by Randy Pellis
FULTON_Breaking down every barrier to treatment, breaking down the stigma of addiction, going with a medical model of treating substance abuse much like the treatment of diabetes or other common medical conditions, providing anti-addiction medication, and providing patients with certified peer advocate counselors who’ve been through addiction and treatment, counselors that patients can truly relate to, that’s what Farnham Family Services is doing in Fulton and Oswego, and that’s what Executive Director Eric Bresee was there to say to councilmen and interested community members at Tuesday’s Fulton Common Council meeting.
Going back to 2010, alcohol abuse was the number 1 concern, said Bresee. Now 45 percent of Farnham’s patients are addicted to heroin, and another 8 percent are addicted to other opioids. Alcohol abuse remains Farnham’s next highest concern affecting 19 percent of patients.
“Alcohol is still a problem. It’s not going away. It’s still there,” said Bresee. “It just doesn’t tend to kill people as quickly. So, the heroin gets a little bit more attention.”
Concerns over marijuana affect 14 percent of the people Farnham sees.
Farnham has clinics in both Fulton and Oswego. Fifty percent of all Farnham’s patients come from Oswego. Twenty-five percent come from Fulton, and the remaining 25 percent come from elsewhere around the region. At the Fulton clinic, located at the Schuyler Street Commons near Price Chopper, 40% of the people seen are 26 to 35 years old. Twenty-two percent are 22 to 25 years old, and 20% are 36 to 45 years old, according to Bresee. Sixty percent of all those seen are male.
But substance abuse is very often not the only problem Farnham is dealing with. It gets more complicated.
According to Bresee, 61% of those people seen have a co-occuring disorder. “What we see a lot of times with substance abuse disorder,” he said, “is there’s also a diagnosed mental health disorder, whether it be depression, bipolar disorder, anxiety, or schizophrenia. Any one of those disorders tends to go along with substance abuse disorder.”
Treatment is not an easy, straight-line path to a drug-free life. It’s a lot of back and forth with 82% having had some form of prior treatment.
“People often come back up to five times before they’re able to get a hold on their substance abuse disorder,” Bresee said. Of those who’ve had some form of prior treatment, 29% have been in treatment 5 times or more.
Bresee doesn’t see that in terms of failure. He sees it in terms comparable to the regular treatment of any other medical condition. People get treatment, they leave, they come back, they get more treatment, and so on.
“We think that type of treatment and that type of approach is going to be more effective and help reduce the stigma a little bit and help people to understand substance abuse disorder a little bit more,” said Bresee.
Normalizing the idea of treatment and removing the stigma that’s been attached to it for so long is borne out in the statistics of just who has a drug problem in today’s world.
Five to 7 years ago, Bresee noted, 70 to 75 percent of all referrals to Farnham for treatment were from probation or parole. Now, he said, only 40 percent come from probation or parole and an equal number are self-referrals.
“What we’re seeing,” said Bresee, “is a lot more people recognizing that their use is out of control, that they need help, that there’s some significant impact on their life, and they’re coming in for help.”
And yet, only 14% complete all their treatment. The state standard for successful completion is only 35%.
“To me,” said Bresee, “that’s failing. That’s not a good intervention if only that many people are getting help.” And as a result, Farnham “started to look at a lot of different ways to make treatment available and the types of treatment that we’re doing.”
Presently, Farnham offers to forms of opioid treatment: Methadone (only available at the Oswego clinic) and Suboxone, both of which, said , “fill the same receptor site in the brain that opiods do, but without the euphoric effect. So, people don’t go into withdrawal, it decreases their cravings, and they don’t get high.”
In the near future, Bresee said, Farnham intends to also offer Vivitrol, a once monthly injection that prevents drug use from having any effect.
All 3 medications are FDA approved.
Nevertheless, these treatments require scheduling and waiting times, often 2 to 3 weeks. That can be a huge barrier to treatment.
Since August, the Oswego clinic has offered walk-in access, though not for methadone treatment.
As a result of the success of Oswego’s walk-in access, Farnham’s Fulton clinic has launched within the last 2 weeks walk-in access Mondays, Tuesdays, and Thursdays from noon to 3 p.m. And even those hours can be flexible.
“If you know somebody that needs to access services outside of those hours,” said Bresee, “please have them call us. We’ll figure out a way to see them.”
And yet, there can still be a wait period of 7 days.
That’s where peer services come in. For even in those 7 days a lot can go on with someone seeking help, said Bresee. And so, to help break down this barrier to treatment, Fulton’s Farnham clinic now has 3 certified recovery peer advocates.
Peer advocates, said Bresee, are people who are “in recovery. They’ve been through it. People take to that model. Having someone that’s dealt with what they’re dealing with, they like to confide in someone like that. People are a lot more apt to be honest with the peers. They talk about relapse, talk about triggers. It’s another nice level of support, and it’s something that’s available immediately. So, you’re walking out of that first appointment with this phone number of somebody that you can call if you need help, you can come in and meet with them, they can meet you out in the community.”
And then, there’s the issue of insurance.
“A lot of people are coming but don’t have any insurance,” said Bresee. “Nobody is denied services based on ability to pay. That should never be an issue.”
In fact, Farnham helps people get insurance. Soon insurance assistants will be on site one day a week during open access.
So, once again, said Bresee, “it’s one less barrier.”
Lastly, Bresee had a lot of praise for the Fulton community and the school district Farnham also serves.
“Fulton is far and away the best district to partner with,” said Bresee. “They really look to partner with services. The administration has never been in denial about the needs in the district, and they welcome people in to kind of help and be available for the students.”