Opioid Crisis Reaches Alaska
In Ketchikan, Alaska, opiate addiction is rising along with meth and alcohol use.
Local experts believe that the level of addicts is roughly the same as they have simply shifted their drug of choice to opiates, and over time it will shift to something else, like a fashion trend.
In Ketchikan there is currently only one treatment center that offers medicated assisted treatment (MAT) to help addicts through their recovery with the use of lower level opiates such as suboxone and methadone. These medications relieve opiate withdrawal symptoms.
Ruth Bullock is the Program Director at Akeela Gateway Clinical.
“Yes, opiate addiction is a problem, I also think meth is a problem. And alcohol is certainly a problem,” she said.
A substance abuse specialist at Gateway, Steve Parker, believes that addiction levels across the nation haven't changed much, it's just a change in what they are addicted to.
“I don’t see the opiate epidemic as anything but a switch from one drug to another drug that will probably switch to another drug and then back to the other drug, leaving the population that’s addicted at 20 percent,” he said.
But for Ketchikan, both of these experts agree that alcohol will continue to be the main problem locally. Even though not many clients are receiving treatment for it, they know that alcoholism is constantly an issue that locals avoid to address.
“But, because it’s the drug of choice of ‘normal’ people, there’s never an epidemic of it,” he said. “At the KAR House right now – which is the treatment facility – we have probably around…”
“You said about four times the number of alcoholics as the number of opioid addicts right now,” Bullock said.
According to Steve Parker, Gateway Clinic views addiction the same across the board, no matter what substance certain people choose to abuse. Any type of addiction is dangerous, and potentially deadly.
Although Gateway offers outpatient services, there is no option locally for detox service. Locals who need detoxification have to leave town to get the treatment.
The KAR House is a small residential program offered by Gateway Clinic as a sober living space for people in recovery to stay.
In the near future, Gateway plans to expand their treatment options by offering medication assisted treatment (MAT).
“There wasn’t a lot of options then for detoxification,” said Bullock. “We had a lot of methadone clinics in Connecticut.”
Since buprenorphine injections are required daily, patients would have to travel to a clinic each day to receive this treatment.
“The buprenorphine itself is an opiate, and it’s not a full stimulator at the opiate receptors, it’s a partial stimulator,” she said.
By blocking opioid receptors, the medication makes withdrawal symptoms more discreet and bearable.
Buprenorphine was later evolved into Suboxone for outpatient clients according to Snow.
“A number of other doctors in town thought I should strictly use it to just detoxify people from opiates,” she said. “However, if you read all the studies, the people who were detoxified with Suboxone had a better chance of maintaining abstinence if they were on it as a maintenance medication for at least a year.”
Snow has shifted her belief in the past years about MAT. She used to believe that it was best to simply abstain from drugs in the recovery process; however, she has changed her mind due to the constant hard work it takes for addicts to maintain sobriety. When opiate blocking medications came onto the market, it became easier for people to stay clean.
The human body naturally produces endorphins which are essentially natural opioids. These are produced during exercise, sex, or even eating chocolate. They make you "feel good" and it is said that when people are addicted to opiates, they overstimulate these receptors and the body stops producing natural endorphins.
“Your body, through its feedback mechanisms decides: ‘There’s no reason for us to be making endorphins anymore. We have all this stimulation coming our way, anyway,’” she said.
For people who are severely addicted to opiates, they can loose all ability for their body to produce any endorphins even after they recover.
Through the years, Snow has noticed a shift in popular drugs. In the 90's there was more cocaine use, then in the 2000's it shifted to methamphetamine. More recently, prescription and illegal opiate use has been on the rise and spreading across the nation.
“I remember the drug rep from Purdue came by my office and said, ‘Oh, I’ve got great news. We’ve changed the formulation for Oxycontin so it can’t be abused anymore,’” she said. “And my thought was, ‘That’s not great news. People will just start using heroin now.’”
Ketchikan Indian Community’s Clinic is another option for locals to receive treatment. The clinic is directed by Craig Ward, who also agrees with Snow and Bullock.
“There are plenty of people who say, ‘I’m not that person you see at the bus stop that’s inebriated. I’m not that person,’” he said.
This clinic works mostly with clients who have already been through inpatient services and need "lower level therapy".
The sad truth is that the success rate for treatment across the board is low. Many people who receive treatment come back, at least once.
“Our most common substance is alcohol, no doubt about it,” he said. “Our second most common substance is opiates. Then cannabis. Then methamphetamine.”
Alcohol will remain a large problem since not many people recognize their addiction enough to receive treatment.
“Why alcohol is not as big of a problem? Because law enforcement is busy with opiate problems,” he said.
Since they are busy dealing with the opioid crisis, the cops deal less with people who have alcohol problems.