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lth Opioid Educational Summit

Solutions and Resources

Community Initiatives

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WELCOME!

Opioid educational summitSeptember 12, 2016

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Tonight’s Schedule6:00 – 6:05: Introduction6:05 – 6:15: Welcome by County Executive Ilene Shapiro6:15 – 6:30: Keynote speech by State Rep Greta Johnson

Speaker’s Forum6:30 – 7:45: How each group contributes to finding a solution to the problem

– Judge Thomas Teodosio – Judge Joy Malek Oldfield– Major Dale Soltis, Summit County Jail– Ryan Collins, Turning Point Graduate

7:45 – 8:00: Summit Psych and Oriana House discuss treatment options in the community8:00: Light Reception

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Summit County Executive –Ilene Shapiro

• Former Summit County Council President

• Accomplished business leader with a history of successful business ventures for high growth, established, turn-around and start-up organizations.

• First female County Executive in Summit County

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Keynote – State RepresentativeGreta Johnson

• Representative Greta Johnson represents Ohio’s 35th District

• Served as prosecutor for Mahoning and Summit Counties, and the City of Akron

• Speaks out for justice, jobs, and opportunity for all Ohioans

• Recently called on Governor Kasich to declare the opioid addiction epidemic a statewide, public health emergency

A Statewide Response to the Opioid Epidemic

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Speakers Forum• Judge Thomas Teodosio, Summit County

Common Pleas • Judge Joy Malek Oldfield, Akron Municipal Court• Major Dale Soltis, Summit County Jail• Ryan Collins, Advocate and Recovering Addict• Deborah Walsh, Ph.D., Summit Psychological

Associates• Allyse Adams, PC, LICDC, Oriana House

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Judge Thomas Teodosio

• Presiding Judge, Court of Common Pleas

• Over 30 years as a law professional – 25 years in private practice– Former President of Summit

County Council– Summit County Common Pleas

Judge since elected in 2006– Presides over The Turning

Point Program

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Turning Point

• Turning Point is an intense 12-month program that helps offenders with drug and/or alcohol addictions get the treatment and skills they need to achieve a sober, law-abiding, positive lifestyle.

• For more information contact: Summit County Common Pleas, 330-643-2281

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Judge Joy Malek Oldfield• Presiding/Administrative

Judge, Akron Municipal Court• Presiding Judge, Akron

Recovery Court• Member of The Summit

County ADM Board's Opiate Task Force, Summit County Criminal Justice Advisory Board and The Oriana House Advisory Committee

• Founding member, Municipal Section, Criminal Justice Advisory Board

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Major Dale Soltis –Summit County Jail

• Former adult probation officer• Over three decades working

for the Summit County Sheriff’s office

• Former D.A.R.E Officer• Instrumental in designing and

coordinating Summit County Jail and its training facilities

• Currently responsible for day-to-day operations at the Summit County Jail

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Major Dale Soltis –Summit County Jail

• Philosophy of the Summit County Jail• Services available at the jail for inmates

– Medical Services– Mental Health Services– Services from the Chaplain– Re-entry services– VIVITROL programming

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Ryan Collins – Advocate and Recovering Addict

• Turning Point graduate

• Recovering addict –Sober since 2014

• Advocate for mental health treatment as a component of substance abuse treatment

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TREATMENT OPTIONSSummit Psychological Associates and Oriana House

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What is Outpatient Treatment

• Client stays in own home and commutes to treatment

• Available services for outpatient treatment– Treatment medication under a general physician– Psychiatric Services– One-on-one mental health treatment or Group

therapy– Case Management Services– Substance abuse group programs

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When is Outpatient Treatment used

• Client is incarcerated or just being released from incarceration

• Client is referred to treatment in lieu of incarceration

• Client prefers to live at home in a supportive family environment

• Inpatient facilities are full with a long waitlist

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Best Practices

• Treatment that focuses on:• Health – manage the disease, live in healthy

way, mental health• Home – establish a stable and safe place to

live• Purpose – meaningful daily activities – work,

school, care of family, volunteering• Community - relationships and social

networks

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What is Medication Assisted Treatment?

• Evidence-based treatment that addresses both physical and mental aspects of drug addiction– Medication is used to treat withdrawal,

dependence and cravings– Mental health therapies are used to treat

mental problems that may have existed prior to drug use and/or developed along side drug use

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What is Medication Assisted Treatment?

• Substance Abuse Treatment to build new behaviors and coping skills

• Addressing basic needs through case management and recovery support services

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A Coordinated EffortSummit Psychological Associates• Mental Health and Addiction

Agency• Thirty (30), plus year history• Medication Assisted

Treatment – VIVITROL Treatment Program

• Outpatient treatment program

• Manages behavioral health services within Summit County Jail

Oriana House – RigelRecovery Services• Quality chemical

dependency treatment programs– Early Assessment– Relapse Prevention – Aftercare

• Ambulatory Detox• Rigel Recovery Services

– outpatient treatment services

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VIVITROL Treatment Program

• Collaborative effort between Summit Psychological Associates and Oriana House – Rigel Recovery Services.

Summit Psychological Associates Oriana House - Rigel

Evaluation for treatment Treatment readiness

Monthly Injections Intensive Outpatient

Mental health evaluations After care

Mental health treatment Support Groups

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Oriana House –Rigel Recovery Services

• At Rigel Recovery Services, we believe alcoholism and substance abuse are diseases that require an individual’s continuous commitment to recovery over the course of his or her life. Our treatment starts individuals on a multi-step journey to rehabilitation through their own admission of a problem, abstinence, avoidance of relapse, and a daily dedication to recovery.

• We are proud to be a part of this process and to assist individuals in regaining control of their lives.

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Target Population• Any individual with a opioid diagnosis.• Referrals come from:

– Community agencies– ADM (Central Assessment & Detox)– Probation and Parole– Physicians– Attorneys– Self– * No one will be turned away for treatment

services.

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What do we offer?• Substance use assessments• Opiate Enhanced Treatment

– Intensive outpatient treatment– Aftercare– Individual counseling

• Drug Testing• VIVITROL Treatment Program (VTP) –

Collaborated with SPA• Family Programming and Involvement

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Substance use Assessments

• A substance use assessment helps the client and the counselor determine the severity of the problem. – The client’s substance use of alcohol and/or

drugs is evaluated in order to determine an appropriate treatment plan and goals.

– Assessments are accepted from Central Assessment and Detox

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Opiate Enhanced Treatment• Opiate Enhanced Treatment allows individuals

with an opioid diagnosis to attend Intensive Outpatient Treatment that is specific to the use of opioids.

• Rigel counselors introduce participants to additional supportive resources including detoxification, twelve step groups, family sessions, and peer support services.

**The goal is to provide a level of care specific to opioid use that assists with and increases the ability to cope with cravings, reduces relapse to opioid use, and facilitates lifestyle changes that support abstinence. **

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VIVITROL Treatment Program (VTP)

• Collaboration between Summit Psychological Associates (SPA) and Oriana House, Inc.

• Program includes:• Opiate Enhanced Treatment services• Psychiatric Diagnostic Assessment• Individual Mental Health Counseling• Monthly VIVITROL injection or oral

Naltrexone• Case Management Services• Drug testing

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VIVITROL Treatment Program (VTP)

• Case Management is offered to assist individuals in addressing life stressors outside of therapeutic needs.

• Will coordinate care with referring agencies and other providers (i.e. CSB, probation, physician)

• Will assist client in managing appointments and medication

• Will act as liaison between Rigel counselor, SPA mental health therapist and the SPA psychiatrist prescribing the VIVITROL.

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What is Naltrexone• Opioid antagonist that is approved for the

treatment of both opioid dependence and alcohol dependence

• Non-opioid medication• Opioid receptor antagonist that binds to the

opioid receptors but instead of activating the receptor it effectively blocks them

• Prevents opioid receptors from being activated by agonist compounds such as heroin and prescription pain killers

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What is Naltrexone• Reduces cravings and prevents relapse• Can be prescribed by any individual who is

licensed to prescribe medication• Both daily oral form and monthly injectable

form approved by the FDA for treatment of opioid dependence

• Oral naltrexone was approved for use in treating opiate addiction in 1984

• VIVITROL approved by the FDA in 2010 for opiate addiciton

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What is VIVITROL

• Injectable form of Naltrexone• Opioid blocker• Once monthly medication (injection)• When combined with counseling, it can

help treat alcohol dependence and/or relapse to opioid use

• VIVITROL is NOT: a narcotic, addicting, or pleasure-producing

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Benefits of Medication Assisted Treatment (MAT) with VIVITROL

• Clients report reduction to elimination of cravings therefore significantly reduces the risk of relapse

• Blocks the effects of opiates • VIVITROL ensures medication compliance• VIVITROL eliminates impulsive use• Non addictive• Has no mood or mind altering effects• Minimal side effects

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Challenges of MAT with VIVITROL

• Clients struggle to acquire the 7 days necessary without any opiates in order to begin medication

• Cost• Detoxification resources• Insurance/pharmacy issues

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Treating Opioid Addiction

PSYCHOLOGICAL EFFECTSCounseling targets the CORTEX

PHYSICAL EFFECTSMedication targets the LIMBIC REGION

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Family Involvement• Conjoint sessions• These sessions are held throughout the course of

treatment in which the client has the opportunity to bring their positive support person to meet with the counselor. The counselor, client and their support person will explore the treatment and recovery process as well as ways to maintain healthy support.

**The goal of is to educate family and friends of the treatment process while providing an environment for family and friends to show support in a way that promotes an honest and positive interaction**

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Family Involvement

• Family Matters– Throughout treatment and self-help meetings

clients will learn that healthy support is a key component to recovery. We do our best to support this by inviting the clients loved ones to engage in the treatment process and receive support themselves. Family members receive skills and tools to assist them with healthy living and setting boundaries with their loved ones.

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Contact Information

• Allyse Adams – Clinical Administrator • 330.996.2222 ext. 2915• Amanda Frye– Clinical Coordinator• 330.535.8181 ext. 411• Emily Nugent – Case Manager• 330.535.8181 ext. • Lisa French– Program Assistant (scheduling)• 330.535.8181 ext. 408

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Medication Assisted TreatmentVIVITROL/Naltrexone

• VIVITROL is a once monthly injectable form of Naltrexone– Naltrexone is also available as a daily oral

medication– Naltrexone is not addictive– Naltrexone blocks the effect of all opioids– Naltrexone can be prescribed by a general

physician– Naltrexone lessens and can even remove

cravings for opioid drugs.

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VIVITROL Treatment Program• Covered by Medicaid,

Medicare and Private Insurance

• Fifty-six (56) active clients are currently involved in the VIVITROL treatment program

• Treatment length - Typical up to 1 ½ years on VIVITROL – can be up to three years

• Clients can continue to access supportive programming after stops injections

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Outcomes

60

53

30

35

52

24

17

26

17

0

10

20

30

40

50

60

70

Opioid Cravings Anxiety/Depression Physical Pain

Cravings and Health Effects

Entrance 3rd Injection 9th Injection

According to our latest data, clients report :

• Nearly 60% of clients come into the program with opioid cravings at least weekly

• By the 3rd injection, the percentage of clients reporting opioid cravings, at least daily, drops to 35%

• By the 9th injection, 83% report zero opioid cravings, with 13% reporting cravings on a weekly basis. Cravings multiple times a week, or daily, drops to 0%

• Decrease in anxiety/depression symptoms and decrease in physical pain

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Q&A

QUESTIONS?