Heroin at Home: Response to Opiate Use

>> “HEROIN AT HOME” IS A MINNESOTA PARTNERSHIP
PRODUCTION, A CO-PRODUCTION OF THE MINNESOTA DEPARTMENT OF HUMAN SERVICES AND TWIN CITIES
PUBLIC TELEVISION. >> WHETHER YOU LOOK AT OPIATES OR HEROIN, OVERDOSE DEATH DATA, TREATMENT OR HOSPITAL EMERGENCY ROOM DATA, ARREST DATA, NO MATTER HOW YOU SLICE IT, WE HAVE NEVER
SEEN THE MAGNITUDE OF THIS PROBLEM IN THE STATE OF MINNESOTA. >> PART OF THAT IS THIS
MASS PROLIFERATION OF PRESCRIPTION OPIATE ADDICTION, THE WIDER AVAILABILITY AND DISSEMINATION
OF PILLS, DOCTOR SHOPPING, MORE PEOPLE ARE RAIDING MEDICINE CABINETS. >> TREATMENT ADMISSIONS
FOR OPIOID USE DISORDERS IN MINNESOTA ARE INCREASING EXPONENTIALLY AND SO THE EPIDEMIC
SEEN NATIONALLY IS AND EPIDEMIC THAT’S OCCURRING HERE. >> MINNESOTA HAS SOME OF THE HIGHEST
PURITY LEVEL HEROIN IN THE COUNTRY. >> IF YOU DIDN’T KNOW, HEROIN IS ALREADY IN THE
SUBURBS. >> THE NUMBER OF DEATHS DUE TO HEROIN OVERDOSES HAVE SKYROCKETED ALL OVER THE METRO.
>> THE STATE NOW CONSIDERS HEROIN ONE OF ITS TOP PRIORITIES AS MORE PEOPLE BECOME ADDICTED.
THERE’S EVEN TALK OF LEGISLATION TO FIGHT THE BATTLE. >> THE STATE HAS ACTUALLY A FORMAL
APPROACH RIGHT NOW. IT’S THE STATE SUBSTANCE ABUSE STRATEGY. IT’S KIND OF A STEP-BY-STEP
PROCESS OF HOW THE STATE OF MINNESOTA IS GOING TO GO ABOUT ADDRESSING A NUMBER OF THE ISSUES
AROUND SUBSTANCE ABUSE, HEROIN AND OPIATES AMONGST OTHER THINGS, AND IT BROUGHT TOGETHER
A NUMBER OF AGENCIES THAT HAD NOT HISTORICALLY ALWAYS WORKED TOGETHER. IT BROUGHT IN LAW
ENFORCEMENT, DEPARTMENT OF HEALTH, DEPARTMENT OF PUBLIC SAFETY, DEPARTMENT OF HUMAN SERVICES,
AND THEN OUT OF THAT WAS THIS LARGE STRATEGIC INITIATIVE THAT IS NOW BEING KIND OF TACTICALLY
PUT INTO PLAY. >> THIS ILLNESS, ONCE IT DEVELOPS, DOESN’T TEND TO GO AWAY UNLESS IT’S AGGRESSIVELY
TREATED AND SO WE’RE DEALING WITH A LARGE COHORT OF MINNESOTANS, MANY OF THEM WHO ARE
YOUNG, WHO HAVE A BAD CHRONIC ILLNESS. >> SO I SHOULD START TO WORK ON MYSELF FIRST — >> THAT’S
WHAT THIS IS ALL ABOUT. >> I’M AT THE CHEMICAL DEPENDENCY TREATMENT AT St. JOSEPH’S HOSPITAL
IN St. PAUL. I HAD A PRETTY NORMAL CHILDHOOD IN MINNESOTA UNTIL I WAS IN FIFTH GRADE. THAT’S
WHEN I STARTED TO USE. I SMOKED WEED AND I DRANK A BIT. IT WAS RIGHT WHEN I GRADUATED
HIGH SCHOOL THAT I STARTED USING HEROIN. >> IF WE LOOK AT THE PRIMARY DEMOGRAPHIC OF PEOPLE
COMING INTO TREATMENT FOR HEROIN AND OTHER OPIATES IN THE TWIN CITIES, IT TENDS TO BE
YOUNG MALES, MANY FROM SUBURBAN AREAS. >> WELL, I’VE BEEN IN TREATMENT FOUR DIFFERENT TIMES.
EVERY TIME I LEAVE TREATMENT, I RELAPSE. THIS TIME I THINK IT’S DIFFERENT JUST BECAUSE I
DON’T WANT TO HURT ANY MORE PEOPLE. IT REALLY IS AWFUL TO HURT YOUR FAMILY AND PEOPLE THAT
YOU LOVE. ALTHOUGH, I GUESS, WHAT SCARES ME THE MOST, IF I AM NOT ABLE TO DO THIS, I’M
GOING TO END UP EITHER DEAD OR IN PRISON. >> THESE PEOPLE THAT ARE GETTING THE LEGAL
PILLS AND THEY SELL ‘EM AND THEY END UP WITH THE MONEY TO GO AND BUY THE HEROIN. >> DID
WE GET ALL THE RECORDS THAT WE CAN GET TO TRY TO BACKGROUND ON THIS GUY? >> I THINK
WE HAVE ENOUGH FOR A WARRANT. >> FROM ELY, TO ROCHESTER, TO MARSHALL, TO MOORHEAD, TO
LITTLE FALLS, ALL OF THESE COMMUNITIES ARE AFFECTED BY THE OPIATE AND HEROIN PROBLEMS
THAT WE HAVE. >> SO HOW MANY PILLS DO WE HAVE SO FAR THAT THIS GUY’S BEEN PICKING UP? >> IT
IS A LEGAL PRESCRIPTION, BUT OF COURSE, IT’S WHAT HE’S DOING AFTER. >> IN THESE DAYS OF
US HAVING LESS GOVERNMENT, THEY ARE COMBINING FORCES IN THESE MULTI-JURISDICTIONAL TASK
FORCES TO TRY TO COMBAT THE PROBLEMS. I DON’T BELIEVE THAT WE NEED TO TRY TO INCARCERATE
OUR WAY OUT OF THIS PROBLEM BUT ARRESTING PEOPLE IN A LOT OF WAYS IS THEIR FIRST STEP
TO GETTING THEM THE HELP THEY NEED, OR IN SOME CASES, GETTING THEM INTO PRISON WHERE
THEIR POISON CAN’T AFFECT THE CITIZENS OF THIS STATE ANYMORE. >> THERE’S KIND OF AN
IMAGE THAT DRUG COURT ONLY SEEMS TO APPLY TO LIKE D.W.I.s AND NOW YOU’RE SEEING AN INCREASED
NUMBER OF DIVERTED OPIATE MEDICATION ABUSERS AND HEROIN ABUSERS ARE STARTING TO COME INTO
DRUG COURT, AS WELL. >> AN ADDICT WILL COST SOCIETY ABOUT $47,000 PER YEAR IF UNTREATED.
RECIDIVISM RATES AND REARREST RATES ARE LOWERED SIGNIFICANTLY FOR DRUG COURT PARTICIPANTS.
I THINK UP TO 70% WILL STAY IN TREATMENT LONGER WHEN THEY’RE IN A DRUG COURT THAN OTHER SITUATIONS,
SO THAT’S PART OF THE POSITIVE IMPACT OF THAT. THE NATIONAL STUDIES WILL SHOW THAT FOR EVERY
DOLLAR INVESTED, JUST ON CORRECTION COSTS, WOULD BE ABOUT A SAVINGS OF $3.38, AND WHAT
WE CAN DO IS TO REFER THEM TO APPROPRIATE RESOURCES TO HELP THEM OUT WITH THOSE ISSUES
TO TRY TO STEM THE TIDE OF THEIR PROBLEM. AND YOU FINALLY SEE THEM WITH SOME SELF-ESTEEM
AND HOPE. >> SO IT’S NOT UNCOMMON AFTER WE ARREST SOMEONE, LAW ENFORCEMENT AND ME IN
PARTICULAR, HAVE RECEIVED CALLS OR LETTERS BACK FROM PEOPLE THANKING US FOR SAVING THEIR
LIFE BECAUSE IF THEY’D HAVE CONTINUED DOWN THAT PATH, THEY BELIEVE IN THEIR OWN MIND
THAT THEY WERE GOING TO DIE. >> DURING THE LAST FIVE YEARS THAT HE WAS ALIVE, I FINALLY
GOT IT — THAT ADDICTION WAS AN INCURABLE DISEASE FROM WHICH THERE’S NO CURE, THERE’S
ONLY RECOVERY. AND I STARTED TO WONDER IF HE WAS GOING TO MAKE IT. HE FOUND OUT ABOUT
DR. FRENZ. AARON HAD HEARD A LOT OF GOOD THINGS ABOUT DR. FRENZ. >> HE CAME TO US AT HEALTH
EAST FOR TREATMENT FOR OPIOID DEPENDENCE. HE HAD BEEN ABUSING NARCOTICS. HE HAD BEEN
THROUGH MANY PRIOR TREATMENTS. >> AND HE TOLD ME, WHEN I GO BACK IN THIS TIME, I WANT TO
BE OFF OF EVERYTHING WHEN I LEAVE, BECAUSE BEING ON OPIATE REPLACEMENTS — AARON WAS
ON ANTI-ANXIETY MEDICATION, HE WAS ON AN ANTIDEPRESSANT– AND HE SAID I DON’T WANT TO TAKE A HANDFUL
OF PILLS TO STAY ALIVE ANYMORE. >> SOMETHING THAT DOCTORS NEED TO DO IS OBTAIN SOMETHING
CALLED INFORMED CONSENT, AND SO WHEN A PATIENT COMES TO US WITH A PROBLEM, OUR OBLIGATIONS
TO THEM AS A PATIENT IS TO INFORM THEM OF THE PROBABLE DIAGNOSIS AND THE VARIOUS TREATMENTS
OPTIONS THAT ARE AVAILABLE WITH THE EXPECTED OUTCOMES AND THE EXPECTED DOWNSIDES OF THOSE
VARIOUS TREATMENTS. SO IT’S NOT NECESSARILY ME TELLING THEM WHAT TO DO. MY JOB IS TO EDUCATE
AND PRESENT AND THEN THEY CHOOSE THE OPTION THAT MAKES SENSE FOR THEM. IT’S THE SAME THING
WITH DISCONTINUING MEDICATIONS. SO THEY CAN COME AND THEY CAN SAY, WELL, SHOULD I STILL
BE ON METHADONE? SHOULD I STILL BE ON SUBOXONE? IT’S THE SAME SORT OF DRILL. I HAVE TO EDUCATE
THEM AS TO WHAT IS KNOWN ABOUT PEOPLE WHO HAVE DISCONTINUED THIS MEDICATION, SO I SHOW
THEM THE DATA. AND I SAY, WELL IT’S YOUR CHOICE. THE ODDS ARE NOT GOOD THAT YOU’RE
GOING TO SUCCEED BUT IT’S ULTIMATELY YOUR CHOICE. >> AND THEY SAID, YOU KNOW, YOU CAN
COMMIT HIM IF YOU WANT, BUT WE CAN’T KEEP HIM HERE. AARON ALWAYS SAID, YOU KNOW, I DON’T
EVER WANT YOU INVOLVED IN PUTTING ME IN TREATMENT. DON’T EVER DO THAT TO ME. YOU KNOW, LET ME
MAKE MY OWN DECISION. I PICKED HIM UP ON A TUESDAY AND HE WAS SIGNED UP FOR AN OUTPATIENT
PROGRAM THERE, AND AT 1:00 SATURDAY MORNING, I WOKE UP AND I JUST KNEW SOMETHING WAS NOT
RIGHT. >> HIS MOTHER FOUND HIM DEAD WITH A SYRINGE STILL IN HIS ARM FROM A HEROIN OVERDOSE.
>> WE FOUND HIM AND HE’D PROBABLY BEEN DEAD FOR, I DON’T KNOW, A DAY OR SO. >> EVEN THOUGH
IT’S HARD TO DO, I CALLED HER, AND SHE CAME TO St. JOE’S AND WE TALKED. SHE HAD A LOT
OF VERY HARD BUT APPROPRIATE QUESTIONS FOR US AS TO HOW HE WAS TREATED, COULD WE HAVE
DONE THINGS DIFFERENTLY, THE SORT OF SOUL-SEARCHING THAT BOTH SURVIVORS AND PHYSICIANS DO AFTER
A DEATH LIKE THIS. THIS
WHOLE IDEA THAT YOU LEAVE TREATMENT AND YOU’RE DONE IS GONE, AND SO THE MODEL THAT WE’VE
CONSTRUCTED AT HEALTH EAST IS YOU WILL COME TO TREATMENT AND BE STABILIZED, BUT THEN IT’S
OUR EXPECTATION, OUR HOPE THAT WE CAN FOLLOW YOU INDEFINITELY, MUCH LIKE OTHER DOCTORS
WOULD FOLLOW YOU FOR HEART FAILURE INDEFINITELY OR DIABETES INDEFINITELY. >> DO YOU FEEL LIKE
YOU’RE WITHDRAWING FROM ANYTHING? >> UMM, NO. >> REALLY? >> NO. >> WITHDRAWAL IS AN
INCREDIBLY SCARY EXPERIENCE THAT PEOPLE WANT TO AVOID. >> IT’S BETTER TO BE ON THE MEDICATION
THAN TO BE OFF OF THE MEDICATION. WOULD YOU LIKE TO BE IN WITHDRAWAL? NO. WITHDRAWAL IS
ABSOLUTELY HORRIBLE. IT’S GOT TO BE WORSE THAN DYING. >> ON A SCALE OF ZERO TO 10, HOW
STRONG ARE THE OPIATE CRAVINGS? >> ZERO TO 10. I WOULD SAY ABOUT A SIX. >> UH-HUH. >> METHADONE
IS STILL AROUND. IT’S STILL THE OLD TRIED AND TRUE, BUT FOLLOWING SOME RESEARCH IN EUROPE,
ABOUT TEN YEARS AGO, A MEDICATION CALLED BUPRENORPHINE, THAT’S THE GENERIC NAME, BECAME AVAILABLE
IN THE UNITED STATES. THE TRADE NAME OR BRAND NAME FOR THAT MEDICATION IS SUBOXONE. >> AND
WHEN YOU’RE ON METHADONE MAINTENANCE OR SUBOXONE MAINTENANCE, YOU DON’T HAVE COGNITIVE IMPAIRMENT.
YOU DON’T GET HIGH. YOU JUST FEEL NORMAL. ADDICTION IS COMPULSIVE, DESTRUCTIVE DRUG
USE. THAT’S NOT WHAT MAINTENANCE IS. MAINTENANCE ALLOWS PEOPLE TO FUNCTION. >> GOOD. NORMAL.
>> IF YOU LOOK AT OPIOID TREATMENT PROGRAMS IN MINNESOTA, WE HAVE 17 OF THEM RIGHT NOW.
WITH INCREASED UNDERSTANDING, I THINK WITH INCREASED RESEARCH, THERE’S MORE OF A GENERAL
ACCEPTANCE OF THE USE OF MEDICATIONS FOR MAINTENANCE PURPOSES. IN THE SAME VEIN, THERE ARE PEOPLE
WHO ARE ADAMANTLY CONVINCED THAT THAT IS NOT THE APPROPRIATE THING TO DO. THERE’S RESEARCH
ARGUED BACK AND FORTH. THE ONE THING YOU CAN NEVER CONTROL FOR IN ANY PIECE OF RESEACH
IS WHO FUNDED IT THOUGH. >> BECAUSE METHADONE IS SO INEXPENSIVE, IT’S BECOME MUCH MORE POPULAR
OVER THE LAST 10 YEARS TO TREAT PAIN, SO WE’VE SEEN THIS INCREDIBLE INCREASE IN METHADONE-RELATED
DEATHS BECAUSE A LOT OF DOCTORS ARE PRESCRIBING IT TO TREAT PAIN. DATA FROM AROUND THE COUNTRY
IS VERY CLEAR THAT THE INCREASE IN METHADONE-RELATED DEATHS, WHICH IS VERY REAL, IS ALMOST SOLELY
ATTRIBUTABLE TO THE INCREASE IN THE USE OF METHADONE TO TREAT PAIN, IN THAT THERE’S BASICALLY
BEEN NO CHANGE IN DEATH RATES ASSOCIATED WITH METHADONE PROVIDED THROUGH METHADONE CLINICS.
>> I’M BEING TAPERED OFF METHADONE AND BEING PUT ON SUBOXONE, AND I’VE BEEN ON SUBOXONE
IN THE PAST. IT’S A REALLY HELPFUL DRUG TO HELP CRAVINGS. METHADONE IS REALLY HELPFUL,
TOO, BUT IT CAN BECOME ITS OWN ADDICTION AND I DON’T WANT TO START THAT. >> ADDICTION’S
ALWAYS BEEN WITH HUMAN BEINGS. IF YOU GO BACK IN THE HEBREW SCRIPTURES, THERE WERE STRICTURES
AGAINST IMBIBING TOO MUCH, DRUNKENNESS, THINGS LIKE THAT. WHAT WE LACKED REALLY AS A PEOPLE
WAS A RESPONSE TO ADDICTION. ALCOHOLICS ANONYMOUS, WHICH CAME ABOUT IN THE 1930s, WAS REALLY
A REVOLUTION. IT WAS THE FIRST REALLY CREDIBLE INTERVENTION FOR PEOPLE WHO HAD A PROBLEM
IN THIS CASE WITH ALCOHOL. >> EVEN ONCE IT TRANSITIONED OUT OF THIS MORAL FAILING OR
ILLEGAL CRIMINAL ACTIVITY, IT’S REALLY BEEN CENSORED IN BEHAVIORAL HEALTH SYSTEMS, WHICH
ARE OFTEN VERY SEPARATED FROM THE REST OF THE MEDICAL CARE SYSTEM. >> AND SO THE MINNESOTA
MODEL BEGAN AT THE WILLMAR STATE HOSPITAL. >> SO THE MINNESOTA MODEL WAS SOMETHING THAT
WAS DEVELOPED IN THE LATE ’60s, EARLY ’70s, AND IT IS WHAT WE TEND TO THINK OF AS THE
TRADITIONAL 28-DAY TREATMENT PROGRAM. >> AND SO THAT MODEL, I THINK, DID PRETTY WELL FOR
ALCOHOL. THE PROBLEM IS WHEN YOU TRIED TO EXTEND IT TO OTHER ADDICTIONS, IT DIDN’T NECESSARILY
WORK SO WELL. >> OVER THE LAST 40 YEARS, AT LEAST FOR OPIATE ADDICTION, WE’VE HAD INCREDIBLE
MEDICATIONS TO HELP TREAT IT. AND SO IN SOME PARTS OF THE COUNTRY THERE HAVE BEEN ESTABLISHED
12-STEP MEETINGS THAT ARE FRIENDLY TO PEOPLE ON MEDICATIONS AND IN OTHER PARTS OF THE COUNTRY
THERE ARE EVEN METHADONE ANONYMOUS MEETINGS. >> MEDICATIONS ARE VERY EFFECTIVE IN THE TREATMENT
OF ADDICTION BUT WE’RE RELUCTANT TO USE THEM IN THE STATE OF MINNESOTA. >> THERE’S JUST
A LOT OF INERTIA INTO MEDICATION-FREE TREATMENT IN THIS PARTICULAR STATE. >> WE DON’T EVEN
HAVE IN THIS STATE THE STANDARD OF INFORMED CONSENT. IF YOU GO TO A PROGRAM THAT IS ABSTINENCE-BASED,
THEY WILL JUST TELL YOU THIS IS THE WAY WE TREAT OPIATE ADDICTION. THEY WON’T MENTION,
OH, BY THE WAY, THERE ARE ALSO VERY EFFECTIVE MEDICATIONS FOR OPIATE ADDICTION. THEY AREN’T
EVEN OBLIGATED TO MENTION THAT, AND THAT’S REALLY UNIQUE. >> THIS IS LIKE A LOT OF CHRONIC
DISEASES IN MEDICINE. A GOOD EXAMPLE I USE IS DIABETES. DIABETES IS A CHRONIC PROBLEM
THAT’S ONCE IT’S DEVELOPED IT TYPICALLY WILL REMAIN FOR THE REST OF YOUR LIFE. TO WITHHOLD
MEDICATION THAT COULD BE LIFE-SAVING AND PROMOTE THEIR HEALTH WOULD SEEM TO BE ABSURD. >> IF
YOU HAD AN ILLNESS WHERE YOUR DOCTOR SAID, YOU KNOW, THIS IS A LONG-ACTING ILLNESS, YOU
MAY OR MAY NOT DIE FROM IT AND I HAVE A TREATMENT FOR THIS ILLNESS THAT HAS A 20% SUCCESS RATE,
OR I HAVE A TREATMENT FOR THIS ILLNESS THAT HAS A 70% SUCCESS RATE, WHICH ONE ARE YOU
GOING TO CHOOSE? >> AND THIS PATERNALISM HAS SORT OF PERSISTED IN ADDICTION TREATMENT MUCH
LONGER THAN OTHER AREAS OF MEDICINE. >> I SEE FAMILIES BANKRUPTING THEMSELVES, SENDING
THEIR KIDS TO RESIDENTIAL PROGRAMS ALL OVER THE COUNTRY, TREATMENT PROGRAM AFTER TREATMENT
PROGRAM. THEY’RE TOLD IF THEY WORK A 12-STEP PROGRAM WELL ENOUGH, THAT THEY’LL RECOVER.
SO IF IT DOESN’T WORK, THEN IT’S YOUR FAULT. SO IT MAKES ADDICTS FEEL HORRIBLE. IT MAKES
FAMILIES ANGRY BECAUSE THEY THINK THE PERSON’S JUST NOT TRYING HARD ENOUGH. THE FACT IS,
THEY’RE NOT BEING GIVEN EFFECTIVE TREATMENT. >> WHEN PEOPLE RELAPSE, THEY UNFORTUNATELY
DIE AT A HIGH RATE, AND SO IF YOU COMPARE PEOPLE WHO ARE OFF MEDICATIONS TO PEOPLE WHO
REMAIN ON MEDICATIONS FOR ADDICTION THE PEOPLE WHO ARE OFF MEDICATIONS HAVE A MUCH HIGHER
RATE OF DEATH COMPARED TO THOSE WHO ARE BEING TREATED WITH MEDICATION. >> I’M NOT SAYING
THAT EVERYONE NEEDS TO BE ON MEDICATION, BUT EVERYONE NEEDS THE INFORMATION SO THEY CAN
MAKE AN INFORMED CHOICE OF WHAT TREATMENT WORKS FOR THEM. THE ONLY THING THAT’S CONTROVERSIAL
ABOUT USING SOMETHING LIKE METHADONE TO TREAT OPIATE ADDICTION IS THAT IT REMAINS CONTROVERSIAL,
BECAUSE THE EVIDENCE IS SO OVERWHELMING THAT IT WORKS. >> THE FACT THAT THE HAZELDEN FOUNDATION,
WHICH IS THE NATIONAL LEADER IN ABSTINENCE-BASED TREATMENT AND A 12-STEP FACILITATION MODEL,
THAT THEY RECENTLY STARTED USING SUBOXONE IN THE TREATMENT OF THEIR OPIATE ADDICTS REALLY
SPEAKS TO HOW YOU NEED TO CHANGE STANDARD PRACTICE TO KEEP UP WITH THE TIMES. >> IT’S
A MAJOR CHANGE IN PHILOSOPHY. HAZELDEN IS WIDELY RECOGNIZED FOR ITS 12-STEP PROGRAM,
WHERE PATIENTS ARE NOT PRESCRIBED ANY MEDICATION IN TREATMENT. AND WHILE THE 12-STEP PROGRAM
WILL BE THE FOCUS, SEPPALA SAYS THE NUMBERS BEG A DIFFERENT APPROACH. >> SO JUST A DRAMATIC
SHIFT. WE HAVEN’T SEEN ANYTHING LIKE THAT WITH OTHER DRUGS. >> THIS IS A BIG SHIFT AND,
YOU KNOW, ACTUALLY WE’VE BEEN THROUGH THIS BEFORE. IN THE 1960s AND ’70s, IT WAS ROUTINE
IF YOU WENT TO AN AA MEETING TO BE TOLD TO GET OFF YOUR LITHIUM IF YOU WERE BIPOLAR,
TO GET OFF YOUR ANTIDEPRESSANTS, TO GET OFF YOUR ANTIPSYCHOTICS BECAUSE YOU WEREN’T REALLY
SOBER. AND NOW YOU’RE MORE LIKELY TO GET A REFERRAL TO A PSYCHIATRIST FROM YOUR SPONSOR
IF YOU’RE DEPRESSED. YOU KNOW, GO GET AN ANTIDEPRESSANT. BUT, SO WE’VE BEEN THROUGH THIS BEFORE AND
WE’LL GET THROUGH THIS AGAIN. I THINK PEOPLE WILL EVENTUALLY ACCOMMODATE TO IT. THERE ARE
NOW A GROWING NUMBER OF 12-STEP GROUPS IN THE TWIN CITIES THAT ARE SUBOXONE-FRIENDLY.
>> MEDICATION-ASSISTED RECOVERY IS ONE OF THE MANY PATHWAYS TO RECOVERY AND, AGAIN,
WE EMBRACE AND ENCOURAGE ALL PATHWAYS TO RECOVERY. 12-STEP IS VERY, VERY STRONG IN MINNESOTA.
THERE’S OVER 500 12-STEP MEETINGS A WEEK JUST IN THE TWIN CITIES METRO AREA. 12-STEP IS
NOT FOR EVERYONE. THAT’S OKAY, THERE’S MANY WAYS THAT PEOPLE CAN RECOVER, THROUGH A CHURCH
OR THROUGH SOME SORT OF CULTURALLY-SPECIFIC WAY. IT’S NOT REALLY FOR US TO SAY WHAT IS,
YOU KNOW, THE RIGHT WAY OR THE WAY FOR A PERSON TO RECOVER. SO RECOVERY COMMUNITY ORGANIZATIONS
ARE ABOUT MAKING THE RECOVERY COMMUNITY VISIBLE SO THAT A PERSON WHO’S NOT GETTING INTO TREATMENT
IN THE FIRST PLACE BECAUSE OF STIGMA OR LACK OF INSURANCE OR LACK OF FINANCIAL RESOURCES,
IT’S ABOUT SERVING THOSE PEOPLE BY WRAPPING THE COMMUNITY AROUND THOSE PEOPLE, CONNECTING
THEM TO THE MANY RESOURCES THAT EXIST IN MINNESOTA THAT CAN HELP REMOVE BARRIERS TO RECOVERY,
CAN HELP BRING A PERSON INTO LONG-TERM RECOVERY. I MYSELF HAVE BEEN IN RECOVERY FOR OVER 15
YEARS. >> I HANG OUT WITH A LOT OF PEOPLE I MET AT SOBER HOUSES AND I HIT A LOT OF MEETINGS
AND MOST IMPORTANT FOR ME, I DO SERVICE WORK. SERVICE WORK ALLOWS ME TO MEET NEW PEOPLE
IN THE COMMUNITY AND I JUST LIKE TO GET OUT THERE. >> I KNOW GETTING INVOLVED WITH ACTIVITIES,
SOBER ACTIVITIES, VOLLEYBALL, SOFTBALL, STUFF LIKE, THAT THAT’S HOW I’VE GOTTEN TO MEET
PEOPLE. >> I WENT TO A MEETING BACK IN NEW MEXICO AND IT WAS JUST LIKE NOT THE SAME AS
HERE AT ALL. >> St. PAUL DOES HAVE A UNIQUE RECOVERY COMMUNITY. THERE IS A LOT OF YOUNG
PEOPLE IN RECOVERY IN St. PAUL. THERE’S A LOT OF SOBER HOUSING IN St. PAUL. MINNEAPOLIS,
TOO, BUT St. PAUL REALLY HAS SOMETHING SPECIAL AND IT’S MORE THAN TREATMENT AND IT’S MORE
THAN, YOU KNOW, THE CLINICAL SERVICES THAT ARE AVAILABLE AND THOSE ARE VERY IMPORTANT
BUT THERE SEEMS TO BE A FELLOWSHIP AND A CAMARADERIE AND SOMETHING THAT IS HAPPENING IN St. PAUL.
BUT UNTIL YOU GET PLUGGED IN, IT CAN BE INVISIBLE, SO THAT’S WHY RECOVERY ADVOCACY IS SO IMPORTANT.
>> EVERYONE IN THIS STATE IS ON A LEARNING CURVE, AND THAT’S FIRST RESPONDERS, TREATMENT
PROVIDERS, DRUG COURT PEOPLE. >> MEDICAL STUDENTS WERE SPENDING FOUR YEARS AT THE UNIVERSITY
OF MINNESOTA MEDICAL SCHOOL AND RECEIVING MORE HOURS OF TRAINING ON BIOTERRORISM THAN
THEY WERE ON ADDICTION. WHICH ONE WERE THEY MORE LIKELY TO ENCOUNTER THROUGHOUT THE COURSE
OF THEIR CAREER? ONE-THIRD OF ALL PHYSICIANS PRACTICING IN THE STATE OF MINNESOTA AT SOME
POINT IN TIME IN THEIR TRAINING SPEND IT AT HENNEPIN COUNTY MEDICAL CENTER, AND SO WE
NEED TO MAKE SURE THAT AT LEAST THERE, THEY’RE GETTING SOME FORM OF EDUCATION IN RECOGNIZING,
DIAGNOSING, AND EVEN LEARNING HOW TO TREAT DRUG ADDICTION. >> IF YOU LOOK AT WHO DOES
SUBSTANCE ABUSE TREATMENT, THEY’VE BEEN UNCONNECTED PROFESSIONALS. SO YOU HAVE PSYCHIATRISTS AS
WELL AS OTHER PHYSICIANS WHO ARE SPECIALISTS IN ADDICTION MEDICINE DOING THEIR THING. YOU
HAVE LICENSED ALCOHOL AND DRUG COUNSELORS DOING THEIR THING. YOU HAVE PSYCHOLOGISTS
AND SOCIAL WORKERS DOING THEIR THING. AND SO THE WORK THAT I DO, IS I’M ACTUALLY TRAINING
NON-PHYSICIANS. MY APPOINTMENTS TO THE UNIVERSITY OF MINNESOTA ARE IN THE PROGRAM THAT TRAINS
LICENSED ALCOHOL AND DRUG COUNSELORS SO THEY GET A PHYSICIAN PERSPECTIVE ON LIFE, AND I
ALSO TEACH IN A PROGRAM THAT’S TEACHING OR TRAINING FUTURE PSYCHOTHERAPISTS, SO, AGAIN,
THESE ARE PEOPLE GETTING A PHYSICIAN PERSPECTIVE DURING THEIR TIME IN EDUCATION. >> DON’T HIDE
IT, YOU KNOW. GIVE THAT INFORMATION TO THE PEOPLE. >> YOU’RE THE ONLY NATIVE AMERICAN
SPECIFIC OPIATE TREATMENT PROGRAM IN THE STATE, IN FACT, IN THE AREA. >> YEAH, YEAH, WE ARE
THE ONLY ONE. SO I THINK MORE COMMUNITY EDUCATION, WORKING TOGETHER WITH COUNCILS, WE CAN STRIDE
FORWARD. >> THAT PROGRAM IN PARTICULAR TRIES TO APPROACH IT NOT SO MUCH AS A MEDICATION
ONLY OR AS INDIVIDUAL AND GROUP THERAPY, AND 12-STEP MEETINGS AND THINGS LIKE THAT, THEY
BRING A CULTURAL NUANCE AND COMPONENT TO IT THAT IS UNIQUELY THEIRS. [SINGING AND DRUMMING]
>> DOCTORS ARE A LITTLE BIT MORE CAUTIOUS IN PROVIDING PRESCRIPTIONS. THERE IS A PRESCRIPTION
DRUG MONITORING PROGRAM THAT OPIATE PRESCRIPTIONS AND OTHER CONTROLLED SUBSTANCES CAN BE TRACKED
BY PHYSICIANS AND I THINK THAT’S PROBABLY CHANGED PRESCRIBING PRACTICES. >> AND IF WE
WANT TO CHANGE BEHAVIOR AND IN THIS CASE, WE WANT TO REDUCE THE MISUSE OF THE PRESCRIPTION
DRUGS, CHANGE THE BEHAVIOR THAT WAY, WE NEED TO CHANGE SOME OF THE NORMS. WE NEED TO START
THINKING MORE ABOUT PREVENTION. WAY TOO OFTEN IN OUR CULTURE, WE WAIT UNTIL SOMETHING GOES
WRONG AND THEN WE TRY TO FIX IT. THERE IS A HUGE BENEFIT TO PREVENTING THE PROBLEM IN
THE FIRST PLACE, AS FAR AS THE HEALTH OF INDIVIDUALS, THE HEALTH OF OUR COMMUNITIES, THE HEALTH
OF OUR STATE. WE’LL BE BETTER OFF FINANCIALLY. AND WE ALSO NEED A LOT OF PEOPLE SAYING THE
SAME THING. WE NEED PERSISTENT AND CONSISTENT MESSAGES – PARENTS, AND GRANDPARENTS, AND
COACHES, AND TEACHERS, AND CLERGY, AND EMPLOYERS, AND ON, AND ON AND ON. IF WE CAN GET EVERYBODY
ON THE SAME PAGE, SAYING THE SAME THING, WE CAN MAKE SOME PROGRESS. >> WITH THE INCREASE
OF PRESCRIPTION MEDICATION ABUSE, THERE HAS THEN BEEN A RESPONSE BOTH STATE AND FEDERAL
BY DIFFERENT AGENCIES THAT PROVIDE EDUCATION, THAT PROVIDE REGULATORY ENFORCEMENT TO, IN
A SENSE, CRACK DOWN ON THAT OR MAKE IT MORE DIFFICULT TO OBTAIN, RETAIN, TO ABUSE SUBSTANCES.
SO YOU’VE SEEN EFFORTS LIKE THE DROP BOXES. IT’S AN AMNESTY PROGRAM WHERE PEOPLE CAN
TAKE UNUSED MEDICATIONS AND DROP THEM OFF, WHICH LITERALLY REMOVES THEM FROM THE STREET.
>> YOU NEED TO TRY TO TAKE OFF THE MID-LEVEL OR UPPER LEVEL DEALERS TO STOP THAT FLOW OF
LARGER QUANTITIES COMING INTO OUR COMMUNITIES. FRUSTRATION OF LAW ENFORCEMENT THAT EVEN REPEAT
OFFENDERS DON’T NECESSARILY GET SENTENCED TO WHAT THE GUIDELINES CALLS FOR AND THE PUBLIC
BELIEVES IS HAPPENING. THEY BELIEVE WE’RE LOCKING UP DRUG DEALERS FOR A LOT LONGER AND
MORE OF THEM THAN WE ACTUALLY ARE. >> YOU KNOW, I THINK STIGMA KEEPS PEOPLE FROM REALLY
HEARING AND SEEING WHAT’S GOING ON IN MINNESOTA IN REGARD TO OPIATE ADDICTION, AND HEROIN
ADDICTION, AND OVERDOSE THAT’S HAPPENING WITH YOUNG PEOPLE, ESPECIALLY. >> IT’S NOT UNCOMMON
FOR ME TO CALL HER AFTER THE DEATH OF ANOTHER PATIENT. I WILL SAY, YOU KNOW, I HAVE ANOTHER
FAMILY WITH A DEATH, OR I’LL PASS ALONG HER NUMBER OR HER WEBSITE TO SURVIVORS. SHE’S
DEVOTED HER LIFE TO IT. I MEAN, IT HAS CHANGED THE ENTIRE TRAJECTORY OF HER LIFE. THIS IS
WHAT SHE DOES NOW. >> BY SOME ESTIMATES, EVERY DAY 23 MILLION AMERICANS ARE IN RECOVERY FROM
ADDICTION. 23 MILLION EXTRAORDINARY AMERICANS! [Cheering] >> MY PARENTS TRIED SO MANY TIMES
TO SIT ME DOWN AND TELL ME I NEEDED HELP, AND IF YOU THINK IT’S YOUR KID, YOU KNOW,
START TAKING CARE OF YOURSELF AND LEARN WHAT NOT TO DO IN TERMS OF TRYING TO HELP YOUR
KID. >> THERE’S DEFINITELY DIFFERENT WAYS PARENTS HANDLE IT DIFFERENTLY AND A LOT OF
PARENTS DON’T KNOW HOW TO HANDLE IT WHEN THEIR — THEY FIND OUT THEIR KID IS USING DRUGS.
AND A LOT OF PARENTS HANDLE IT WRONG AND I DON’T THINK PEOPLE WANT TO REALIZE THAT. WHEN
IT COMES UP WITH SOMETHING LIKE DRUG ADDICTION, AND A PARENT’S NEVER DEALT WITH IT BEFORE,
THEY’RE VERY CAPABLE OF MESSING UP, TOO, JUST LIKE WE’RE CAPABLE OF MESSING UP IN OUR RECOVERY.
>> YOU CAN’T JUST GO TO A 28-DAY PROGRAM AND BE MAGICALLY CURED. IT JUST DOESN’T HAPPEN.
SO I THINK MY PARENTS SUGGESTING THAT I GO TO AFTER-CARE OR I WOULD BE HOMELESS AGAIN
WAS KIND OF THE POINT WHERE I STARTED TO REALIZE, OKAY, I MIGHT AS WELL GIVE THIS A SERIOUS
SHOT BECAUSE I’M GOING TO BE HERE WHETHER I LIKE IT OR NOT UNLESS I WANT TO BE ON MY
OWN, SO I THINK IT TOOK AROUND MAYBE SIX OR SEVEN MONTHS BEFORE I DECIDED TO ACTUALLY
GIVE IT A TRY, GET A SPONSOR, SEE WHAT THIS RECOVERY THING WAS ALL ABOUT. >> I’M A BIT NERVOUS. THIS IS THE FIRST TREATMENT THAT I’VE BEEN TO THAT I’VE COME TO WILLINGLYAND THAT I WANT TO DO THIS FOR MYSELF. I’M NOT DOING IT FOR THE COURTS OR LEGAL THINGS OR SOMEBODY ELSE. I’M DOING IT FOR MYSELF AND I WANT TO GET BETTER, SO THAT’S WHY IT’S
WORKING A LOT BETTER THIS TIME. I’M 25 DAYS SOBER AND FEELING GOOD. [Laughter] >> SHOULD WE NOT LOOK AT THE CAMERA? >> YOU CAN LOOKNOW. >> [Laughter] >> I’VE BEEN SOBER SINCE
APRIL 19th, 2011. >> I’VE BEEN SOBER SINCE JULY 20th, 2012. >> I’VE BEEN SOBER SINCE
JULY 27th, 2012. >> I’VE BEEN SOBER SINCE APRIL 13th, 2012. >> I’VE BEEN SOBER SINCE
OCTOBER 20th, 2012. >> I’VE BEEN SOBER SINCE OCTOBER 16th, 2012. >> I’VE BEEN SOBER SINCE
DECEMBER 23RD, 2011. >> “HEROIN AT HOME” IS A MINNESOTA PARTNERSHIP PRODUCTION, A CO-PRODUCTION
OF THE MINNESOTA DEPARTMENT OF HUMAN SERVICES AND TWIN CITIES PUBLIC TELEVISION.

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