Tuesday , September 05, 2017 - 5:15 AM
A once-a-month injection that curbs narcotic cravings is helping newly released inmates keep off drugs and avoid return trips to jail.
“My biggest downfall is trying to stay off heroin,” said Brandon, describing his 10 years of narcotics addiction. “I always seem to go back to it. I’ve never been able to get the right tools to stay clean.”
But after pleading guilty to a felony DUI in 2016, the Davis County man was accepted into a drug court program.
The 31-year-old receives an injection of Vivitrol every four weeks that he says allows him to shrug off thoughts of heroin, excel at work and mend damaged relationships.
“When I found out about Vivitrol I had such a sense of relief,” Brandon said. “It keeps my mind occupied and not on the urge to use. I can focus on getting myself better.”
Brandon is one of dozens of released criminal offenders who have been receiving Vivitrol over the past year after stints in the Davis, Weber and Salt Lake County jails.
It’s part of a local, state and federal effort to attack surging opioid drug addiction and help save former inmates from going back behind bars.
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Despite its successes, the Vivitrol program barely dents the substance abuse wave washing over Utah.
An estimated 134,000 people in Utah are eligible for assisted drug abuse treatment, but government agencies can afford to serve only about 15,000, according to data from the Utah Division of Substance Abuse and Mental Health.
That’s a conservative estimate of the need and does not even include the potential demand for addiction treatment for people with private insurance, said division spokesman Jeff Marrott.
The state budgeted $66.3 million to fund local substance abuse programs around Utah in fiscal year 2016, Marrott said. That was up from $57.9 million in fiscal 2015, according to the division’s annual reports.
“That seems like a lot of money, but the need is so great, it’s not enough,” Marrott said.
Widespread adoption of Vivitrol is also hindered by the drug’s high cost, about $1,400 per injection.
Earlier generations of addiction withdrawal drugs are much cheaper, such as methadone, about $20 a month, and Suboxone, $200, but those medicines are narcotics-based and prone to be abused..
PILOT PROGRAMS IN NORTHERN UTAH JAILS
In local jails, inmates with drug abuse histories are evaluated for post-release treatment potential.
Since mid-2016, 10 to 15 Davis County Jail inmates have graduated to Vivitrol, said Nancy Moss, who coordinates medication-assisted treatment for Davis Behavioral Health. The group still distributes methadone and Suboxone because they can be effective and their regular administration help caregivers keep close tabs on the recovering addicts.
“We thought (Vivitrol) might be a magic bullet, but it really appears it works best when they are just released from jail, to save lives and help them become stabilized and get into treatment,” Moss said.
Vivitrol is probably the best way to treat opioid addiction recovery, said Brandon Hatch, Davis Behavioral Health CEO.
“We’re about to step it up a little bit, because it’s such a big deal,” he said.
Kay Haw, the Weber County Jail’s health services coordinator, said that each month, up to half a dozen inmates receive Vivitrol injections when they are being released.
“It’s working very well,” Haw said.
Eligibility is recommended by the local drug court and the jail staff then gauges the inmate’s interest. The jail makes sure follow-up appointments for substance abuse treatment on the outside are made before.the inmate is released.
Salt Lake County has been running a Vivitrol program for almost two years and more than 200 inmates have participated, according to a state report.
But officials emphasized that drug-assisted treatment must be accompanied by an ongoing substance abuse program to reduce the chance of relapses and build long-term recovery.
“What we’re finding is that people who have been able to be clean and sober for six to 12 months start to have cravings again, so coming in for extra help works really well for them,” Moss said.
RECOVERY, AND ENDURING STIGMA
Brandon, who is served by Moss and others at Davis Behavioral Health in Layton, agreed to be interviewed if his last name was not used.
“I know how people look at heroin addicts,” he said. “It’s just got a really bad stigma.”
Brandon said he became addicted to pain pills.
“They got too expensive so I switched to heroin,” he said. “I got progressively worse until the point I was using it through IV.”
Davis County has a high rate of drug addicted people who use by injection — 35 percent, state data shows. Weber County’s rate is 20 percent; the state average is 29 percent.
Most people who receive public substance abuse treatment in Utah share a set of challenging demographic traits, according to state figures.
Of 14,729 people treated in fiscal year 2016, 12,487 were in poverty and 41 percent were unemployed. Fewer than two-thirds had graduated from high school or attended college, and 57 percent were referred from the criminal justice system.
Weber County had 1,124 enrolled for government-funded treatment in 2016, and Davis had 707.
NOT ENOUGH MONEY TO HELP ALL
“Those hurting most are the unfunded” — people who can’t get treatment from the government or private sources, Moss said.
“Doors are just shut continually for them and these are good, good people … they are just caught in the loop,” she said. “They don’t want to be using pills or heroin, they just want to be avoiding the withdrawals or cravings.”
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In the Vivitrol program, most patients receive shots for six months, Moss said.
It helps when they’re tapered from Suboxone or methadone. Six months’ worth gives them a good footing to gather recovery tools,” she said. “So the benefit is being able to see people regain their lives and function as parents and community members.”
Local agencies have been relying on a few temporary funding streams to provide Vivitrol. They include a two-year grant from Intermountain Healthcare, a $350,000 federal grant obtained by the Midtown Community Health Center in Ogden, and funds from the state’s 2015 Justice Reinvestment Initiative.
Moss said the Vivitrol manufacturer, Alkermes Inc., has given free samples to Davis Behavioral Health to help extend the program, Moss said.
Because Vivitrol and some other newer addiction treatment drugs are non-narcotic, “they have less chance for being abused than older medicines like methadone,” Marrott said.
Indeed, Suboxone is popular among some consumers of illegal narcotics because it can be abused, or combined with other drugs to power highs.
A Drug Enforcement Agency report said more than 21,000 emergency room visits a year are attributed to Suboxone abuse, including three deaths in 2011.
“We are really helping people once they have the disorder to maintain that recovery,” Marrott said. “The best way to handle this is prevention, but we are way past that as a state and as a nation. And it all boils down to funding.”
Public education and interest in helping the afflicted also is needed.
“There is no family that isn’t affected by this in some way, be it an uncle or a cousin … one of the things is to help people understand that addiction and substance abuse is not a moral failing or character flaw,” Marrott said. “It is an illness and can be treated effectively.”
NO ‘MIND CHANGES’
Brandon said he tried methadone one of the times he tried to get off heroin.
“it doesn’t really help you at all. It’s just like a pain pill, it still gets you high, and the abuse of it is just as much as heroin,” he said. “I went through withdrawal that was worse than coming off heroin.”
So he returned to heroin.
But now on Vivitrol, “There are no side effects or sickness or mind changes,” he said. “You don’t have to take it every morning, it’s once a month and you are able to focus on really getting back to being a normal person.”
That includes a recovered sense of self worth.
“My work is so good,” he said. “I used to have to get high to go to work -- I’d get high on the first break, every break, and after work. Now I can get things done well, and people have faith in me again. It feels good to be appreciated for what you do.”
His heroin addiction carried with it family estrangement.
“My family, we did not get along for a long time,” Brandon said. “I had a horrible relationship with my dad, but now it’s gotten so good.
“I regret all the times I was getting high.”
You can reach reporter Mark Shenefelt at 801 625-4224 or firstname.lastname@example.org. Follow on Twitter at @mshenefelt and Facebook at www.facebook.com/SEmarkshenefelt.
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