Pubdate: Wed, 20 Aug 2014
Source: Cincinnati Enquirer (OH)
Copyright: 2014 The Cincinnati Enquirer
Contact: http://drugsense.org/url/aeNtfDqb
Website: http://www.cincinnati.com/
Details: http://www.mapinc.org/media/86
Author: Scott Wartman

COULD VIVITROL HELP NKY HEROIN EPIDEMIC?

There's no magic pill to cure the heroin epidemic but judges in Ohio
think they may have found an injection that can at least put a big
dent in the problem.

Now Kentucky lawmakers will look at whether Vivitrol could work in
Kentucky, where it hasn't been tried in the legal system.

Hocking County, Ohio Municipal Court Judge Frederick Moses will talk
to Kentucky lawmakers on Thursday in Lexington about the success he's
had in his drug court with Vivitrol to help addicts kick the habit.

Moses is one of a handful of judges in Ohio who have offered some
offenders Vivitrol, a non-narcotic that blocks the ability of addicts
to get high off opiates and alcohol. The Enquirer last fall chronicled
Warren County Common Pleas Judge Robert Peeler's efforts last fall
when he started offering Vivitrol to defendants.

Much like in Cincinnati, heroin has ravaged Hocking County in
southeastern Ohio, Moses said.

"This is an epidemic like we've never seen before," Moses said. "It is
real bad. There's not a public restroom in my county where someone has
not overdosed."

Moses became one of the first judges in Ohio to offer Vivitrol to some
defendants in 2012.

The Hocking County Vivitrol Drug Court screens defendants to determine
who has the physical and mental stamina to stick with the treatment.
So far, Moses has had 24 defendants receive Vivitrol. Four have
graduated and 20 remain in the program. The four graduates have jobs
and have remained clean so far, he said.

Of the 800 drug tests the defendants have taken, only two have come
back positive for drugs, Moses said. He wouldn't go into specific
numbers, but said that is a much higher success rate than defendants
who go on Suboxone or methadone, which are synthetic opiates often
used to ease people off heroin.

"This tool is effective," Moses said. "The community has bought in.
Law enforcement has bought in. We've been doing very well with it."

While some judges in Ohio have tested the waters with Vivitrol,
Kentucky judges have not. Local drug court judges said the Kentucky
Court of Justice regulations don't allow for medication-assisted
therapy, which also includes synthetic opiates like Suboxone and
methadone, and instead favor a support group therapy approach.

Vivitrol still must overcome skepticism in the medical and legal
community.

One of the main hurdles is the cost. At $1,000 a shot, Vivitrol isn't
cheap. Medicaid has paid for most of the defendants in Hocking County,
along with state and local grants.

Someone's got to pay that, said Campbell County District Court Judge
Karen Thomas, who runs the Campbell County Drug Court.

"Our court process gets paid for by the state," Thomas said. "The drug
court would have to get tax money to pay for something like that."

Drug courts in Kentucky have turned to support groups and counseling
to get addicts to quite cold turkey without medication, she said

Between 10-20 offenders graduate each year from the Campbell County
Drug Court, and only 8 percent relapse, she said.

Thomas has just started to look at Vivitrol and doesn't know whether
it would be effective. But she doesn't hold Suboxone or methodone in
high regard. She, along with other critics, see it as trading one drug
for another.

"It is the addiction issue that causes the criminal behavior, not the
type of drug," Thomas said. "One man told me he was on methadone and
Suboxone for four years. That's just another way to get high."

Many remain unfamiliar with Vivitrol, which is a relatively new tool
to combat drugs.

Vivitrol is the injectible form of the non-narcotic drug naltrexone,
which has been used since since 1994 to treat alcohol dependence. The
FDA approved natrexone in 2006 for opiate addiction. The FDA approved
Vivitrol for monthly intramuscular injection in 2010.

Supporters of Vivitrol point out that Vivitrol won't get you high,
unlike Suboxone and methadone. There's no street value to Vivitrol
while Suboxone and methadone get dealt on the street, Moses said.

"You can't traffic it and divert it, which is a huge issue," Moses
said.

Vivitrol does have its critics. A 2011 pilot program that provided
Warren County inmates with Vivitrol injections had a 25 percent
success rate.

"It's a waste of money at 25 percent. That means you are a 75 percent
failure," Butler County Sheriff Richard K. Jones told the Enquirer in
2012. "We stopped all drug rehab programs and drug classes, alcohol
classes five years ago. We have no money for anything like that.

Vivitrol alone won't solve the heroin problem, Moses said. It is only
part of the treatment that includes support groups, counseling and
therapy, he said. It will, however, allow addicts to stop their
cravings long enough to get clean, he said. That's what he'll tell
lawmakers when he speaks to the Interim Joint Judiciary Committee at
the Lexington Convention Center at 1:30 p.m. on Thursday.

"Vivitrol is a tool to get people clean for six to 18 months so then
they can deal with their issues," Moses said. "The goal is, with
Vivitrol, they have the tools not to use again."  
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MAP posted-by: Jo-D