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Addiction doctor helps people kick opioids

Pendleton clinic helps users wean off opioids and break addiction
Kathy Aney

East Oregonian

Published on January 31, 2018 8:48PM

Last changed on January 31, 2018 9:37PM

Dr. Joel Rice interviews a patient, who did not wish to be identified, about his recovery at an anti-addition clinic Friday in Pendleton.

Staff photo by E.J. Harris

Dr. Joel Rice interviews a patient, who did not wish to be identified, about his recovery at an anti-addition clinic Friday in Pendleton.

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Michelle Frizzell recounts her ten-year addition to opioids after breaking her foot that led to the Department of Human Services taking her son.

Staff photo by E.J. Harris

Michelle Frizzell recounts her ten-year addition to opioids after breaking her foot that led to the Department of Human Services taking her son.

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This Aug. 2017 file photo shows an arrangement of pills of the opioid oxycodone-acetaminophen, also known as Percocet.

AP Photo/Patrick Sison

This Aug. 2017 file photo shows an arrangement of pills of the opioid oxycodone-acetaminophen, also known as Percocet.

Michelle Frizzell got hooked on painkillers after breaking her foot.

She spent the next 10 years addicted to oxycodone and then heroin, which was cheaper and easier to procure. Her day of reckoning came when a Department of Human Services worker showed up at her front door and removed her son from the home. He was placed with a family member. Frizzell desperately tried to stop using, but continued for nine more months.

“It was a compulsion to use even though I hated every second of it,” she says now. “I would cry and inject drugs because I couldn’t stop. I felt like I was going to die without it. Your brain is completely hijacked.”

Finally, a kindly pharmacist gave her some advice after she entered a Rite Aid one day to buy syringes.

“The pharmacist gave me Joel Rice’s phone number,” Frizzell said. “He said, “This man can help you.”

‘It’s not what you think’

Dr. Joel Rice’s business is helping people kick opioids. The psychiatrist operates Grande Ronde Recovery Center with two anti-addiction clinics, one in La Grande and the other in Pendleton’s John Murray building, which Rice bought about a month ago. His therapy is a mixture of anti-addiction medication and talk therapy.

On a recent morning, Rice greeted the first in a steady stream of patients. By 9 a.m., he’d already seen three and expected 30 more by day’s end. These patients don’t fit into a particular demographic mold, ranging from retirees, business people and soccer moms to college students and homeless people living in tents. One patient, a wheat farmer, once lined up four syringes on his combine seat to get him through the day, before he finally got help.

“They’re nice, good people,” Rice said. “It’s not what you think.”

Rice prescribes Suboxone, with active ingredients buprenorphine and naloxone, to help addicts break free. Critics say using Suboxone, which is also an addictive opioid, is simply exchanging one drug for another. But Rice considers the drug a critical tool to help people break the hold of painkillers.

“It’s easier to get off of,” he said. “Your brain clears and you go back to normal thinking.”

Deaths from opioid abuse rose sharply in the United States from 2015 to 2016, the latest year in a recent Centers for Disease Control and Prevention report. About 100 people die every day in this country from opioid overdoses. In a recent joint news conference, Acting Secretary of Health and Human Services Eric Hargen and CDC Director Brenda Fitzgerald sounded the alarm.

“A lot of our fellow Americans are addicted to opioids right now,” Hargen said. “This is a health crisis of historic proportions.”

“One of the biggest threats we are facing today is the opioid crisis,” Fitzgerald said.

‘This is not a character flaw’

Some people find the strength to walk into clinics like Rice’s to get their lives back.

Rice isn’t a white coat kind of guy. With his longish gray hair, denim jeans and empathetic manner, he is someone to whom you’d spill your guts over a cup of coffee. His patients settle into comfy leather chairs and chat openly about the past weeks or days. One twenty-something man said he started taking pain pills after shoulder surgery.

“I kind of liked the way they made me feel,” he said. “After the doctor stopped prescribing, I kept taking them.”

They talked about dosages and side effects and upcoming surgeries. One female patient had experienced stomach cramps after dissolving a film version of Suboxone under her tongue. Rice suggested letting the drug absorb in her mouth and then spitting out the rest.

Rice chips away at the opioid crisis each day. The epidemic has grown into a beast with several heads. In 2016, more Americans died from opioids than breast cancer.

Alena Davis, one of Rice’s patients, managed to avoid such a fate. The Pendleton registered nurse injured herself in 2006 while helping to move a 500-pound hospital patient. She soon found herself addicted to hydrocodone. That started an 11-year odyssey.

Davis functioned as a nurse, working at an assisted living facility and hospital. Even her common-law husband didn’t realize her secret. Finally, as she despaired about ever getting off opioids and facing horrible withdrawal symptoms, she attempted suicide. The next day, her brother and husband drove her to La Grande to see Dr. Rice.

“The first thing Dr. Rice said to me was, ‘This is not a character flaw,’” she recalled. “I will always remember that.”

Davis got started on Suboxone, felt better almost immediately and is slowly whittling her dosage. She works as a traveling school nurse with the InterMountain Education Service District.

‘They were wrong’

Dwight Holten, CEO of Lines for Life, an organization that works to prevent suicide and drug addiction, likes to hear such success stories. He said Oregon has turned a corner. Doctors are prescribing fewer opioids here than they were several years ago, though Oregon leads the way in numbers of seniors hospitalized for opioids.

“We are making progress, but we have lots of work to do,” he said.

Holten said doctors must write fewer narcotic pain prescriptions and explore other ways to manage pain (such as physical therapy and acupuncture). Addicts need better access to treatment and the public needs greater understanding of the danger of opioids.

Holten places the blame for the opioid crisis squarely on the doorstep of Big Pharma, which in the late 1990s and early 2000s marketed opioids such as hydrocodone and oxycodone as having a low risk of addiction.

“They were wrong. The risk of addiction is extraordinary,” Holten said. “If you’re on opioids for 30 days, there’s a 47 percent likelihood that you’re still on them in three years. If you’re on them for 90 days, there’s a 60 percent likelihood you’re still on them in five years.”

Opioid prescriptions almost tripled between 1991 and 2011.

Holten worries about super-strength synthetic opioids like fentanyl and carfentanil that are hitting the streets, especially on the East Coast. Fentanyl is 50 times more potent than heroin and a few grains can kill. Carfentanil, used to sedate elephants and other large animals, can be lethal for humans.

Holten said getting people into treatment for opioid addiction is an uphill battle.

“It’s significantly easier to get opioids than to get treatment for opioids,” he said. “We’re going to flip that.”

Especially in rural America, there aren’t enough doctors who have taken the eight-hour class required to prescribe Suboxone. Even when they get the training, they are limited in the number of prescriptions they can write. The limit rises over time. Rice can write prescriptions for 275 patients at any one time, but he is always bumping up against his limit. More doctors are coming around and as of 2017, nurse practitioners and physician assistants are eligible to prescribe, Rice said, but there is a shortage. Those who get trained won’t be sorry, he said.

“It’s an incredible rush,” Rice said. “I don’t know why everyone doesn’t do this.”

He gets an avalanche of Christmas cards each year from grateful former patients.

Michelle Frizzell, now 42 and clean for more than five years, works at Rice’s Pendleton clinic as a certified alcohol and drug counselor. She tells opioid addicts they are strong enough to get clean.

“Your brain can be rewired. You can recover,” Frizzell said. “It doesn’t have to be a death sentence.”

“They’re just regular people,” said Rice, of those who start treatment. “The vast majority of people get better.”


Contact Kathy Aney at kaney@eastoregonian.com or 541-966-0810.


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