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GUEST VIEW: Community needs to understand and be realistic about treatment for opiate addiction

I attended the Carlton County Opioid and Heroin Community Forum Oct. 5 at the Forestry Center in Cloquet. This was an important and informative gathering. The large number of community members who took time to attend indicates the importance of the subject to the area’s people.

During the forum, the only time the majority of attendees applauded was when a panelist stated the best treatment for opiate addicts is not the initiation of methadone maintenance therapy, but complete detox and abstinence. Although this may be true for some, it is not true for many individuals suffering from opiate addiction. Being realistic, not fatalistic, by using methadone to allow the individual to start with making smaller goals — such as no longer shooting up and/or no longer taking illegal prescription drugs — can oftentimes be more successful in the long term. Prior to what some may think is “abstinence” is months of very difficult self-examination overcoming obstacles such as personal traumas, mental health difficulties, unemployment, legal issues, etc. As an addiction counselor who has worked with opiate addicts, I understand the enormous difficulties in getting and staying sober.

Regardless of how the individual got to the point of requiring help (i.e. treatment), the individual is the only one who can successfully make and keep the promise of sober living to themselves.

The public complaint that all methadone clinics are out for the money is counterintuitive. Although the corporation/corporate level has profit as its bottom line (which is true of all companies), as a counselor who cares very deeply for each of my patients/clients, my goal is an individual’s sobriety and re-entry into their lives.

My responsibility is to meet my patient where she/he is (e.g. What is the person’s age? What is their level of education? Do they have mental health concerns? What is their employment status? Is domestic violence present? Do they have legal system involvement? Are they still using another drug such as alcohol? Are other family members still using?, etc.), and help that person get to their goals (not my goals; not their family members’ goals).

Assuming or expecting someone who is addicted to any drug(s) — alcohol is a drug — to “just stop, go through detox, stay sober” may imply that any progress made towards the goal of sobriety is wasted time and effort.

Near the end of the forum, one community member voiced the “true” state of addiction treatment and needs: the idea that oftentimes insurance-set short treatment time limits should solve the “problem.” This forum member didn’t have the time needed nor the appropriate audience platform to expound on his input, but he was on the right track. Getting and staying sober is the beginning of a new life, not a portion of time during which the individual “stops using.”

When the Lake Superior Treatment Center (LSTC) in Duluth was closed in August of this year, it was possibly the most regulator-scrutinized, examinator-visited methadone clinic in the state of Minnesota. Over the two years LSTC was operating under a temporary license, the employees working at that time spent countless hours as a team to create the best run, most organized facility serving the population of opiate addicts in this area.

LSTC was operating with the best team of clinicians, nurses, technicians, coordinator, and program director I have ever worked with. This team was incredibly dedicated to the wellness, happiness, and sobriety of each and every opiate-addicted member of our community who walked in the door starting at 5:30 a.m. every day. It took a tremendous team effort many hours of oftentimes unpaid overtime and dedication to ensure all state and federal laws and regulations were adhered to by constant documentation improvements, state personnel oversight, and personal accountability of each patient’s record.

The LSTC addressed the problem of methadone diversion by disallowing the privilege of “takeouts” for the majority of patients. Allowing someone to walk out the facility door with their methadone prescription is a privilege earned by following the treatment facility’s rules (e.g. attending clinic daily, attending one-to-one sessions with their counselor, attending required sober support meetings held at the clinic, etc.).

CARF personnel (Commission on Accreditation of Rehabilitation Facilities) stated they had not come across a better run facility in their recent site inspections. (I personally attended this facility inspection summary meeting. The inspectors were visibly impressed by the dedication and obvious professionalism of the entire team of the Lake Superior Treatment Center working at that time.)

The Lake Superior Treatment Center closed due to the opening of the Center for Alcohol and Drug Treatment’s opening of their Clear Path Clinic, not due to the performance of LSTC’s then current operations. During the two years LSTC was operating under a temporary license and working diligently to ensure adherence to all requirements of state and federal regulations for a new license to be issued, the Center for Alcohol and Drug Treatment developed their Clear Path program in partnership with St. Louis County.

If you have not worked as an employee of an intensive outpatient clinic with all the troubles, traumas, and heartbreak that comes in the front door every day, please don’t assume someone can “just go through detox” and should be good. This mindset can cause failure for the addicted individual before a real start down the road to sobriety even starts.

As another forum attendee stated, the opening of a methadone clinic in Carlton County may be a part of the answer to the scourge of drug abuse, crime, and opiate-related deaths in our area. The Lake Superior Treatment Center’s assembled team’s goal was ultimately the sobriety of their client/patient. If that sobriety continues to be maintained by the use of a daily dose of a highly regulated and legally prescribed medication such as methadone, this is much better than shooting heroin or stealing prescribed medications from relatives and friends.

Writer and Wrenshall resident Cheryl Lund has been a licensed alcohol and drug counselor for 10 years. She has a BS degree in psychology and a BAS in criminology.