LOCH SHELDRAKE, NY — The opioid crisis in Sullivan County has continued unabated for years. Many people trying to reverse that trend turned out to the 2019 Opioid Prevention Conference at New Hope Community on November 1. The conference was sponsored by Sullivan County Public Services.

Medication assistant treatment (MAT) is an increasingly common method for treating opioid addiction. One of the presenters, Kelly Ramsey, practices MAT with Hudson River Healthcare.
Ramsay, who refers to her patients as people with “substance-use disorders,” spoke at length about drugs’ effect on the brain.

“When you use drugs or do anything pleasurable, you get surges of dopamine, and we like dopamine because dopamine feels good. And so your brain actually gets rewired in neural circuits and changes to expect that higher level of dopamine, and what that means is your brain is primed for those dopamine surges and when you don’t have those dopamine surges you feel dysphoric or depressed,” she said.

She also said that people who have substance-use disorders, also have issues with impulse control and often also mental health issues. “By the time someone meets the criteria for substance-use disorder, they can’t stop,” she said. “That’s the very crux of the issue, it’s not that they don’t want to stop, they can’t stop.”

In 2017, there were 49,068 deaths in the U.S. due to opioid overdoses, and from 2016 to 2017 deaths from the synthetic opioid fentanyl increased by 45 percent.

Ramsay said when a patient with a substance-use disorder comes to her seeking relief, she often prescribes buprenorphine, which reduces the craving for other opioids. She said the aim is “to get harm reduction so your risk of dying goes down.”

“After that we’ll determine what the patient’s goals are, it’s always individualized. So it may be to get their child back, it may be to reconcile with their family, it may be to go back to school,” she said.