Few Delaware County residents can say their lives have gone untouched by the nation’s opioid crisis. A 2018 Siena College poll found that 54 percent of New Yorkers said they had been personally affected by opioid abuse, 83 percent felt that opioid abuse has worsened in the last few years, and one in four knew someone who had died from overdosing on opioids.
Rural Catskill communities have not escaped the effects of the opioid crisis. In 2018 overdose deaths in Delaware County from heroin and opioid pain medications (such as Oxycontin) were at least double the rate of New York State. Information on hospitalizations for opioid overdose shows there were nearly twice the number of hospitalizations in Delaware County than all of New York State in 2017.
Why do People Get Addicted?
Addiction often begins with the voluntary use of a drug, although it can quickly escalate to uncontrollable drug seeking and use despite negative consequences. When a drug is used repeatedly—whether alcohol, nicotine, opioids, or meth—brain changes occur that alter the person’s ability to stop using. These brain changes drive a person to seek out more of the drug at higher doses because tolerance to the drug builds up. With long-term use, the drugs affect the user’s behavior, decision-making, judgment, memory, and learning.
Because of these brain changes, relapse is common. Those who go into treatment may have cravings that last for years. Addiction should not be considered a moral failing of an individual though. Rather it is a chronic relapsing disease not unlike other chronic diseases such as heart disease, asthma, or diabetes, and should be managed accordingly.
Treatments for opioid and substance addictions should focus on a whole-person approach. For youth, early intervention with therapy is key, as adolescents are less likely than adults to experience withdrawal symptoms or issues when stopping the drug. Medications such as Suboxone (a combination of buprenorphine and naloxoneor) or methadone are the first recommended treatment along with behavioral therapy.
Dr. Hugo Hanson, an emergency room physician from Kingston Hospital (part of the HealthAlliance of Hudson Valley and the Westchester Medical Center Network), is working to ensure that people addicted to opioids who come to the hospital are provided with these medications and referrals. “The earlier that someone receives treatment, the longer they are able to sustain treatment,” he noted.
Current resource for initiation of treatment in the community include the inpatient unit at UHS Delaware Valley Hospital in Walton, and the chemical dependency unit at Benedictine Hospital in Kingston. Emergency treatment can be sought at any emergency department, including Margaretville hospital, where hospitalist Dr. Khuram Farooq is certified to prescribe treatment with Suboxone. The hospital is exploring how to improve access to addiction treatments. One residential treatment program in the region is The New Direction program, helping people since 1977 (http://www.thenewdirection.com/). The Delaware County Alcohol and Drug Abuse Services can provide information on treatment options and referrals (http://www.co.delaware.ny.us/departments/mhc/ada.htm)
Access to treatment and providers is still a major issue in this region, as it is in the most rural communities throughout the country. Work here is currently being done to develop strategies for increasing the number of providers and access to treatment for opioid and substance abuse. On Friday, Jan. 18 a Community Action Summit will be held to develop solutions for preventing and treating substance abuse in Delaware County with an initial focus on youth. More information is available from the Eastern Delaware County Coalition for Substance Abuse Prevention & Treatment at EDCCSAPT@Gmail.com.
This article was written by Karen Driskill, RN, BSN, on behalf of the Eastern Delaware County Coalition for Substance Abuse Prevention and Treatment.