While I am very aware there is an opioid crisis, I’d be the first to admit I don’t know squat about the current thinking regarding opiate addiction treatment. The last time I checked, it was all about tough love, incarceration, and success narrowly defined by a person giving up all use.
So I was eager to attend the 2019 Columbia Pacific Opioid and Substance Abuse Summit held last week at the convention center. The vision of the summit was to develop a trauma-informed network for all substance use disorders, ensuring timely and equitable access, as well as reducing stigma. The organizers also hoped to promote cross-organizational coordination with a community already experienced in working towards long-term recovery support.
The summit was huge. The Necanicum Room was packed. Attendees and sponsors from OHSU, Legacy Health, the Rinehart Clinic and Pharmacy, Columbia Memorial Hospital, Adventist Health, Providence Seaside Hospital, Tillamook Family Counseling, Tides of Change, Helping Hands and other support communities were there, as well as a slew of medical personnel, treatment court coordinators, firefighters, paramedics, and social workers.
After a welcome and introduction given by Dr. Safina Koreishi, medical director for Columbia Pacific CCO, and a moving presentation by Kerry Strickland, chair and founder of Jordan’s Hope for Recovery, the audience listened in rapt attention to the recovery story of Dr. Ana Hilde, a child and adolescent psychiatrist with OHSU. Dr. Hilde told the shocking story of her own addiction to heroin while she was in medical school.
A big takeaway from Dr. Hilde’s story is that people do relapse. The road to recovery isn’t easy. There will be setbacks.
At a breakout session introducing and explaining “CRAFT,” which stands for Community Reinforcement and Family Training given by Cordelia Kraus, a psychotherapist with Vital Space LLC, I learned expecting complete abstinence from opioid use may be setting the bar too high. Reducing use over the long run may actually be enough. Kraus said that 9.4 percent of Oregonians struggle with substance abuse, and for every person who struggles, four of their friends, family members or co-workers are being impacted. The goal of CRAFT training is motivating families to change their approach how they respond to their addict loved ones. Positive phrasing, offering understanding statements, and being specific in praise when something goes right or is well done is more effective than tough love.
At a seminar on chronic pain called, “Why Do People Use Drugs?” Dr. David Labby, a health strategy advisor with Health Share of Oregon, said there is a fine line between medically treating a patient in pain and making them dangerously numb. Childhood emotional abuse is a significant factor why people use, as is depression. I learned doctors are prescribing Benzodiazpines, commonly called “benzos,” a class of psychoactive drugs, more than ever, and the strength of these narcotics has increased precipitously. Dr. Labby remarked that increased access to medical care has in fact influenced how many people use.
I learned women are closing the gender gap for alcohol abuse, and scary as the opioid crisis is, the alcohol problem is even bigger.
At a seminar led by Julianne M. Heuer, treatment court coordinator for Columbia County state courts, I learned poverty is the primary component as to who winds up in drug court. In Columbia County, coordinated treatment plans are available for nonviolent offenders who are substance abusers. Referrals to drug court come from probation officers, law enforcement, sometimes from the jails themselves. There’s a one-year program and an 18-month program. The longer you stay in the program, the better the outcome. The intention of drug court is not just to get non-violent offenders off drugs, but also to reunite parents with their children.
I’m sorry I ran out of energy to attend the seminars on management of methamphetamine use; how to talk to adolescents about drugs; and housing support for people in recovery, which I think is an urgent and important issue.
The main takeaway for me of the day was learning that when it comes to treating substance abuse, progress, not perfection, is the goal.