Doctors in Clallam, Jefferson counties turning to medically assisted treatment for opioid addiction

About a dozen doctors in Clallam County and several in Jefferson County prescribe Suboxone, a drug that contains buprenorphine and is used to treat people addicted to opioids.

As the North Olympic Peninsula medical community looks to treat heroin and opioid addiction in Clallam and Jefferson counties, more doctors are turning to medically assisted treatment.

About a dozen doctors in Clallam County and several in Jefferson County prescribe Suboxone, a drug that contains buprenorphine and is used to treat people addicted to opioids.

North Olympic Healthcare Network’s doctors make up a good portion of the doctors that prescribe Suboxone, and the health center is looking at expanding its medically assisted treatment program, said Katrina Weller, chief medical officer.

As of September, the community health center had five doctors treating nearly 90 patients, with Weller and another doctor preparing to also prescribe Suboxone.

Suboxone is a partial agonist, meaning it fulfills the physical craving for opioids but doesn’t produce the same high. The drug also contains Naloxone, which counteracts opioid overdoses and helps prevent people from abusing Suboxone.

In medically assisted treatment programs, patients are typically given about a week’s supply of Suboxone and meet with doctors and chemical dependency counselors.

Once they have been in the program for some time, doctors typically begin providing larger supplies.

North Olympic Healthcare Network is developing a full-fledged program to treat people addicted to opioids, but officials wanted to help before that program is fully developed, Weller said.

“Our job is not only to take care of the health of our patients, but to help the health of the community and this is a community need,” she said.

“It’s going to take awhile to build a real set-in-stone program, but we didn’t want to wait,” Weller said.

NOHN created a fast-track program that helps Suboxone patients get a doctor quickly. In the fast-track program it can take less than a week for patients to get a doctor.

While there are efforts to expand medically assisted opioid addiction treatment programs in Clallam County, the need still far exceeds the number of providers that are available, said Dr. Chris Frank, Clallam County Health Officer.

“We know right now our local resources aren’t even close to meeting the need,” he said, adding it’s difficult to estimate how many people would actually want the treatment.

“When patients do seek treatment through our chemical dependency providers, the jail, through syringe services program, we know even for patients who identify themselves and want treatment, sometimes it’s difficult to get them in with a prescriber.”

While it’s difficult to know how many people use heroin in Clallam County, statistics show the county’s opioid addiction problem is worse than the state average.

In 2014, there were 292 opioid associated hospitalizations per 100,000 people in Clallam County, 84 more than the state average, Frank said.

The death rate was at 13.4 per 100,000 people, while the state average was eight. So far this year there have been 52 overdoses and five deaths.

The county doesn’t have data for previous years because it only recently started tracking that data.

While Jefferson County’s opioid addiction problem isn’t as extensive as Clallam’s, Dr. Tom Locke sees a need for more prescribers in the county.

Locke, the Jefferson County Health Officer, said he knows of three doctors who prescribe Suboxone in Jefferson County and that he believed only one accepted Medicaid as insurance.

“Most of the people who are candidates for Suboxone … are low income and their insurance source is Medicaid,” he said. “We definitely feel the need here for expanded access.”

Locke is also one of three doctors who prescribe Suboxone to patients at the Jamestown Family Health Clinic in Sequim and sees the need for such programs first hand.

“There’s a need in both counties,” he said. “Ideally I’d like to see this offered in all clinics and as part of primary care.”

He sees an urgent need for expanding access and knows there are people willing to go into treatment who can’t because of lack of access.

“I see them every week,” he said. “We want those people into treatment to keep them safe and allow them to return to a productive life.”

The Clallam County jail also operates a medically assisted opioid addiction treatment program that uses Suboxone to stop heroin cravings in inmates.

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Reporter Jesse Major can be reached at 360-452-2345, ext. 56250, or at [email protected].

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