Last in a series
Even though the prescription drug abuse problem looks grim, groups in the area and across Tennessee are trying to find solutions to the issue.
One of the best solutions will be to treat the disease of addiction. Some believe there are not enough available treatment centers for addiction in the area.
“We’re not on the side of rehabilitation, but I find sadly, there are not a lot of drug treatment programs, especially affordable drug treatment programs,” said Joseph Perrin, assistant district attorney general for Sullivan County. “I’m constantly talking to defense attorneys who say he or she wants help but there’s no place to put them.”
Rehabilitation is the most popular way to treat addiction. Programs can range from a few days to a few months, depending on the facility and the income of the individual. According to the National Institute of Drug Abuse (NIDA), the most effective way to treat addiction is to combine treatment medications with behavioral thera p y.
Frontier Health is one of the main service providers of addiction treatment in the area, and they are noticing there is more happening underneath the surface in addiction.
Randy Jessee, senior vice president for specialty services at Frontier Health, said there have been increasing cases of mental illness along with the disease of addiction. Many people who come to Frontier Health for addiction also have untreated depression or other mental illness. He said officials don’t know if people became addicted because they were trying to self-treat a mental disorder of if the drug abuse has caused a mental illness.
Coming off a drug is not easy, and coming off of opioids, the addictive ingredient in prescription pain pills, is the worst. Addicts refer to the feeling of coming off prescription pain pills as being “dope sick.” Jessee calls addiction to prescription pain pills “treatment resistant.”
The reason it is treatment resistant is the excessive dopamine produced makes the withdrawal process almost unbearable.
“It’s not something they (addicts) want to do,” Jessee said. “It feels like the flu.”
Jessee said Frontier Health utilizes comfort medicine to get an addict through the worst of the withdrawal symptoms. Medications can also be used to help addicts adapt to the absence of the drug and help people focus on therapy and counseling.
Rehab doesn’t always work. In many cases, people will find themselves relapsing and going back to the addiction lifestyle. NIDA said that relapse abuse is not only possible but likely.
Tommy Guss knows about relapsing. He is a recovering addict who works at a suboxone clinic. He said of all the drug-addicted people he has met through his recovery, only a handful got clean and stayed clean on the first try.
Jessee knows the majority of people who come through Frontier Health for treatment addiction will most likely leave early or relapse.
“What we see is people who have failed to come back into treatment,” he said. “We lose a lot of folks, it’s a tough business to be in.”
Guss thinks there needs to be more education on the disease of addiction. When he was in the throes of his addiction, Guss ended up in trouble — sometimes on drug-related charges.
There are as many drugs in jail as on the street, especially when the people know how to be savvy when sneaking the drugs in, he said. Once people are in jail, they get angry because they are in jail and can’t wait to get out and do the same things again.
“A lot of people don’t know there is a different lifestyle,” he said. “I didn’t know there was any other way to live but to be a drug addict.”
Looking through the grant money handed out in Tennessee during fiscal year 2010, about $70 million was given to the Department of Health and Human Services programs, while around $46 million was given to the Department of Justice programs.
When it comes to combating “pill mills,” there are a few different ways officials can go about shutting down these illegitimate pain management clinics.
One of the ways Tennessee has tried to combat this is a prescription drug monitoring program. According to a presentation from the Sullivan County anti-drug coalition made in 2012, only one-third of pharmacists in Tennessee use the state’s monitoring program.
Lawmakers in Nashville passed a law in May regarding pill mills. The “pill mill” bill calls for more oversight and training and limits dispensing opiate and narcotic drugs to 30 days. It also requires prescribers to report to a Controlled Substance Monitoring Database, register with the federal government and eliminate cash payments. It was signed into law on May 16.
District Attorney General Barry Staubus doesn’t think it is helping and feels more action is needed.
“The frustration is we can get the person who gets the prescription or the person who buys the drug and then resells it, we’re flooded with those people,” Staubus said. “We’re busy making those buys and making those busts. The problem is the source of it is really the pill mills, whether they’re out of state or ever increasingly in-state. Until we can really find a legislative solution to regulate those in such a way to make those less financially lucrative, ... they’re going to continue doing it.”
One of the problems with the legislation is money. When the bill was proposed, the state’s Fiscal Review Office projected it would create more than $170 million in drug and diagnostic testing expenses in the state’s TennCare program for low income residents.
Another problem Staubus has been seeing is the non-communication of medical records between states. For example, a person can go to North Carolina or Virginia and get prescribed pills and bring the prescriptions back to Tennessee without any information being entered in the database.
Tennessee is unique because it borders eight states and even if state laws are enacted, the pill mills could move to another state with more relaxed laws. For example, when Tennessee cracked down on synthetic drugs, people who made the drugs moved across the line to North Carolina, where laws are not as strict. If there were federal laws, regulations and oversight regarding these mills, it would make for a much more comprehensive solution, Staubus said.
Undercover officers from all over Sullivan County believe there needs to be a culture shift regarding prescription pills. Officers said the big problem is people don’t view prescription drugs in the same light as cocaine or heroin.
Solutions, in whatever form they may take, are not going to come easy. The problem has been building for many years and it may take many more years to stem the tide, but the question is: How much more will this epidemic cost Sullivan County and the whole of Northeast Tennessee?
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