At a roundtable discussion last Thursday, State Attorney General Josh Stein and local leaders discussed the opioid crisis and how our region is dealing with it. The event, hosted by Stein and WECT, featured different viewpoints on the epidemic. But many of these local perspectives echoed a larger, national conversation.
Over 2 million people in the United States have a substance use disorder related to opioid pain medicines. But, less than 18 percent actually receive treatment. That’s according to 2016 data cited by the National Institute on Drug Abuse.
The challenge for communities all across the country is how to get more people suffering from these disorders into treatment.
At Thursday’s meeting, there’s chatter and the room is packed. Officials from local government, law enforcement, behavioral health, and the court system are all sitting at a table, working to provide answers.
New Hanover County Commissioner Woody White shares his perspective that motivation is a key element in getting individuals to participate in a treatment program.
“Science tells us and statistics, that women particularly are much more receptive to recovery in turning their lives around when they're pregnant. And that's a big deal. Recovery is for those who want it, not for those who need it.”
His view is a widely-shared one. More than three-quarters of respondents in a 2016 national survey characterized people with OUD, or opioid use disorder, as lacking self-discipline.
One audience member, Shannon Lloyd, who lost a son to an opioid overdose, shares a different take.
“There's a lot of people out there who don't go forth and get help because they don't have insurance. Some of them, it's not the fact that they don't want to clean up. It's not the fact that they don't want to heal. There's such a stigma out there right now.”
Attorney General Stein agrees with her. He says that the two biggest obstacles to care are money and stigma. His solution is Medicaid expansion.
“We are one of a handful of states that have refused to take that money back in the form of Medicaid expansion. So the single most important thing that anyone in this room can do to deal with this crisis… is to urge your local representatives to say yes like other states across the country… we have a half million folks who don't have health insurance.”
North Carolina Governor Roy Cooper has highlighted Medicaid expansion as a weapon in the opioid crisis as part of his NC Opioid Action Plan. And studies do show it’s associated with increases in access to services and treatment for OUD and opioid overdose. But other lawmakers argue that Medicaid actually contributes to the opioid crisis, by making opioid painkillers inexpensive and easier to obtain.
How to get patients into treatment is controversial, but so are specific treatment methods.
Methadone is one drug used in the treatment of OUD. Controversial when first introduced in the mid-20th century, it has since gained respectability. But, some people still have doubts -- including Lloyd:
“Is there some alternative to methadone in treatment of the addiction? Because all that does is cause more addiction. To my knowledge, it’s just like a legal drug dealer. You are pacifying one drug for another drug.”
Kenny House, Vice-President of Clinical Services for Coastal Horizons Center, is also at the meeting, and offers a different perspective -- saying effective treatment depends on the individual.
“There are a lot of paths to recovery. Medications -- whether they're the FDA-approved medications, methadone, buprenorphine, are all very effective with different individuals in different populations. There are others who find recovery without those medications and there's a lot of in between. I don't think we need to focus so much on which path of recovery or which medication, but make whatever's available that'll help people find recovery.”
Many medical studies support methadone's effectiveness in reducing opioid use. And, according to the National Institute on Drug Abuse, it can also help patients stay in treatment for longer -- which helps reduce the risk of overdose mortality.
In addition to discussing different treatment methods, House also brings up the importance of community collaboration and having these types of conversations.
“We've never had this many players around the table work together so well as we have in the last five years. And a lot of our progress is due to that.”
And he mentions what he thinks is one of the most important factors in providing successful treatment -- hope.
“We need to increase hope at all different levels so that people who take this courageous journey into recovery are fully supported and not shamed. That's why I'm so glad that we're actually talking about real stories here, and people right here in the room. So we've got to support this courageous journey of recovery, increase the hope, so that… our efforts can be helpful with everyone at the table that needs to be there.”