As Pennsylvanians have gathered at town halls to discuss the heroin-painkiller addiction crisis, there have been many stories, often from parents, telling of their loved one finally becoming willing to receive help, then finding out no treatment bed was available. Some were told it would take weeks for an opening. With that, the addict would return to heroin, and a potentially lifesaving opportunity would be lost.
Hopefully, that won’t happen so often beginning in early October, after the opening of 25 “Centers of Excellence” across the state. The purpose of the centers is to immediately connect people, especially overdose survivors, to treatment. On Jan. 1, 20 more of the centers will open.
The centers also will have staff trained in the use of medications such as buprenorphine and naltrexone to treat opioid addiction. This will expand the availability of so-called “medication assisted treatment,” now seen as necessary for some addicts to overcome craving and temptation and stay clean long term.
The centers are expected to fill a critical need now that many Pennsylvania police departments are carrying naloxone, which can reverse an overdose caused by an opioid, which include heroin and prescription painkillers. Since late 2014, police have saved about 1,400 overdose victims, according to state officials.
But that often leads to another problem. Sometimes there is no treatment opening. Sometimes the addict is simply given a phone number and chooses not to call. As a result, overdose survivors commonly go back to using. That has led to frustration among police, who commonly tell of saving the same person multiple times.
The state hopes the centers will help about 11,000 during their first year.
In conjunction with opening the centers, the state has been working with hospital emergency departments so they are aware of the centers and have procedures for directly referring overdose victims, according to Gary Tennis, the state’s secretary of drug and alcohol programs. Tennis attended a PennLive edit board meeting Friday. The centers will then connect the addict with treatment. While the centers won’t necessarily provide inpatient treatment, its staff, with their knowledge of available resources and ability to navigate the system, will make it more likely the addict can immediately begin treatment. And in the event no program is immediately available, a staffer will stay in touch with addict, even with the addict likely to resume using, to get them into treatment when it becomes available, Tennis said.
The centers are intended for people covered by Medicaid, the health insurance program for people with lower incomes which Pennsylvania recently expanded to cover hundreds of thousands more people. Since addicts typically lose their employment and exhaust their financially resources, it’s likely many are eligible for Medicaid, although they might not know it.
During a recent meeting with the PennLive/Patriot-News editorial board, Tennis was asked what would happen to an addict referred to the center who wasn’t signed up for Medicaid. He said the addict would receive help in signing up, although it can take several weeks for the coverage to take effect. Meanwhile, individual counties typically have a pot of state money that can be used to pay for the treatment until the Medicaid kicks in.
While the centers are aimed at people covered by Medicaid, Tennis said that anyone referred to one would be given help.
The role of the centers involve more than just getting people started on treatment. They will do things including connecting them with treatment for mental health issues, which are often present in addicts, and providing long term support to help addicts stay involved with treatment and remain clean.
The centers are among the tactics, some underway and some which will require legislation, aimed at the overdose crisis that killed about 3,500 people in Pennsylvania in 2015, up by about 1,000 from the previous year. Tennis predicts the 2016 toll will be higher.
Asked about the overall availability of treatment and funds to pay for it, Tennis said “I think we’re short on everything right now.”
Tennis also said, “We are trying to expand our system as fast as we can. We can’t grow it fast enough.”
Still, the state, which has about 700 licensed treatment providers, has received applications for 86 more this year, after averaging about ten per year before the opioid crisis, Tennis said.
Meanwhile, Tennis said the 45 centers will move the state closer to the goal of “warm hand offs” – where everyone brought to an ER for an overdose can be immediately sent into treatment. Otherwise, they will return to a path that will likely lead to jail or death. “It’s a life and death situation for these people when we get them after an overdose,” he said.