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Reducing demand for the use of illegal substances has become the national strategy for battling America's addiction issues, federal officials said Thursday in Terre Haute. 

“At the end of the day, we have to realize it's the disease of addiction that is pulling the drugs here,” U.S. drug czar Jim Carroll said Thursday morning during a roundtable discussion on the meth and drug crisis hosted by Indiana State University.

“People want to talk about this as a war on drugs, but it's not [a war] that we are ever going to be able to declare victory,” Carroll said.

His visit to Terre Haute as guest of U.S. Rep. Larry Bucshon, R-Newburgh, featured a conversation with agency leaders on the front line of the addictions and recovery issues in the Wabash Valley. Carroll is the director of the U.S. Office of National Drug Control Policy.

“We have a huge methamphetamine epidemic in our county,” said Clay County Prosecutor Emily Clarke.

More than 20 percent of the criminal filings in court this year are for possession of meth, she said, and about 75 percent of other filings – such as domestic battery and strangulation – are meth related.

The local law enforcement agencies are overwhelmed by the crisis, she said, and drug use is generational an widespread in the community.

“We're kind of treading water in Clay County at this point because we don't have the manpower or funding to combat it,” Clarke said.

Meth use knows few boundaries, she told Carroll and Bucshon, noting she recently filed meth-related juvenile-court charges on a 13-year-old andr regularly files meth charges on people in their 50s and 60s.

Treatment options are limited in the community, she said, and meth is so prevalent it is hard for people in recovery not to be faced with friends and family members using it.

Vigo County Sheriff John Plasse agreed with Clarke, saying an effort has been made to increase drug task for personnel and target dealers in the community.

Plasse said his agency works with Hamilton Center to get people the addiction and mental health treatment they need, but the epidemic is overwhelming available services and funding.

All local law enforcement officers have been trained in the use of naloxone to reverse the effects of an opioid overdose, Plasse said. Replacing the naloxone units that are used is becoming expensive, and although useful naloxone is not a solution for addiction.

Bucshon said a national discussion has been occurring about co-prescribing naloxone to people who also receive a prescription for an opioid medication. 

It is a controversial issue, he said.

Carroll compared the co-prescribing as similar to keeping a fire extinguisher in one's house. Having the fire extinguisher does not mean a person will burn a house down, he said, and having naloxone on hand is merely a precaution, not a predictor of addiction.

Dr. James Turner, medical director of the Lugar Center for Rural Health at Union Hospital, said he thinks medical schools are doing a poor job of educating students about addiction treatment.

Caroline Mallory, ISU's dean of the College of Health and Human Services, said the demand for addictions specialists and psychiatrists to handle mental health needs are far outstripping the number of medical professionals being trained.

Angela Hays, assistant professor in human services at Ivy Tech Community College, said the low wages one receives upon completion of a degree contributes to the shortage in the profession.

To earn an addiction license in the state of Indiana requires minimally a bachelor’s degree, specific coursework in addictions, 350 hours internship, while in college and then 2,000 supervised hours post graduation before one can sit for licensure, Hayes said. Once licensed, the starting salary is not proportionate to the education/training required.

Unfortunately, this is also true for mental health counselors, social workers and others in the profession, she said. The profession is education/training laden, but the compensation for the work is too low.

At Valley Professionals Community Health Center, executive director T.J. Warren said addictions treatment has become a large focus, as well as a big barrier to improving community health.

Funding for treatment is limited by federal insurance programs, Warren said.

Stigma is also a barrier, said Mark Collins, chief clinical officer at Hamilton Center.

“We can't arrest our way out of this. We have to stop looking at it as a moral deficiency. It's a disease,” Collins said of addiction.

Brenda Reetz, CEO of Greene County General Hospital, said her rural community also sees the stigma associated with mental health treatment. Mental illness is an underlying reason many people become involved in illegal drug use – self-medication to ease anxiety, depression and other mental illness.

“Adding social workings into the hospital and primary care practices means all patients have access to mental health services, without the stigma associated with it,” Reetz said of the strategy that resulted in more people accepting treatment.

Roopam Harshawat, president of Harsha Behavioral Center, said her hospital originated to treat children with mental health issues.

But it has expanded due to the prevalence of issues caused by maternal drug use while pregnant.

“We are bringing a whole generation of children into this world who will not be able to function,” Harshawat said.

Lack of federal insurance reimbursements for addictions and mental health treatments are also a barrier to treatment for patients and providers, she said.

Brandon Halleck of Chances and Services for Indiana Youth and Richard Payonk of United Way of the Wabash Valley also talked about the programs they have addressing the needs of families and children in the community. Stigma, they agreed, is an issue that works against folks seeking treatment.

Mentoring programs, Halleck said, are another way to steer children away from the substance use they may see at home, and direct them toward a positive future

Carroll said he is impressed by the many programs and agencies working in Indiana to address the methamphetamine and addictions crisis locally.

“There are some great things happening here in Indiana,” Carroll said, “You have more than doubled the national average in terms of saving lives of more folks here than anywhere else in the country – 2.5 times the national average.”

The investment of federal dollars into state and local programs to combat substance abuse is money well-spent, Carroll said.

“When we spend money on treatment and prevention and also support law enforcement, it's a wonderful way to save money in the long run,” he said. “We are not only making better citizens, better community members, we are saving our own families. And that's what people have to understand when they think about the disease of addiction. It can strike anyone.”

Carroll said he plans to take some of the lessons he is learning in Indiana back to Washington to inform the discussion and action plans to battle the nationals' addiction crisis.

And he commended the local agencies for working together to problem-solve the addictions crisis.

“I'm seeing people willing to reach across all political divides and help neighbors and help family,” Carroll said. “That's a wonderful thing that's happening in Indiana.”

Lisa Trigg
Tribune-Star