May 28, 2015

Manchin: Addiction response needed | Herald Dispatch

HUNTINGTON - "Changes have to come. We can't keep doing what we're doing."

Those were the words of U.S. Sen. Joe Manchin, D-W.Va., during a public forum hosted Wednesday by Huntington Mayor Steve Williams to bring federal officials into the community discussion on steps to address the drug addiction epidemic.

Manchin and U.S. District Attorney Booth Goodwin joined a panel of experts representing the fields of addiction recovery, prevention, pharmacies, churches and schools, as well as a group of law enforcement officials active in the fight against substance abuse.

Manchin sought input about what's working and not working. Panelists and audience members discussed efforts already underway, as well as bringing attention to issues that could be addressed at the federal level to help curb addiction in a county that has seen more than 300 overdoses this year, at least 30 resulting in death.

"What you see here is why Huntington is a model in this fight," Goodwin said. People are working hard to reduce the supply of drugs and to reduce demand for drugs, and it's going to take both working closely together to succeed, he said.

When you look at the globe, there are no other countries that can take on the United States in terms of its military or its economy, Manchin said. They're simply waiting for Americans to destroy themselves from within, and he's seeing it in his own state.

"They believe we will not have a workforce with the skill sets or that's clean enough to perform to keep us a superpower, and if we don't turn this around now, we could have a serious problem," Manchin said. "This is of epidemic proportion. There's not one of you in this room that hasn't had somebody who's in your family or extended family or a close friend affected. I have."

In West Virginia, the largest killer is legal substances you can find in your medicine cabinet, Manchin said.

"You want to clean up your neighborhood? Say something. Get involved," he said. "Don't sit back and wait for somebody else. People say, 'I don't want to make a phone call. That might cause a problem.' You (already have) a problem."

In terms of the justice system, one order of business is new sentencing guidelines, he said.

"We've been putting them away for 20-30 years," he said. "Guess what, 20 years later, all we're doing is building jails. We're not giving any money for rehab.

"...You put away a first offense felony, they're done. They can't get a job, and if they do, it's minimum wage. It's awful what we're doing. Now there's a lot of people who deserve not to be in the jail, but under the jail. I'm the first to tell you that. But do we have enough sense and compassion to save a human being before we put them down the path where they're unsavable?"

Audience members discussed a slew of issues relating to substance abuse. Michelle Perdue of the Cabell County Substance Abuse Prevention Partnership reported how 200 Cabell County students are actively working on drug prevention in their schools. West Virginia Delegate Don Perdue, D-Wayne, suggested adding resources so that teens in recovery, perhaps from other regions, could travel here and talk to students locally as well. The programs are "recovery high schools," he said, and they're valuable because kids are far more likely to listen to other kids.

"We're nibbling at the tip of this iceberg here," he said.

Audience member Brad Barnett, who is in long-term addiction recovery and now works in the recovery field at the Logan-Mingo Area Mental Health Center, said he began using drugs when he worked in a pharmacy and had easy access. Over the course of 11 years, he got to the point where he was taking 150 pills a day. He said he believes the length of time in treatment is directly related to a person's success, and he said addicts cannot be seen as inherently evil but as human beings with a brain disease and an inability to cope. He said consequences finally made him change.

Dr. Lana Davenport, a psychiatrist who treats patients with addiction at Mildred Mitchell-Bateman Hospital, said she thinks more education is needed about the potential benefits of Suboxone, or buprenorphine. She acknowledged that it's sold on the street, but that it can be a useful tool to help some patients beat opiate addiction and live a productive life.

Tim Weber, director of pharmacy operations for Fruth, suggested that practitioners involve the pharmacies more in the prescribing of buprenorphine, because as pharmacists, it's tricky to determine which purchases are legitimate and which are for illegal purposes.

Dr. Kevin Yingling, dean of the Marshall University School of Pharmacy, also cautioned that patients need to eventually be weaned from buprenorphine.

"There has to be a pathway from the hidden culture away from that," he said. "There's either going to be abstinence or (medication like Suboxone). One caveat is that there has to be an end point for that."

West Virginia Delegate Dr. Matt Rorbach, R-Cabell, talked about a statewide pilot program in which addicts in the criminal justice system would get linked with a health care provider who would administer monthly injections of naltrexone or Vivitrol, a non-addictive drug that blocks the effects of opiates and decreases dependency. Participants would also receive therapy and other supports.

Others at the meeting talked about the importance of kindness toward addicts, so they feel safe about reaching out for help and find the right network of people to keep them on the right path.

The Rev. Sam Moore of Full Gospel Assembly, a former educator in Cabell County Schools, talked about a young drug user he once approached, telling her that when she needed help, he was there. Years later, she sought him out when she was in the hospital, based on that one conversation. He said she has since fallen back into addiction, but it's important to be open to helping people.

"We have to have a comfortable relationship with people," he said. "We have to support them and have them in the right company. We have to create success opportunities for people."

Goodwin mentioned the pilot program, Handle with Care, that is in target schools in Kanawha and Cabell counties. These programs facilitate communication between law enforcement and schools, so that children whose family members were arrested or involved in a crime-related situation the previous day are treated with a little more patience, care and understanding at school. That might mean counseling, a little extra time for their homework, or even a chance to take a nap in the nurses' station, Goodwin said. The path to addiction and crime can start young, he said. He once asked inmates in Raleigh County when they started heading down the wrong path, and many said between age 7 and 9, he said.

Registered nurse Sara Murray works at Lily's Place, which treats newborns that were born with addiction after being in the womb of drug-addicted mothers and provides education and support services for the mothers. She voiced concerns about sending babies home into drug-riddled families after hearing a statistic that eight in 10 children raised in drug-using families become drug users themselves.

"I wake up worrying about those babies, and I go to sleep worrying about those babies," she said.

Karen Yost, CEO of Prestera Center, discussed the challenge of meeting all the needs with decreasing government funds, reimbursement rates that never go up, a stifling regulatory environment and the high cost of bricks and mortar.

"Every day, we're trying to serve more with less," she said.

Mary Calhoun Brown, a co-founder of Lily's Place, echoed Yost's concerns about serving people quickly in a "regulatory nightmare" and finding enough resources.

"We rely on community donations, and we have an impoverished community," Brown said. "So it's hard to sustain something that's incredible and new. We're a model for eight other states that want to do what we're doing because we do it inexpensively." 

Several other concerns were mentioned as well, from stricter sentencing for sellers and abusers who cause harm to others, to making Neurontin a schedule II drug, to making peer recovery services reimbursable by Medicaid, and others. Matt Boggs, director of development at Recovery Point of Huntington, said it was just notified that the state funding it would receive for its new facilities in Mercer County and Charleston has been cut from $300,000 to $35,000.

"I think the state legislature needs to make a commitment and follow through with that, and I think at the federal level, programs like SAMSHA (Substance Abuse and Mental Health Services Administration) should offer to enhance recovery programs," he said. "Ultimately, what we're wanting to build is a recovery-ready community with full recovery support for folks so that when they're incarcerated and get out of jail, they can be reintegrated into society with recovery supports. That increases people's stability, housing, employment and job opportunities and so on, but it also decreases recidivism."

Huntington is a leader in this fight because the stakes are high, Williams said.

"With all the wonderful things we have going on in this community, the one thing holding us back from achieving the heights that we know we're able to accomplish - because of the university, because of the medical centers, because of the medical school and pharmacy program, the clergy and neighborhoods we have - we have to state the brutal facts that we have a horrible problem of addiction," Williams said. "On the other hand, we all are able to stand here and say without a doubt, we have unending faith in our ability to prevail, and we will with (federal) support."


By:  Jean Tarbett Hardiman