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Overdose deaths driving up demand for methadone

October 13, 2013

WOONSOCKET – While state officials report an alarming increase in drug overdose deaths, the city’s only methadone clinic is struggling to keep up with demand for treatment.

“The phone is ringing off the hook with calls from people in our area who are seeking treatment,” said Peggy Sakosky, the director of Discovery House. “It’s hard for us to keep up with the demand.”

Methadone is one of the most widely used drugs in the treatment of addiction to heroin and other opiates. The clinic has about 550 clients, which is up about 10 percent more than last year, according to Sakosky.

Private clinicians have also noted an increase in demand for services. Lisa Carcifero of Lincoln Psychotherapy says the office has seen an increase in patients who want help getting off painkillers and other prescription drugs.

“Over the last couple of years, definitely,” she said. “They don’t fit the stereotype of what you think a drug user is supposed to be. It cuts across every level of society.”

Coupled with increased overdoses, Sakosky said the higher demand for treatment suggests the availability of narcotics is also on the rise. But Police Chief Thomas Carey says there is no evidence of that, at least not based on the amount of heroin and cocaine police have seized.

Sizable amounts of cocaine and heroin were seized from 2009 to 2012, but if the figures were graphed they wouldn’t show a steady rise on an annual basis. The figures for heroin have ranged from a low of 183 grams in 2011 to a high of 936 grams in 2012; for cocaine, 815 grams in 2010 to 1,914 grams in 2011.

“There’s no clear trend,” says Carey.

It’s impossible to make the same statement about drug overdose deaths tracked by the office of the state medical examiner during the same period, according to Health Director Michael Fine.

The total number of accidental drug overdose deaths between 2009 and 2012 rose from 137 to 182. Many of those involved prescription painkillers and alcohol.

During the same period, the number of accidental overdose deaths attributable solely to illicit street drugs – mostly heroin and cocaine – nearly doubled, from 53 to 97.

“It’s disturbing,” said Gregory McWilliams, the director of Addition Recovery Institute, a methadone clinic with facilities in Pawtucket and Warwick. “I feel bad. It just shows that addiction is a life-threatening, progressive illness that people can die from. Unfortunately, without treatment, that’s what happens.”

The state Department of Health said that the latest data for 2013 suggest that accidental deaths involving prescription drugs such as Vicodin and Oxycodone appear to be tapering off. But Fine said that regardless of whether street drugs or prescription medications were involved, overdose remains a leading cause of accidental deaths in Rhode Island, occurring at the rate of about four per week.

Calling the trend an “epidemic,” Fine said the statistics also contradict the conventional wisdom that most of the overdose deaths involve younger adult males. While twice as many men died as a result of accidental drug overdoses, individuals between 40 and 60 years old accounted for the majority of deaths overall.

“These data give us a better understanding of how this epidemic is affecting Rhode Islanders and who is most at risk,” said Fine. “The upward trend in illicit drug overdose deaths is especially of concern because we know that IV drugs pose other health risks, such as HIV and Hepatitis C.”

In partnership with an assortment of local agencies, health officials have made some inroads in curbing overdoses caused by prescription drugs.

“That’s why we installed the medication dropoff box at Woonsocket police headquarters,” according to Carcifero, who also heads up the Woonsocket Prevention Coalition. “People are dropping off tons of drugs. They’re really using it and really getting rid of the medications. That’s good because if prescriptions are not disposed of properly they can fall into the hands of children.”

The prevention coalition is keenly aware of the overdose problem and plans on holding a “town meeting” next month on the subject of overdose prevention in partnership with the Woonsocket police, said Carcifero. She and Carey have both begun attending the meetings of a Health Department panel known as the Drug Overdose Prevention and Rescue Coalition.

Carey said he’s participating to explore strategies to complement enforcement as a way of intervening in the lives of at-risk drug abusers.

“It’s painful and you don’t want your loved ones addicted to any kind of drug,” said Carey. “Sometimes you can’t arrest your way out of a problem.”

Because of medical privacy rules, the death statistics are not grouped by geographic area. But this spring “northern Rhode Island” was targeted by health officials as the epicenter for a sudden spike in deaths caused by a never-before-seen form of fentanyl, a synthetic opiate sold on the street. Fourteen deaths were attributed to the drug, and two local men were later arrested on federal charges of obstructing the police investigation into its source, which authorities said was probably an underground lab.

Craig Stenning, director of the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, said the overall trends in overdose deaths “are of great concern to our department.

“We are committed to continuing to develop effective prevention strategies and increasing access to treatment and recovery support services in an effort to help improve these statistics.”

During the press briefing, officials gave Walgreen’s a pat on the back for being the only pharmacy chain in the state to make Naloxone available without a prescription. The drug is routinely used in clinical settings to reverse the effects of opiate intoxication. Walgreen’s makes it possible for the layperson to obtain the drug quickly to intervene in drug-related emergencies involving a friend or loved one, they said.

Other bright spots in the war on accidental overdoses: Rhode Island has just expanded its “Good Samaritan” law. Callers to 911 now have immunity from prosecution if illicit drugs are involved in a medical emergency.

DOH also launched the Prescription Monitoring Program, or PMP, in 2012. The program is supposed to give doctors and pharmacists a tool to figure out if patients are obtaining prescription drugs from more than one source. The idea is to “monitor and protect patients from dangerous drug combinations and quantities” and help “reduce the amount of prescription drugs that can get into the hands of people without a prescription,” DOH said.

Physician use of the PMP is voluntary.

Follow Russ Olivo on Twitter @russolivo

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