Medication working for youth struggling with opioid addiction

WASILLA — Recovery rates may be on the rise for young Wasilla-area residents struggling with opioid addiction.

At the homeless youth center in Wasilla, MY House, Executive Director Michelle Overstreet said 80 percent of her clients report drug use, and more than half report leaving home because of parents’ or family members’ drug abuse and related problems. As with the rest of the nation right now, often the drug of choice is heroin.

“It’s clear that we need a detox center,” Overstreet said.

Last week, the local opioid task force chaired by MY House Vice President Michael Carson had its monthly meeting to continue the discussion of treatment options for area residents, and present subcommittee and statewide task force reports. Guest speakers Emily Stevens, chief nursing officer at Mat-Su Regional Medical Center, and Nick Stavros from the new Wasilla methadone clinic, Community Medical Services, were invited to present their perspectives at the meeting.

Carson said Stavros’ presence sparked a “very lively and interesting conversation,” given the controversy among survivors of opioid abuse about methadone as a solution to addiction.

The local task force that has been meeting since the end of February consists of about 30 medical professionals, government officials, educators, nonprofit organizers and other community members, including former addicts and parents who have lost their children to heroin. Over the last few months, several of these individuals, including Overstreet, have voiced their concerns about methadone as well as suboxone, another drug commonly used in opioid replacement therapy.

“The problem with methadone and suboxone is diversion,” she said.

Overstreet recalled one former MY House client whose insurance paid for $9,000 a month of more suboxone treatment than he needed or allegedly wanted, so he started selling the drug to others.

“The guy said, why would I get a job when I can just sell suboxone myself and hold enough back to pass the (doctor’s) drug tests?” she said.

In a research document provided for the June 24 Alaska Opioid Task Force meeting titled, “The Neurobiology of Opioid Dependence: Implications for Treatment,” doctors Thomas Kosten and Tony George describe naltrexone, buprenorphine — a component of suboxone — and methadone. Naltrexone “does not itself produce pleasurable feelings,” they wrote, which limits patient compliance. Buprenorphine, at low doses, is like methadone, which does give the user a kind of high, normalizes hormonal disruptions and regulates stress responses, but also “causes dependence.” At high doses, buprenorphine can cause withdrawals in patients already highly dependent on opioids.

Vivitrol, on the other hand — a once-monthly, non-addictive treatment for opioid or alcohol dependence — appears to be doing all the work necessary to get MY House clients clean.

“I’ve met kids who have used Vivitrol who say, if they didn’t have Vivitrol, they would not be able to get off opiates,” said Kurt Hoenack, who manages the Gathering Grounds Cafe at MY House.

Hoenack said he thought those personal testimonies made a stronger statement about the effectiveness of a drug than the assurances of a pharmaceutical company.

Overstreet said Vivitrol has been administered to MY House clients locally for a couple months now, and they are clearly progressing in recovery.

Still, Carson said there’s no one-size-fits-all solution for every person attempting to recover from opiate addiction.

“Some clients may want to be clean and sober but not with medication because they’ve been self-medicating for a number of years,” he said.

This is part of the reason why, as chairman of the local task force, he invites speakers like Stavros to share their ideas.

“I’m not advocating for detox with or without medication, that’s not my call. I just want the Valley to have a center where all options are available for clients to come in and take part,” Carson said. “I believe if someone had a number of choices, and they picked the one they want, that would be more successful for the client because they chose that.”

The next local task force meeting will be held at Wasilla City Hall on Tuesday, Aug. 2 at 4 p.m., and medical providers especially are encouraged to attend, Carson said.

A wellness summit with a focus on opioid dependence and treatment is scheduled for Thursday, Aug. 4, at the Glenn Massay Theater and Mat-Su College campus, though details have not yet been finalized.

The next statewide task force meeting is scheduled for Friday, July 22 at 9 a.m. The public can access the meeting via teleconference. Teleconference numbers for each meeting are posted with the meeting agenda online at dhss.alaska.gov/AKOpioidTaskForce

Contact reporter Caitlin Skvorc at 352-2266 or caitlin.skvorc@frontiersman.com.

CORRECTION: An earlier version of this story erroneously described naltrexone as a component of suboxone. The latter drug is composed of buprenorphine and naloxone.