At Friday morning's second heroin task force meeting, a group of medical experts discussed ways the medical community could address the burgeoning local heroin crisis.
The discussion branched to methadone clinics, which helps wean heroin and other opioid addicts and eventually transition them into a life without drug abuse. A methadone clinic recently opened on Lycoming Creek Road, and its fate still is being discussed by Old Lycoming Township Supervisors, but "It's most likely staying and operating," supervisor Chairman John Eck said. While he said he sees a need for it, he questions the location.
Heroin highs are unlike any other, reaching extreme levels of euphoria, but methadone blocks that high, said Dr. Ayaz Khan, director of his Pain Management practice in Williamsport, and medical director at Habit OPCO, a methadone treatment center in Watsontown.
"(Heroin) is like a chemical heaven for patients using it," he said, but that heaven quickly turns into a ravaging hell. "Every time you seek that high, you need to keep increasing it - two bags, four bags, more." Death hovers with each increase, as overdose is often the end conclusion.
True treatment requires a multifaceted approach, Khan said. Methadone treatment only addresses 30 percent of the problem - counseling is the main component that empowers and transforms the patients' lives, he said.
"We have to talk with our patients - we can't just write prescriptions," Khan said.
Treatment addresses not just the patients, but their environment and the whole family so triggers can become more neutralized.
"The mind should control the body. ... That's why counseling is paramount. ... Until we know what is right and wrong, we won't be able to get over it," he said.
However, there is the risk of addicts stealing methadone to sell it. After three or four months of treatment, patients can earn a take-home privilege, Khan said.
One anonymous city resident in another focus group said he's seen the negative side of such clinics.
"My experience is, you can cop anything you want," he said. Problems arise when "you put a bunch of addicts together" at these clinics.
Khan said there are risks, but that's why counseling is paramount to the program, and each clinic should be strictly run, and patients should have at least one year of drug abuse prior to enrollment. Urine testing is mandatory at these clinics, he said, and each drop of methadone is accounted for. Khan said his program is successful and gets good results.
"I think methadone clinics, if run properly, do a tremendous job in keeping people away from drugs. It goes a long way in preventing crimes, but again, it has to be run properly. The doctor has to have a sense of community service. It takes a lot of time, a lot of courage," Khan said.
Vivatrol is another option, as it cancels out the high and actually gives a bad feeling, retraining the brain in how it associates pleasure with opioids. But it is very costly at about $1,000 per shot once every three months, and not many providers are licensed to do so, Khan said.
The benefit of Vivatrol is it isn't taken home, but is administered by a physician in shot form so it can't be sold.
Beyond methadone clinics, a more comprehensive approach in the medical community is needed, Khan said. Before doctors prescribe any narcotics, urine testing should be done, he said. In order to prevent patients from "doctor shopping" where they go doctor to doctor to get prescription narcotics, the patients' histories need to be more accessible for each doctor to cross-reference along with an emergency room database, he said.
"If we all start doing the same thing, it will stop (doctor shopping)," he said.
Imprisonment also works to keep people off drugs, but Khan argued it doesn't change the patients' environments once they get out.