SUNBURY — A medication used in addiction treatment to quell cravings and thwart effects of opioids and alcohol is now available through drug and alcohol programs in the Valley.
Positive Recovery Solutions of Washington, Pa., began administering Vivitrol injections in Northumberland County on Friday. The firm is also contracted to treat clients of Columbia Montour Snyder Union Service System (CMSU), which began in late December.
An injection of Vivitrol blocks the effects of alcohol and opioids like prescription painkillers and heroin for up to a month. It’s an extended-release version of naltrexone. Vivitrol is not a narcotic and not addictive, according to the National Institute on Drug Abuse. Since it’s received in the form of a monthly injection, it can’t be shared or sold by the user.
It was approved as an opioid-dependence treatment in 2010, and in 2006 for alcohol dependence.
“You work on recovery free of compulsion and obsession,” said Amanda Cope, chief operating officer of Positive Recovery Solutions (PRS).
The respective Drug and Alcohol programs require clients couple the medication with counseling. Referrals are made to area outpatient providers.
“I view it as another tool. It’s not appropriate for everyone but is certainly something that has a lot of potential,” said Barbara Gorrell, CMSU Drug and Alcohol administrator. “There’s no magic bullet. You must get treatment. That’s where we come in.”
“They’re not just getting a shot and walking away,” said Glenda Bonetti, administrator of Northumberland County Drug and Alcohol.
Bonetti said her agency is able to fund shots for 12 clients and expects another 10 to 15 people referred to the agency to obtain Vivitrol through Medicaid. Anyone with private insurance referred to the agency for treatment may also be eligible.
More clients expected
CMSU has 12 clients receiving the treatment, a figure Gorrell expects will increase.
Access to treatment services is one of many challenges substance abusers in rural areas face when attempting to get sober.
According to the Vivitrol website, White Deer Run treatment facility in Allenwood is the closest location offering the medication. The next closest providers are in the Williamsport, Pottsville and Harrisburg areas.
Positive Recovery Solutions had clients driving as long as four hours to get to its clinic outside of Pittsburgh, according to Cope. She decided in 2015 to take the clinic to them. The company purchased a vacation trailer, retrofitted it into a mobile clinic, hitched it to a pickup truck and traveled the Southwestern part of the state.
“We decided we would create a service that would take this medication and these services to hard to reach populations,” Cope said.
The mobile clinic is parked in discreet lots to serve clients in Danville and Lewisburg, according to Mark Rupert, physician’s assistant with PRS. The firm will provide the shots inside the drug and alcohol office in Sunbury. Rupert compared the Sunbury area to Lemoyne, located outside Harrisburg, where he said the patient base grew from three to 14 clients in two months. He expects the same type of growth in Sunbury and plans to visit twice monthly and perhaps weekly if demand necessitates it.
200 injections monthly
PRS averages between 200 and 275 injections monthly for clients across 20 counties, Cope said. She’s working to expand into each of the state’s 67 counties.
The company receives referrals through service agencies, courts and probation and treatment providers. It also accepts self-referrals.
Cope said Vivitrol users must be clean for up to 10 days before they’re able to start the medication. Once they start, the treatment model supports complete abstinence. She said patients remain on the medication between 12 and 18 months, on average, as the brain recovers from substance abuse. As Gorrell and Bonetti stressed, Cope said counseling is key.
William Poray, director of outpatient programs at Geisinger Marworth Treatment Center, said the use of Vivitrol has shown positive results. Patients who volunteer to take the medication receive a shot before discharge from inpatient treatment and return monthly during outpatient counseling.
“The program has an astounding 95 percent retention rate, which is atypical for this population of clients,” Poray said.
Gaudenzia, which offers inpatient and outpatient treatment, had long maintained a model of total abstinence. That’s still the goal but the organization has since begun to treat clients who undergo medication-assisted treatment.
Jayme Hendricks, division director of outpatient services, said Gaudenzia prefers Vivitrol over competing medications like Suboxone and methadone because it isn’t addictive. It’s preferred, too, over Revia, an oral naltrexone, because it can’t be diverted.
Hendricks cautioned that its long-term effects are not clear and though covered by insurance plans, is costly without it.
About 9 percent of Gaudenzia’s outpatient clients in the Valley are in a medication-assisted program, Hendricks said. She said there must be an end-game for these treatments — that patients be put on a program to carefully step down dosages and eventually discontinue use of the medication.
Dependency on drugs to beat addiction can be dangerous, she said.
“That puts that thought in people’s heads making it more difficult for them to even think ‘drug free’ could ever be an option for them. I know this is occurring,” Hendricks said. “Many people are able to achieve total abstinence with the right education, treatment and support systems.”
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