Addiction: What Now?

The Bridge to Hope spokesman Domenic Marks tells the audience at Dan Miller’s Substance Abuse Forum about his daughter’s struggle with addiction.

Domenic Marks’ daughter started using prescribed narcotics at 14 when she had her wisdom teeth removed. It started her on the pathway to addiction, a nine-year journey that included heroin. Marks didn’t find out she had a problem until she was about 18. “It put my family in absolute chaos,” The Bridge to Hope spokesperson and advisory board member told the more than 150 people who attended State Rep. Dan Miller’s Substance Abuse Forum last week at St. Paul’s Episcopal Church in Mt. Lebanon.

Unfortunately, stories like Marks’s are common. The heroin and opioid epidemic is the number one public safety and health crisis in Pennsylvania, according to Attorney General Josh Shapiro, who kicked off the forum. It’s easy to see why. “We will lose 13 Pennsylvanians yesterday, the day before, the day before that, today, tomorrow,” Shapiro said. “We can’t arrest our way out of this crisis,” he added. “We have to understand the different angles and have compassion. Drug addiction is a disease, not a crime.”

Pa. Attorney General Josh Shapiro speaks at the forum, sponsored by State Rep. Dan Miller, pictured at right.

Key is making treatment part of the solution, Shapiro said. But he called for real, meaningful treatment, instead of jail. His office is going after big-time dealers in the streets, but Congress also needs to be called upon to do something. he said. Since the path of addiction often starts with legal prescription drugs, “Are we bringing pharmaceutical companies into that equation?” Shapiro asked. The question drew applause.

In addition to ensuring that doctors are re-educated and included in the solution, Shapiro said the law should be changed to mandate that someone go into treatment when revived with Narcan. Narcan, the brand name for naloxone, is a drug that stops the effects of an opioid overdose and revives a patient who has stopped breathing. Law enforcement officers are experiencing fatigue because they’re repeatedly reviving the same people, who refuse medical transport.  The culture needs to be changed and the community, which foots the bill, has to step up, Shapiro said. This means adding drug deactivation drop boxes that make medication inert, pushing lawmakers, rewarding law enforcement agencies when they work together, appreciating the work, reducing the stigma and reclaiming our communities.

What is having an impact is arresting drug dealers and charging them not only with drug delivery but with homicide when someone dies as a result of a deal. Dealers are now afraid of getting hit with a murder charge. “Give law enforcement greater tools,” Shapiro urged. And “support lawmakers who are helping.”

This crisis clearly goes well beyond a bipartisan issue. “One of the positive things you can say about this is that it affects everyone and unites us,” Rep. Miller said. He isn’t immune; he lost a friend to heroin and four years ago lost a cousin to addiction. He speaks from personal experience when he says, “When one member of the family has an addiction of any type, it consumes the entire family.”

The forum provided an opportunity for attendees to learn about obstacles to treatment

And families are crucial in fighting the epidemic. Marks said that families aren’t educated, and need to be better prepared. When he was referred to the Bridge to Hope, a support group with a mission to educate and support families impacted by a loved one’s addiction, he realized he needed to learn what he could about the disease. “How can I come up with a plan or solution if I don’t know what this disease will do?” he asked.

Many families view addiction as a character flaw when in reality it’s a disease of their choice. It becomes much easier to accept once this is part of the thought process, Marks said. Families also need to understand that relapse is part of the journey. There’s also a biological factor involved; families should know to look at their history. People always say, “Not me, not my family,” but Marks asked, “If not my kid, tell me how do we have the numbers we have?”

Marks’ daughter went to treatment and rehab a few times, but each time she went, she picked up a tool for dealing with her addiction. Eventually, she got to a point where she tired of the lifestyle and had to make a decision. She got married in September. “She can relapse,” he admitted, but the hope is that “recovery is so strong, she won’t fall back.”

Dr. Dennis Daley, professor of psychiatry and social work who served for 14 years as the Chief of Addiction Medicine Services at Western Psychiatric Institute and Clinic and the University of Pittsburgh School of Medicine, also was a panel member. Daley said we aren’t a preventative society, but we should be. Because there’s no short term solution for addiction, we need more funding for effective long-term treatment, he said.

Our society needs to have a preventative mindset, one panelist said.

A shortage of treatment beds doesn’t help. Shapiro said Medicaid, which pays for care for low income patients, won’t reimburse for treatment if a facility has more than 16 beds.

This is where programs like Triangle Residential Options for Substance Abusers, Inc. (TROSA) in North Carolina would have an impact. It’s a two-year treatment for addicts, which doesn’t cost anything—not even to insurance companies or families. The self-sustained work program educates and prepares addicts to step back out into the world, Marks said, praising it.

The forum attendees’ questions were specific and highlighted issues of which Miller was personally unaware. One thing he learned is that public health care plans often provide significantly better coverage to people seeking treatment and looking to maintain their recovery than private insurance. He plans to look into that issue.

The personal stories stand out for him. “I really appreciated people talking to me in the back of the room about the challenges they were facing just as much as I appreciated our panelists sharing their stories of triumph and struggle in front of everyone,” Miller said. He never forgets them, which helps him understand the issue and often provides the fuel needed to fight for change in Harrisburg.

State Rep. Dan Miller spoke at the forum but also listened, to hear attendees’ personal experiences.

Plans include supporting a number of bills under the HOPE (Heroin, Opioid Prevention and Education) Caucus banner. This won’t be the last event on the subject, Miller said. “Unfortunately, issues related to the current crisis and the challenges faced by those who are in recovery are not likely to go away anytime soon, and there is still a great deal of work to be done.”

Photography by George Mendel