‘Even the thought of drugs scares me now’: Medication-assisted treatment shows promise

Newsrooms across the commonwealth have spent years documenting the opioid crisis in their own communities. But now, in the special project State of Emergency: Searching for Solutions to Pennsylvania’s Opioids Crisis, we are marshalling resources to spotlight what Pennsylvanians are doing to try to reverse the soaring number of overdose deaths.

WITF is releasing more than 60 stories, videos and photos throughout July. This week, you will find stories about police intervention, courts and treatment.

Joanna Temple, of Washington, spent three months in jail last year for crimes related to her heroin addiction. In those three months, her brother and her fiancé of 15 years both died from overdoses.

“Because I was an opiate user, they didn’t let me out of jail to attend the funerals,” Temple said.

After losing so much, Temple knew she had to find a way to get clean to stay alive for her three children.

“I’m all my kids have right now,” she said. “Even the thought of drugs scares me now.”

Temple, 33, decided to be one of the first two people in Washington County to try the Vivitrol Plus Program, a combination of medicine and treatment. Vivitrol is the trade name for a naltrexone, or “opioid antagonist,” that counters the high one typically experiences from ingesting opioids.

“It’s cut with naloxone,” said Shianne Scott, case management specialist for the Washington Drug & Alcohol Commission. “It’s an opiate blocker. If you were to try to get high using an opiate, it completely blocks it.”

The drug and alcohol commission distributes the Vivitrol shot through a provider, Allied Addiction Recovery. The program was funded through a $148,000 grant from the Pennsylvania Commission on Crime and Delinquency and has been in effect for about a year. Erich Curnow, director of clinical and case management services with the commission, said the Vivitrol manufacturer, Alkermes, offers the first shot, given while the individual is in jail, for free. After that, shots cost about $986 each and are paid for through insurance when possible and through the grant.

“Our main objective is to keep people in the most vulnerable populations from overdosing and dying,” Curnow said. “We based the grant on documented research that people coming out of prison were much more likely to overdose and die because their tolerance to opiates had reset during their incarceration time.”

Scott said the shot also is intended to keep people from returning to jail on drug-related charges.

Temple, who battled heroin addiction for five years, is representative of that success.

She had been arrested for violating parole April 28, 2017. It was Temple’s fourth time behind bars, and those three months were certainly the worst of her life. Three days after her arrest, her brother, William Temple, 36, died of an overdose, followed just one month later by the death of her fiancé, Brandin Noble Sr., 43, also from an overdose.

Temple had tried other types of treatment, like suboxone and inpatient treatment, but nothing seemed to work.

“There were times when I’d get out of jail and do drugs within that hour,” she said. “This time it was really different, and the shot had a lot to do with it.”

The shot, which is injected in the buttocks, is typically given to people while they’re in jail, to ensure they’ve been sober for at least two weeks. Temple received it three days before she was released July 22.

Molly Orange works inside the jail as a case management specialist with the commission. She said candidates have to be medically and clinically cleared before entering the Vivitrol program, which is a voluntary program, “not something we want people to be court-ordered into.”

Curnow said the “plus” part of the program refers to the intensive outpatient treatment that occurs before, during and after the shot. He said research showed that integrating treatment into the jail setting decreases rates of incarceration and death. That’s why they try to get people three months of individual and group outpatient treatment inside the jail before their first injection and parole.

Temple is no longer receiving the shot – her last one was in November – but she’s still attending weekly, group outpatient treatment. She’s been sober since April 28, 2017.

“I’ve been around drugs since and people who do drugs, but my train of thought is a lot different than what it was,” she said.