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Wednesday, April 16, 2014
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Published: 2/24/2014

EDITORIAL

An addict’s hell

Ohio communities must expand their use of medications to help treat opioid addiction

The death last week of 37-year-old Jeffrie Shirey, after a long fight with heroin addiction, should send a clear message about how hard it is to kick an opioid habit — and how much local communities need medication-assisted treatment to help addicts get through recovery.

Mr. Shirey’s mother, Carolyn Shirey of Holland, told The Blade that her son didn’t believe rehabilitation would help. He had told her repeatedly that his withdrawal symptoms were so horrible he would rather die than go through them.

The father of four children was struck and killed by a truck last week along U.S. 23 after he had walked away from Flower Hospital, where he had sought help to detoxify. Ms. Shirey believes her son committed suicide.

Opiates can become an unyielding hunger. Withdrawal symptoms are similar to a bad case of the flu — but much worse. People who go through opiate withdrawal feel as though their skin were pricked by razors. Sleep or rest is practically impossible, and the addict often slips into deep depression.

Ohio must expand medication-assisted treatment, using drugs such as Suboxone and methadone to ease greatly the agony of withdrawal. Suboxone is expensive: A full dose can cost as much as $5,000 a year, most of which will have to be paid by public programs or private insurance.

Partly because of its cost, little medication-assisted treatment is available in Lucas County. Scott Sylak, executive director of the county’s Mental Health and Recovery Services Board, said that in 2013, the board could fund only enough Suboxone to treat 18 people. Last year was the first time the medication was offered in Lucas County.

Until recently, treatment programs have not widely used Suboxone, which was approved by the U.S. Food and Drug Administration in 2002. An early Suboxone study by Columbia University in New York showed a success rate of more than 80 percent. Other studies have shown success rates of about 50 percent, though it’s unclear how many people stay clean after ending Suboxone use.

More studies on the long-term success of Suboxone are needed. Still, with success rates for opiate treatment often at only 10 percent to 35 percent, Suboxone has shown great promise, if its use is coupled with counseling and a gradual reduction of dosage.

It’s not a panacea. Suboxone can be addictive, but it is far less addictive than opioids and probably safer than methadone. In any case, medication-assisted treatment can give new hope to some of the estimated 200,000 people in Ohio who are addicted to opioids.

“We need to make sure that there’s a better understanding of why medication and medication-assisted treatment need to be part of the mix,” Orman Hall, the director of Gov. John Kasich’s Opiate Action Team, told The Blade’s editorial page. “We still have a number of abstinence-based treatment providers that don’t understand why medications like Suboxone, methadone, and Vivitrol are essential for this particular disease.”

Unfortunately, it’s too late for Jeffrie Shirey. But with thousands of people addicted to opioids in northwest Ohio, and heroin-related deaths more than doubling last year, Lucas County and the rest of Ohio need to expand medication-assisted treatment.



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