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Opioid treatment in Litchfield County

Fourth in a series about addiction

 

Cell biologists like to study problems where we have experimental control; thus, petri dishes of growing nerve cells or identical white mice. The results of such experiments are useful, but basic scientists are laboratory creatures. Outside the lab, where diverse people need to be treated, good experimental controls are rare and saving lives is complicated, we can be like New Yorkers lost in the woods.  

From June 1 to Aug. 15, there were nine opioid overdose deaths in Litchfield County: six died without naloxone (a heroin antidote), three passed away after multiple doses of naloxone. There have been 33 non-fatal overdoses, of which 26 received a single dose of naloxone and seven survived without help. My colleague Patrick Sullivan provides more detailed numbers in a story on Page A1 in this week’s Lakeville Journal.

On the third Thursday morning of every month, about 60 people devoted to containing the opioid epidemic in Litchfield County gather at the McCall Center for Behavioral Health in Torrington. There are addiction case managers, physicians, nurses, first responders, social workers and grant writers. There are representatives of Charlotte Hungerford Hospital, state and federal agencies and other substance abuse services. The Torrington chief of police and the chief of the fire department also attend.  

Maria Coutant Skinner, LCSW, the executive director of the McCall Center, and Lauren Pristo, MPH, the Network Coordinator of the Litchfield County Opiate Task Force, open these meetings with a message of inspiration and ask for success stories.  There were stories about people who had resisted treatment but had now accepted it and had entered in-patient programs. There was a report about new ways to map areas most likely to see overdoses, called the OD map. Knowing where to expect trouble has led to a reduction in lethal overdoses. There was a discussion of whether the supply of opioid antagonist naloxone (Narcan) was adequate. It is, and the Department of Public Health has a new app that trains people on how to administer Narcan. A new method is available to field test for fentanyl, a potent heroin analogue, which is essential information in treatment. 

The people I met at the Thursday meetings (twice now) seemed happily engaged against daunting problems. There was no sense of hopelessness. If you are suffering from depression about our current political and social climate, this meeting is a good place to visit: Call it naloxone for cynics. 

The goal of the Litchfield County Opioid Task Force is harm reduction in all cases and treatment when possible. Most users decline treatment at first. Opiates hijack the brain’s reward system and at first the users feel great. After several overdoses, the effect wanes and more people agree to treatment, which involves detox, medically assisted therapy and extensive counseling. Nobody is weaned off opiates and left without further medical therapy because that is a dangerous moment for overdose death, for biological reasons described in a previous column.  

People become addicted in different ways, but many cases involve childhood trauma. The ACEs questionnaire for Adverse Childhood Experiences assesses abuse and deprivation, which is not uncommon. This and other tools provide essential information for therapy. Further outpatient care, including continued medically assisted treatment with Suboxone or other medications, is provided. There is success, but there are also relapses. Opioid use disorder is a difficult disease.

It would, of course, be better if trauma and early drug use were reduced or eliminated. That is the important task of the Northwest Corner Prevention Network, sponsored by the McCall Center and the Foundation for Community Health, a nonprofit philanthropy that works in the northern Litchfield Hills and nearby areas of New York State.  

Maria Coutant Skinner says that treating trauma early would prevent a lot of addiction: “We see recovery every day, but if we can prevent addiction? All the heartache and pain and suffering that could be alleviated, that would never start — who wouldn’t want that?” 

Find the Task Force at Charlotte Hungerford Hospital at 860-496-6381 or on Facebook: The Litchfield County Opiate Task Force. To find out more, there are excellent publications from the McCall Center. One is called, “Beneath The Surface: The Opioid Epidemic in Northwest Connecticut.” Lauren Pristo, the task force coordinator, gave me a book called, “Opioid Use Disorders: A Holistic Guide to Assessment, Treatment, and Recovery,” by Charles Atkins, MD, which is available online. For affected families and naïve basic scientists like me, the information it offers is thorough, sensible and humane.

 

Richard Kessin, PhD, is Professor Emeritus of Pathology and Cell Biology at The Columbia University Irving Medical Center. He lives in Norfolk and can be contacted at richard.kessin@gmail.com.