Ed Dittenhoefer Photography for the Ithaca Voice

ITHACA, NY – On Wednesday, Ithaca officials will announce The Ithaca Plan — a four pillared approach proposed to combat heroin addiction in the city. One of the four pillars of the new drug policy is “Treatment.”

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Ithaca’s existing drug treatment programs, says Mayor Svante Myrick, take an “abstinence only” approach.

“These programs assume that if you’re ready to quit using drugs you’re ready to white knuckle it, just give it all up,” Myrick said. “That works for some folks but that doesn’t work for a lot of people.”

The treatment pillar of The Ithaca Plan would look to provide medicated treatment for people looking to kick their addictions.

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This includes things like methadone and suboxone. These are legal — albeit tightly controlled — opioids which help addicts wean off of heroin addiction by helping them fight their cravings and withdrawal symptoms while remaining functional in their day-to-day lives.

Methadone and suboxone have themselves been the subjects of some criticism and controversy, but The Ithaca Plan would go a step further, potentially introducing heroin assisted therapy to the city’s treatment options.

In short, heroin assisted therapy allows an addict to get heroin from a doctor and use it under supervision, similar to prescribed medication.

“The idea behind it is that for some people heroin is going to be the only thing that allows them to continue to function so they can get other treatment and eventually wean themselves off the drug,” said Myrick. He noted that this avenue of treatment would only be reserved for extreme cases.

For a more detailed breakdown of what heroin assisted therapy, read our article on the “Harm Reduction” pillar.

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Why now?

Currently, the nearest place that an addict can get a dose of methadone is Syracuse. Since the drug is so tightly controlled, only single doses are given at a time. This means individuals who want to pursue that course of treatment must make the two-plus hour round trip to Syracuse every day.

“We have some people whose treatment is paid for by medicaid. So medicaid is paying for a cab ride for them to Syracuse every day, which is nuts,” said Myrick.

Additionally, Myrick points out, this leads to a difficult choice for the addict every day: to make the trip and, if their treatment isn’t covered, pay for an expensive dose of methadone — or find a dealer in Ithaca to get a faster and cheaper fix.

As for why the city hasn’t pursued methadone or suboxone treatments already, Myrick echoed the theory put forth by Bill Rusen, CEO of Cayuga Addiction Recovery Services. In an interview with the the Ithaca Journal, Rusen said the stigma around detoxing and heroin use in general were major deterrents.

“I think there’s less of a stigma now, now that more people know folks who are struggling with heroin addiction, I think more people see why we need that kind of medicated treatment,” Myrick said.

The hidden costs of untreated addiction

Myrick said that talking with Cayuga Medical Center staff and other medical professionals revealed just how taxing treating addicts could be, both emotionally for the staff and financially for the healthcare system.

“What we heard from doctors and nurses is, ‘We’ve got people coming in the emergency room either with horrific injuries or infections they’ve let go on too long, we need to keep them in the hospital for weeks. In the meantime, while they’re coming down, they are abusive, manipulative, some of them become violent, some become ill,’” Myrick said.

In some cases, addicts end up making frequent return trips to the emergency room for addiction-related injuries and illnesses.

“They pulled these records and said that 13 or 14 people cost them $400,000 — the same 13 or 14 people. That’s a lot of wasted resources, that’s a lot of nights in a bed in a hospital that could be used by somebody else,” Myrick said.

Medicated solutions, possibly including heroin assisted therapy, could give medical staff a way to prevent the physical and emotional withdrawal symptoms so they could treat the immediate, potentially life-threatening problem.

Such treatments could also present opportunities to set addicts on a healthier path, Myrick suggests.

An addict who isn’t focused on getting his or her next fix is more likely to be receptive to taking care of their other needs. Furthermore, being in a hospital setting rather than on the street gives them access to resources and services to help them if they want to get clean.

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Michael Smith

Michael Smith reports on politics and local news for the Ithaca Voice. He can be reached via email at msmith@ithacavoice.com, by cell at (607) 229-0885, or via Google Voice at (518) 650-3639.