09/18/16 — Heroin crisis -- Treatment: Limited options, increased needs

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Heroin crisis -- Treatment: Limited options, increased needs

By Melinda Harrell
Published in News on September 18, 2016 12:19 AM

George Carr, licensed clinical social worker and therapist at Waynesboro Family Clinic, says it is heartbreaking to tell an addict there are no beds available in a detox facility.

"It is heartbreaking when you have someone in your office that are willing to get help, and you make all these phone calls, and you have to come back out and tell them there are no beds today," he said.

Courtney Boyette, community relations specialist for Eastpointe, which is an organization that provides resource information to those suffering from addictions and mental health issues, said most of the 40,000 calls that Eastpointe's call center receives in its 12-county service area are people seeking detox. She also said Eastpointe's largest provider, PORT Human Services in Kinston, indicates that the majority of the population it sees are heroin and opioid dependent who are "young, in their late teens and early 20s."

She also said the increase in drug abuse among heroin and opioid abusers has led to the decline in immediate and available services.

"Generally what happens, a lot of the calls funnel through Eastpointe, our call center or to our Mobile Crisis or people go to the emergency room seeking detox or they can go to provider agencies like Waynesboro, and they can refer to detoxes, but one of the challenges that we have right now is all the detoxes are full," Ms. Boyette said.

"They are full with waiting lists. It is very challenging. It is sort of like more demand than resources. It is sort of like a bottleneck at times because we are trying to get people at times to use the resources and treatment that they need, but sometimes the detox beds and facilities that they can go are full and sometimes it takes a few days to get in."

Heroin overdose rates have shown a spike in Wayne County.

In April of this year, Wayne Memorial Hospital reported 12 overdose cases in the span of seven days.

When a patient is admitted to the hospital with a heroin overdose naloxone is typically administered, said emergency department Dr. Lloyd Smith.

Naloxone, also called narcan, is a drug that counters the effects of a heroin overdose.

"Patients that come in here are usually not breathing well, and we may have to resuscitate them," he said.

Naloxone has proven to be so important in combating deaths from heroin that the North Carolina General Assembly recently passed legislation allowing anyone the ability to go to a pharmacy and acquire a dose of the drug.

After administering the naloxone, the overdose patient is kept in the hospital until the effects of heroin have worn off and they are summarily released, said Smith.

"We encourage them to follow up at Waynesboro," he said, but the patient is not given any psychological consult or evaluation at the time.

"There is a scarcity in the entire state (for treatment facilities)," Smith said.

Carr said when patients come into the clinic they genuinely want help getting and staying clean.

"There is help out there. Heroin is really hard to kick. There is a lot of physical and psychological dependency. They can try to kick it at home, see one of the psychologists here to get medicine to (alleviate) withdrawal. They can go to detox for seven to 14 days, but they can leave if they choose, there is a methadone clinic that they can go to, there are local physicians that are prescribing buprenorphine (which is a) legal substitute for the heroin," he said.

Carr said education is key in helping someone recover from such a severe addiction.

"The one thing we don't want is for them to give up," he said.

"What I see is a lot of fear. I see a lot of fear. I see a lot of people who try, and it doesn't work out, and then there is a delay between that and trying again. That is kind of where we come in. We are trying to shorten that delay. In this field, we are very much aware there is a high-relapse rate, and it is not uncommon to have multiple attempts at recovery. We are used to that, but we are here to try to shorten the delay in those attempts. I beg people to schedule a follow-up appointment, and you tell me if it is working out."

And though Carr said that outpatient treatment works for some, detox and intensive inpatient treatment may also be the pathway to recovery.

Facilities for that specific type of treatment are in short supply, he said.

"TORSO is a facility in Durham and is voluntary only, and you can stay up to two years there," he said.

"All the other long-term places are further out than that. There is a place between Newton Grove and Dunn called Harvest House, and it is for 28 to 45 days, and we have Angelic House which is a facility for women. We refer people to the N.A. (Narcotics Anonymous) meetings and then here, in our facility, we have a group that meets three times a week that is led by professional counselors as well. It is a group they graduate from. There are a lot of options there is help out there. A lot of times, when people choose to go to detox facility, we have a problem where all four in Eastern North Carolina will all be full and that is starting to happen more than it used to."