December 22, 2014

Elyria
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Two clinics hope to help heroin addicts recover with help from new drug

Two new drug clinics have opened or are about to open in Lorain County, where fatal overdoses from heroin or prescription pills have spiked. There were 60 deaths last year compared to 22 in 2010 and 22 in 2011. There have been 25 deaths this year through Sunday, said Dr. Stephen Evans, Lorain County coroner.

The increase in Lorain County mirrors a state and national increase. Overdoses were the leading cause of accidental deaths in Ohio since 2007, according to the Ohio Department o Health.

Approximately 2 million Americans were hooked on heroin or prescription pills in 2010, according to the Substance Abuse and Mental Health Administration. Between 2009 and 2010, the number of reported heroin addicts increased from 214,000 to 359,000, a 68 percent hike.

Some 23.5 million Americans are alcoholics or drug addicts, but only about 11 percent receive treatment, according to the administration. Clinic owners say they’re opening to help fill an unmet need for treatment.

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Anthony Villa understands people are apprehensive when a drug treatment clinic opens near them because they fear addicts.

“The question really is: Do we support a recovery program that is trying to enhance the health and safety of our community? Because those people are out there, regardless,” said Villa, co-owner of Fortaleza LLC, a for-profit clinic whose name means strength or fortitude in Spanish. “Either they’re getting treatment and they’re trying to get better, which makes our community safer and healthier, or they’re out their committing crimes trying to feed their addiction.”

Villa said people not directly affected by drug addiction have become numb to the problem, but they need to face reality.

“It’s not going to go away by itself,” said Villa, whose clinic is scheduled to open July 1. “Unless we as a community come together and really pool all our resources, it’s going to overwhelm us.”

Villa, 55, said he has seen firsthand the damage addiction can do. At 15, he said he began injecting heroin. Villa, who said he has been clean and sober since 1986, said friends and relatives helped him recover.

His recovery led him to become a drug counselor. Villa — who said he graduated from Ashland University in 1993 with a psychology degree — said he has worked in drug treatment in Bowling Green, Lorain, Toledo and Las Vegas, Nev.

Villa said even the most successful drug treatment clinics have a 40 percent relapse rate among patients. The goal is to complete treatment in two or three years, but Villa said some addicts will need lifelong treatment.

While Villa supports expanding treatment, he said getting clean is ultimately about attitude.

“Recovery is something you have to really want,” he said. “You have to work really hard for it. It’s not an easy path.”

Villa said he used to subscribe to the belief that addicts had to go cold turkey to kick their habits but now believes in treating some patients with Suboxone. Suboxone is the brand name for buprenorphine and naxolone — synthetic opioids designed to block opiate cravings — and can help some addicts stay drug-free. Suboxone is less debilitating than methadone, proponents say.

Villa said screenings will determine if Suboxone is right for Fortaleza patients. “Our goal is one day they will not need Suboxone or any other medical treatment,” he said.

While the clinic is for-profit, Villa said the goal is not just to make money. When the clinic is established and can afford it, Villa said a percentage of profits will be diverted toward treating indigent addicts who lack health care.
Elaine Georgas, Lorain County’s Alcohol and Drug Addiction Services Board executive director, said many addicts can’t afford treatment. Georgas, who met with Villa a few weeks ago, said it’s good that the clinic is opening, but, “I’m not clear how they’re going to be able to get reimbursement for services.”

Thomas Stuber also wonders how Fortaleza can make money. Stuber, CEO and president of Lorain County Alcohol Drug Abuse, a nonprofit group that provides counseling and treatment, said there is potential. If the Legislature agrees to the Medicaid expansion that is part of ObamaCare, Stuber said more indigent addicts can be served.

While Stuber’s group offers inpatient care to a small group of female addicts and their children, there is no other inpatient treatment in Lorain County. While outpatient care is far less expensive than inpatient care, critics say that it is often ineffective because when addicts leave clinics, they return to the same environment where they became addicted.

While not wanting to get into specifics, Villa said if the clinic is successful, inpatient treatment may be considered. Regardless of the type of treatment, Villa promised all addicts would be treated with dignity and respect.

“Others have helped me get where I am today, and I’m giving it back,” he said. “That’s what we’re about here at Fortaleza.”

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Dr. John Sorboro, medical director of Addiction Outreach Clinic, which opened May 29, is sold on Suboxone.

Opponents say using it is trading one addiction for another and can cause hair and tooth loss, low testosterone and thyroid problems. They say Suboxone also is being sold on the black market as an alternative to other prescription pills.

Sorboro said using Suboxone is a trade, but a worthy one. He said unlike heroin, Suboxone is “remarkably safe,” and there have been no documented overdose deaths from Suboxone in Ohio.

“To compare Suboxone to the drugs that people are coming in on is absurd,” he said. “Are you trading one dependence for another? Yes, but the results are dramatically different.”

Sorboro said the naxolone in Soboxone blocks the euphoric effects of buprenorphine and unlike methadone, patients on Suboxone can function normally.

“They want their life back and this gives it to them,” said Sorboro, 49. “In 20 years of psychiatric practice, it is the only thing I’ve seen that consistently makes people better. Not everyone, but those who are serious about recovery.”

Sorboro said patient use of Suboxone will be closely monitored, including random drug tests and pill counts to ensure the drug isn’t sold illegally. He said training of doctors for prescribing Suboxone is “pathetically limited” with many doctors inexperienced in dealing with addicts.

Sorboro said the outreach clinics are different. Sorboro said each doctor hired at the clinic will have to study a 70-page manual he wrote on Suboxone treatment, and he will oversee their training and reviews. He said the clinic will closely work with police and the Drug Enforcement Administration to avoid prescription abuse.

Sorboro said most addicts can eventually be weaned off of Suboxone. However, Georgas said Suboxone marketing representatives haven’t provided her group with long-term studies on how to get addicts off Suboxone.

“We’ve asked them, and they’ve really not come to say, ‘A client’s on this for their life, or they can get phased off,’” she said. “It’s not a cheap medicine, so if the client’s on it for the duration, the question is, how will it be funded?”

Despite her reservations about Suboxone, Georgas said her group is willing to work with the clinic. She said some former addicts have contacted the board about volunteering to work with recovering addicts to help them maintain sobriety.

Sorboro said clinic representatives plan to attend service board meetings and introduce the clinic to the South Amherst City Council tonight. A presentation to the Lorain City Council is scheduled for July 8 and staff plan to take part in an anti-drug forum in Avon Lake in August.

Sorboro said one of his main messages is that medical treatment is the only scientifically proven way to help addicts. The number of patients in outpatient clinics using methadone or Suboxone has risen from 228,140 per day in 2002 to 313,460 in 2011, a 37 percent increase, the New York Times reported Sunday.

The cost of inpatient treatment at a private facility is between $20,000 to $32,000 for a four- to six-week stay, far more expensive than outpatient treatment. While inpatient supporters say it allows addicts to get out of the environment where they were abusing drugs, Soboro said it’s too expensive and ineffective.

“If somebody doesn’t learn to be sober in the world they live in, they’re not going to be sober,” he said. “This idea that we can send somebody away for 30 days and then magically they’re going to come back changed, it is a wishful fantasy.”

Fortaleza LLC

  • 41641 North Ridge Road, Elyria Township.
  • Staff: 11 part-time employees including two doctors and three counselors. The majority of the staff is bilingual.
  • Services: Drug evaluations, individual drug counseling and monitored use of Suboxone — a narcotic alternative to methadone used to treat heroin addicts.

Addiction Outreach Clinic

  • 5342 Meadow Lane Court, Sheffield. The company also has clinics in Boardman, Kent, New Philadelphia West Union and Clarion, Pa.
  • Staff: About a half dozen part-time workers including at least one doctor.
  • Services: Drug evaluations, voluntary counseling and monitored use of Suboxone.

Contact Evan Goodenow at 329-7129 or egoodenow@chroniclet.com.