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Oklahoma's drug rehab homes drive back people who are trying to escape opioid addiction by taking medications considered extremely effective for their cure.
Oxford House, one of the largest networks of drug and alcohol treatment centers in the state, is trying to convince more of its residences to accept applicants who are taking drugs that reduce cravings and withdrawal symptoms, such as Suboxone or methadone. But the resistance is strong.
Each of the state's 110 Oxford homes – there are 2400 at the national level – is self-sustaining and residents vote to allow applicants to live there.
Because Oxford Houses are sober houses, discouraging drug and alcohol use, many residents oppose the possibility of letting newcomers take drugs like Suboxone, designed to help them break out of opioid addiction. . Residents fear that the presence of Suboxone and methadone, which can also be addictive, compromises their sobriety.
Of the 835 residents of Oxford Houses in the state, about 40, or less than 5%, are on drug treatment with Suboxone or methadone, according to Dan Hahn, who coordinates nonprofit awareness activities in the state. the whole country. That's from scratch 11 months ago.
Concerns about releases have reached the representatives of the state government.
Oklahoma Department of Mental Health and Addiction Services Received $ 7.3 Million in Federal Funding Last Year to Address Opioid Crisis in the State, Resulting in Hundreds of Overdoses deadly every year. In 2016, opioids were responsible for 444 deaths, according to reports from the National Institute for Combating Drug Abuse. A small portion of the $ 140,000 grant went to Oxford House to educate residents about the value of drug-assisted treatment.
"One of the greatest strengths of Oxford House is also one of its weaknesses," says the grant application. "Oxford House functions as a true democracy and new members are elected at home (and sometimes outside) with a majority of voices of 80%." But "stigma and lack of understanding … usually lead to a "no" for a (drug treatment aid). "The application has, however, noted signs of change.
Jeff Dismukes, a spokesman for the Department of Mental Health, said that sober living conditions were essential for a successful healing. "Going back into an environment where people use does not promote recovery. It's not an option, "he said.
Some residents concerned
Wendy Knapp has spent dozens of years in substance abuse recovery programs and alcoholism. Today, this 56-year-old fast food restaurant has been sober for three years and lives at Oxford House Boomer in
Norman. She is confident this time that her recovery will continue.
After each relapse, Knapp left the cold turkey relying on abstinence, sober homes and peer support groups to stay healthy. So, when a woman who was taking prescribed medications to cure her opioid addiction was admitted to the house this summer, Knapp voted against it, and the woman was fired.
"We do not want that here," Knapp said. "We talked about it, and we just do not agree with that in this house."
The feeling is similar at Oxford House Amina in Ardmore, which faces the dilemma. Resident Natasha Knight recently said that the house was about to question a candidate who was receiving medication and that she might be rejected.
"For some people at home, yes, it's a problem," said Knight. "I went to a seminar about a month ago that opened my eyes, but before I was completely against it. She will probably be rejected because of that. "
Admission resistance in people receiving drug-assisted opioid drug dependence is rooted in a culture of total abstinence, which is found in many peer support programs. , such as Alcoholics Anonymous and Narcotics Anonymous.
On its national website, Oxford House states: "In its simplest form, an Oxford House is an autonomous, self-contained, drug-free home. It's run democratically. "Residents pay rent and expenses, and typical houses have six to 16 residents. which means that in small houses, one vote is enough to prevent an applicant from moving in.
In 2010, Oxford House updated its policy, which banned drug-assisted treatment to allow residents to call.
"We try to maintain the integrity of our model, but also to be progressive because we know things are changing," Hahn said.
Mixed messages
Much of the controversy surrounds the increasing use of Suboxone, which, according to addiction specialists, is effective when it is associated with counseling programs and, possibly, peer support. Suboxone is a combination of opioid buprenorphine and naloxone, a drug that blocks the effects of other opioids and discourages prescription abuse.
Oklahoma doctors have written more than 169,000 prescriptions of buprenorphine-containing drugs since the beginning of the year, according to data from the Oklahoma Office of Drugs Control and Dangerous Drugs. . This represents approximately 145,000 in 2014.
Dr. Layne Subera is one of more than 250 Oklahoma practitioners licensed to prescribe buprenorphine. Physicians must seek a waiver from the Drug Enforcement Administration and limit the number of patients they can treat with the drug. Subera, a Skiatook family doctor, just north of Tulsa, said it was difficult to find residential programs for her 140 patients benefiting from drug-assisted treatment.
Many sober homes, mental health facilities and peer support groups across the state reject patients taking these drugs because they do not understand the value of treatment, he said.
"Many people do not like the idea that we are fighting an opioid addiction, but I rather like to think about it more like fighting fire with fire," Subera said. "It's not perfect, but it's the best we have right now."
Hahn, of Oxford House, said he was working to educate residents about medication-assisted treatment and to promote "multiple pathways to recovery." He explained that these efforts helped to influence the opinion of many urban homes, but that it was harder to change perceptions in rural areas. Locations.
Since the end of 2017, the majority of drug users who have applied to Oxford House have been accepted, Hahn said. The residents, however, indicated that many did not even ask to enter a house because of its reputation of refusing people.
Hahn said people using drugs for treatment were not suitable for all households. They should be redirected to homes where about 100 of them are currently recovering, after being victims of Suboxone abuse, he said.
New homes, those with high turnover or transition leadership should also be excluded. Residents who take medication assign more responsibilities to householders, for example by forcing them to take the daily count of pills, he said.
Green House, Oxford House of Tulsa, was one of the first Oklahoma residents to accept the use of Suboxone. Resident Shannon Kelly, who has been living in the home for 10 months, said two women on medical assistance had moved in and integrated well.
Taylyr Williams, 27, had not taken any medications in January when she ran for Norman's Oxford House Elmhurst. Williams had abused opioids from time to time for about eight years, starting with Oxycontin and switching to heroin. She tried to get out of the cycle, but without any treatment program or support group to support, she relapsed several times. She even fell once after moving to an Oxford House. She decided to ask for additional help.
"I watched my sister, who was even worse off than me, then she went to Suboxone and it was a success for her," Williams said. "I used to be against it too, but that changed my whole point of view about it."
Williams waited two months for an appointment at a clinic in Normandy, where she was finally subjected to a treatment plan including Suboxone. As Williams was already living in an Oxford home, she had to get approval from her roommates to be able to administer her daily dose. She spoke to them at a house meeting and they approved her request. Williams said that his house was open minded and accepted his treatment.
"Medications help reduce cravings, so I do not even think about it anymore," Williams said. "They made a huge difference by staying sober this time."
Despite testimonies like these, suspicions persist.
Troy Rouse, who lives at Oxford House Rockford in Ardmore, said he was comfortable with anyone taking medication after seeing his sister abusing her Suboxone prescription. Rouse stated that he did not think that prescription treatment was a good idea for any addict and "if someone came to the house, I would tell him that pills like these would not be good for one. addict."
Oklahoma Watch is a nonprofit, non-partisan news organization that produces in-depth journalism and investigation of issues facing the state. For more content on Oklahoma Watch, go to oklahomawatch.org.
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