There is hope, help
Clinics in Texarkana use medicines, counseling to treat opioid addiction
EDITOR’S NOTE: Today is the final installment of a three-part series examining how the opioid crisis has affected Texarkana. Today’s stories examine local treatment methods for those addicted to opioids and highlight a former nurse who has had the unconditional support of her family through her struggles to beat the addiction. Saturday’s stories highlighted a woman whose obsession with pain pills and then other drugs led to incarceration and a look at how local doctors are curbing misuse and abuse of opioids. Sunday’s stories examined the surge of prescriptions written for opioids and how people’s usage affects the court system and law enforcement.
For people addicted to opioids, help is available in Texarkana.
Arkansas Treatment Services PA and Stockton Medical Group treat those trying to beat an opiate addiction with a combination of drug therapy to help control withdrawal symptoms and counseling to address underlying issues that lead to addiction.
Painkillers are addictive because in addition to getting rid of pain, they also create feelings of euphoria.
“It suppresses pain and gives courage,” said Rebecca Liles, lead counselor and outreach at Stockton Medical Group. “It goes through the process of rerouting a person’s system and it says, ‘You need to keep doing this … because it feels really good.’ But once it becomes an addiction, it’s no longer a sense of feeling good. It’s functionality. They have to have it just to put their feet on the floor the next day.”
Arkansas Treatment Services uses methadone to help alleviate withdrawal symptoms.
“Our medical director prescribes methadone hydrochloride, a well-researched and extremely effective medication that is approved for the treatment of addiction,” said Anne Saqer, operations coordinator for Arkansas Treatment Services. “He prescribes it in therapeutic doses that do not produce a ‘high’ or feeling of euphoria. The way he prescribes it is very different than the perception that often comes to mind when methadone is mentioned. We choose to utilize (it) to help our patients deal with cravings and physical withdrawal symptoms.”
Stockton Medical Group uses buprenorphine and suboxone.
“We use buprenorphine for the first week of treatment, and then we switch them to suboxone,” Liles said. “Buprenorphine is a partial opiate antagonist. Basically, what it does is fill the receptors up about halfway.”
That allows patients’ levels to stabilize and helps with with-
drawal symptoms, which can include nausea, muscle cramping, agitation, anxiety, depression and cravings.
Medications such as methadone and suboxone provide patients a chance to get their lives back on track by making cravings bearable.
Quitting cold turkey isn’t an option for many addicted to opiates.
“When quitting cold turkey, you have a higher risk of fatality involved with detox, especially if you’re doing it alone and not in a medical detox place,” Liles said. “That’s the seriousness of it. You can die. Withdrawals from opiates is not pleasant at all. … Your body no longer produces dopamine or endorphins naturally because it’s depleted of crucial neurochemicals. You’ll feel a lot of pain and be absolutely miserable for six or seven days. A lot of times by the fifth or sixth day, you’re reaching for an opiate.”
Officials for both clinics say the medication gets patients to a point where counseling, the real star of the program, can work.
“The real treatment and real progress happens in individual and group counseling sessions, where patients learn coping skills and strategies and address the root cause of their addictions,” Saqer said. “Methadone is just an adjunct to our counseling program, and not the other way around. We believe that treatment without a comprehensive counseling program is suboptimal and sets patients up for more relapse, something that is common to all forms of addiction.” “Without counseling and getting into the nitty gritty, all it would be is just handing out medication,” Liles said. “We want to see them succeed. The medication is just that first step. You need something to follow it up with to really make an impact on the addiction itself.”
Counseling and routine drug testing are required for patients at both clinics.
Opioid addiction, unlike many other addictions, often doesn’t start with illegal activity, but with a prescription from a trusted medical provider.
“I think the general public would be surprised to see a composite of what our patients look like,” Saqer said. “We treat people from every walk of life and socioeconomic class … business owners, white-collar professionals, food-service workers and even other health care providers. … Opioid addiction is an equal-opportunity disease and respects no socioeconomic boundaries.”
“The majority of our patients became addicted after an accident or an injury or a surgery and were not recreational drug users. Many of our patients became addicted after being treated for chronic pain by pain management physicians who wrote too many prescriptions for the patient,” Saqer said.
Stockton Medical Group officials also see a diverse group of patients.
“The danger we see for opioids is it can affect anybody and everybody,” Liles said. “It doesn’t discriminate.”
Insurance, in some cases, may cover the cost of medication or treatment, but both clinics take cash only. The price tag for treatment is $250 to $300 a month.
The downside to suboxone and methadone is they are addictive, too.
“The downside to methadone is that our patients can remain physically dependent on it, which means they are still addicted to a substance, even though it’s not as dangerous as the substance to which they were previously addicted,” Saqer said.
Liles said it’s difficult for people to completely wean themselves off suboxone.
“We will try if they decide it’s an option. It’s really a case-by-case basis. Some we see taper down. So far, a lot of our clients have gotten down to one and a half pills a day. If they go lower than that, some of them experience withdrawal. After years of hard opioid use, this is the brain’s only way of getting those chemicals, so we don’t see a lot get off suboxone. Some can, but it’s not always easy.”
Seeking treatment takes courage on many levels.
“There is still a stigma attached to addiction treatment, and many people do not want to file for insurance claims because they do not want addiction treatment to be part of their permanent medical records. Or they do not want their family or employer to find out. We battle that stigma every day in our practice,” Saqer said.