OK – thought this might be interesting – for those of us who have wonderede – and i bet a lot of opiate users have – just what the goddamn would happen to us if there was a hurricane or earthquake? I mean methadone or some kind of opiate isnt really the most important thing in the world, but then again, in a way, it kinda can be and to think of the days when your in the thick of it – or just have been on a ‘script for years and years. And then one freakishly windy or cold day – you cant get there. or its closed – or its UNDERWATER!!!!....Ignore the title of this newsletter Alcoholism and Drug Abuse Weekly’ – but it poses some interesting dilemas facing the methadone clinics and ensureing we are not left pulling our hair out!
Hurricane Sandy and daily doses of methadone:
Challenges for N.Y. and N.J.
On Monday, October 29, as a killer hurricane swooped down on the shores of New Jersey and New York,
methadone patients worried about how to get their daily doses and opioid treatment programs (OTPs) worried about security and patient safety.
Those hardest hit — in Asbury Park, N.J., for example, where Ed Higgins’ legendary JSAS Healthcare was still without power a week later — had to rely on the emergency take-homes.
And in New York City, treatment advocate Walter Ginter told ADAW that some OTPs did not manage to get those take-homes to patients, some of whom relapsed to heroin use.
Both states had advised OTPs the Friday before the storm that they could use their emergency authority to give out take-homes. Under the federal regulations, the OTP medical director has the discretion to approve take-homes.
On October 26, the New York Office of Alcoholism and Substance Abuse Services (OASAS) “sent an email to all OTPs potentially targeted by the storm to adhere to the OASAS Emergency Guidelines and to seek to prepare for any and all contingencies,” OASAS spokeswoman Jannette Rondo told ADAW.
These guidelines provide information to help OTPs in emergencies
such as transit strikes, crippling weather conditions or unforeseen disasters, she said. “The main goal of OTPs in an emergency is to assure that all patients receive methadone or buprenorphine,” she said. “Emergency disaster plans automatically become effective in an emergency, even without notice from OASAS.”
Jude Iheoma, Ph.D., State Opioid Treatment Authority with the Division of Mental Health and Addiction.
tion Services for New Jersey, told ADAW that he was in the process of preparing a report for Assistant Commissioner Lynn Kovich on the state’s implementation of its OTP disaster plan. “We are still being bombarded by the aftermath of Sandy and now the Nor’easter,” Iheoma told ADAW November 7, when a snowstorm accompanied by heavy winds was hitting the same areas as Sandy. Kovich had to approve the report before he could share it with us. Guest dosing The federal Substance Abuse and Mental Health Services Administration (SAMHSA), which regulates OTPs at the federal level, has been working on ways to make sure patients do not miss methadone doses since before September 11, 2001. Even before 9/11, a blackout in New York City caused serious problems for patients, and during that time patients were told that they could go to any OTP in the city and tell the program their dose level as part of a “guest-dosing” policy, recalled Nicholas Reuter, senior public health analyst with SAMHSA’s Center for Substance Abuse Treatment (CSAT). “It was the honor system,” he said. Patients could self-report their dose level, but they were told that the guest-dosing program would follow sandy from page 1 up with their home OTP. This worked, said Reuter. “Patients were honest” (Well suprise suprise – ed)