Difficulties Addressing Drug Treatment Outcomes

Attention Getter: Imagine 60,000 people in one city, all dealing with the same problem, addiction. According to an article written by Carter M. Yang for ABC news on March 14th of this year, there are 60, 000 people in Baltimore alone that are addicted to illicit drugs. These numbers are disheartening and unfortunate. I can relate to every one of these people struggling with substance abuse, because I am an addict. A program called Narcotics Anonymous has

Various levels of governments in different communities across North America have initiated programs to deal with the opioid epidemic and its effect. Some of these initiatives will be examined in more details below.

The content of this paper is an interview with Laura Crain from the McHenry County Substance Abuse Coalition. In the paper I touch on the history of the Coalition and how its evolved throughout the years. The coalition has a lot of involvement with the community in various counties. The work on a larger scheme rather than on a one to one basis. This interview covered the mission and goals set for the Coalition. Laura discussed with me the influences internal as well as external that affect the Coalition. Another thing we discussed was the struggles that come along with running an organization like this. I also touched on my personal experience and my thoughts regarding my internship.

As previously discussed, the program the author would choose to evaluate is MAT treatment programs. This population consists of individuals that have been diagnosed with opiate use disorder, and receive opiate-substitution medications, such as Methadone or Suboxone. These program evaluations would be consumer-centered, performed in the clinics they receive services. Interested stakeholders would include the treatment center where the participants receive services, as well as other MAT service providers. Additionally, the funding sources for these individuals and program centers, such as county, state, and federal agencies, along with medical insurers, would also gain value from the program evaluation research.

There are a variety of treatment modalities, both conservative and emerging, that clinicians, therapists, and doctors use to treat heroin and opioid dependence. Cognitive behavioral therapy (CBT), motivational interviewing (MI), 12 step programs, and acceptance and commitment therapy (ACT) are just a few that have been used in the past, and even today, in the treatment of substance dependence. Medication-assisted treatment (MAT) is yet another form of therapy; particularly for opioid and heroin dependence, that has been around for decades. However, it has recently begun to spark interest and controversy in light of the growing epidemic.

The Maryland drug court system has failed plenty of people since it was first introduced 1993, because of the goals and requirements are unrealistic and the offenders with an actual serious drug problem in the program are not getting the proper treatments they need to successfully stay clean once they graduate. In this essay elaborate on the practices that should be changed and if rehabilitation, detoxification and opioid treatments need to be available were to be implemented it would improve the program and keep people like my loved one on the right track and not headed to prison.

America has a major problem with opioid addicts, and many facilities are helping the addicts by providing safer options to taking the drugs their bodies crave. Methadone clinics are places where people addicted to opioids can receive medicine-based therapy. Opioid use, drugs such as heroin, morphine, and prescribed painkillers, has increased in the US with all age groups and incomes. People become addicted to these drugs when they are prescribed, recreationally used with other addicts, or they are born addicted. Many health institutions are addressing this issue with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted

This data is based on public meetings, hearing from victims, correctional experts, organizations, and citizens around the state. The data that was gathered help develop strategies to reduce spending on corrections, and reinvest in public safety (Justice Reinvestment in Maryland). Maryland developed the Maryland Justice Reinvestment Act in Bipartisan with 26 other states that changed or amended earlier policies adopted from the war on drugs. The JRA aimed to reduce Maryland’s prison population and to use the savings to focus on rehabilitation as opposed to incarceration (Smoot). The JRA made changes to Maryland’s sentencing, release, and supervision policies. First, this act reduces the maximum penalty time for convictions on drug distribution charges. Second, this act repeals mandatory sentences for nonviolent drug crimes. Finally, this act offers sanctions for parole and probation violators rather than reincarceration

“In 1949, Isbell and Vogel, working at the U.S. Public Health Hospital in Lexington, Kentucky, showed methadone to be the most effective medication for withdrawing addicts from heroin (Joseph, Stancliff, & Landgord, 2000, p. 347). Further studies revealed that administering methadone to an addict for seven to ten days had a relapse rate of more than 90% when treatment ceased. “By 1998, the number of methadone patients in the United States had increased from the original six research patients in 1964 to about 44,000 patients in New York Stated and 179,000 patients worldwide” (Joseph, Stancliff, & Landgord, 2000, p. 347). The number of individuals enrolled in MMT continues to increase as the methadone clinics and the overall effectiveness of MMT gains

Post World War II New York City was faced with a major heroin epidemic with over 151,000 names listed in the Narcotics Register (Herman). As a medical response, methadone was developed to treat heroin addiction (Herman). Today methadone maintenance treatment has grown to become a popular therapy for drug addiction as well as pain management. Methadone has helped many people to create new lives for themselves, yet there is still debate over the success of this program. Methadone assisted treatment should be seen as an effective program in combating opioid addiction due to its health and social benefits for both users and the community.

Many articles I have read say that both law enforcement agencies and state officials suspect that the rise of heroin abuse is due to many reasons. One theory is that because local and federal drug agencies have been shutting down illegal prescription pill mills, and that drug abusers that were hooked on prescription opiates are seeking out cheaper alternatives such as heroin (Kounang, 2015). “Heroin seems to be the drug of choice right now for a number of reasons. Users can inject it, they can snort it and it’s very, very inexpensive and easy to obtain. We’re are seeing that it is cheaper in Providence than it is here in Massachusetts.” stated Ramos when I asked him why it’s so popular. In my opinion, one thing is clear. Both national and local authorities are making an effort to combat this growing issue. They are not turning a blind eye to this epidemic.

Methadone is taken in orally and survives through the digestive system so there is no need to be injected into the patient. It reaches the brain slowly, dampening the “high” that would occur with other routes of administration while also preventing withdrawal symptoms (Heroin, 2014). The advantages of using methadone for heroin addicts are its comparatively low cost and long half-life. According to the Center for Disease Control, methadone helps to restore a degree of normalcy to brain function and behavior, resulting in increased employment rates and lower risk of HIV and other diseases and criminal behavior (Methadone Maintence Treatment, 2002). However, there are a variety of different effective treatments that are available for heroin addiction, including both behavioral therapies and medications. Heroin addicts should be place on less addictive medications like Burenorphine before being placed on Methadone. Buprenorphine, overall, is safer than methadone, and it is easier for an addict to stop buprenorphine than to detox from methadone (Heroin,

Drug treatment centers have skilled staffs that are experts or specialists in drug treatment. These people shoulder a great deal of responsibility because their patients need to be carefully handled in the center and treated in a holistic way.

¨ More than a quarter of a million Americans are enrolled in methadone clinics, where they participate in “methadone replacement” or “methadone maintenance” to treat narcotic addictions to heroin or morphine, or prescription painkillers like oxycodone, hydrocodone, OxyContin or Vicodin.¨ (Novus Detox, 2016) Clinics that treat opioid addiction use several combinations other than methadone to be effective. In addition to daily methadone treatments, there are also random drug test to make sure the individual is complying with the program. There is also individual and group counseling that provides education and support with each being customized with goals set forth by the patient. Some addiction require patients struggling to seek professional help with a psychiatrist and/or speciality

Peter Beilenson and Patrick McGuire had many obstacles and disappoints in their path to establish a needle exchange program in Baltimore. Peter Beilenson did not come up with the idea by himself, but got the idea, while working at John Hopkins in 1990, from the then health commissioner, Maxie Collier (Beilenson, 62). The program was hard subject to bring up and many politicians would not pass a bill for it. Beilenson’s bill that he brought to the General Assembly in 1993 was to establish a needle exchange program and to have the drug paraphernalia law exempted (Beilenson, 65). Unfortunately the General Assembly denied the bill, because many of the people felt that it would “simply be making it easier for addicts to pursue their illegal habit”