GREENVILLE – One of the biggest challenges in the fight against the heroin epidemic has been the overwhelming hold the drug has over users, so that even those who want desperately to escape its grip find they cannot stop using it.
A relatively new tool being used against that pull to relapse into using is the drug naltrexone, which is distributed under the brand name Vivitrol as an injection and ReVia as an oral pill version.
Jerri Lynn Stanley, Clinical Director for Recovery and Wellness Center in Greenville, said the organization has been using the drug for about a year now, and “It is going well.”
Stanley said the center’s clients for the Vivitrol program may come to them as self-referrals or from the court system.
Stanley said self-referrals calls in to the agency and provide their information. They are then set up with an assessment, for which they are then seen within one week’s time.
“If we can get them in that same day, we’ll do that,” Stanley said. “We try to see them as soon as possible and always within a week.”
During the assessment, they are evaluated to see, first, if they will be able to “get clean” on their own or if they will need professional help. Detoxification involves no longer taking the drug and getting all of it out of the system, as well as getting over the physical symptoms of withdrawal.
Stanley said Tri-County Board of Recovery and Mental Health Services has a contract with Nova House in Dayton for professional detox services.
“It’s typically a 28-day program for detox,” Stanley said. “They will receive their first Vivitrol shot at Nova, or we arrange for them to come in (to Recovery and Wellness) the day they’re released, then our agency does the Vivitrol.
Vivitrol is a monthly injection that is used in both opiate and alcohol addiction. It blocks other opioids from acting on the receptors in the brain and can help to ease drug cravings.
By blocking the effects of the opiates, it eliminates that pleasurable “high,” which can help prevent relapse.
Vivitrol is used in conjunction with a comprehensive and customized recovery program, including counseling, support groups, mental health care if needed, health and social services.
Studies have shown that patients addicted to heroin who use Vivitrol in addition to counseling had significantly longer periods of abstinence from the drug, considerably reduced cravings and fewer incidents of relapse.
Stanley said treatment is customized for each client and lasts as long as it needs to until the patient is evaluated and deemed ready to face the rest of their recovery without medicinal intervention.
After clients receive their first shot, they are placed in groups at the agency, with which they meet for counseling three times a week.
They also are required to attend outside support meetings, such as Narcotics Anonymous (NA) or Alcoholics Anonymous (AA) three times a week, and attendance at these meetings must be documented.
Clients also are subject to random urine screens for drug use while they are in treatment.
“Each client is individual,” Stanley said. “What works for one may not work for another, so we provide individualized care.”
Stanley said clients remain in the full treatment program for the entire time they are on Vivitrol.
When the time comes to stop the Vivitrol program, Stanley said the entire treatment team, including counselors, mental health providers, physicians and clients, evaluate the readiness of the client.
“We look at where the client is,” she said. “Where we feel they are, where they feel they are. They have to have a relapse prevention plan, and the client has to have a support system in place.”
Stanley said the client needs to have people in place they can contact if needed – whether its a sponsor from NA or someone else.
“They need to have several support people in place,” Stanley said. “And we always tell the client that we are always here even if they are discharged from us. Our goal is to build that relationship. We’ve had many clients come back.”
Stanley said the 12-step community (NA and AA) has a philosophy of “service work” to get clean and then mentor to help others.
“It’s help yoiu to help others,” Stanley said. “Even if its just making coffee at the metings, trying to be there for someone else. It could be just someone shows up at their first meeting and they’re nervous and you sit with them and talk to them.”
“The 12-step community is an amazing community,” Stanley said. “You find some of the best people there who have hit rock bottom and then changed their lives.”
For clients referred to the Vivitrol program through the court system, things are quite similar.
“Judge (Jonathan) Hein (Darke County Common Pleas Court) and Judge (Julie) Monnin (Darke County Municipal Court) are wonderful,” Stanley said. “And the probation department is amazing and very caring. They work closely with us to make sure that we’re doing what’s best for the clients.”
Stanley said the judges’ and probation officers’ personal level of involvement is unusual and tremendously helpful in the clients’ recovery process.
“A lot of counties you don’t have that close-knit community with each other,” Stanley said. “They’re on board. If we have any issues or concerns, they’ll come over to meet with the client and us.”
This cooperative effort is more effective for clients in the criminal system who might be somewhat more difficult than those who have approached the program on their own.
“The client needs to be able to see that we’re working as a team,” Stanley said. “We’re keeping the lines of communication open and they won’t be able to ‘put one over’ on any of us.”
Clients referred by the courts also will go through an assessment to determine if they can detox on their own or if they will need professional assistance at Nova House. In some cases, they will be incarcerated for the period of their detox.
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