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Vivitrol Plus Program another tool for fighting addiction

6 min read
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Celeste Van Kirk/Observer-Reporter

Joanna Temple of Washington won back custody of her children, daughter Destinee Noble, 12, and son Brandin Noble, 11, after struggling with addiction and becoming clean with help from the Vivitrol Plus Program.

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Joanna Temple credits her children – daughter Destinee, 12, and son Brandin, 11 – for playing a big role in her recovery. 

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Joanna Temple is shown with daughter Destinee Noble, 12, and son Brandin Noble, 11, at Washington Park.

Joanna Temple, of Washington, spent three months in jail last year for crimes related to her heroin addiction. In those three months, her brother and her fiancé of 15 years both died from overdoses.

“Because I was an opiate user, they didn’t let me out of jail to attend the funerals,” Temple said in a recent interview.

After losing so much, Temple knew she had to find a way to get clean to stay alive for her three children.

“I’m all my kids have right now,” she said. “Even the thought of drugs scares me now.”

Temple, 33, decided to be one of the first two people in Washington County to try the Vivitrol Plus Program, a combination of medicine and treatment. Vivitrol is the trade name for a naltrexone, or “opioid antagonist,” that counters the high one typically experiences from ingesting opioids.

“It’s an opiate blocker,” said Shianne Scott, case management specialist for Washington Drug & Alcohol Commission. ” If you were to try to get high using an opiate, it completely blocks it.”

The drug and alcohol commission distributes the Vivitrol shot through a provider, Allied Addiction Recovery. The program was funded through a $148,000 grant from the Pennsylvania Commission on Crime and Delinquency and has been in effect for about a year. Erich Curnow, director of clinical and case management services with the commission, said the Vivitrol manufacturer, Alkermes, offers the first shot, given while the individual is in jail, for free. After that, shots cost about $986 each and are paid through insurance when possible and through the grant.

“Our main objective is to keep people in the most vulnerable populations from overdosing and dying,” Curnow said. “We based the grant on documented research that people coming out of prison were much more likely to overdose and die because their tolerance to opiates had reset during their incarceration time.”

Scott said the shot also is intended to keep people from returning to jail on drug-related charges.

“We don’t want people to become incarcerated again due to their substance abuse,” she said. “We have had a lot of success in that way.”

Temple, who battled heroin addiction for five years, is representative of that success.

She had been arrested for violating parole April 28, 2017. It was Temple’s fourth time behind bars, and those three months were certainly the worst of her life. Three days after her arrest, her brother, William Temple, 36, died of an overdose, followed just one month later by the death of her fiancé, Brandin Noble Sr., 43, also from an overdose.

She heard about the Vivitrol program and took a chance on it.

“It was new,” she said. “I was one of the first people who left the jail on the shot. They didn’t really know if it would work, and they didn’t give you much detail about it. But I was on board – I was willing to try anything.”

Temple had tried other types of treatment, like suboxone and inpatient treatment, but nothing seemed to work.

“There were times when I’d get out of jail and do drugs within that hour,” she said. “This time it was really different, and the shot had a lot to do with it.”

The shot, which is injected in the buttocks, is typically given to people while they’re in jail, to ensure they’ve been sober for at least two weeks. Temple received it three days before she was released July 22.

“It hurts,” she said. “It’s a big needle, too – I had anxiety every time I got it.”

But the shots, which Temple received once a month for seven months, were effective.

“When you’re addicted to drugs, you have withdrawals and cravings, and that shot prevents a lot of that,” she said. “For myself, I had no cravings, no thoughts about using, no nothing.”

Molly Orange works inside the jail as a case management specialist with the commission. She said candidates have to be medically and clinically cleared before entering the Vivitrol program, which is a voluntary program, “not something we want people to be court-ordered into.”

“Their participation won’t lessen their time in jail,” she said. “If they’re internally motivated, we’re trying to put things in place that will help them achieve that success on the outside.”

Curnow said the “plus” part of the program refers to the intensive outpatient treatment that occurs before, during and after the shot. He said research showed integrating treatment into the jail setting decreases rates of incarceration and death. That’s why they try to get people three months of individual and group outpatient treatment inside the jail before their first injection and parole.

“We know that medication plus treatment is going to give them the best chance of having a good outcome and achieving long-term recovery,” Curnow said.

Temple is no longer receiving the shot – her last one was in November – but she’s still attending weekly group outpatient treatment. She’s been sober since April 28, 2017.

“I’ve been around drugs since and people who do drugs, but my train of thought is a lot different than what it was,” she said.

Scott, who is responsible for tracking individuals in the program, said they’ve had a few people who were discharged from the program due to relapse, incarceration or simply not showing up to receive treatment.

“It’s a program that’s not for everybody, and you’re going to have that with anything, I think,” Scott said.

Because the program is still new, no one has successfully completed it yet, but Temple could be the first.

“That hasn’t really been defined yet,” Scott said. “Joanna’s one of the first three people to get the shot, so we haven’t really gotten there yet.”

The program isn’t technically complete for Temple until she’s comfortable ending her outpatient treatment, but for many who have struggled with addiction, that’s something they continue the rest of their lives. Regardless of her completion, Temple is considered to be in remission.

“She has done really well,” Scott said. “She is a great success story.”

Scott attributed any success in the program to determination from participants.

“It always comes down to the person really wanting to stay clean,” she said. “It’s way more effective for the people that are willing to change and give it a try and put in effort. You can speak to anyone in recovery. They have to want it themselves.”

That determination is what brought Temple this far. She’s currently serving a 6-month house arrest sentence for the charges filed against her last year. She has work release as well as permission to attend group meetings and any child-care responsibilities, now that she’s won back custody of her children – ages 15, 12, and 11 – and works two jobs to provide for them.

“Recovery was something I was ready to do, and I wanted to do it,” she said. “My kids, for sure, played the biggest part. They are proud of me.”

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