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WEDNESDAYS • May 16, 2018
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Efforts to preserve black cemeteries - 5 New era in Poor People’s Campaign - 8 Failure to suppress rap and hip-hop - 10 Local schools recognize top teachers - 13 Carson: Hurting the poorest Americans - 15
Richmond & Hampton Roads
LEGACYNEWSPAPER.COM • FREE
Virginia shows how Medicaid can help end the opioid crisis
Aubrey Gholson has been receiving addiction treatment at Daily Planet for eight months and is thankful for its medication-based approach. GERMAN LOPEZ VOX - Fawn Ricciuti started using opioids a decade ago, when she was enrolled in a New Jersey pain management program. What followed is the kind of story that’s been told thousands of times over the past few years as America’s opioid epidemic has grown: Her casual use of opioid painkillers over time turned into full-blown addiction. Her doctors eventually tried to wean her off painkillers, arguing that her dosage was too high. While that led her to use fewer opioids for a while, she’d still buy opioid painkillers from the street, she said, to manage pain stemming from painful disorders, including scoliosis. The drug use turned more recreational as she began using opioids with her ex-boyfriend, who’s also the father of her son. Pretty soon, the drugs consumed her life. But unlike the stories commonly told in the news and coroners’ reports, Ricciuti did not overdose and die. Early in 2017, she got on buprenorphine (common brand name: Suboxone),
which does not produce a euphoric high when taken as prescribed. She said that the drug, paired with group therapy, helps her treat not just the cravings and withdrawal that come with addiction and dependence but also, along with chiropractic, the pain that led her to use opioid painkillers in the first place. Withdrawal “is like going from being how you are now to the worst flu you can think of within hours,” said Ricciuti, who’s 33 and now lives in the Richmond, area. “Now I don’t have to stress about whether I have something [drugs] for the morning and how I’m going to get something in the afternoon.” When this reporter spoke to Ricciuti at one of the Richmond clinics run by Daily Planet Health Services, she said that addiction treatment, paid for through Medicaid, let her start getting her life in order — allowing her to focus more on her family and search for more sustainable work. “I have a better relationship with my daughter, my mom,” she said. “If I hadn’t gone to treatment,” she went
on, “my daughter wouldn’t be able to do soccer because I couldn’t guarantee that I could pick her up at 5:30 to get her home every day.” Ricciuiti reflected on her other ambitions. “Do you know what water ice is? “Oh, man, it’s so good. But yeah, I want to open a water ice place down here. It’s kind of like Italian ice that you run through blenders, so it’s softserved.” She added, “I got a business idea. I just want to do a couple classes and make sure that I have everything set so I’m not jumping into something over my head.” Here’s the thing: Ricciuti’s success story isn’t unique. Despite much of the despair that surrounds the opioid crisis, the medication she’s on has been known to work for opioid addiction for decades. And it’s not the only one; two others, methadone and naltrexone, can work better for some people than buprenorphine. Studies show that the medications reduce the all-cause mortality rate among opioid addiction patients by half or more and do a far better job of
keeping people in treatment than nonmedication approaches. In France, the government expanded doctors’ ability to prescribe buprenorphine in 1995 to confront an opioid epidemic — and overdose deaths declined by 79 percent from 1995 to 1999 as the number of people in treatment went up, according to a 2004 study published in The American Journal on Addictions. Despite the evidence, the medications are commonly stigmatized as just “substituting one drug with another.” But the problem with addiction isn’t drug use per se. The problem is when drug use turns compulsive and harmful — creating health risks, leading someone to neglect family and children, driving someone to commit crimes, and so on. As Ricciuti’s story shows, buprenorphine addresses these issues by letting her get a handle on her drug use without such negative outcomes, even if it needs to be taken indefinitely. The
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