Meagan Fisher, director of Magnolia Ridge Alcohol and Drug Treatment in Johnson City, answered the following questions about substance abuse and addiction in this area.
What do you think is the most commonly abused substance in this region?
“Opiates are the number one thing we see, and when I say opiates, that includes people detoxing from Suboxone and Subutex, because that gets grouped into the opioid diagnosis,” Fisher said. “Opiates and alcohol, (and) for a couple years when I first started, there was a lot more meth. Now meth is not quite so much, but I will say in the last six months, we've seen a little uptick again in the meth."
What do you think contributes to substance abuse, particularly in this area?
Fisher attributes substance abuse to a variety of factors, particularly family history and the stigma that comes with seeking treatment.
“In this particular region, it's 'Pick up your bootstraps, get better and just stop doing it,' but it's not that easy,” Fisher said. “It's a disease, and I think a lot of people don't see it as a disease. They see it as a moral problem, and so that stigma really causes a lot of problems.”
With opiates in particular, Fisher said many of the clients she’s observed started out taking the medicines on a prescription to recover from an injury, surgery or other problem, not realizing they would get addicted.
“It was, 'I need to be able to work, so give me something that will let me continue to work,' and before they knew it, they were addicted to these medicines,” Fisher said. “Then the doctors wouldn't prescribe them anymore, so then they have to get them on the street, and that makes the problem exponentially worse. I think that all the Suboxone and Subutex clinics we had were well-intentioned with trying to help people with that, but with no regulation, it became just as big of a problem."
What is Magnolia Ridge?
Magnolia Ridge is an alcohol and drug detoxification center in Johnson City. It accepts clients who are struggling with addiction, in addition to those with co-occurring mental health disorders. Fisher said the facility includes 19 beds for inpatient treatment, and the average stay ranges between 14 and 28 days, depending on the patient’s insurance and individual needs.
While at Magnolia Ridge, Fisher said patients participate in individual therapy, family counseling, group therapy and other services, including parenting classes and outside meetings. Upon completing their inpatient treatment, Fisher said the clients are referred to outpatient services so that they can build on their progress.
How many people typically use your services per year?
Fisher said between 700 and 800 people come through Magnolia Ridge each year, and the demand is significant. Currently, the center has a waiting list between four and 16 weeks long, simply because there isn’t enough room to house them.
“I've got 19 (beds) here and then 12 at our female facility, and when they're here for a month at a time, it's going to take a while to get through those people,” Fisher said. “I know there are people on that list who have died already because we're the only inpatient resource around here.”
What makes opiates so addictive?
Fisher said the addictiveness of these drugs has a lot to do with their ability to change the reward pathway in the brain. This change is caused by a release of dopamine, a neurotransmitter found naturally in the body that affects the brain’s reward and pleasure centers.
“(Opiates) release such a flood of dopamine that it's better than anything you've ever felt. Then the brain eventually will switch, and so what used to make you happy — your children, your husband, your wife, any of that — doesn't release the same amount of dopamine,” Fisher said. “So the only way to feel good is to have that opiate release it. It has the ability to just flood the brain with these neurotransmitters more than any other drug we see."
Do you believe incarceration is effective in curbing drug addiction?
Fisher believes incarceration does not work for substance abusers because it doesn’t address the underlying issues that could be causing their problem, such as childhood trauma. She added that alternatives, such as court ordering them to treatment, may or may not be effective.
“Court ordering them to treatment is a great idea, but at the same time, they have to want to change, too,” Fisher said. “I can have somebody who's here because they have to be and give them the exact same care (as a voluntary patient), and if they don't really want it, it's not going to matter.”
How can the community help remedy the substance abuse problem?
"I think these are really, really good people who have developed a really, really bad coping skill, and they deserve a chance at the life they deserve,” Fisher said. “It affects their children; it affects their children's children. So if we're going to do something for our community, then we've got to come together and rally around these people and get them to the help that they need. It takes a village to raise a child, and it takes a village to help support an addict."