is primarily composed of two opioid dependency medications called buprenorphine and naloxone. Essentially, the drug is able to prevent withdrawal symptoms in patients who stop taking opiates by binding to the opiate receptors in the patient’s brain. This means they get relief from withdrawal symptoms without any of the euphoria normally associated with opioids like heroin and narcotic painkillers.
Naltrexone, another pharmaceutical option provided at Valley General, is in the same class of drugs as naloxone, which is also known as Narcan. It can be used to help patients cope with alcohol cravings, and will block the effects of opiate medications so that, if the patient takes an opiate, no euphoric feelings are produced.
Patz explained that medications like Suboxone and Naltrexone can be effective tools when used to manage a patient’s opiate dependency, particularly when combined with a personal 12-step recovery program.
“In my observation the people who don’t do that, who don’t work a personal recovery program, sooner or later, they fail,” said Patz.
Patz has watched a progression of drug abuse since his work in addiction began over 10 years ago. At the time, OxyContin, a time-released formulation of the pain medication oxycodone, became so highly abused that the drug companies began seeking ways to create abuse-deterrent formulations of the drug.
The new formulation came out about four years ago and according to the National Institute of Health, the number of abuse related deaths has gone down as a result.
But while they succeeded in producing medication that couldn’t be crushed, dissolved or injected, what this did in some cases was drive addicted individuals to seeking an alternate means of getting what they needed. In many cases this turned out to be heroin.
“There’s no quality control with heroin,” said Patz. “It’s a nasty thing.”
To Patz, the positive aspects of long-term, medically-assisted sobriety begin to outweigh the negative. He shared that, if he were treating any other disease, such as diabetes or high blood pressure; there wouldn’t be this tremendous emphasis on minimizing or ceasing the patient’s dose.
“We don’t do that to people with other diseases,” said Patz. “So why should we do it to people with opiate dependency?”
For more information on the Valley General Recovery Center, the detoxification facility and the CUP program, please visit the website: http://www.valleygeneral.com/services/Chemical_Dependency.asp.