Opioids: Do drugs to fight drugs help or hurt?

Feb 7, 2017

When it comes to drug addiction, a challenge facing everyone from first responders to long-term caregivers is interrupting the cycle of dependency.  This installment of our series "Opioids: Turning the Tide in the Crisis," looks at  overdose antidotes and replacement therapy.

A needle and a prayer
Tom Korrin is in Phoenix House, a sober-living program in Canton. Now past 60, he says he spent more than half his life hooked on heroin; he has overdosed multiple times.

“I got to a point, I’d say a prayer before I shot up. I didn’t know if I was gonna live or die. But I still wanted it.  You know? I would say a prayer, and still do it.”  

Korrin says he’s not sure why, but he didn’t die. And he stopped doing and dealing drugs and started getting sober 10 years ago.

Naloxone (Narcan) kit
Credit James Heilman, MD / Wikipedia

“Lazarus” drug
Now, Narcan (naloxone), a drug designed to reverse the effects of opioids, is in wide use for what is increasingly a life-and-death treatment step before any recovery can begin: reviving overdose victims.

But Dr. Douglas Smith, chief clinical officer of the Summit County ADM Board, says, of late, Narcan is becoming less effective.

“With the newer things that are being added to the heroin, fentanyl and now carfentanil, it takes a lot of doses of Narcan potentially to get the person back to breathing.” 

Cost to the public
Providing those doses, not to mention the long-term care that follows them, can be a drain on a community’s resources. In Akron, first responders are going on as many as a dozen intervention calls a day.

Fire Chief Clarence Tucker says there are training and workload burdens.

"It is an additional cost. But, my real concern is that these are people that really need our help. And we’re trying to work with other agencies to get them the help they need prior to an emergency.” 

There are public and private resources
That means justice system and social-service programs, hospitals and out-patient clinics and sober-living homes.

(L-R) Daryle Smith, U.S. Sen. Rob Portman, Phoenix House Program Coordinator Ron Atkinson, Phoenix House founder Larry Parsons, Jr., Thomas Korrin
Credit Tim Rudell / WKSU

Larry Parsons is a founder of the Phoenix House. It provides a stable and secure living environment for recovering addicts, and tools they can use to regain control of their lives.

“You can see a counselor, work with a therapist, can hold a job. You can live a normal life. And be around people in recovery as long as you need to. Because we don’t set time limits in recovery. We have guidelines and rules they have to follow as long as they’re here.  But their recovery is their own.  It’s personal.”  

Tough love
Parsons knows first-hand.  He says he was a hopeless addict 20 years ago when his family -- who had been supporting him -- realized they were enabling him. 

My mom said, 'You’re going to go to sober housing, and you’re going to stay there. And if you don’t get sober, don’t call me.’  I’m like, ‘What does that mean?’  She said, 'You’ll figure it out.’

Fighting drugs with drugs

'She says, 'I'd rather be dead than feel like I feel now.' The next morning she OD'd and died.'

Phoenix House client Daryle Smith says making a hard change in your environment and, at least temporarily, in who is your life is important for recovery.  He says for him so, too, is avoiding addiction triggers by staying away from all drugs -- even those like methadone and suboxone, meant to help with addiction treatment.

“All of it, alcohol, crack, pills, all of it has a grip on all of us.  To administer another drug like suboxone to wean people off this is substituting one drug for another.”  

But, Smith notes that that depends on where a person is in the struggle for recovery and defers to fellow Phoenix House resident Tom Korrin to talk about withdrawal.

“My sister. she’d got out. She’d been in for six months. And I told her, ‘We’re getting too old for this.  And she says ‘I’d rather be dead than feel like I feel now.’  The next morning she OD’d and died.”      

Dr. Douglas Smith
Credit Fran Rudell / Summit County ADM Board

It’s complicated
Dr. Douglas Smith with the Summit County ADM Board says like addiction itself, addiction treatment is not simple. And especially locally, and with regard to using drugs in treatment, it is not without differing opinions on what should be done.

“We are in the birthplace of AA. Based on lots of great principles, it truly is very helpful, AA, or now Narcotics Anonymous since we’re talking about opiates

"But there is some tension at times between, 'Hey, we’ve got medications we can give,' we call that medication assisted treatment, versus basically, will-power your way out of it.” 

No effect found
One point of concern is whether a drug like Narcan, that has brought OD victims back from the moment of death, fosters the illusion of a safety net, and therefore enables drug abusers.

Smith says that has been answered.

“New England started use of Narcan earlier than I think anywhere else in the country.  And they had this exact question. And they did not find that people were playing ‘Russian Roulette’ with their drug use because they had a buddy with Narcan sitting there.”   

A fight on many fronts
Government statistics show more than 52,000 people in the U.S. died of overdoses in 2016, up 12 percent from the previous year.  It seems likely that, from Narcan to long-term treatment solutions, there will be a full arsenal in use in the fight against drug addiction and overdose deaths.