As opiate abuse disorders and related deaths continue to rise throughout the nation, administrators at Grays Harbor Community Hospital in Aberdeen are asking what’s being doing locally to address the epidemic.
Bill Bonnes, Director of Behavioral Health told the Public Hospital District’s board of directors at their meeting yesterday. “In 2016 we had anywhere from 22 to 30 opiate-related deaths in our county, in 2015 he [Grays Harbor County Coroner Lane Youmans] reported 12 to 18.”
The Washington State Department of Health reported more than 700 opiate-related deaths last year, Nationally the New York Times said opiates claimed 33,000 people in 2016. By contrast, 2016 was reported to be the deadliest year on American roads in over a decade. The National Safety Council estimated as many as 40,000 died in motor vehicle crashes last year.
Dr. Bruce Worth began the chemical dependency program in Grays Harbor over 30 years ago which became Harborcrest Behavioral Health. He told the board yesterday, “Opioids are different than alcohol in the sense that with alcohol; 12-step programs really work pretty well. They have not worked really well at all by themselves for treating opioid-dependent people.” He said 60-70% of those who complete an alcohol treatment program will stay sober within a year, that number is closer to 1 or 2% with opiates.
Many opiate drugs are legal prescription painkillers like Codeine, Vicodin, Oxycontin, fentanyl, and hydrocodone.
Dr. Worth said that Methadone, a synthetic opioid antagonist, became the standard treatment method, however, it has its own potential for abuse and overdose.
The drug buprenorphine was approved for treatment in 2000 and works a little like methadone. It’s an opioid partial agonist, meaning it produces similar – weaker effects than heroin or even methadone, it also has a plateau effect which deters abuse.
Dr. Worth noted that even a successful buprenorphine treatment requires follow-up care for a lifetime. “You know when I tell people that a lot of them go ‘we gosh can’t you get them off of the medication?’ and the answer is the same thing happens, generally, when you try to get them off of methadone and that is that they relapse.”
Dr. Worth continued, “Even though they’re incredibly productive it’s like we have this little voice in the back of our heads that says ‘you could just do it one more time’ and as long as they’re taking a suppressive dose of buprenorphine that little voice is not there. But when they stop doing that – no matter how well their life is going, the answer is they tend to relapse.”
Locally, Dr. Bonnes said Harborcrest provides in-patient treatment programs for about 600 patients per year, and their 4-week outpatient program sees about 12 patients daily. Dr. Worth said that usually about half of their patients are pregnant, “we are one of the three programs in the state of Washington that take care of chemically-dependant pregnant women, and most of those are opioid-dependent.” Dr. Bonnes added that the babies are not born addicted and do not go through withdrawals at birth.
Harborcrest is organizing and plans to release more details soon on an opiate symposium in November to train or update training for all first responders in the county.