ALLENWOOD — The continued crisis of heroin and opioid addiction spurred White Deer Run to plan for a new 60-bed unit, expand the availability of treatment medication and add an x-ray body scanner to reduce the risk of contraband at its Union County complex.
White Deer Run Allenwood’s current inpatient capacity is 264 patients. Anywhere from 75 to 80 percent seek treatment for substance use disorder for heroin and opioids, according to Jeff Thomas, chief executive officer. He estimated it fluctuated between 35 to 40 percent in 2005.
“On any given day we are at full capacity. We continue to get calls to our admission department,” Thomas said.
The rehabilitation facility is in the permitting process to build a 60-bed unit for males. It measures at nearly 10,000 square feet, with the top floor for treatment services and housing and the bottom floor for activities. September completion is targeted.
The addition will free up some existing beds for females and possibly a co-ed unit specifically for older patients, Thomas said. The female population ranges from 60 to 90 patients on any given day, he said.
The new beds represent a 27 percent increase, raising rehabilitation inpatient capacity to 282. Add in its 42 existing beds for detoxification and White Deer Run Allenwood’s capacity across all inpatient services would rise to 324.
“We will be saving more lives,” said Donna Bookhammer, clinical director. “That will not be an issue, trying to fill those beds.”
Pennsylvania remains in a state of emergency for opioid abuse, with Gov. Tom Wolf signing the sixth 90-day renewal of a disaster declaration in March.
A 2018 Surgeon General’s report on opioids called medication-assisted treatment, or MAT, the “gold standard.”
“There is strong scientific evidence that this combination of therapeutic interventions is life-saving and can enable people to recover to healthy lives,” Dr. Elinore F. McCance-Katz of Substance Abuse and Mental Health Services Administration, wrote in the report, adding that an expansion to such services is an agency priority.
MAT is at the center of the Wolf Administration’s response, one largely focused on increasing access to outpatient services coupling medication with behavioral health and other types of counseling.
There were 5,456 fatal overdoses in Pennsylvania in 2017, according to coroner data. The state Bureau of Health Statistics estimates that figure to drop to 4,267 for 2018 based on preliminary mortality data.
This year, Montour and Northumberland counties experienced a surge in deaths through April that could forecast the deadliest year in the 20-year crisis if the trend holds.
Coroner reports mirror what Thomas observed: Patients are increasingly abusing harder street drugs like illicit fentanyl as prescription drug abuse tapers off. More often, patients are reporting the abuse of multiple drugs, especially methamphetamine, he said.
“For many decades, we’ve seen people leave here and die of an overdose, but not like we’ve seen recently,” Thomas said. “We’re seeing a much higher rate of overdose post-treatment for those who don’t complete the program and those who don’t go to long-term aftercare.”
It’s shifting philosophies at White Deer Run Allenwood. The culture is one of total abstinence, meaning true recovery is best achieved without any maintenance even if the medication’s responsibly prescribed and monitored.
The shift isn’t easy, Thomas said, but the addition of methadone and buprenorphine, brand name Suboxone, is intended to save lives and not necessarily change minds about treatment theory. The addition is pending the regulatory process with the state, which Thomas expects to be completed this summer.
“We believe there are certain people that simply cannot achieve total abstinence. Because of that, we feel we should offer methadone maintenance and suboxone maintenance as an alternative to try to save their life until such time as they’re willing to be drug-free,” Thomas said.
Joshua Childs, clinical supervisor, detox unit, said withdrawal symptoms are powerful enough to push people out of rehabilitation before they ever transfer out of detox.
“I believe you’ll have fewer patients leaving against medical advice,” Childs said of MAT. “It’s a person’s treatment choice. If they’re able to get involved in treatment, whatever that is, and improve their quality of life, we need to be able to help them do that.”
White Deer Run Allenwood already incorporates methadone in its detox program and offers its residential rehabilitation patients naltrexone, commonly known by the injection medication brand Vivitrol. It’s also offering electronic stimulation treatment which Thomas said has worked remarkably to beat back withdrawal symptoms.
The treatment facility invested in an x-ray body-and-package scanner to prevent smuggling during patient intake. It’s reduced not just drugs but cellphones from entering the facility, Thomas said.
It’s a measure meant for the safety of patients and staff, and one Thomas said many patients appreciate — those committed to recovery want such risks eliminated.
“As far as I know, we’re the first ones in the country to have it,” Thomas said.
"Now that the word is out, I don't think as many people are even attempting. It's been very valuable," Childs said.