Lake County navigates opioid crisis
Treating opioids with science not moral shame works best
A consultant with a renowned health management company led discussions in the Board of Supervisors Chambers January, 26 to share information safely, regarding the federal government's successful Opioid abuse lawsuit, litigated the past couple of years.
“Our purpose is to deliberate how can Lake County reinvest in the community impacted by the Opioid crisis of recent years?” Charles Robbins, Master of Business Administration and a principal of Health Management Associates, a community strategies consultancy based in Los Angeles, told the chamber audience last week. “I spent three decades leading nonprofits, so I understand the role of a local based provider service in a community, he said.
Robbins explained there will be two more meetings on the opioid settlement. One in March and one in May each in a different location to be certain to have a presence across the county. “At the end of the discussions we'll come up with priorities for debate to allocate the monies coming to Lake County. Your input to this discussion will help shape that.”
Elise Jones, director of Behavioral Health Services explained the reason they hosted the discussion was not to tell people what they should do with funds, but the funds belonged to the various communities across Lake County. And as regards to actual implementation of solutions, since Behavioral Health Services is the administrative entity responsible for that, if one of the proposals resulted in investing in a certain level of care, which the department does not provide, they might have to put out a bid for request for proposal to deliver that level of care to the community.
Robbins screened a powerful video, “Why is Addiction a Disease We Have to Understand” narrated by Dr. Corey Waller, MD, MS FACEP. Waller noted 21 million Americans have an addiction, 15 million of those suffer alcohol use disorder and 3 million suffer Opioid use disorder. Waller also said there were 50,000 deaths from Opioid in 2015.
Waller went on to say humans need tree things to survive: food, water and dopamine, a brain e chemical in the limbic system. Humans need dopamine because it's the chemical that's responsible for motivation. “It's the thing that pushes you to do better,” Waller said.
In the Criminal Justice world, we have to stop criminalizing these patients that we have a treatment for, Waller noted. “We know that behavior can be defined as a craving. Craving can be seen on a functional MRI, and we know that craving is greater than starvation or dehydration.”
Yet science knows we have treatments for this. “So, to take someone who is in obvious behaviors of addiction and place them in jail doesn't make any sense,” added Waller. “Addiction is a chronic disease, not a moral failing. It has treatments that are up to 75% effective. It has behavioral theories well identified and we can apply on a regular basis and the fundamental for all addiction, is in this dopamine reward axis. That part of the brain is what is responsible for motivation and ultimately survival. And if we can use science to affect survival in our patients, then we'll absolutely come out ahead.”
Theresa Kemp, an Adventist Health on-site community healthcare worker had earlier in her youth been a frequent narcotics user. She confided she didn't know it was possible to overdose using methadone amphetamine. “I was an active user half my life,” she said. “I saw I had three options: quit using, kill myself or die from using.” A turning point arrived when she learned about the Tule House — Recovery From Addiction resource. “I learned how to use that dopamine natural balance,” she recalled. “It was a great feeling knowing to do that. I had forgotten everything.” Kemp then got into a program at the Hope Center Rising, transitional housing site. “I was going to rehab and I spent two weeks at the Warming Shelter,” she said. “Then I went to Hope Center. A year ago, I was in a horrible place — no electricity, no water.” She managed to stay three days without using. “I had to have the drugs because, I was going to do nothing. Having mentors at the Hope Center I got started at college. Lake County, I can't say enough about the place.
Lori Carter-Ruynon, also graduated from recovery programs. Her parents had divorced when she was young she recalled. “They came from an extremely successful family on the East Coast. “I didn't grow up lacking an education or burdened by poverty. I did run away, because I was using cocaine and so much acid. I started drinking by 13, I was locked up by the time I was 14, graduated high school and into college by the time I was 17. Ended up leaving New Hampshire because of abuse by my father at 18. Finding Meth became my love when I came to California on a visit. I was here on a visit and I stayed. I still didn't take it seriously.” She said she ended up getting arrested one more time, she was waiting in court, and the court were going to send her to prison.
“A fire alarm went off, talk about an intervention. The next day the judge gave me treatment instead. People say forced treatment doesn't work. The day I was going to graduate (rehab), they realized I was piece of crap mom. Everything I did as out of anger or hate.”
But since that time, Carter-Ruynon said she has been clean, yet she was still expelled from a program but managed to get enrolled into another one. “People think if they give you 60 or 90 day's sentence, ” she said. “Nonsense. It took me six months before I started to really live and change.”
She was in a state of denial and survival. And yet addicts are inspired by the challenges they endured and are motivated to fight on behalf of others who managed to prevail. “But we need to fight for people to survive, and then again, we understand, no one way, is the right way,” Carter-Runyon said.