Indiana’s Drug Czar, Douglas Huntsinger, recently visited Knox County as part of an ongoing effort to respond to the state’s opioid drug crisis, which has worsened amid the COVID-19 pandemic.
Huntsinger, who advises Gov. Eric Holcomb regarding substance use policy, said before COVID shuttered the doors of businesses as well as drug treatment facilities, Indiana was making great strides in the fight against opioid addiction.
“Pre-COVID we were in a pretty good place statewide. For instance, we were seeing our overdose death rates coming down at twice the national average,” he said.
Huntsinger cited the institution of a Medicaid waver for drug treatment programs as one reason the Hoosier state was heading in the right direction for recovery.
“It allowed 1.6 million Hoosiers to have access to a treatment source. It was a game-changer, and then COVID hit,” he said.
A state report completed in August showed that after Holcomb instituted a statewide shutdown of all non-essential businesses, the number of overdose cases in emergency rooms rose by a startling 79%.
“There was a period of time where people were going to the emergency room either for COVID or for an overdose. There wasn’t much in between,” Huntsinger said.
Though rural Knox County once seemed relatively sheltered from the opioid crisis found in other cities and small towns across the U.S., by 2017 that was clearly beginning to change.
Knox County Sheriff Doug Vantlin on Friday said that while methamphetamines are still the biggest problem locally, there are currently several individuals in the jail facing opioid charges.
“Heroin is on the rise here,” he said.
With heroin, crystal meth and prescription opioids flowing into the county from Chicago and Louisville, prevention programs, law enforcement and drug treatment programs are all key in preventing the area from going the way of other Indiana counties — like Scott County, which has been devastated in recent years by overdoses, crime and HIV outbreaks.
“People who commit crimes — so many of them are on some kind of drug and are out supporting their habits by breaking into cars and houses,” Vantlin said.
And Huntsinger says, once a person takes an opiate, they are no longer capable of thinking of anything else, making them likely to find any way possible — including theft, robbery, forgery and violence — to support the immediate addiction.
Huntsinger and others working at the state level view substance use disorder through a medical lens.
“Look at what heroin does to the brain, for instance. The opioid binds to the receptors in the brain, and every decision is now centered around finding the next fix,” he said.
“Whether they want to stop or not, their brain is not going to let them. To say they should simply quit cold turkey is not taking into account a whole host of medical information.”
So, says Huntsinger, Indiana is using every available tool across the state to treat the disease, and one primary component includes drug treatment centers that utilize methadone to quell withdrawal symptoms.
During his visit, Huntsinger toured the newly opened WIN Recovery opioid treatment center at 1433 Willow St.
Opening its doors in June, WIN Recovery is one of only three opioid treatment programs licensed and opened by the Indiana Division of Mental Health and Addiction during the COVID-19 stay-at-home order.
The new facility — operated by Terre Haute based Hamilton Center — houses an examination room, three medication dosing stations, drug screening rooms and rooms for individual and group counseling.
The treatment program provides daily methadone medication treatment, along with individual therapy, group therapy and case management services to adults 18 years or older who struggle with addiction to heroin or other opioids, such as prescription pain medication.
While some critics are skeptical of methadone treatment facilities, leaders of the Hamilton Center say methadone treatment, when combined with therapy, is the most effective approach to dealing with the opioid crisis.
“The combination of medication and behavioral health interventions is the most effective in combating this disease,” said DJ Rhodes, chief of opioid treatment at Hamilton Center Inc.
“Opioid Use Disorder is a disease — treatment works and recovery is absolutely possible,” he said.
And Huntsinger agrees, saying that research proves recovery is possible, particularly when appropriate medications to ease withdrawal are used.
“Methadone is the gold standard for treatment,” he said. “There’s a lot of data that shows that those who go on medication and seek treatment have much better outcomes.
“Why wouldn’t we help people with the tools we know are evidence-based and work?”
But officials with the Hamilton Center behavioral health system say people often hesitate to begin the recovery process out of fear of painful withdrawal symptoms or fear of failure.
Jessica Nevill, WIN Recovery’s clinical director, said “real recovery begins” when patients begin taking methadone at appropriate daily levels and when stabilization occurs as cravings are minimized and withdrawal is avoided.
Beyond using methadone-based treatment, Huntsinger said the state is utilizing and pursuing other tactics that are also considered controversial, such as syringe exchange programs and expanded use of life-saving Naloxone, which has the ability to save an individual from a deadly overdose.
To critics of the move, Huntsinger says, “to not do this is reckless.”
And it goes beyond the compassion for the individual he says, citing financial reasons as part of the state’s efforts to combat the opioid crisis.
“I understand syringe service programs can be controversial, but they are first and foremost a cost-savings program when you look at how much it would cost to treat someone for Hepatitis C or HIV at the local hospital,” he said.
“This program will save millions of dollars over the course of that person’s life.”
The vast majority of patients in methadone clinics are employed, and the state’s research shows that as they continue with treatment — which includes therapy — they often receive promotions or better jobs, attain stable housing or buy homes and become thriving community members and taxpayers.
“Every person, regardless of how much they have cost, how many times they’ve been in jail, or the emotional toll they’ve inflicted, they are always someone’s son, daughter, niece or nephew,” Huntsinger said.
“We’re never going to just throw them away.”
To help stem the flow of drugs across Knox County, residents are always encouraged to report suspected drug activity to local law enforcement.
“Don’t get discouraged. Continue to call us,” said Vantlin.
Those ready to receive help breaking their addiction to opioids are encouraged to call WIN Recovery at 812-494-2215.
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