Clean, Sober and $41,000 Deep in Out-of-Pocket Addiction Recovery Costs

Tess Henry with her rescue dogs, in a photo taken by her mother. Ms. Henry was the subject of a recent Sunday Review essay, which generated over 400 reader comments.
Credit Patricia Mehrmann

People recovering from opioid addiction and their families discuss the financial and emotional costs of treatment.

Tess Henry’s family paid $12,000 for 30 days of rehab from opioid addiction. She had done two more cycles of treatment without achieving sobriety. So her family agreed to pay $20,000 for 28 days of more rehab. But they never got the chance.

A few days after assuring her mother that she planned to fly to Virginia to resume treatment, Ms. Henry was murdered.

The tragic end of Ms. Henry’s six-year struggle to recover from an opioid addiction that began with a prescription for cough syrup was chronicled last week in The New York Times by Beth Macy, a journalist who covers the opioid crisis.

It takes eight years, and four to five attempts at treatment, for the average person addicted to opioids to achieve one year of remission, according to John Kelly, a researcher and professor of psychiatry at Harvard Medical School, whom Ms. Macy cited in her Sunday Review essay.

Some people manage to achieve recovery through free 12-step programs, while others spend hundreds of thousands of dollars.

Ms. Henry’s story prompted readers to share with us in our comments section their own struggles with recovery or the struggles of their family members.

Here is a selection of the comments that cite costs — in out-of-pocket expenses, as well as in time, insurance payouts and human patience — of recovery. They are condensed and lightly edited.

‘I’m lucky it didn’t cost me more’

$25,000 for Suboxone, $16,000 of doctor appointments, $200,000 paid by insurance

I abused opiates for four years. I quit one-time and have been sober for five years. I’ve been on Suboxone [a drug that helps prevent opioid withdrawal symptoms] for five years as well. Luckily I make enough money to spend $400/month on Suboxone. I also moved 1,500 miles away from where I bought OxyContin when I quit, went to a $100,000 rehab on private insurance, and then stayed for 10 more months working as a nighttime janitor and going to A.A. like 10 times a week.

Recovering from opiates has cost me over $25,000 for Suboxone, $16,000 of doctor appointments, and it’s cost my insurance about $200,000. It cost me five years of my life. I’m lucky it didn’t cost me more.

Demi Lovato is Awake, With Family Following Apparent Drug Overdose

Pop star Demi Lovato is recovering in a hospital Wednesday following an apparent drug overdose at her Hollywood Hills home. The 25-year-old has been open about her struggles with drug and alcohol addiction, hinting recently of a relapse in her song “Sober.” A representative for Lovato says she is “awake and with her family.” NBC’s Natalie Morales reports for TODAY.

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Investigation Shows How Florida Sparked U.S. Heroin Crisis

A Palm Beach Post investigation has uncovered Florida’s role in igniting the country’s heroin epidemic in 2011.

The Palm Beach Post traced the origins of the heroin crisis, driving down the “Oxy Express” highways, which users and dealers used to load up on oxycodone pills.

The state’s repeated failure to control its own prescription drug problem would eventually lead to more addicts turning to heroin not only on Florida, but in other states around the country.

WLRN’s Christine DiMattei fills in for Tom Hudson as host of The Florida Roundup. She sat down with Pat Beall, investigative reporter at The Palm Beach Post, to explore the so-called “Oxy Express.”

WLRN: To connect the dots, you and your team traveled to what’s become known as the “Oxy Express.” What is that and where is it exactly?

PAT BEALL: The Oxy Express was the nickname given to a stretch of roadways from South Florida – specifically Palm Beach and Broward Counties – all through the Appalachians. It was an area where people would drive down, van loads of people, load up on drugs here in Palm Beach County through our pill mills and then drive back to the Appalachians and sell or use the same drugs.

There were plenty of people along the way who told you flatly that this story is unprovable. Epidemiologists particularly who were among those that said that available data alone could never definitively prove this oxycodone-to-heroin transition. Much less Florida’s role in this. What was the first tip you got that launched this whole thing? And what was your reaction to that tip?

P.B.: I really wasn’t paying attention. I think that pretty much sums it up. It was in early 2012, and I had been doing a story about online drug sales. In speaking to a couple of treatment counselors locally in Palm Beach County, I was told, Listen the crack down on prescription pills and pill mills isn’t driving people to online drug sales; it’s driving them to heroin. I really couldn’t buy that. I couldn’t buy it because I think I had at that time something of the same skewed perception that people had about who a heroin user would be. And why would anybody who was using pills jump to a street drug? So it took a little time for me to wrap my head around that.

Let’s go back to the pill mill crisis. You’ve traced the beginnings of this problem to the rogue pain management clinics in Florida – back when the pill mills were a thriving business in South Florida. How did they get the prescription meds in the first place?

P.B.: Florida failed to regulate pill mills, and it really went back many years. There was a problem in Florida that was pretty obvious starting in 2002-2003 with prescription pills. Florida just did nothing. Other states adopted prescription-monitoring programs. Other states cracked down on their own pill mill activity and rogue doctors. We didn’t. So that allowed not only pill mills to thrive and illicit opioids to be transported across state lines, it also provided this incredible window of time that gave addiction time to take root and grow.

David Cassidy claimed he didn’t have dementia — he just lied about getting sober

A few weeks before his death in November, David Cassidy confessed that the sudden decline in his health was brought on by alcohol abuse — not dementia, as he previously claimed.

The revelation comes courtesy of A&E Networks, which is airing a two-hour documentary next week originally intended to chronicle the onetime teen idol as he recorded a tribute record to his late father, Jack Cassidy. Instead, David Cassidy fell gravely ill and struggled with what he first said was the onset of dementia.

The truth was just as bad. After becoming ill and being hospitalized during production, Cassidy was told that he had liver disease, which would ultimately become multiple organ failure.

“The head doctor at the hospital, she said, ‘I believe that your dementia was directly related to your alcoholism,’” Cassidy told A&E producer Saralena Weinfield in a taped phone call from a Fort Lauderdale, Fla., hospital.

“I did it to myself, man. I did it to myself, to cover up the sadness and the emptiness,” he said.

Cassidy explained that after a few days where he was unconscious and near death, his memory came back.

“That’s such a blessing,” he told the producer, beginning to laugh as if he were telling a wry joke. “That means I’m cognizant of my surroundings, that I’m alive and it’s daytime and I know what day of the week it is. There is no sign of me having dementia at this stage of my life. It was complete alcohol poisoning. And the fact is, I lied about my drinking.”

After he was arrested for DUI in 2014 — his wife filed for divorce the next week — Cassidy was sentenced to rehab and put on probation. In early February 2017, he told People that he was suffering from dementia and would stop touring to focus on his private life.

The former star of “The Partridge Family” died soon after at age 67 from organ failure, including his liver and kidneys.

Although Their Introductions as Treatment are Different, Two Top Medications for Opioid Addiction are Equally Effective

With opioid addiction officially declared a public health emergency in the U.S., medical intervention to treat the illness is increasingly important in responding to the epidemic. Now, a new study concludes that two of the top medications available for outpatient, office-based treatment, once initiated, are equally safe and effective in curtailing opioid use, relapse, treatment drop-out and overdose.

Researchers in the Departments of Psychiatry and Population Health at NYU School of Medicine, who led the study sponsored by the National Institute on Drug Abuse (NIDA) and published online November 14, 2017 in The Lancet, conclude that extended-release naltrexone (an opioid antagonist marketed as Vivitrol) demonstrated similar safety and clinical effectiveness to more commonly prescribed buprenorphine-naloxone (an opioid agonist marketed both generically and as Suboxone).

However, the study also points out differences that have previously been known: Patients being treated with naltrexone must detoxify before it can be administered. (This is commonly referred to as the “detox hurdle.”) On the other hand, buprenorphine allows individuals to transition relatively seamlessly from opioid use to medication maintenance without needing to detoxify.

Agonist (buprenorphine) and antagonist (naltrexone) treatment are pharmacologically, conceptually and logistically near-opposites — allowing patients, families and providers to choose an approach in line with their goals and preferences. Among the differences:

  • Agonists activate opioid receptors, have opioid-like effects, and maintain physical dependence on opioids, while antagonists have no effects on their own and block the effects of opioids
  • Agonists can be started while a patient is still opioid dependent or detoxifying, but antagonists only can be administered after full detoxification to avoid opioid withdrawals
  • When discontinued, agonists are associated with withdrawal symptoms; antagonists are not
  • Agonists have abuse potential and diversion risks; antagonists do not
  • There are differences in prescribing regulations and community acceptance between the two forms of treatment

Despite these differences, the researchers say, until now there had been no comparative data on the effectiveness of both treatments. “As the epidemic has escalated, and hundreds of people in the U.S. and elsewhere are dying every day, there is an increased urgency to provide immediate and effective medical treatment,” says John Rotrosen, MD, professor in the Department of Psychiatry at NYU School of Medicine and the study’s senior author. “Our findings should dispel some commonly held misconceptions and help patients choose between these different approaches to treatment.”

What the Study Examined

The clinical trial took place from 2014 to 2017 at eight community treatment programs affiliated with NIDA’s Clinical Trials Network across the U.S. The patient cohort involved 570 opioid dependent adults, approximately two-thirds of whom were men and 82% primarily using heroin. They were recruited during admission for detoxification and randomly assigned to two study groups for up to 24 weeks of treatment. One group received a monthly injection of naltrexone initiated after completing detoxification, and the other self-administered a daily oral dose of buprenorphine initiated as early as possible after randomization.

Among those treated, 24-week relapse rates were similar — 52% for naltrexone and 55.6% for buprenorphine, as were other measures of opioid use. In addition, craving for opioids was lower with naltrexone, though by the end of 24 weeks, the buprenorphine group had caught up. Other than mild to moderate injection site reactions with naltrexone, adverse events, including fatal and non-fatal overdoses, were similar across the two study groups.

The study also examined the detox hurdle — a critical point of initiation for active users (though a non-issue for those who are already fully detoxed). Approximately 25% of participants assigned to the naltrexone group were unable to complete detox and get a first dose of naltrexone — though for those assigned to naltrexone later in the detox process, the hurdle wasn’t so insurmountable. In contrast, only 6%, of patients were unable to start buprenorphine.

The study could have immediate implications for how the U.S. responds to a crisis that has already claimed 300,000 lives since 2000, according to the U.S. Centers for Disease Control and Prevention.

“Both medications are effective treatments for opioid use disorders versus counseling-only approaches or compared to placebo,” says Joshua D. Lee, MD, MSc, associate professor in the Departments of Medicine and Population Health at NYU School of Medicine and the study’s lead author. “What is now clear is how similar the outcomes are for those initiating treatment with either medication.”

The researchers also point out that the study sheds light on the likelihood that those dropping out of detox will rapidly relapse. “Patients wanting naltrexone, but who are unable to complete detox,” Lee adds, “should be encouraged to start an agonist-based treatment like buprenorphine.”

A smaller (total cohort of 159 patients) and shorter (up to 12 weeks of treatment) parallel study conducted in Norway over the same period found naltrexone and buprenorphine to be equally effective in retaining patients in treatment and reducing opioid use. However, all participants in that study were randomized late in detox so there was no “hurdle” to clear. Prior to these two studies, the field had no comparative effectiveness data. An earlier multi-site clinical trial led by NYU School of Medicine found in 2016 that extended-release Naltrexone was effective at preventing opioid relapse in criminal justice offenders.

Opioid Epidemic Leaving grandparents to Raise Grandchildren

A million children now live with their grandparents primarily due to their parents’ addictions, increasingly because of opioids.

The growing opioid crisis has been declared a public health emergency. It’s sparked a parallel crisis you rarely hear about: the impact on children neglected by addicted parents. More than one million American children now live with grandparents, primarily because of their parent’s addiction to opioids and other drugs: heroin, crack, meth and alcohol. Grandparents are putting off retirement and plowing through savings to rescue their grandchildren from dangerous situations.

To see how widespread this is, we went to one of the healthiest states in the country, Utah. Tonight, we’ll introduce you to a few families around Salt Lake City, and meet children, raised in the wreckage of the opioid crisis, getting a chance at a normal life.

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The Controlled Substances Bill is Florida’s response to opioid abuse.

This website provides basic information pertaining to CS/CS/HB 21, the Controlled Substances Bill, and the upcoming changes for prescribers and dispensers. Signed by the Governor on March 19, 2018 with an effective date of July 1, 2018, the law addresses opioid abuse by establishing prescribing limits, requiring continuing education on controlled substance prescribing, expanding required use of Florida’s Prescription Drug Monitoring Program, EFORCSE, and more.

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Woman lost 2 sons in one night to opioids; fighting the crisis is now her life’s work

Everything just kind of seemed like a blur that day,” Becky Savage said. “Your mind is not really meant to process something that extreme.” The day Savage is describing is June 14, 2015.

The Indiana mom’s two oldest sons, Nick and Jack, were celebrating at high school graduation parties the night before. The boys came home about 12:30 a.m. and checked in with their mom, who had been waiting up.

The next morning, as Savage was picking up laundry in Jack’s room, she noticed that he wasn’t stirring as she tried to wake him.
“He was unresponsive. I called 911, and I remember hollering for Nick, for him to come up, and how he never came.”

Nick, her eldest son, was downstairs sleeping in the basement with friends.

The first responders arrived and tried to resuscitate Jack, and then Savage noticed one of them going downstairs to the basement.

“I had no idea at that point what they were doing in our basement. And then I remember one of them coming up and asking for a coroner. That’s the last thing that I remember that day.”

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Worried about your alcohol consumption? Sober moms share their advice

If you think alcohol may be affecting your life or serving as a crutch, it’s time to get curious about your behavior. That’s one of several tips from three women who decided to stop drinking. “I want the women who are watching to know that we are never alone. There needs to be no shame attached to this,” mother and psychotherapist Kelley Kitley told Megyn Kelly.

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Substance Abuse in Older Adults – Topic Overview

Many people think alcohol and drug abuse happen only to teens and younger adults. But all ages can have problems with drugs and alcohol, including older adults.

Older adults may use illegal drugs, use prescription or over-the-counter medicines in harmful ways, drink too much alcohol, or mix alcohol and medicines. Doing any of these can cause serious health problems and problems with money and the law. It also can harm relationships with family and friends.

Substance abuse in older adults may be overlooked, because:

Older adults are more likely to drink or use drugs at home rather than in public.
Older adults may not have duties that are affected by substance abuse, such as going to school or work.
Signs of abuse are similar to those found in health problems that many older adults have, such as depression and dementia.
Caregivers of older adults may be aware of the problem but may not want to talk about it.

Alcohol

Alcohol abuse is dangerous for all people, and it can be very dangerous for older adults. Older adults:1

  • Usually need less alcohol to become drunk (intoxicated) than someone younger.
  • Stay drunk longer, because their bodies process alcohol more slowly.
  • May have vision and hearing problems and slower reaction times. Alcohol can make these problems worse, which means alcohol-related falls, car crashes, and other kinds of accidents are more likely.
  • May be more likely to mix alcohol and medicine because they are taking so many medicines. Mixing alcohol with many over-the-counter and prescription medicines can be dangerous or even fatal.

In older adults, alcohol can trigger some health problems or make them worse. These health problems include high blood pressure, ulcers, liver disease, anxiety, sleep problems, and depression.1

Experts suggest that adults 65 and older have:1

  • No more than 1 standard drink camera.gif a day.
  • No more than 2 drinks on any drinking occasion, such as New Year’s Eve or weddings.

Some older adults should not drink alcohol. Women who are small may want to ask their doctors what amount of alcohol is safe for them.