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Thursday, September 21, 2023

Madison County applies for buprenorphine pilot program

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WAMPSVILLE, NY – The Madison County Board of Supervisors has approved the Madison County Police Department to apply for a grant from the New York State Health Corporation to install a pilot program with buprenorphine injectable.

The scholarship, if approved, will be in the amount of $250,000 and will cover a period of 36 months. The program will allow the sheriff’s department to assess the effectiveness of buprenorphine injections compared to oral buprenorphine, and to observe the difference between inmates with addiction. The Sheriff’s Department is also applying for a federal grant to help fund the program.

“The prison just started a drug-assisted treatment program for opioid use disorder,” said Capt. Timothy Flynn of the Madison County Sheriff’s Department. It is now in the planning stages. Jail is required under recently enacted state law to put a program in place no later than October 7th.”

Buprenorphine is a prescription drug used as an alternative drug in the treatment of heroin and methadone addiction. The use of a prescribed drug as an alternative drug to treat addiction is known as pharmacotherapy.

The grant will allow direct observations between the injection and the oral application of buprenorphine.

“Oral application is via dissolvable strips or daily-released tablets,” Flynn said. “Each dose requires a member of the facility’s medical and security staff [to] Presence to check and monitor the incarcerated person to reduce the possibility of drug misuse or hoarding.”

The drug takes about 15 minutes to dissolve.

“After the drug has dissolved, the incarcerated person will need to eat and drink, and an examination of the mouth and hand will be done to ensure that the drug is taken as required,” Flynn said. “Even with these checks, the possibility of diversion remains. The delivery method also causes ‘highs and lows’ in the levels of the drug in the body resulting in daily cravings.”

The results of buprenorphine injections will also be studied.

“Injection injections are performed once per month by the facility’s medical staff with a member of the security staff present,” Flynn said. “After the initial doses, drug levels remain constant, virtually eliminating cravings caused by low drug levels.”

Flynn said in the second quarter of 2022, from April to June, that 24 of the 90, or 27%, of incarcerated individuals screened while taking the facility had an opioid use disorder.

The Centers for Disease Control’s National Center for Health Statistics reports that there were an estimated 107,622 drug overdose deaths in the United States in 2021, an increase of approximately 15% from the 93,655 deaths estimated in 2020. The increase in 2021 was half of what it had been previously. A year ago when overdose deaths rose 30% from 2019 to 2020.

Madison County had seven suspected overdoses in May; Six were non-fatal and naloxone was not taken. There was one suspected fatal overdose, with no naloxone being taken.

The overdose death rate for 2020 was lower than in surrounding counties, but health officials noted the largest increase in that rate to date. Between 2019 and 2020, the rate increased from 5.6 to 14.0 per 100,000 residents. The rate of emergency department visits in Madison County for opioid overdoses remains below state and Chinese yuan rates.

Flynn said that many social, mental, and economic risk factors for addiction exist. These factors almost always overlap. They include a family history of addiction and a possible genetic predisposition to addiction. Studies show that first-degree relatives, siblings, parents, or children of someone with a history of addiction are four to eight times more likely to have the addiction themselves than those without a family member with the addiction.

And children of parents who abuse alcohol or use drugs will follow suit or use them because the substances are readily available.

The lack of family participation exacerbates the problem. Clinical psychologist Dr. Marian Rosenthal said that teens with uninvolved, passive parents are at 75 percent more likely to be at risk of substance abuse than those from well-organized and disciplined families.

Poverty is not considered a direct effect of addiction, but factors associated with hopelessness, stress, and loss of self-esteem and social support are factors that contribute to addiction.

Addicts sometimes suffer from a mental health disorder and take drugs to overcome it. But the continued use of illegal substances leads to an increase in mental and physical problems. Experts prefer treating addiction and a mental health problem together.

Options for this treatment include cognitive behavioral therapy, which is talk therapy that challenges irrational thoughts and changes behaviors; Dialectical behavior therapy, which promotes mindfulness and self-awareness. This helps reduce strong feelings and reduce destructive behaviors including suicide attempts and the temptation to use drugs as a shelter. It also improves relationships. The third option is assertive community therapy.

Psychological and physical trauma often lead to addiction. Experts with the Turnbridge Addiction Program say that nearly two-thirds of people with post-traumatic stress disorder (PTSD) also deal with substance addiction. More than 70 percent of teens who receive drug treatment have a history of trauma. About 3 out of 4 drug addicted women have experienced sexual abuse in their lifetime. They deal with themselves to escape feelings of guilt or shame.

Peer pressure can have a moderate to strong effect on temptation to use. Staff at American Addiction Centers suggest saying “no” assertively when near peers who use drugs, to remind peers that up to 60 percent of addicts relapse, avoid temptations, use the buddy system when out, and a friend is another sober and strong person to see about temptation and offered to be the designated driver.

The National Institute on Drug Abuse warns that early use is a risk factor for addiction. Young people take a drug or drink out of curiosity and to perform better, to feel good, and love the feelings it gives—and also the misconception that they can control their need for it.

Taking a highly addictive drug can lead to addiction. Drugs such as marijuana, alcohol, nicotine, and prescription drugs are relatively easy to obtain and can quickly lead to the use of cocaine, heroin, and fentanyl.

Madison County has programs designed to help at-risk residents cope with the factors that lead to illicit drug use. Its Department of Social Services offers groups of men and women to deal with the trauma of divorce and financial problems. DSS also offers HEAP, SNAP, and Medicaid for those who struggle to pay heating, food, and medical bills. Their number is (315) 366-2211.


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