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Programs treat opioid addiction as illness, not crime | TribLIVE.com
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Programs treat opioid addiction as illness, not crime

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Dan Speicher | Tribune-Review
Judge Meagan Bilik-DeFazio and Judge Christopher Feliciani speak to graduates of Drug Court during the graduation ceremony, at the Westmoreland County Courthouse, in Greensburg, on Thursday, Dec. 28, 2017.
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Dan Speicher | Tribune-Review
Judge Meagan Bilik-DeFazio and Judge Christopher Feliciani speak to graduates of Drug Court during the graduation ceremony, at the Westmoreland County Courthouse, in Greensburg, on Thursday, Dec. 28, 2017.
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Dan Speicher | Tribune-Review
Brian Kephart, executive clinical director of Strive Health, in Greensburg, talks about their intensive outpatient treatment program, at their flagship office along Main Street, on Tuesday, Oct. 10, 2017.
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Dan Speicher | Tribune-Review
Judge Meagan Bilik-DeFazio and Judge Christopher Feliciani speak to graduates of Drug Court during the graduation ceremony, at the Westmoreland County Courthouse, in Greensburg, on Thursday, Dec. 28, 2017.
gtrdecadefolo001010118
Dan Speicher | Tribune-Review
Judge Meagan Bilik-DeFazio and Judge Christopher Feliciani speak to graduates of Drug Court during the graduation ceremony, at the Westmoreland County Courthouse, in Greensburg, on Thursday, Dec. 28, 2017.
gtrdrugtreatment001101117
Dan Speicher | Tribune-Review
Brian Kephart, executive clinical director of Strive Health, in Greensburg, talks about their intensive outpatient treatment program, at their flagship office along Main Street, on Tuesday, Oct. 10, 2017.

Editor’s note: This is the second part of a look at the opioid crisis in the region.

There were no candlelight vigils or memorial photo slide shows for the victims of drug overdoses 10 years ago.

Options for addiction treatment were few and far between in Westmoreland County and drug treatment court didn’t exist.

That was before the rising toll of the opioid epidemic in Westmoreland — 825 people died of drug overdoses between 2007 and 2016 — became clear.

Now, an evolution is under way in how communities are tackling a plague that experts say may not peak until the middle of the next decade.

“People are dying,” said Brian Kephart, executive clinical director of the new Strive Health counseling center in Greensburg. “It’s not only the people on the street who are suffering. It’s the co-workers, it’s the people who teach, it’s the children, it’s the fellow churchgoers, and we need to be able to work together and understand these people are sick.

“We’re not treating them because they did something wrong. They’re people in our community who are being treated for sickness,” he said.

The transformation has many facets:

• Experts are endorsing a new term ­— substance abuse disorder — to describe what they say is a chronic illness, not criminal behavior, that is wreaking havoc on communities in an effort to improve how others think of people with an addiction.

• Anyone can get a dose of naloxone, an opioid overdose reversal drug, and administer it. And people who call 911 for help are exempt from prosecution under state law.

• A new niche is developing in the health care sector while local officials and citizen groups try anything they can to build up support and awareness of the crisis that is erasing lives from communities from all corners of the county.

“I’m actually really encouraged by the response that we’ve seen in the community from all different aspects,” said Judge Meagan Bilik-DeFazio, who runs the county’s drug court with Judge Christopher Feliciani. “I think it’s because so many families and so many people are being affected.”

Focus on treatment

At the close of 2017, 18 applications for new facilities were pending before the Pennsylvania Department of Drug and Alcohol Programs, including in Fayette and Allegheny counties. At least two proposed clinics in Westmoreland County have yet to make that stage of the licensing process.

Authorities also anticipate a growth in the development of recovery homes — group settings for those in outpatient treatment — now that the state regulates such facilities.

In September, Greensburg became the first of Strive’s three new for-profit centers, elsewhere in New Hampshire and New Jersey. The company is taking a holistic approach, addressing underlying mental health issues in patients and emphasizing community involvement during an 18-month treatment protocol focused on counseling and group therapy.

The medical community, whom some fault for spurring the epidemic by unwittingly unleashing a torrent of highly addictive prescription painkillers on patients over the last two decades, is among those seeking answers.

Experts have concluded it may be another decade before overdose deaths peak.

Dr. John Gallagher, chairman of the Pennsylvania Medical Society’s task force on opioids, said evidence suggests that it is the emergence of more deadly synthetic opioids — fentanyl and its analogues — rather than any dramatic increase in drug abuse that accounts for the mounting death toll.

“It may be 2024 or some other date, but what you’ve got to understand is even if we stop right now, there are a lot of people on the streets addicted and they are going to get cured or die,” he said. “We have to get people into treatment, and there aren’t enough spots.”

A spokeswoman for the Westmoreland County Drug and Alcohol Commission said that shortage was behind the award of a $358,000 state grant to a Greensburg businessman to develop a 66-bed inpatient facility in Hempfield. The facility, Clear Day Treatment Center, could open in 2018 and will accept Medicaid patients.

Lawmakers, courts respond

Like the medical community, law enforcement and the courts have seen a shift in sensibilities. The state has enacted a prescription drug monitoring program to track a patient’s painkiller prescription history. And several doctors across the state, including two in Westmoreland, have been charged by the attorney general’s office in connection with the overdose deaths of patients.

Westmoreland County’s Drug Treatment Court — a diversionary court started in 2015 to deal with drug abuse — graduated 14 people in 2017. The program will expand this year — a probation officer recently was added, bringing the capacity to 60 to 65 participants.

More options such as recovery houses are needed locally, Bilik-DeFazio said. Defendants seeking a halfway house typically go to Washington County.

“With the epidemic that we have, we don’t have enough in the way of treatment and supports in the county here,” she said.

For those who wind up at the Westmoreland County Prison, where about two-thirds of all new prisoners need to be detoxed from substance abuse, a shot that curbs opioid cravings could be on the way. Warden John Walton said officials are discussing the possibility of administering shots of Vivitrol, a non-narcotic drug that reduces cravings for 30 days, to inmates scheduled for release.

Pennsylvania’s state prison system as well as several surrounding counties including Washington, Allegheny and Armstrong already have launched Vivitrol programs.

“The shot is quite costly,” Walton said. “But if we can stop some of this, it might be worth the cost.”

The epidemic has come with a high price tag for taxpayers, as costs for treatment, corrections, investigations and autopsies continue to rise. After tallying a minimum of $19 million in drug-related costs, Westmoreland County commissioners in December joined the growing list of states, cities and counties filing suit against drug companies they claim are responsible for sending a torrent of millions of pills into communities across the county.

“It’s going all across the state, the rural counties are affected just as much … as the larger cities,” said Pennsylvania Family Support Alliance Program Director Beth Bitler, who developed a program in use in New Kensington to help families heal from addiction. “Now there isn’t anywhere in the state that it isn’t a huge problem.”

Lawmakers in Harrisburg are scrambling to address the issue. As of late November, more than 80 separate bills addressing various facets of the opioid epidemic were pending in the General Assembly.

When will it end?

In the meantime, pastors are counseling families affected by the crisis, schools are implementing education aimed at opioids and local groups are trying anything they can to turn a corner.

“I think the more people talk about the issue of addiction, the more awareness there is,” said the Rev. Michael Begolly of Mt. St. Peter Parish in New Kensington. “It tears families apart.”

The question remains: When will it all end?

Going to the same addresses for overdose calls, reviving the same people, handing out treatment options and phone numbers, no arrests — it’s practically a daily occurrence for emergency responders, including in Derry Borough.

“We’re saving lives … but I don’t know what the incentive is to stop (using drugs),” said police Chief Randy Glick. “You can overdose six, seven times in a month, and there’s no penalty.”

There, 13 people have died from an overdose between 2009 and mid-December.

“There is a huge problem, but who has the answer on how to fix it?” Glick asked.

Renatta Signorini and Debra Erdley are Tribune-Review staff writers. Reach Signorini at 724-837-5374, [email protected] or via Twitter @byrenatta. Reach Erdley at 412-320-7996 or [email protected].

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