Here's his first column!
Monday, June 20, 2016
Shinholser: Step one in fighting opioid addiction is better public policy
Our President and Co-Founder John Shinholser was asked to be a guest columnist for the Richmond Times-Dispatch this past week.
Here's his first column!
Here's his first column!
Posted: Saturday, June 18, 2016 10:30 pm
Perhaps one of several main challenges facing our community today with the opiate addiction crisis is that there is a large group of “desperately seeking a fix” addicts. This group of opiate addicts wants help in the form of buprenorphine 5-day step-down detox, thus eliminating the physical pain associated with withdrawal. There will be those that would want a longer detox using Suboxone or a simple medication replacement treatment of indefinite duration of Suboxone or methadone. For this column we focus on a five-day detox.
For more than 50 years, the leading addiction experts have agreed that the best time to help an addict is when they ask for help.
This very short window of opportunity closes within hours in most cases. This “contact” with the opiate addict — history and best practices demonstrate — is when chances for the most optimal long-term recovery outcomes are greatest.
Opiate addicts almost always are penniless, in debt, with no resources, having burnt every bridge, with no hope but from tax-funded agencies or charities specializing in addiction. If we don’t provide same-day access to medication-assisted withdrawal — buprenorphine — then the criminal justice system most likely will serve that same addict (same-day service) as a result of a “public safety” activity involvement: They will be arrested for a drug seeking crime. These would be avoidable arrests, if we have same-day detox available.
Our systems (and society) seem to have have no problem spending more than $7,000 (of taxpayers’ money) per opiate arrest. And add to that the daily rate for incarceration, then the cost of probation and parole upon release.
Yet our society will not execute a much less costly recovery system that cost $625 for a five-day step down buprenorphine detox.
To add insult to injury, the automatic incarceration system increases recidivism, whereas the detox system decrease recidivism, increasing public safety.
Yes, these are chronic cases for the most part, frequent fliers as they are called. It seems our policymakers are addicted to bad policies, just as the addict is to the drug.
It would be a great day in Virginia if we could get our policymakers in recovery from making bad decisions.
Perhaps we can instill a genuine desire in our policymakers’ hearts to really want to improve our opiate recovery systems.
For starters, any addict who has that one moment of clarity and musters up the strength to ask for help should get same-day appropriate help. Any addict that does not have $625 should be able to walk in a Community Service Board (CSB) or Behavioral Health Authority (BHA) and receive same-day, five-day Buprenorphine detox, complete with wrap-around peer supports. Ten percent of our Department of Corrections (DOC) budget would provide ample of funds for this approach.
The population of chronic addicts that this approach would serve in the community could save DOC 30 percent or more of its costs because of inmate reduction — which would save them more than the 10 percent used for detox.
This action and some dialing back of a few irresponsible drug laws would create a recidivism-reduction trend that could reach 50 percent in a decade or less. Think about it: We could cut the correction population in half ten years from now. Our prisons would actually be for bad criminals, not mentally ill addicts who are very salvageable with the proper service systems in our communities.
A large surge of recovering people in our communities adds tremendous value to our prevention and recovery efforts. To this day, one of the main principles in a recovering addict’s life is to help other addicts achieve recovery. This is done through public information, active-reality prevention services, and attraction to recovery in general. These activities add a much-needed dimension to our “help the addict to recovery” efforts. We will see a major decrease in the drug-seeking population.
Stigma prevents many from seeking recovery as much as the lack of appropriate available services.
A more humane approach to detox and an increase in our recovering communities will usher in a new age of much-needed pride in recovery.
Some people say one of the main sources of shame in addiction is not seeking help once you realize you need help, but a bigger shame is our community not providing appropriate help when the addict comes seeking help.
One last thing: Do not underestimate the ability of addiction to strike your family and loved ones. Trust me, addiction does not discriminate. Do the math: 56 million Americans are in recovery or need to be in recovery. This pretty much means we all have someone we love and or care deeply for who is an addict.
You do want the best system available, don’t you?
John Shinholser is president of the McShin Foundation, a central Virginia nonprofit full-service Recovery Community Organization (RCO), committed to serving individuals and families in their fight against substance-use disorders. Contact him at firstname.lastname@example.org.