Clallam opioid program to combine counseling, medication

PORT ANGELES — More people die of opioid overdoses in Clallam County than any other county in the state.

“It’s not a number one you want to be,” said Dr. Chris Frank, Clallam County Public Health Officer.

“Right now, it’s easier for people to steal something, sell it, go find a quiet place, use drugs and repeat that four times a day than to get treatment,” Frank said.

An opioid treatment center coming to Clallam County could help patients break that cycle of addiction, said Sam Agnew, chemical dependency manager of Salish Behavioral Health.

Salish Behavioral Health Organization recently selected BayMark Health Services to establish two outpatient treatment centers, one each in Clallam and Kitsap counties.

The Texas-based for-profit treatment provider has not decided on a location in Clallam County.

Tom Schwallie of BayMark estimated it will be “upwards of six months” until the center opens.

On Friday, Salish Behavioral Health hosted a public forum in Port Angeles to answer questions about the center. The forum followed this opioid treatment program FAQ.

The centers will provide medication-assisted treatment, which couples counseling and behavioral therapies with medications, including methadone, buprenorphone (or Suboxone) and Vivitrol.

The medications normalize brain chemistry and block the euphoric effects of misused opioids, relieving physiological cravings, according to the group.

“Out of all those things, the biggest element is the inclusion of medication,” Agnew said.

Methadone may be the least accessible medication now to county residents, Frank said.

“We simply don’t have methadone in Clallam County,” he said.

BayMark president Jason Kletter said the center will provide treatment on demand, meaning same-day medication.

“We know we need to need to strike while the iron is hot,” Kletter said. “When they experience a moment of clarity — we know it’s a chronically relapsing disease — we provide treatment on demand.”

The program favors a “harm-reduction” approach over an abstinence model, Agnew said.

Licensed physicians will determine the precise dosages — over which, “huge” oversight exists, Agnew noted — not to produce a state of euphoria but a state of stability, he said.

It removes the constant withdrawals and pain, Agnew said.

The idea is to stabilize the patient before engaging in other recovery efforts, said Lisa Thomas of Olympic Community of Health, one of nine accountable community of health regions in the state that is part of the state’s plans for implementing the Affordable Care Act. It covers Clallam, Jefferson and Kitsap Counties.

“In particular, we can keep people alive,” Thomas said. “If we can’t keep people alive, we can’t get them into treatment and we can’t help them recover.”

Last year, the county had 62 documented overdoses and at least six deaths, according to data released January following mandatory reporting.

Since 2010, the number of recorded opioid-related deaths in the county ranges from seven up to 14, with about 10.5 deaths per year.

In 2014, the county’s opioid death rate stood at 13.4 per 100,000 people, while the state average was eight. Neighboring Jefferson County had an opioid death rate of 9.7 per 100,000 in 2013.

A woman, who did not identify herself at the forum, said her sister died of an overdose this year.

Her sister agreed to try medications such as buprenorphone or Vivitrol, she said, but did not obtain them before she died.

“This medicine may not work for everybody because addictions are different but I do know one thing: my sister was a true addict,” she said.

Had she lived long enough to access such medications, her sister might still be alive today, she said.

“Maybe methadone would have been her last drug. Maybe she would be alive.”

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Reporter Sarah Sharp can be reached at 360-452-2345, ext. 56650, or at ssharp@peninsuladailynews.com.

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