Emily Rice Published

Lawmakers Weigh Opioid Treatment Options

Two men are standing at a podium as one of them speaks into the microphone in a House of Delegates.
Ed Boyle testifies in front of the Joint Committee on Health as Dr. Kevin Blankenship waits to testify.
Perry Bennett/WV Legislative Photography

Legislators heard from board members of the private donation-funded opioid treatment center Lauren’s Wish during the first interim session this week.

Between March 2021 and March 2022, West Virginia reported 1,403 fentanyl overdoses. In 2021 alone, there were 1,253 opioid overdose deaths in West Virginia, 83 percent of which were fentanyl-related.

Ed Boyle, director of Facilities at Lauren’s Wish, said his organization’s board members, all of whom have been affected by the state’s opioid crisis, found a gap in the opioid overdose recovery process.

“Through this pain and recovery process, these six directors met over a year-long process of studying where as a society we seem to be failing the youth of this state and our communities,” Boyle said. “We came up with the idea of Lauren’s Wish Addiction Triage Center.”

When an individual overdoses and is taken to the emergency room, they are given Narcan and stabilized. Some hospitals have peer recovery coaches to set the person up with a bed in a treatment center, but that bed might not be available for a week or more. That leaves the hospital to discharge the patient back into the environment in which they overdosed.

Boyle said the board of directors at Lauren’s Wish termed the pattern, “treat and street.” To avoid this cycle, Lauren’s Wish Addiction Triage Center was opened as a 28-bed facility at Hazel’s House of Hope in Morgantown.

Dr. Kevin Blankenship is the Medical Services Director of Lauren’s Wish and founder of Jacob’s Ladder, another private patient-centered recovery program located in Aurora, West Virginia.

“We’ve got lots of beds available in West Virginia but most of those are 30-day programs, at best,” Blankenship said. “What I saw was missing was long-term treatment and that’s what Jacob’s Ladder is. Jacob’s Ladder is a six-month treatment program, that then transitions into another three to six months of sober living. The reason for that is because addiction takes time to heal from. Your brain can heal from this, but you’ve got to give it the right environment.”

Blankenship noted the same gap in treatment between an overdose treatment in an emergency room and treatment and recovery bed availability. He also said 28 days is not enough time to heal from opioid addiction.

“If you’re a doctor or a lawyer or an airline pilot, you’ll be entered into a program for two to five years for your addiction, right? For everybody else 30 days, you should be good,” Blankenship said. “They’re not good and we’re not planning for them after they’re done with their 28-day program. So the program itself is too short. There’s nowhere for them to go afterward.”

Programs like Lauren’s Wish and Jacob’s Ladder need to be duplicated throughout the state, Blankenship recommended to lawmakers. 

“This is a necessary program,” Blankenship said. “You probably need four or five of these around our state, regionally located so that different ERs and hospital systems can take advantage of that. It’ll take a load off of our EMS system, it’ll take a load off of our ERs, the folks in there can take care of the heart attacks and the brain bleeds that are coming into the door, instead of devoting all their time to this.”

According to Boyle, Lauren’s Wish has had 152 clients go through their system and be placed in an aftercare or recovery process like a sobering center or medium or short-term rehabilitation stays. 

Blankenship said the Jacob’s Ladder program has been in existence for seven years and has a success rate of 75 percent. He credits the program’s success to the time they give their patients to heal, noting the first two weeks of a 28-day stay would be spent in withdrawal.

“There’s something to be said about time when you’re talking about healing the brain and that’s what addiction is, it’s a brain disorder that can be healed with time and the appropriate treatment,” Blankenship said. 

Del. Heather Tully, R-Nicholas, asked Blankenship how Jacob’s Ladder is able to keep track of their patients years into their recovery in order to study the outcomes of this type of treatment.

Blankenship credited the strength of the alumni community of Jacob’s Ladder for a portion of their long-term success but also noted the organization has weekly and monthly contact with each person and is able to tell if they’ve relapsed or struggling.

“That doesn’t mean that none of them relapse,” Blankenship said. “The difference in a relapse from a graduate from Jacob’s Ladder, for instance, versus someone who had spent 28 days, is you find out about it immediately, as soon as they use they’ve picked up the phone, someone’s noticed something, they didn’t make a meeting, they didn’t make a commitment that they had. We know pretty early on. And it’s so much easier to deal with that type of a bump in the road, rather than a full-blown relapse, where you’re out six months, using again.”

Blankenship said the cycle of the 28-day treatment model is inefficient and costly. 

“The unfortunate part about the 28-day [treatment], and I hate to even suggest this, but they’re incentivized to have folks relapsed and come back because they can just keep billing, you know, you can’t go for longer than 28 days,” Blankenship said. “But if you relapse next week, come back, I got four more weeks I can bill for. So they don’t really have the incentive to make sure that these folks are out there doing healthy things for the next 10 years, which is what our goal is.”

Del. Amy Summers, R-Taylor, referenced a presentation from an earlier meeting of the Legislative Oversight Commission on Health and Human Resources in which Cindy Beane, commissioner of the Bureau for Medical Services, testified to the implementation of Senate Bill 419 from the 2022 West Virginia Legislative session.

“It’s very difficult for a residential provider to basically track that person who is now not even in the county that they treated the person in a whole other county that might be across the state,” Beane said. “So it’s very difficult for the expectation of the bill for somebody to basically track somebody three years down the road.”

Senate Bill 419 directed the state Department of Health and Human Resources, through the Bureau for Medical Services, to establish a pilot project to evaluate the impact of certain post-substance use disorder residential treatments in West Virginia.

“We had a presentation yesterday through a committee where recovery treatment centers, as you say, are possibly incentivized to have people come back because that’s how they make money,” Summers said. “They think that it’s too difficult to be able to follow people because they say when they leave, they leave and they don’t have the technology to do it. It sounds like you make a phone call.”

Blankenship said the graduates of Jacob’s Ladder are like a family and schedule face-to-face time with one another to check in for coffee or lunch. Also, to enter into the program, the person has to be serious about their recovery. He also noted that 80 percent of people who go through a 28-day program will relapse within three months.