As Industry Grows, So Does Substance Abuse

Editor’s Note: This story has been updated to remove incorrect information regarding Northeast Behavioral Health’s provision of medical marijuana evaluations. The service is provided, but not for patients going through suboxone treatment.

YOUNGSTOWN, Ohio – While the COVID-19 pandemic slowed some of the influx to drug treatment centers nationwide, that doesn’t mean business slowed for local offices.

Thanks to relaxed insurance regulations, centers were able to pivot and offer telehealth services ranging from health care to peer support services, helping those battling drug addiction maintain their course of treatment. reported in February the substance abuse treatment industry is on track to reach $42 billion in revenue by the end of the year, with more than 13,000 treatment centers and counting. Locally, the number of inpatient and outpatient treatment sites is growing. But that growth is limited by the stigma of addiction, which can cause many who need treatment to avoid it.

“Stigma is still an issue, although it has lessened some as more people have had family members affected, but many still think it’s a lifestyle and not a disease and a choice people have made,” says Lauren Thorp, director of recovery and youth programs at Trumbull County Mental Health and Recovery Board.

Substance abuse carries a hefty price tag for employers. The American Association for Occupational Health reported in 2014 that the impact on drugs in the workplace is $81 billion a year.

The cost of excessive alcohol use is even higher, draining the economy by $249 billion in 2018, according to a study by the National Institute of Alcohol Abuse and Alcoholism. The study cites $179 billion is lost in workplace productivity because of excessive alcohol use.

The Substance Abuse and Mental Health Services Administration reports that of all drug users, 68.9% are employed and active in the workplace. And the Department of Labor & Workforce Development states one-third of all employees are aware of illegal sales of drugs in their workplace.

The National Council on Safety is attempting to educate businesses on the savings by getting employees drug treatment through an online calculator. The council reports that for every employee in recovery, employers can save more than $3,200 per year.

America’s drug epidemic has killed more than 700,000 since 1999, and while the focus has been on opioids, the Centers for Disease Control and Prevention states officials should pay attention to cocaine and methamphetamines as well.

The common thread in the equation is fentanyl, a cheap synthetic opioid that is a hundred times more potent than morphine. The drug is involved in three quarters of cocaine and methamphetamine overdoses, according to the CDC, a trend that is reflected locally.

Overdose rates have spiked in Trumbull County with 90 in May and 107 in June, making 2020 the deadliest year since 2017, according to Trumbull County Health Commissioner Frank Migliozzi.

Thorp points out that fentanyl was found in every toxicology report of the overdoses seen this year in Trumbull County.

Fentanyl, cocaine and meth are found in many post-mortem toxicology reports in both Mahoning and Trumbull counties.

So far this year, Trumbull County has had 462 overdoses through the end of June, 111 more than at this time last year. Mahoning County has recorded 41 accidental overdose deaths through May. Last year, there were 103 deaths linked to overdose.

“We attribute this increase due to fentanyl being mixed with other substances, primarily cocaine,” says April Caraway, executive director of the Trumbull County Mental Health and Recovery Board. “You can’t see, taste, or smell fentanyl. … There are many treatment options here and I implore people to get the addiction treatment they need.”

Several addiction experts say they have clients who have tested positive for fentanyl and claimed they didn’t know they were using it. Other experts say they hear anecdotal stories that the stimulants of cocaine and meth are thought to keep them from overdosing on the depressant of opioids.

According to the CDC, there were 67,367 drug overdose deaths nationwide in 2018, with two-thirds of all opioid overdose deaths involving synthetic opioids, excluding methadone.

“It’s all about availability,” Thorp says. “Fentanyl is really cheap and because it’s more potent, it sells in smaller doses and takes less to cut with other drugs. Meth is just easier to produce.”

Carolyn Givens, vice president of Neil Kennedy Recovery Centers, says the increased use of meth is triggering psychosis in those using drugs.

“[Cocaine] and fentanyl have been here a while,” explains Cindy O’Keefe, chief operating officer for Travco Behavioral Health. “Meth is new and that’s just a whole different beast.”

Fentanyl’s combination with other illicit drugs has changed the landscape of addiction treatment, according to Cindy Woodford, chief operating officer of First Step Recovery and Parkman Recovery Center in Warren. Woodford says one change in the five years since First Step opened is the introduction of fentanyl.

“I remember thinking to myself, ‘This just feels so different than when we first started and it was just heroin,’ ” Woodford says. “It seems to have morphed into something that was just calling people back out to the streets in a way that we hadn’t experienced before.”

New Day Recovery, an inpatient withdrawal management center in Boardman, works with sister company On Demand Drug Counseling to treat patients from start to finish. New Day also operates residential recovery housing in Columbiana, Mahoning and Trumbull counties.

On Demand took over the old Sears distribution building on Patriot Drive in Austintown. Over the past year, the company has renovated the building into a center offering outpatient services, physical therapy and primary care, drug testing and, as of July 7, a pharmacy.

“We want to provide as much care in one spot as possible so you can get all your needs taken of under one roof,” says Sydney Metzel, director of marketing and community outreach. “We are trying to tear down barriers for people by providing a recovery campus.”

Audra Olesky, clinical director at On Demand, says the pharmacy will help if people come in for late appointments or are attending night outpatient meetings and need to get prescriptions filled.

Stepping Stone operates an intensive outpatient program at CommuniCare’s Canfield Healthcare Center, a 90-bed skilled nursing home in Cornersburg. Sarah Lee, admissions and marketing director, says residents receiving skilled nursing care at the facility can also access recovery services.

Intensive outpatient treatment began as a pilot program in December and the inpatient services started in March. To be eligible for recovery services, patients must already be admitted for skilled care nursing. There are about 15 people receiving treatment services at Canfield Healthcare Center.

“A lot of people in our population have underlying substance abuse issues that are exacerbated by physical issues,” Lee says. “These services are given in combination to skilled nursing and allow us to treat the whole person. Intensive outpatient therapy is given for sobriety and recovery for them to be more independent.”