CleanSlate Blog

Seeking treatment for an addiction takes courage. There’s an unfair stigma surrounding the disease of addiction, which makes it tough for people to reach out for help. When they do, they should be supported in every way possible.

So it’s mystifying when they’re not. Especially when the stigma surrounding addiction comes from leaders within the addiction treatment field itself, including the two brand-names in addiction support - Alcoholics Anonymous (AA) and Narcotics Anonymous (NA).

But this is often the bewildering experience of people engaged in medication-assisted treatment (MAT). They’re sometimes stigmatized by the supporters of traditional addiction treatment organizations for a recovery path that isn’t abstinence-only. Since the two most common addiction medications contain a small amount of opiates, MAT patients are  discriminated against for “replacing one drug with another.”

Across the country, the stigma around medication-assisted treatment (MAT) is slowly subsiding, and many more people who suffer from addiction are accessing medication that can save their lives. A growing chorus of leaders in healthcare, public policy, law enforcement, and other areas of expertise agree that MAT is a critical pillar of care for people suffering from opioid use disorder (OUD).

But misunderstandings remain, and MAT is still vastly underutilized.

A recent report from the  U.S. Centers for Disease Control and Prevention revealed that Ohio suffered the second-highest number of opioid-involved deaths per capita in 2017.

Springfield, located approximately midway between Dayton and Columbus, saw its overdose death rate double between 2014 and 2017, partially due to the increased prevalence of synthetic drugs like fentanyl. It now ranks third among Ohio counties in overdose death rate.

Despite seeing an increase in the number of addiction treatment providers in Ohio, many organizations leading the State’s efforts to address the epidemic, including the State Attorney General’s Office and multiple health systems, agree that there continues to be a shortage of providers delivering quality, evidence-based, outpatient medication-assisted treatment (MAT) services.

CleanSlate is responding to this need by expanding its operations to treat opioid and alcohol addictions in Ohio. The company is opening a new outpatient MAT center in Springfield, CleanSlate’s third center in the state.

Located at 1416 W 1^st St., CleanSlate’s Springfield center opened its doors to patients today. CleanSlate participates in-network with most Medicaid and commercial providers in Ohio so that Springfield patients can be treated with minimal or no financial burden.

Living on the streets in Boston, Mass., Peter Mulroney struggled with an addiction to heroin.

One day, he woke up in his homeless encampment and knew something was wrong. A friend gave him a ride to Boston Medical Center, where he was diagnosed with endocarditis, an inflammation of the inner layer of the heart.

On his fourth day at the hospital, Peter fell into a coma. The nurses called his parents to obtain permission to perform a spinal tap on Peter.

When they did, the doctors discovered another deadly infection: West Nile Virus.

Peter was in a coma for seven days. He was in the ICU for two months.

His diagnosis was grim. Doctors told Jake’s parents that he would never walk or talk again.

Somehow, Peter defied the odds. After a few weeks, he began talking. Eventually, he even began walking with a cane.

But while recovering from his deadly infections, Peter still had to sustain the recovery path for his other disease: opioid use disorder (OUD). All while being treated with opioid pain medication.

February is National Children’s Dental Health month, an observance sponsored by the American Dental Association (ADA) that brings together healthcare providers and educators to promote the benefits of good oral health to children and their caregivers.

This year, the ADA’s theme is “Brush and clean in between to build a healthy smile!” But for dentists and teens, the most important lesson of children’s dental health could come through increased education about a danger far more serious than plaque: an opioid prescription.

That’s because the first time that many American teens receive a prescription for opioid painkillers is at the dentist’s office. While teens in other countries are rarely prescribed opioids after dental surgeries like wisdom tooth removal, American teens are much more likely to be prescribed highly addictive drugs such as Vicodin.   

And the danger of addiction is real. A majority of all heroin users started by taking prescription painkillers, including oxycodone, hydrocodone, codeine, and morphine.

A 2015 study in the journal Pediatrics found that prescribed opioid use makes teens 33% more likely to abuse opioids later on. A more recent study, published last December in JAMA Internal Medicine by the Stanford University School of Medicine, found that teens and young adults who receive an initial opioid prescription from their dentists or oral surgeons are at increased risk for opioid addiction as soon as the following year.

A new report from the Centers for Disease Control and Prevention (CDC) concludes that while the opioid epidemic has profoundly impacted all parts of the population over the past nearly 20 years, drug overdose rates have dramatically multiplied amongst one group of people in particular. The findings have garnered wide news coverage as “unexpected.”

Why? Because the group in question is middle-aged women.

This may seem like surprising news, but it isn’t. A deeper look shows that this group has long been vulnerable to high rates of overdoses, a fact that has been well documented for years. For example, a study several years ago by Geisinger Health System concluded that white, middle-aged women were most at risk of prescription opioid overdose. If you want to go back further, we can even time travel to the late 1800s, when women made up 60 percent of the population addicted to opium.

There's a very long history here, which we’ll get to in a minute.

February is for the heart.

It’s Valentine’s Day season, when we’re besieged with images of love, cupid’s arrows, and heart-shaped everything. Whether we want to or not, it’s a time when we receive messages about our hearts, in the romantic sense.

So it’s not a coincidence that the Powers That Be who choose seasonal observations picked this month to educate people about our hearts, in the biological sense. February is American Heart Month, and also the month for the American Heart Association’s signature initiative for women’s heart health, “Go Red for Women.”

Heart disease remains the number one killer of American men and women, leading to one in four deaths in the United States. The goal of American Heart Month is to spread awareness about healthy choices that can help prevent heart disease, including smarter food choices and increased physical activity.

But there’s another risk to heart health that has been steadily growing: opioid addiction.

A recent study, 22 years in the making, has found that the opioid epidemic and IV drug use has fueled an alarming rise in strokes. Infections known as bacterial endocarditis can be caused by dirty or shared needles; when injected into the bloodstream they can enter the brain and lead to a massive stroke.

Decades ago, bacterial endocarditis used to be common in patients who had childhood rheumatic fever, a disease that is virtually extinct now.

"It used to be rare that we saw anybody with bacterial endocarditis-related stroke," said Dr. Carl McComas, a neurologist at St. Mary’s Medical Center in West Virginia, to the Charleston Gazette-Mail. "Now we see one at least every week.”

For reasons related largely to stigma and lack of understanding about addiction, the mainstream medical industry has long been reluctant to integrate addiction treatment into the traditional healthcare system.

But as the opioid epidemic grinds on, experts and policymakers are recognizing that the old solutions aren’t working. More people are suggesting that medication-assisted treatment (MAT) should play a significant role in how we help people with addiction, and that this treatment should be approached as part of the standard patient-doctor experience.

Some leaders around the country are acknowledging that one of the best times to engage people in addiction treatment is during a visit to the emergency room, especially during withdrawal or after an overdose. Massachusetts, for example, has now enacted legislation to mandate that all ERs in the state treat addiction patients with medication.

If more widely adopted, this shift could help people who suffer from addiction immediately begin medical treatment and stem withdrawals, thus minimizing or avoiding relapses that might find them back in the ER.

CleanSlate Centers, a national leader in outpatient addiction medicine, opened its doors to patients in Warsaw, Indiana today with a new outpatient medication-assisted treatment center. Located at 2936 Frontage Road, the physician-led center continues CleanSlate’s push to expand resources for addiction treatment in Indiana, including rural and underserved communities. 

Between 2016 and 2017, Indiana experienced a 22.5% increase in overdose deaths, the sharpest rise of any state in the country, according to the Center for Disease Control and Prevention. 

“Despite the tremendous need for high-quality, affordable addiction treatment in smaller communities like Warsaw, we have found that many providers are being pulled towards more populous areas in Indiana,” said Rachael Thompson, CleanSlate’s Regional Managing Director. “We at CleanSlate are eager to fill the treatment gaps in Warsaw and join this community’s battle to save lives that hang in the balance.”

Through our work in addiction medicine, the CleanSlate team is on the frontlines of the vast human suffering caused by the opioid epidemic. Some of the most tragic stories we currently encounter involve counterfeit medications.

Last year, at the Healthy Tennessee Opioid Summit, Carrie Luther shared the story of her 29-year-old son, Tosh. After Tosh came down with a case of hives that was keeping him up at night, a friend gave him a Xanax to help him sleep. As instructed, Tosh took one quarter of one pill. Unbeknownst to Tosh or his friend, the Xanax was actually fentanyl. From just a sliver of one pill, Tosh ingested thirteen times the lethal dose of fentanyl and died within 30 minutes from an overdose.