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Heroin problem hits home in rural areas like Wayne County

Published by Reid Health, April 28, 2016.

It’s fall 2014, and a few kids are out for a joyride through Wayne County’s back roads. The mood darkens when a kid in the backseat — a high school sophomore – pulls out a heroin syringe and shoots up.

The dose is too high, and he loses consciousness. His friends, some of whom are also high, stop the car in a panic, leave the overdosing teenager on the side of the road, and call 911 as they speed away. The 911 operator guides emergency responders to the teen’s location. On the scene, the paramedics begin triage.

The first line of treatment for heroin overdose is a drug called Narcan, which can reverse the effects of heroin within two minutes. The paramedics quickly administer Narcan and bring him back from the brink. The teen is briefly hospitalized, but soon he’s back to school. And sadly, back to using heroin.

Indiana, like many areas across the country, continues to face a heroin epidemic. The drug has become easy to find and cheap to buy, causing problems in Indiana and across the country. But because of caring individuals in our community, like Hagerstown teacher Jason Schmittler, awareness is becoming action.

Inspiring education

While teaching an English class, Jason watched a teen lose consciousness in his classroom. After the student was taken to receive medical care, Jason learned that the teen’s abnormal behavior was caused by heroin. He was shocked:  “It occurred to me that this is unusual, but heroin is nowhere on my radar.”

This experience inspired Jason to educate his students on the horrors of heroin use. “I didn’t know then what I was going to do, but I’m not going to watch this kid die, and I’m not going to watch another kid die.”

Jason began researching heroin abuse and reaching out to others in the community, like Reid Health and Wayne County’s drug task force. With the support of school administration, he planned a heroin abuse education and prevention initiative aimed at convincing students to never pick up the drug.

A focus on prevention

It became clear to Schmittler that the message needed to be focused on prevention, a sentiment echoed by Reid Health CEO Craig Kinyon. “Inherently, there are so many people who don’t understand the power of addiction,” Kinyon said.

Heroin use is exceptionally dangerous, and overdose is frighteningly common. In 2015, approximately 203 patients were treated with Narcan for opioid overdose at Reid Health’s emergency room. Treatment for heroin addiction is challenging for patients and requires motivation and commitment. “Sometimes you can’t get someone motivated to be clean,” said Reid Health physician Dr. Erika Brandenstein at a meeting on the impacts of heroin. Relapse is common.

Community involvement

Prevention and education are vital to stopping the cycle of heroin addiction. With the cooperation of Reid Health, Wayne County drug task force, and the community organization Heroin is Here, Hagerstown hosted heroin abuse education presentations for students, parents, and the community.

By design, the presentations didn’t sugarcoat the gruesome reality of heroin abuse. Medical professionals from Reid Health, including Lisa Suttle, Director of Psychiatric Services, along with an emergency room physician, presented information on the mental and physical impacts of heroin use. Suttle, who leads Reid Health’s Neonatal Abstinence Intervention Committee, shared information on the unfortunate number of babies born addicted to heroin at Reid Health.

Wayne County Coroner Ron Stevens presented statistics on the number of recent heroin-related deaths, emphasizing that heroin addiction often ends with a trip to the city morgue. A local mother shared the story of her son, lost to a tragic heroin addiction. Finally, before opening a question and answer session, the Wayne County drug task force showed examples of common forms of heroin, including powder and rock heroin.

All portions of the presentation shared the same message- never start using.

The presentations highlighted the strength of our community when we come together to face an issue. “The drug task force can’t do it alone, Reid Health can’t do it alone, and the schools can’t do it alone,” says Jason “We all came together as one unit to give a powerful presentation.”

So far, similar presentations have been given at a few area schools and at meetings of community organizations, with more planned in the coming months. A recent meeting

If you or someone you know is struggling with heroin addiction, call 211 for support.

New device offers hope, less painful opioid detox

Published by Reid Health, February 9, 2016.

A new device designed to help with withdrawal from opiates could become another important tool in helping deal with heroin/opiate addiction in the region.

The device, called the Neuro-Stims Systems (NSS) BRIDGE, was pioneered by Indiana company Innovative Health Solutions and offers an alternative to the pain of opioid withdrawal in patients overcoming the disease of addiction. The BRIDGE is a tool that could help with one of the most challenging aspects of overcoming an opioid addiction — the initial detox, company officials said.

Powerful, non-narcotic pain relief

“This is a tool to help with the withdrawal and detox portions of the disease,” says Brian Carrico, Vice President of Innovative Health Solutions, “this is a paradigm shift in the treatment of addiction through innovative technology.”

Addiction withdrawal, especially opioid and heroin detox, is painful and typically takes 10-14 days for a person to overcome. “Imagine the worst flu you’ve ever had. Now imagine it ten times worse,” says Dr. Eric Davis, Co-Executive Director of the Life Recovery Center, a facility for the treatment of substance abuse. “People come to me and say that their family member is going through withdrawal. They ask if he’s going to die. I tell them, ‘he’s probably not going to die, but he’s going to want to.’”

Many patients quit during this challenging detox time, even before long term treatment (like with Naltrexone or Vivitrol) can begin. The BRIDGE is a powerful pain relief device- it can reduce pain by up to 75% within 30 minutes, and reduces detox from 10-14 days to only 2-4 days. Using the BRIDGE helps more patients make it to long term treatment. Studies are showing the BRIDGE helps 8 out of 10 patients successfully progress to long-term treatment in fewer than four days.

The BRIDGE is intended to be one part of a system of treatment that includes detox, therapy, and long-term treatment. Craig Kinyon, President/CEO of Reid Health, said his team welcomes  anything that brings new hope to better manage withdrawal and addiction. “Our health system recognizes the impact of heroin and opiate addiction on our communities. We have to attack this problem with all tools at our disposal. This new technology provides great promise for managing withdrawal. We also recognize that technology alone won’t be effective without addiction counseling. In other words, we need to continually treat the ongoing disease of addiction.”

BRIDGE presentation in Lingle Hall

In addition to providing benefits to detox patients through non-narcotic pain relief, it could also prove to be a more cost-effective way to treat addiction. Indiana legislators, Reid Health leadership and physicians, Wayne County law enforcement, prosecutors, and representatives from the community attended a presentation about the BRIDGE in Reid Health’s Lingle Hall recently to learn more.

The device, which costs about $495 per patient, is followed by treatment with a medication like Vivitrol and therapy over the course of 16 months. The entire course of treatment costs about $15,000, but is offset by some insurance plans.

Senator Jim Merritt attended the presentation and commented on the potential this technology has to not only save lives, but to decrease treatment costs and reduce the number of addicted individuals. Many people struggling with opioid addiction end up in trouble with the law, and end up in prison. According to him, it costs more than $44,000 to house a person in a correctional institution for a year, whereas a comprehensive treatment plan with the BRIDGE, Vivitrol, and therapy would cost a comparatively inexpensive $16,000. “We have a very good opportunity to rehab an individual,” Merritt says, “We need to make sure this is recognized as a disease and not a character flaw. We need to offer hope and empathy. But when you get down to it, in terms of dollars and cents, it’s crazy.”

Representative Cindy Ziemke, who also attended the presentation, spoke in favor of having the device as a component of an addiction treatment plan, hopefully supported by Medicaid and insurance. “If we can get the correct funding, we would have a really comprehensive plan and you would have no bigger fan than me.”

Pilot program explored by Reid Health, Heroin is Here committee

As part of ongoing efforts to address the heroin epidemic, Reid Health and the Heroin is Herecommittee are exploring ways to bring new tools for addiction treatment, like the BRIDGE, to the community. Physicians and representatives from Innovative Health Solutions are working together to review the device and put together a comprehensive treatment plan, and possibly a pilot program, that combines the BRIDGE and Vivitrol. Such a plan would make it less painful to for a person to face addiction, and more likely to succeed with a long-term sobriety plan.

Babies born addicted: An extremely painful way to start life

Published by Reid Health, January 25, 2016.

An underweight newborn lies swaddled in the arms of a nurse. Even though the blanket is warm, the little boy seizes and shakes. He’s dripping with sweat, and there’s nothing the nurse can do to ease his terrified cries. At only two days old, he’s suffering from heroin withdrawal- and is one of a growing number of affected infants, according to the community organization Heroin is Here.

These infants are the unfortunate victims of an increase in heroin and opiate use in the Richmond community. “The reality is we’re seeing this all over the country,” says Craig Kinyon, CEO of Reid Health, of the increasing heroin trend. And unfortunately, meaningful change is going to be a challenge. “It’s a long, drawn-out issue, requiring a long-term commitment.” Awareness of the issue is key, which is why Reid Health has developed a committee on heroin and Neonatal Abstinence Syndrome (NAS), the clinical term for a baby’s withdrawal, to put these babies front-and-center.

A baby’s life shouldn’t begin with detox

Defenseless and battling a monster they don’t understand, these infants have an especially challenging start in life. When a pregnant mother consumes drugs, they pass through her placenta and enter the baby’s system.

Like the mother, the baby becomes dependent on the drug. Lisa Suttle, Director of Reid Health’s Psychiatric Service Line, recently interviewed Grace, a new mother who was undergoing methadone treatment during her pregnancy. “There were times I didn’t care whether I lived or died,” Grace says of her heroin addiction, “I felt so lost.” One day, a snowstorm prevented her from leaving to buy heroin, and that’s the day she decided she wanted to change.

She found information about a methadone treatment facility and began treatment. Grace was afraid about what methadone was doing to her baby, and asked other mothers undergoing treatment if their babies had been born healthy.

Methadone treatment was a challenging time for her — the combination of methadone and pregnancy meant she was always sick. She also said in the same breath that it made her stronger. Grace is one of the fortunate individuals able to commit to their personal addiction treatment plan, but other mothers are not as successful: “Even the patients who are motivated to get clean,” says Reid Health’s Dr. Erika Brandenstein, “most typically fall off [their addiction treatment plans] when they leave the hospital.”

Grace has been free from heroin addiction for two years. Grace’s daughter was born 11 months ago. “When she was born, you know the first time I saw her, I thought, I would do anything for her.  It is hard to understand that feeling.” Because when the baby stops receiving the drug after birth, withdrawal begins.

Each baby’s detox symptoms are different and can range from excessive crying, fever, and poor feeding, to seizures, vomiting and rapid breathing. NAS is a scary and painful experience for the baby. “Infants with NAS experience pain,” says Reid Health Pediatrician Dr. Loretta Ryan, “evidenced by excessive crying and difficulty in being soothed.” As withdrawal set in, Grace’s little girl suffered tremors, cried inconsolably, and required a feeding tube. It was a painful time for Grace, too: “It was really hard to watch her go through it.”

Time is the only thing that can help these babies — time for the drugs to leave their bodies and withdrawal symptoms to end. Some medical interventions can ease detox symptoms, but only if the syndrome is identified before mother and baby leave the hospital. However, withdrawal symptoms may not begin until 48 hours after birth, when most babies are being discharged from the hospital. Without treatment, babies suffering from NAS will struggle to gain weight, or may end up in the emergency room after experiencing severe symptoms like tremors or seizures.

These issues can become very severe, according to Dr. Ryan. “Short term prognosis is generally good if NAS is recognized and appropriate treatment is provided. Untreated NAS can lead to death from repeated seizures or dehydration from poor feeding,” she says, “I know of one baby several years ago that presented to the ER with seizures.”

After a baby is diagnosed with NAS, treatment can begin to ease withdrawal symptoms. A care team will carefully watch the baby and provide treatments like swaddling to calm fussiness, supporting weight gain with higher-calorie formula, or treating dehydration with an IV. In extreme cases, the baby will receive methadone or morphine to ease the transition. Babies suffering from heroin addiction need time to heal and overcome withdrawal, which can last up to six months.

The average hospital stay for a baby suffering from NAS is 16 to 20 days, compared to three days for typical post-birth care. Dr. Ryan says the child is likely to continue to encounter issues well into their childhood, including significant behavior problems, impulsivity and learning disorders. “Very few women who use drugs intend to get pregnant. I wish that any woman of child-bearing age who is using heroin or other street drugs had the opportunity to be on long-term birth control to prevent pregnancy. No mother wants her newborn to suffer withdrawal or to have long-term problems from the devastating effect of drugs on the developing brain.”

Awareness and action in our community

As of December 2015, Reid Health identified 54 babies born addicted to an opioid. By comparison, 31 babies were born addicted in all of 2014. Sadly, this increase in the number of affected babies is related to an increase in heroin activity in Richmond, Wayne County, and the surrounding areas. Reid Health is leading initiatives to bring awareness to both issues — the increase in opioid use, and the increase in babies born addicted.

The Heroin is Here group, started in Fall 2014, regularly meets to share progress on awareness goals and identify intervention resolutions. The group hopes to bring awareness and change into the Richmond community through collaboration, communication, and education. A meeting in October included more elected officials, reflecting growing concern about the issue.

Reid Heath has assembled a NAS-focused committee in response to the alarming increase in the number of addicted babies. The group is charged with identifying key initiatives to lead change, such as education, prevention and treatments. Collaboration is key to effectively communicating and educating in our community, so the group is comprised of both Reid Health physicians and employees, Richmond Treatment Center, community mental health centers, independent practitioners, the Department of Child Services, law enforcement and court officers. All are working together to provide options and solutions to this crisis.

“It takes partnership,” to drive meaningful change, according to Kay Cartwright, Reid Health Vice President. The NAS committee is focused on how addiction impacts mothers and babies in our community, and will work cooperatively with local organizations like the Department of Child Services and the Richmond Treatment Center, to combat the prevalence of NAS.

 

What to do after a breast cancer diagnosis

Published at reidhealth.org, November 2015

After receiving a breast cancer diagnosis, it’s normal to feel overwhelmed and anxious about the uncertainty ahead. Take time to understand your diagnosis and learn about the support resources available in your community. As you begin to develop a treatment plan with your doctors, it’s important to take an active role in your well being, empower yourself with knowledge, and know that you’re not alone.

Become actively involved in your care plan

What to do after breast cancer diagnosisAfter your breast cancer diagnosis, you’ll meet a care team dedicated to your treatment. This team will answer your questions and explore your treatment options. You may want to bring a friend or family member to your appointments to lend support and serve as an extra set of ears for processing the information.

Don’t be afraid to speak up. You should feel comfortable having an honest discussion with your oncologist, nurses and support staff. If you don’t understand something, ask for clarification. There are no silly questions.

Opt for a healthy lifestyle

Remember that healing involves your whole self, and that reaching out to a counselor, therapist, or even social worker can be a health-enabling component of your care journey. Proactively making healthy choices is another great way to take control of your overall well-being and help your body fight breast cancer. Making small changes in your everyday living, such as limiting your alcohol intake, taking daily walks, reducing stress, or quitting smoking, are key to a healthy lifestyle and are important components of cancer care.

Above all, continue to participate in activities that bring you joy. A breast cancer diagnosis will require time to absorb. It’s important to be kind to yourself. Read a good book, socialize with friends and laugh whenever possible.

Understand your treatment options

Having answers to your questions will help you to feel more in control and minimize anxiety. Ask your doctor for your pathology report, and begin an open dialogue about your unique breast cancer diagnosis. Reputable online resources such as the American Cancer Society can help you understand the medical language you might find in your test results and help you prepare for appointments with your care team. Keep a medical file at home for storing all the information you receive, so you’ll have it all in one place and easily accessible.

Find support

Every day, nearly 600 women in the United States receive a breast cancer diagnosis. Programs and services are available to help you and your family cope with your cancer diagnosis and treatment, both online and in your community. Joining support forums or participating in awareness events like Reid Health’s Bravo can empower you on the path to recovery.

Image source: morgueFile

Article source: Reid Health.

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