Heroin, pill task force release report
Dr. Mitch West was one of the specialists analyzing data and trends with addiction and overdoses in the region.
U.S. Attorney David Hickton (middle) and Drs. Mike Flaherty (left) and Neil Capretto address questions at Sept. 30 press conference.
Overdose antidotes aren’t widely available, doctors often can’t prescribe them for known heroin addicts and “doctor shopping” for opioid painkillers continues in the absence of a state drug monitoring program.
These were some of the findings printed in a 52-page report from an advisory group headed by U.S. Attorney David Hickton and addiction specialists Drs. Mike Flaherty and Neil Capretto.
“We cannot prosecute our way out of this problem. We need a 360-degree solution with all hands on deck,” Hickton said at a Sept. 30 press conference.
“Something the legislature can do is vote on Senate Bill 1180, a prescription pill monitoring program that can track physician and patient prescription trends,” Capretto said.
“Some view (a database) as an extra burden, but it’s being responsible. A doctor wouldn’t prescribe insulin without checking blood sugar,” he said.
“Only 10 to 15 percent of people who need treatment for addiction are getting it,” Flaherty said.
He noted at-risk groups aren’t often thought of as “really at-risk,” such as those going into treatment, those coming home right after treatment and those coming out of incarceration.
“Prison is not exactly a therapeutic environment. And often they’re talking about drugs. The first thing a person wants to do when they get out if they were addicted when they came in is get high,” Dr. Mitch West of Bethel Park said.
West quit his job as an emergency care physician with UPMC to take part in the addiction and overdose task force formed in April.
“I’ve given naloxone, or Narcan, the overdose antidote, hundreds of times. It’s saved so many lives. But this stuff is typically only in the hands of first responders and doctors,” West said, “You generally have two to five minutes from overdose to death. So, we need to be getting this in the hands of people who are around the victim at the time.”
“It can be prescribed, but doctors are fearful it’ll embolden addicts; that they’ll have a fail-safe in their pocket. But most overdoses are not intentional, and they’re often a mix of drugs, or a mistake of a dosage. They’re not looking to kill themselves.”
Overdoses are the result of a preventable problem. West said the treatment medication buprenorphine needs to be used more often than methadone because it doesn’t trigger a high.
“The thing with buprenorphine is it’s a partial agonist and antagonist for the brain’s opiate receptors. You give this to patients and they say, ‘doc, I feel like I did before I became addicted.’ It satiates the craving while also making them feel ‘good’ but it doesn’t make them high.”
But federal regulations make prescribing the drug difficult.
“Right now, you can only give this stuff to 30 patients a year. Otherwise, you need a waiver from the Drug Enforcement Agency,” West said.
The task force will reconvene in four months to re-evaluate implementation of community efforts, such as training 911 operators to help callers use emergency antidotes and improving post-treatment counseling.