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Providers work hard to stay ahead of heroin epidemic

This article first appeared in the St. Louis Beacon, Nov. 12, 2012 - When Christian Hospital opened its drug treatment center about eight years ago, it probably didn’t expect some of the addiction trends that have since taken shape among young people in the St. Louis area. Experts say growing abuse of pain pills among young people has led many of them to graduate to heroin and that is keeping both hospital and free-standing treatment centers busy.

“Oh, gosh, we see a lot of them,” says Erin Bostick, a therapist at Christian Hospital, of patients coming in for heroin addiction. “This year, I’ve probably worked with 30 to 40 patients.”

Christian in North County is among area hospitals that have set up treatment facilities and educational programs in response to heroin use, among other drugs.

“We often get parents who need guidance on what to do about a son or daughter,” she says. “As you can imagine, most parents don’t know much about the problem, don’t know what’s available to them, and don’t know where to go.”

Christian, part of the BJC HealthCare network, runs a weekly family education program where anyone can drop by for a free discussion about drug addiction. This is in addition to an outpatient program consisting of eight to 12 sessions, each lasting three hours, and focusing on treatment and therapy for heroin addicts.

A slightly different approach is used at DePaul Health Center, part of SSM Health Care. Patients take part in the hospital’s New Vision program, involving four days and three nights of inpatient treatment, which includes stabilizing those withdrawing from an addiction such as heroin, according to Michael White, service coordinator of the hospital’s New Vision program.

He says in the public’s mind-set heroin is associated with images of zombie-like people standing on street corners or sleeping in derelict cars or abandoned buildings.

“But the reality now is that we’re talking about kids from all socio-economic backgrounds using heroin because it’s cheap and accessible,” he says.

Hospital services are useful – and expensive. Unless patients have health insurance or can get financial assistance from a social service agency, their out-of-pocket cost for treatment for heroin addiction can run between $3,000 to $4,000. DePaul, Christian and other hospitals note that their services can include thorough psychiatric evaluations, medicine to help patients cope with heroin withdrawal and long-term recovery plans that, ideally, will discourage people from continuing to abuse the drug.

But much of the treatment and outreach is still accomplished through the local office of  the National Council on Alcoholism and Drug Abuse, along with two other respected groups -- Preferred Family Healthcare and Bridgeway Behavioral Health. These three organizations are giving school-age young people free services to treat heroin addiction. Some of the financial help comes from the children’s service fund that some counties have set up through a ¼ cent sales tax for mental health and drug treatment programs for young people.

The three groups providing the services are also part of a heroin collaboration project that United Way helped to set up to boost local spending for heroin treatment and outreach services. The group expects to meet its first year goal of adding 200 new outpatient treatment slots for young people coping with heroin addiction.

Among those grateful for help is Andrea Purvis, 19, who became addicted to heroin while a student at Lindbergh High School. She says it wasn’t just the initial detoxification and, later, inpatient services that made a difference when she got help from Tim Gorman, clinical supervisor, and others at Preferred Family’s office in South County.

“They are the best because I was really shy, and I didn’t like to talk to anybody,” she says. That was before she met Meghan Brawner, who used to be Andrea’s community support specialist.

“Megan proved herself by listening and showing me that she cared,” Purvis says. “That helped me open up. Preferred Family was really welcoming when I’d go there. It was my safety net.”

Bryan Quick, vice president of clinical services at Preferred Family, says he wished there were even more resources to uplift youngsters like Purvis.

“There is not enough money, and there are not enough resources,” he says, while praising the collaboration’s work to raise at least $1 million each year over the next three years for more outpatient treatment slots, public engagement and public awareness.

He says the public awareness component aimed at parents and high schools is important because too many people still don’t realize heroin’s deadly impact among all economic classes in the St. Louis area. Although heroin deaths in St. Louis County are projected to be lower this year, at least 500 people have died of heroin-related causes during the past two years, officials say.

“Heroin is cheap,” Quick says. “It costs only $10 bucks, but you end up spending $10 bucks 15 times a day and doing whatever you need to do to get the drug and avoid ending up being sick when you don’t use it.”

Parents need to know that the problem starts before heroin is first used, he says. It’s an observation often repeated by experts. They say the problem usually begins with abuse of pain pills.

“Our problem isn’t a city problem anymore,” says DePaul’s White. “And it’s not just heroin. It’s prescription pain medication, and it’s astounding how much of that is out there.”

The region and state must come to grips with that issue, many say, if it is serious about taking an important step toward corralling Missouri’s heroin problem. Some distraught parents whose children have died from drug overdoses know too well the connection between pain pills and heroin. Many of them tell stories of watching helplessly as their children graduated from being hooked on prescription drugs to shifting eventually to heroin and developing deadly habits.

Some state lawmakers have attempted to enact a prescription drug monitoring law to make it more difficult for abusers and peddlers to obtain. Missouri is the only state without a monitoring system. Some lawmakers oppose the idea, arguing that monitoring wouldn’t solve the problem.

Chad Saboda, a recovering addict, is dismayed by such views, just as he wonders why Missouri doesn’t enact a Good Samaritan law, which he said might prevent some heroin deaths by encouraging people to call for help when someone is experiencing an overdose. Without a Good Samaritan law, many people don't call 911 out of fear of being convicted of being part of a crime, Saboda says.

“We need that kind of law,” he says. “We need prescription monitoring, too, because it would slow the amount of pain pills getting into high schools and communities. Would it fix the problem? Probably not. But we do know that pain pills are turning young kids into heroin addicts.”

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.

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