Work in St. Joseph County to fight opioid epidemic getting international coverage


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    St Joseph County addiction experts are weighing in on an international level. In an academic journal several local experts, including a St Joseph County judge, share what they are doing to help people and how, they say, their innovative interventions are working.

    Here is the article: https://www.tandfonline.com/doi/full/10.1080/07347324.2019.1571877

    The article, "A Perspective from the Field: Five Interventions to Combat the Opioid Epidemic and Ending the Dichotomy of Harm-reduction versus Abstinence-Based Programs," dives into the innovative interventions being used in our area.

    “We wanted to share what we have found is working here and in our county with other people,” says John Gallagher, IU South Bend social work professor and addiction therapist

    Gallagher, and 6 other colleagues (Todd D. Whitmore, John Horsley, Brooke Marshall, Mike Deranek, Sam Callantine & Jane Woodward Miller) collaborated on the article – just as they’ve been working together in the community.

    The article states, “their hope is that the knowledge gained from this article will be transferred to other states and counties to further promote recovery and well-being for individuals who have opioid use disorders.”

    They recommend:

    -Naltrexone (injectable extended release) be offered in county jails

    -Drug courts incorporate medication-assisted treatments into their programming

    -Recovery coaches and groups be more accessible

    -Naloxone be readily available to communities

    -A shift in how some professionals approach treatment and conceptualize recovery,. The article states: “recovery is best understood on a spectrum and should be defined by the individuals”

    Judge Jane Woodward Miller presides over the St. Joseph County Drug Court and she has something in common with the people who end up there.

    “You are always in recovery. I’ll always be an alcoholic but the question is whether I live in my addiction or in recovery,” says Miller.

    Miller has been sober for decades. She is open about this in her court and uses her experience and knowledge to help others.

    “For there to be hope, that person still needs to be alive,” says Miller.

    That is why, Miller says her court has embraced medically assisted treatment over the years. Some people are using methadone, suboxone and vivitrol while making their way through St. Joseph County’s drug court.

    Miller and her colleagues say research shows, when people are on those medications they are less likely to overdose and die, they are more likely to abstain from drugs and quality of life improves.

    “I had to get beyond my parochial thinking about it,” explains Miller, “the goal is still abstinence but what we’ve come to recognize is there are a number of paths to get to that.”

    And nobody’s path looks the same. Which is why local experts, like Gallagher say there needs to be a shift in how professionals treat addicts.

    “If you have 10 people that are in recovery there’s going to be 10 different definitions of recovery,” says Gallagher.

    Gallagher says, right now the norm in the treatment community is abstinence based. Meaning, patients are often terminated from treatment if they can’t or won’t comply. Gallagher says, that is the wrong approach. “We do not deny anyone treatment we do not kick anyone out a treatment for having symptoms of their disease,” he says.

    Instead, Gallagher says treatment should be defined by the addict.

    “We meet them where they’re at. And if they are using drugs I actually want them in my care. I want a close eye on them. I want to retain them in treatment,” says Gallagher.

    And Gallagher goes a step further, blaming abstinence only programs as contributing to the opioid problem.

    “As part of the paper we actually identify that the addiction treatment profession as a whole is a contributor toward the opioid epidemic,” says Gallagher, “if we are kicking people out of treatment -- if we are denying people treatment for their disease because they are having symptoms of their disease, then we are a contributing factor toward that.”

    Ultimately, Gallagher and Miller want to help more people – in more communities. They hope their article and future work in St. Joseph County can help other communities battle the opioid epidemic.

    “It’s ultimately an inside job. Every person suffering from addiction hast to do it and has to be committed to it but we certainly can be there to assist and provide support,” says Miller.

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