Category: Dr. Peter Provet

The Narcan Experiment

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Odyssey House President Dr. Peter Provet comments in The New York Times on a recent report (“If This Were an Overdose, Would You Help?” news article, May 10) on a controversial proposal to install lockboxes containing the opioid overdose antidote naloxone on the streets of Cambridge, MA. Dr. Provet argues that the public administration of naloxone could become a turning point in the opioid epidemic.

To the Editor:

The public administration of naloxone has the potential to be a turning point in the opioid epidemic. While overdose deaths continue to multiply throughout the country, a tipping point has yet to be reached regarding political resolve to fund treatment and a groundswell of public concern and compassion.

This experiment in Massachusetts to address the deadly consequences of addiction by empowering the public to administer a lifesaving dose of naloxone may be just what we need to get citizens involved in addressing our morass of addiction.

Ultimately, a vast number of lives will be saved only if the public comes to view addiction as a chronic relapsing disease that requires treatment that is coordinated, comprehensive and compassionate.

PETER PROVET, NEW YORK
The writer is president and chief executive of Odyssey House.

Connecting New Yorkers to treatment services

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Harlem drug treatment outreachYesterday, Odyssey House hosted a press conference announcing a new program designed to improve addiction treatment services in East Harlem. The NYS Office of Alcoholism and Substance Abuse Services (OASAS) has awarded $190,000 to Odyssey House and Mount Sinai Behavioral Health System to support a new peer engagement specialist initiative.

Speakers inOpioid treatment Harlem announcementcluded OASAS Commissioner Arlene Gonzalez-Sanchez, Odyssey House President & CEO Dr. Peter Provet, and Teri Friedman, Director, Mount Sinai Behavioral Health System. The two peer engagement specialists, Anita Kennedy (Mount Sinai) and Mark Fowler (Odyssey House), also addressed the crowd, describing their experiences within the recovery community and how they plan to conduct outreach to connect individuals in East Harlem with treatment services.

You can find more information in the press release.  Below is the press coverage from the announcement:

NYS OASAS Launches New Initiative to Help Connect More New Yorkers to Addiction Services in New York City

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$190,000 to Support Peer Engagement Specialists in East Harlem

The New York State Office of Alcoholism and Substance Abuse Services (NYS OASAS) today announced more than $190,000 in funding was awarded to two NYS OASAS-certified addiction treatment providers, Odyssey House and Mount Sinai Behavioral Health System, to support a new peer engagement specialist initiative in East Harlem in New York City. The program, developed by NYS OASAS, is part of Governor Cuomo’s multi-pronged approach to aggressively address substance use disorders in the state. This collaborative effort will focus on reducing street drug use, lowering potential for overdoses and other drug-related emergencies, and addressing community concerns about drug abuse, including the use of synthetics, heroin, and opioids, with a focus in East Harlem.

“A reversal from an overdose is a second chance,” said Lieutenant Governor Kathy Hochul, co-chair of Governor Cuomo’s Combat Heroin and Prescription Opioid Addiction Task Force. “That moment when a person with a substance use disorder is in crisis is an opportune time for us to step in to make sure that that individual is connected to the addiction treatments services he or she needs. This program will help those connections happen in East Harlem.”

Peer engagement specialists, who are knowledgeable about the alcohol and substance use disorder treatment system, will work with Emergency Department (ED) personnel in the hospitals serving the area to help establish connections to addiction treatment and other supports after an opioid overdose reversal or after discharge from another substance use-related ED visit. The two peer engagement specialists, one from each substance use disorder treatment program, also will conduct outreach to connect individuals in 125th Street Corridor with addiction treatment services and mental health and other support services. They will also lead community education events about addiction.

“Connection to addiction-focused care is always critical, but is particularly so after an alcohol or drug-related crisis,” said NYS OASAS Commissioner Arlene González-Sánchez. “Connecting a person to treatment after an overdose reversal is crucial to getting them started on the path to recovery, and can help prevent relapse and lower the risk for a potential subsequent overdose. These peer professionals can be the warm hand that individuals need to guide them into treatment so that they can get the help they need and hopefully join the millions of Americans who are living a healthy life in recovery.”

The peer engagement specialists will provide outreach to vulnerable individuals in East Harlem, focusing on the area between 96th and 138th Streets from 5th Avenue East. Their main tasks will be referring individuals for substance use disorder treatment, providing information regarding addiction to individuals, and assisting individuals with accessing treatment. The PESs will also connect with Emergency Departments, community-based organizations, soup kitchens, religious centers, and neighborhood health care and addiction treatment providers. They will also conduct presentations to help increase local knowledge about substance use disorder treatment and support services that are available in the community. They will also track referrals to treatment and support services, and collect other pertinent data to assess the efficacy of the project. NYS OASAS will oversee the initiative.

Dr. Peter Provet, President of Odyssey House, said, “When a community works together to fight drug abuse, individual lives are saved and everyone’s lives are improved. Local partners armed with local knowledge who share a commitment to the neighborhood they live and work in are an essential part of the glue that keeps families together, the streets safe, and businesses and neighborhoods thriving. I am proud to partner with NYS OASAS and Mount Sinai Behavioral Health System on this essential street outreach initiative that extends awareness of treatment services to people in need throughout East Harlem. The peer engagement specialists who will lead this effort understand the importance of reaching people before they overdose because, even with the increased prevalence of naloxone (the opioid reversal medication), emergency services, treatment providers, and hospital detox centers, cannot reach everyone in time to avoid a tragic death. This initiative is a big step forward in protecting the health of New Yorkers struggling with addiction.”

“Mount Sinai is proud to partner with OASAS and Odyssey House in this important initiative,” said Sabina Lim, MD, MPH, Vice President and Chief of Strategy, Behavioral Health, Mount Sinai Health System. “Peer professionals have a critical and invaluable role in the path to recovery for people with substance use disorders. They provide meaningful and proactive connections for people with substance use disorders at a critical time. Effective intervention when the potential for change may be at its greatest will help improve access and continuity of care to treatment and support services. We look forward to working more closely with our partners, to help make a substantive impact in the lives of people with substance use disorders in the communities we serve.”

“The peer engagement specialist initiative is an important step towards combating the substance use disorders that are becoming all too common,” said New York State Senator José M. Serrano. “This important program will allow drug prevention and recovery resources to be readily available, help these individuals remain on a healthy track, and educate the community on the dangers of drug addiction. Many thanks to the New York State Office of Alcoholism and Substance Abuse Services for recognizing the seriousness of this issue, and providing a crucial step to recovery.”

“The OASAS Peer Engagement program represents the type of creative and effective effort necessary to address the challenges created by street drug use,” Assemblymember Robert J. Rodriguez. “This important initiative will help connect those in need with the services necessary to get them into recovery and reduce the number of overdoses on our streets. I am proud to have been an integral part in securing the support necessary to see this program come to fruition. I salute and congratulate Commissioner Sanchez and the staff of OASAS on the program launch today.”

“Substance abuse has become a crisis throughout the country, and addiction prevention services are some of the most vital programs we can offer in the fight to stave off this public health epidemic,” said New York City Council Speaker Melissa Mark-Viverito. “Drug-related emergencies affect our communities and fill our medical centers at an unsustainable rate, and by meeting them at their level by providing peer engagement specialists both in the hospital and on the ground, we can work to ensure that outreach is targeted to the places where it will be most effective. This is a problem that has been felt in El Barrio/East Harlem and around the city, and I applaud OASAS for collaborating with residents to solve this critical issue.”

New Yorkers struggling with an addiction, or whose loved ones are struggling, can find help and hope by calling the state’s toll-free, 24-hour, 7-day-a-week HOPEline at 1-877-8-HOPENY (1-877-846-7369) or by texting HOPENY (Short Code 467369). Available addiction treatment including crisis/detox, inpatient, community residence, or outpatient care can be found using the NYS OASAS Treatment Availability Dashboard at FindAddictionTreatment.ny.gov or through the Access Treatment page on the NYS OASAS website. Visit the #CombatAddiction web pages at oasas.ny.gov/CombatAddiction to learn more about how you can help to #CombatAddiction in your community. Visit www.combatheroin.ny.gov for more information on addressing heroin and prescription opioid abuse, including a Kitchen Table Tool Kit to help start the conversation about the warning signs of addiction and where to get help. For tools to use in talking to a young person about preventing alcohol or drug use, visit the State’s Talk2Prevent website.

Top 10 Primer Points for President-elect Trump on Addiction Treatment

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President-elect Trump takes office in the midst of a devastating opioid epidemic. As he begins to grapple with the causes and solutions of this growing national tragedy, Odyssey House President Dr. Peter Provet offers ten fundamental points to anchor his efforts.

1: Treatment works. But there isn’t enough of it. Approximately 14 percent of Americans with substance abuse problems are able to get the appropriate treatment they need to stop using drugs, maintain a drug-free lifestyle, and be functional – and contributing – members of society, at work, and in the family. This means of the 21.7 million adults and teenagers who are addicted to legal and illegal substances, only 3 million people get the help they need.

2: Addiction does not discriminate. Substance abuse is a health problem that destroys the lives of men and women, young and old, from all ethnic backgrounds and communities. Today’s opioid epidemic is devastating families across the country. Prescription pain reliever overdose deaths among women have increased more than 400 percent from 1999-2010, compared to a 237 percent among men, and the number of deaths from heroin among women tripled from 2010 to 2013. Adolescents are using prescription pain relievers for nonmedical needs in large numbers: in 2015, 276,000 teenagers were current nonmedical users of pain relievers, with 122,000 having an addiction to prescription pain relievers.

3: Drug overdose is the leading cause of accidental death in the US. Of the 47,055 lethal overdoses in 2014, opioids claimed the lives of 29,467 Americans, with prescription pain relievers related to 18,893 overdose deaths and heroin 10,574. In all, opioid overdose deaths claim the lives of 91 Americans a day.

4: The tragedy is that a great many of these lives can be saved and for as little as $75 or less. Treatment centers, hospitals, police forces, fire departments, and other community organizations are training their personnel in the use of naloxone – a life-saving, easy-to-administer drug, proven to reverse opioid overdose death. A 2013 survey of organizations who provide naloxone to laypersons who might witness an overdose, including persons who use drugs, their families and friends, and service providers, received reports of 26,463 overdose reversals. The role of naloxone in saving people from a potentially fatal opioid overdose is dramatic: a 160 percent increase in the number of reversals reported; a 243 percent increase in the number of local sites providing naloxone; a 187 percent increase the number of laypersons provided naloxone kits; and a 94 percent increase in states with at least one organization providing naloxone.

5: While the human cost of addiction can be devastating, the financial burden on all Americans is staggering. The US spends more than $700 billion annually in costs related to health care, lost work productivity, and crime. Abuse of illicit drugs alone costs $193 billion.

6: The cost of treatment for substance abuse disorders pales in comparison to the costs of abuse. Publicly-funded, residential treatment administered professionally using evidence-based programs costs $62 a day. In-hospital opioid detox starts at $1,000 a day. In 2012, New York City paid $460 a day to feed, house, and guard each inmate, the majority nonviolent drug offenders.

7: Funding for treatment has not kept up with demand. When the Comprehensive Addiction Recovery Act (CARA) was passed into law in July 2016, it was the most significant federal legislation on addiction treatment in 40 years. CARA received overwhelming bi-partisan support in Congress and the Senate. It was hailed as the most comprehensive effort undertaken to address the opioid epidemic, encompassing all six pillars necessary for such a coordinated response – prevention, treatment, recovery, law enforcement, criminal justice reform, and overdose reversal. But the funding request was drastically reduced from $1Billion to $181Million.

Now we have cause to be hopeful that funding will be restored. Just this month the US House of Representatives passed HR 34, The 21st Century Cures Act. The legislation provides $1Billion over several years to states through the existing grant program for prevention, treatment, prescription drug monitoring programs, opioid treatment programs, and workforce development. The bill creates federal drug courts and programs for alternatives to incarceration for individuals with SUD. It also encourages the integration of care for SUD with primary care.

This landmark legislation – a turning point for addiction treatment and prevention – has now been signed by President Obama.

8: As demand for treatment increases, we are faced with a growing workforce crisis in the addictions field. This crisis is due to a variety of factors, including stigma, an aging workforce, and inadequate compensation.  A report to Congress from the Substance Abuse and Mental Health Services Administration (SAMHSA) warned that the addiction services field will need to fill more than 330,000 jobs to keep pace with demand for care.

9: Addiction is a brain disease to be treated, not a criminal justice issue to be punished. A decade or more of scientific research has conclusively shown addiction is a disease that affects both the brain and behavior. Science has identified many of the biological and environmental factors and is beginning to search for the genetic variations that contribute to the development and progression of the disease.

10: Voters in eight states approved passage of marijuana laws ranging from full legalization of recreational use of marijuana to approving or easing of restrictions for medical marijuana laws. These laws will have undoubtedly increase marijuana use – and misuse. Keeping marijuana out of the hands of youth is everyone’s concern.  Ensuring prevention and treatment programs are ready to help those, is everyone’s commitment.

‘The Drumbeat of Bad News’ on the Opioid Toll

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In today’s edition of The New York Times, Odyssey House President Dr. Peter Provet comments on “New Mothers Derailed by Drugs Find Support in New Hampshire Home” (News, Dec. 12), on the devastating toll the opioid epidemic is inflicting on families.

The drumbeat of bad news on the toll the opioid epidemic is taking on communities across America just keeps getting worse. But the statistic cited in your article that as of 2012 a baby is born suffering from opioid withdrawal every 25 minutes is most sobering.

We have not seen such a collapse of families since the crack epidemic of the 1980s and 1990s. What we learned then, and need to remember today, is that when we connect pregnant women with treatment services that keep the mother and child together, we save two lives.

What’s different now is that many of the families affected are from rural and suburban communities, where access to treatment is limited, if not nonexistent. In urban centers like New York City, treatment organizations have developed supportive networks that connect at-risk people with services that both save lives and protect communities.

As we look to a new president with so much unknown about the direction his administration will take on containing the opioid epidemic, we hope that he will be open to listening to lessons learned decades ago: that treatment, not punishment, is the surest and cheapest cure for addiction, and that what works in the cities will also work in the suburbs and rural America.

Dr. Provet on the Surgeon General’s Report on Alcohol, Drugs, and Health

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It couldn’t be clearer. The Surgeon General’s Report on Alcohol, Drugs, and Health (The New York Times, Nov 17) is a wake-up call that we are facing a public health challenge that is ‘taking an enormous toll on individuals, families, and society.’ The financial costs of alcohol and illicit drug use combined are $442 billion. But the personal costs are much, much greater. At least 85 people a day (some reports say over 100) are dying from opioid-related overdoses.

Addiction costs infographicIt can’t go on. The death rate from what is a preventable, and treatable disease, is unconscionable. The financial costs are unsustainable.

Surgeon General Dr. Vivek H. Murthy makes a strong case for at last treating addiction as a public health not criminal justice issue. This is critical. Stigma and punishment combined have stopped people from getting help; have tied up our law enforcement agencies in a vicious and dangerous cycle of recidivism; and have claimed the lives of thousands and thousands of young Americans.

Let’s bring addiction out of the shadows of shame and commit to treating it like any other medical or mental health issue.

Our Winter 2016 newsletter is online

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Odyssey House Newsletter Winter 2016


The Winter 2016 edition of Odyssey House News is now available online. Read about our newest supportive housing building, client success stories, grant renewals, and more. Check it out and let us know what you think in the comments or on our Facebook wall. Click here to read it (pdf). If you’d like to receive a copy in the mail, please email your contact information to info(at)odysseyhousenyc.org.

Deaths and Broken Lives from Drug Overdoses

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In today’s edition of The New York Times, Odyssey House President Dr. Peter Provet comments on a recent article (“Drug Overdoses Propel Rise in Mortality Rates of Whites,” front page, Jan. 17) on the rising death rates for young white adults, driven by the opioid epidemic.

 

Deaths and Broken Lives from Drug Overdoses

To the Editor:

The dramatic increase in drug overdose deaths is not new to drug treatment. For several years treatment providers have been racing to save the lives of young Americans addicted to opioids as what started as a surge in prescription drug abuse morphed into a full-blown opioid epidemic.

It is also not news that intensive residential and outpatient treatment services are in short supply, and what resources are available in many parts of the country are often prohibitively expensive for the vulnerable populations who need them the most.

That today’s vulnerable addicts now include growing numbers of young white Americans highlights the tragedy of opioid addiction as a great equalizer.

Decades of experience treating young people from inner-city communities ravaged by drugs has shown us that recovery is a multistep, time-consuming process that, for the fortunate ones who are helped quickly enough, starts with overdose-prevention injections and detox, and continues with medically assisted treatment, behavior therapy and continuing community-based support.

Anything less just doesn’t work and is merely a Band-Aid that will inevitably lead to the loss of more young lives – tragically, lives we know how to save.

 

The year ahead

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Experts’ Contributions: “Hopes and Fears” 2016

Leaders in the field of drug treatment share their predictions for 2016 and the challenges ahead. See Dr. Provet’s below. Click here for the full report. 

The escalating opioid epidemic among middle-class Americans drew unusual attention last year to our field across a wide public sphere of elected officials, leaders of medical and scientific communities, members of criminal justice and law enforcement agencies, and the mainstream media.

While this attention is welcome, we need to make sure the urgent need for treatment is reflected in the stabilization and expansion of services for vulnerable populations. As states (including New York, with high-need, disadvantaged populations) look to contain costs under Medicaid managed care, we must work hard to ensure that the federal block grant is maintained, the IMD [Institutions for Mental Diseases] exclusion is eliminated and parity under the ACA [Affordable Care Act] is fully enforced. Without these essential provisions built into federal and state budgets and policies, nonprofit organizations that provide the bulk of safety net services will find it harder and harder to meet the increased demands for care.

At Odyssey House, we have been preparing for the impact of managed care for quite some time and have established new systems to both contain costs and streamline care. These include: electronic health record keeping and linkages with hospital and other community-based providers; evidence-based practices and medication-assisted treatment; and extended outpatient and housing support services.

My hope as we look to 2016 is that we will not only continue to provide quality care for disadvantaged substance abusers (who often require intensive residential services in order to have a chance at achieving and maintaining a functional life), but that their needs will be reflected in the ongoing national debate on how best to treat addiction and its accompanying social ills.

Peter Provet, Ph.D.
President & Chief Executive Officer

The Best and Worst of 2015, and Hopes and Fears for 2016

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Leaders in the field of drug treatment share their predictions for 2016 and the challenges ahead. See Dr. Provet’s below. Click here for the full report.

The escalating opioid epidemic among middle-class Americans drew unusual attention last year to our field across a wide public sphere of elected officials, leaders of medical and scientific communities, members of criminal justice and law enforcement agencies, and the mainstream media.

While this attention is welcome, we need to make sure the urgent need for treatment is reflected in the stabilization and expansion of services for vulnerable populations. As states (including New York, with high-need, disadvantaged populations) look to contain costs under Medicaid managed care, we must work hard to ensure that the federal block grant is maintained, the IMD [Institutions for Mental Diseases] exclusion is eliminated and parity under the ACA [Affordable Care Act] is fully enforced. Without these essential provisions built in to federal and state budgets and policies, nonprofit organizations that provide the bulk of safety net services will find it harder and harder to meet the increased demands for care.

At Odyssey House, we have been preparing for the impact of managed care for quite some time and have established new systems to both contain costs and streamline care. These include: electronic health record keeping and linkages with hospital and other community-based providers; evidence-based practices and medication-assisted treatment; and extended outpatient and housing support services.

My hope as we look to 2016 is that we will not only continue to provide quality care for disadvantaged substance abusers (who often require intensive residential services in order to have a chance at achieving and maintaining a functional life), but that their needs will be reflected in the ongoing national debate on how best to treat addiction and its accompanying social ills.

Peter Provet, Ph.D.

President & Chief Executive Officer