In 2016, Pennsylvania Governor Tom Wolf went to the White House with his concerns about the high rate of addiction to prescription opioids in his state. The governor chose to focus his efforts on remedying shortcomings in the medical training arena. As Governor Wolf accurately notes, most medical and dental schools teach students about opioid medications but do not sufficiently educate them on their attendant risk of addiction. For Governor Wolf, the lack of emphasis and proper training on addiction at the level of medical and dental education has contributed to doctors writing prescriptions for patients who were not adequately screened for addiction potential.
Although there are more layers to the prescription opioid epidemic raging in Pennsylvania, the governor’s approach addresses an important root cause. This approach would help to ensure that the next generation of practicing physicians learns from prior mistakes and helps their patients to avoid addiction.
The prescription opioid epidemic in Pennsylvania and the US overall is unique in that the drugs of abuse are legally manufactured and lawfully distributed. However, the availability of these drugs and their high risk of addiction have led to perverse practices among people seeking to abuse prescription opioids. For instance, some individuals engage in a practice known as doctor shopping, which involves going to different doctors to collect extra opioid medications. In some instances, the individual may have a health condition that requires pain management but takes too much of these medications in order to get high. In other instances, a person may doctor shop and falsify symptoms in order to get medications. Doctors may not have adequate training to recognize opioid abuse, but there is a way to help stop the practice of doctor shopping.
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In 2014, Pennsylvania passed a law that implemented a prescription monitoring database. Now doctors as well as law enforcement officials may have access to patient information that can reveal doctor shopping. It would be helpful if this information could also legally be used to identify individuals who need treatment. Although the drug epidemic in Pennsylvania is complex, it’s clear Governor Wolf is willing to be creative in his efforts to help his constituents dig out of the trenches of prescription abuse.
Drug Abuse and Treatment Rates in Pennsylvania
The White House collects state-specific data on drug abuse rates. As these are some of the most reliable statistics available, it is helpful to consider information the White House has published on Pennsylvania.
The following facts and statistics provide a broad but useful picture on the extent of drug abuse in the Keystone State:
According to one survey, an estimated 7 percent of Pennsylvania residents were currently using illicit drugs. This percentage was lower than the national average of 8 percent.
A survey revealed that 3.11 percent of Pennsylvanians used illicit drugs other than marijuana.
The number of drug-involved fatal overdoses is higher in Pennsylvania than the national average (14.6 per every 100,000 versus 12.7 per 100,000). In 2007, 1,182 people died as a direct result of drug use. This number of deaths was greater than the number who died from car accidents (1,604) and firearms (1,325).
To help stem the number of drug-involved car crashes, Pennsylvania is one of only 17 states to adopt a per se This means that if any amount of an illegal drug is found in a driver’s system while operating a car then that person can be found guilty of drugged driving.
Today, it is generally accepted that the War on Drugs failed. In June 1971, in a public address, President Nixon advised the public that he and his administration were waging a war on drugs. Heroin abuse was at the forefront of Nixon’s mind. Today, parts of the US are facing as severe of a heroin crisis as former President Nixon faced. In this way, the War on Drugs has been a failure because the very drug it focused on rooting out continues to maintain a stronghold in American soil.
But the War on Drugs campaign was ill-fated for deeper reasons. Drugs were framed as the adversary, and the government vowed to fight them. However, the government really ended up fighting people who take drugs. As a result of War on Drugs thinking, incarceration rates soared in the US. Today, there is a general understanding that individuals who are experiencing substance abuse need compassion and recovery services. However, there is an ongoing gap between the number of individuals who need treatment for substance abuse and those who actually get help.
The White House provides the following information on the number of drug treatment admissions in Pennsylvania in the 2010 survey year:
Approximately 7,200 individuals who sought treatment services reported that heroin was their primary drug of abuse.
Although marijuana is the most commonly abused illicit drug in the US, it ranked second in terms of treatment services.
About 4,200 individuals who entered rehab were suffering primarily from addiction to opiates and opioids other than heroin (e.g. prescription pain relievers, morphine, etc.).
Around 3,500 people sought help in a rehab program for cocaine abuse.
There were fewer than 1,000 admissions each for the following drug types: inhalants, PCP, sedatives, stimulants, and hallucinogens.
Statistics and factual findings are critical to open the public’s eyes to the extent of the drug problem in Pennsylvania. But local drug awareness events and personal stories provide insights into substance abuse that are relatable and motivational. Fox 43 reported on an event in Harrisburg in 2015 for International Overdose Day. The Department of Drug and Alcohol Programs and the Department of Health organized an event as part of its Building Bridges to Recovery initiative. The event was intended to draw attention to the alarming rate of drug overdoses in the state. Sponsored activities included individuals in recovery painting a mural to reflect their feelings toward addiction and the recovery process. The mural served as a public icebreaker; different individuals in recovery came forward to speak about their experience. One man shared that he once overdosed and was near death, but a person armed with naloxone saved his life. Naloxone is an overdose response drug that can reverse an opioid overdose. The Pennsylvania State Police and local departments now have access to naloxone.
Since its introduction, naloxone has reportedly saved at least 289 lives in Pennsylvania. The man who shared his story had reportedly been sober since 2013 and now supports others in recovery. The availability of naloxone is a testament to the advances that are being made to save lives. Though the lifesaving drug can only be used to reverse to opioid overdoses, almost anyone can use it. In this way, emergency medical teams, police officers, and civilians can potentially administer this antidote as needed. The hope is that the future brings medications that can have a similar effect on other lethal drugs of abuse.
The complexity of drug addiction translates into a need for comprehensive services to treat it. Speaking in broad strokes, the recovery process involves three main phases: medical detox, primary care for addiction, and aftercare. In some instances, a person may enter a rehab facility that provides this full continuum of care. In other instances, recovery necessarily occurs in a more piecemeal way. For example, some individuals will need to undergo medical detox at a facility before receiving primary addiction treatment services at a rehab center. Detox can take place in a hospital or specialized detox facility. Depending on the individual’s needs, such as the severity of the addiction, detox may occur on an inpatient or outpatient basis.
Similarly, primary treatment can be inpatient or outpatient. A typical program is at least 28 days though in most cases a 90-day program is most advisable. Some individuals go into long-term treatment, which can last several months.
Regarding aftercare, this is the longest phase and often lasts a lifetime because recovery is an ongoing process. Aftercare is typically a self-directed process with a recovering person engaging different types of services, such as group recovery meetings, residence in a sober living home, ongoing individual therapy, therapist-led group therapy, and continuing opioid replacement therapy as necessary (e.g., Suboxone or methadone maintenance).
Against this backdrop, it is easier to consider the many different potential types of care available to individuals who need recovery services in Pennsylvania. The recovery landscape is layered and can be challenging to navigate, but there are many resources available to help. The Pennsylvania Department of Drug and Alcohol Programs maintains several online resources, including but not limited to the following:
For individuals who are seeking rehab centers that offer free, low-cost, or sliding scale treatment services, there is at least one free or low-cost rehab center in many of the larger cities in Pennsylvania, including Philadelphia, Harrisburg, Pittsburg, and Pottsville.
Individuals with health insurance can contact their insurance company directly for a list of in-network service providers. Similarly, individuals with Medicaid or other state-funded insurance can contact their local Department of Human Services for assistance in locating rehab treatment providers. For individuals in Pennsylvania, the Pennsylvania Department of Human Services can provide assistance with applying for state health insurance.
Although there is a copious amount of information available on getting help for drug abuse in Pennsylvania, an individual’s private fears may be a significant barrier to entry – but recovery is always possible. To help drive home this point, it can be beneficial for individuals who are thinking about starting recovery to learn about other people’s experiences with the process. Recovery & Me is an informational site that provides stories of recovery in Berks County, Pennsylvania, and beyond.
A review of the site shows that there are a multitude of stories that speak from different angles of the drug abuse experience. For instance, some stories describe being required to go to rehab to avoid a prison sentence, but the people involved recover nonetheless. In fact, according to the National Institute on Drug Abuse, individuals who are court-ordered to rehab fare just as well as those who begin the rehab process voluntarily.
Other stories on the site discuss the transformative experience of recovery. The site provides a snapshot of different experiences and gives a voice to people who want to share their recovery process and help others. Help comes in a lot of different ways — sometimes in the form of direct admission to a rehab center and sometimes, over time, starting with one inspirational story. The key is for individuals in Pennsylvania who need recovery services to know that the state is full of helpful resources and professionals who can help with each and every step of the process.
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